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  • 1.
    Adolfsson, Päivi
    et al.
    Department of Public Health and Caring Sciences, Disability and Habilitation, Uppsala University, Uppsala, Sweden; Department of Public Health and Caring Sciences, Centre for Disability Research, Uppsala University, Uppsala, Sweden.
    Lindstedt, Helena
    Department of Public Health and Caring Sciences, Disability and Habilitation, Uppsala University, Uppsala, Sweden.
    Pettersson, Ingvor
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Norling Hermansson, Liselotte
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Prosthetics and Orthotics, Örebro County Council, Örebro, Sweden.
    Janeslätt, Gunnel
    Department of Public Health and Caring Sciences, Disability and Habilitation, Uppsala University, Uppsala, Sweden; Center for Clinical Research Dalarna, Falun, Sweden; CHILD, School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Perception of the influence of environmental factors in the use of electronic planning devices in adults with cognitive disabilities2016In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 11, no 6, p. 493-500Article in journal (Refereed)
    Abstract [en]

    Background: Adults with cognitive disabilities often have difficulties in dealing with the complexity of everyday life. With cognitive assistive technology (e.g. electronic planning devices [EPDs] and individual support), they can bring order to their often chaotic life. Assumptions are that environmental factors influence with non-use of EPDs.

    Objective: To explore how adults with cognitive disabilities perceive the influence of environmental factors in the use of EPDs.

    Methods: A reference group with experience of use of EPDs assisted the researchers. Twelve adults with cognitive disabilities and experience of using EPDs participated. An interview guide was implemented covering environmental factors according to the International Classification of Functioning, Disability and Health. Qualitative content analysis was applied in the analyses.

    Results: Five categories and two themes emerged, which were integrated into a model of facilitating factors influencing the use of EPDs. Measures to prevent or eliminate negative influences of the device use are important to be taken.

    Conclusions: Professionals need more knowledge about EPDs, while users need individual adaption of the EPDs. EPDs need to be user-friendly, manageable and work in any seasons.

  • 2.
    Amer, Ahmed
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital.
    Eliasson, Ann-Christin
    Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
    Peny-Dahlstrand, Marie
    Regional Rehabilitation Centre, Queen Silvia Children's Hospital, Gothenburg, Sweden; Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Hermansson, Liselotte
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Department of Prosthetics and Orthotics, Örebro University Hospital, Örebro, Sweden.
    Validity and test-retest reliability of Children's Hand-use Experience Questionnaire in children with unilateral cerebral palsy2016In: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 58, no 7, p. 743-749Article in journal (Refereed)
    Abstract [en]

    Aim: To investigate the validity of the internet-based version of the Children's Hand-use Experience Questionnaire (CHEQ) by testing the new four-category rating scale, internal structure, and test-retest reliability.

    Method: Data were collected for 242 children with unilateral cerebral palsy (CP) (137 males and 105 females; mean age 9y 10mo, SD 3y 5mo, range 6-18y). Twenty children from the study sample (mean age 11y 8mo, SD 3y 10mo) participated in a retest within 7 to 14 days. Validity was tested by Rasch analysis based on a rating scale model and test-retest reliability by Kappa analysis and intraclass correlation coefficient (ICC).

    Results: The four-category rating scale was within recommended criteria for rating scale structure. One item was removed because of misfit. CHEQ showed good scale structure according to the criteria. The effective operational range was >90% for two of the CHEQ scales. Test-retest reliability for the three CHEQ scales was: grasp efficacy, ICC=0.91; time taken, ICC=0.88; and feeling bothered, ICC=0.91.

    Interpretation: The internet-based CHEQ with a four-category rating scale is valid and reliable for use in children with unilateral CP. Further studies are needed to investigate the validity of the internet-based version of CHEQ for children with upper limb reduction deficiency or obstetric brachial plexus palsy and the validity of the recommended improvements to the current version.

  • 3.
    Amer, Ahmed
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Rehabilitation Research, Örebro County Council, Örebro, Sweden.
    Jarl, Gustav M
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Centre for Rehabilitation Research, Örebro County Council, Örebro, Sweden; Department of Prosthetics and Orthotics, Örebro County Council, Örebro, Sweden.
    Hermansson, Liselotte M. N.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Rehabilitation Research, Örebro County Council, Örebro, Sweden; Department of Prosthetics and Orthotics, Örebro County Council, Örebro, Sweden.
    The effect of insoles on foot pain and daily activities2014In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 38, no 6, p. 474-480Article in journal (Other academic)
    Abstract [en]

    BACKGROUND:

    Foot pain decreases individuals' ability to perform daily activities. Insoles are often prescribed to reduce the pain which, in turn, may promote return to normal activities.

    OBJECTIVES:

    To evaluate the effects of insoles on foot pain and daily activities, and to investigate the relationship between individuals' satisfaction with insoles and actual use of them.

    STUDY DESIGN:

    A 4-week pre-post intervention follow-up.

    METHODS:

    Brief Pain Inventory, International Physical Activity Questionnaire and Lower Extremities Functional Status were used as outcome measures. Client Satisfaction with Device was used in the follow-up.

    RESULTS:

    A total of 67 participants answered the questionnaires (81% women). Overall, a reduction in Pain Severity (p = 0.002) and Pain Interference (p = 0.008) was shown. Secondary analyses revealed a significant effect only in women. No changes in daily activities (Walking, p = 0.867; Total Physical Activity, p = 0.842; Lower Extremities Functional Status, p = 0.939) could be seen. There was no relation between Client Satisfaction with Device measures and duration of insole use. A difference in sex was shown; women scored higher than men on Pain Severity.

    CONCLUSION:

    Insoles reduce pain and pain interference with daily activities for women with foot pain. Satisfaction with the insoles is not a predictor of actual insole use. The effect of insoles on activity performance needs further study.

    CLINICAL RELEVANCE:

    This study provides evidence for prescribing insoles to people with foot pain. Nonetheless, insoles are not enough to increase their physical activity level in the short term. Satisfaction with insoles and duration of use are not correlated and cannot be inferred from each other.

  • 4.
    Amer, Ahmed
    et al.
    University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Kakooza-Mwesige, A.
    Department of Paediatrics & Child Health, Makerere University College of Health Sciences, Kampala, Uganda; Mulago Hospital, Kampala, Uganda; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Jarl, Gustav
    Örebro University, School of Medical Sciences. Örebro University Hospital. University Health Care Research Center, Region Örebro County, Örebro, Sweden; Department of Prosthetics and Orthotics, Örebro University Hospital, Örebro, Sweden.
    Tumwine, J. K.
    Department of Paediatrics & Child Health, Makerere University College of Health Sciences, Kampala, Uganda; Mulago Hospital, Kampala, Uganda.
    Forssberg, H.
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Eliasson, A.-C.
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Hermansson, Liselotte
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of Prosthetics and Orthotics, Örebro University Hospital, Örebro, Sweden.
    The Ugandan version of the Pediatric Evaluation of Disability Inventory (PEDI-UG). Part II: Psychometric properties2018In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 44, no 4, p. 562-571Article in journal (Refereed)
    Abstract [en]

    Background: The Pediatric Evaluation of Disability Inventory (PEDI) has been recommended as a gold standard in paediatric rehabilitation. A Ugandan version of PEDI (PEDI-UG) has been developed by culturally adapting and translating the original PEDI. The aim of this study was to investigate the psychometric properties of the PEDI-UG in Ugandan children by testing the instrument's rating scale functioning, internal structure, and test-retest reliability.

    Methods: Two hundred forty-nine Ugandan children (125 girls) aged 6 months to 7.5 years (Mean = 3.4, SD = 1.9) with typical development were tested using the PEDI-UG. Forty-nine children were tested twice to assess test-retest reliability. Validity was investigated by Rasch analysis and reliability by intraclass correlation coefficient.

    Results: The PEDI-UG domains showed good unidimensionality based on principal component analysis of residuals. Most activities (95%) showed acceptable fit to the Rasch model. Six misfit items were deleted from the Functional Skills scales and one from the Caregiver Assistance scales. The category steps on the Caregiver Assistance scales' rating scale were reversed but functioned well when changed from a 6-point to 4-point rating scale. The reliability was excellent; intraclass correlation coefficient was 0.87-0.92 for the domains of the Functional Skills scales and 0.86-0.88 for the domains of the Caregiver Assistance scales.

    Conclusion: The PEDI-UG has good to excellent psychometric properties and provides a valid measure of the functional performance of typically developing children from the age of 6 months to 7.5 years in Uganda. Further analysis of all items, including misfit and deleted items, in children with functional disability is recommended.

  • 5. Buchert, Paulina
    et al.
    Svanborg, Cecilia
    Almborg, Ann-Helene
    Pankowski, Sara
    Pettersson, Ingvor
    Hermansson, Liselotte M. N.
    Örebro University, School of Health Sciences.
    Translation and linguistic validation of self-administered Swedish version of WHODAS 2.02015Conference paper (Refereed)
    Abstract [en]

    Background: Use of Patient-Reported Outcomes (PROs) is increasingly requested in clinical practice and research. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a generic instrument for self-report capturing functioning in the life-domains of understanding and communicating, getting around, self-care, getting along with people, life activities and participation in society. It is based on the same conceptual foundation as the International Classification of Functioning Disability and Health (ICF). Several language versions of WHODAS 2.0 are available and a Swedish version is in progress.

    Aim: To translate the self-administered 36-item version of WHODAS 2.0 into Swedish and examine the understanding and interpretation of the instruments´ content and response processes.

    Methods: Translation process was made following WHO guidelines and the WHODAS 2.0 translation package (version 1.0) including: forward-translation, expert panel discussion, back-translation, pre-test of preliminary version, final version, and pilot-testing of the final version.

    Pre-test was conducted through structured interviews in purposeful samples of Swedish-speaking adults including two patients with bi-polar disorder and a sample from the general population. Pilot-testing of the final version will be performed by structured interviews in a purposeful sample of outpatients.

    Results: Forward-translation, expert panel discussion, and back-translation resulted in a preliminary Swedish version of WHODAS 2.0. Pre-test revealed some issues related to items in the Participation in society domain, and in the overall lay-out. This resulted in minor changes in selection of words in the final version and suggestions for future revision of the instrument.

    Pilot-testing of the final version in outpatients are under progress and the result will be ready to present before Conference date in November 2015.

    Conclusion: The preliminary Swedish self-administered version of WHODAS 2.0 is easy to understand and respond to. Further studies are needed to provide evidence for validity of the final Swedish WHODAS 2.0.

  • 6.
    Burger, Helena
    et al.
    Institute for Rehabilitation, University of Ljubljana, Ljubljana, Slovenia.
    Hermansson, Liselotte M. N.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Heinemann, Allen W.
    Feinberg School of Medicine, Rehabilitation Institute of Chicago, Northwestern University, Chicago, USA.
    Development of the Orthotic Prosthetic Users’ Survey: Upper Extremity Functional Status module version 3.0 – OPUS-UEFS 3.02015Conference paper (Refereed)
  • 7.
    Fredriksson, Carin
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Hermansson, Liselotte
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Hagberg, Lars
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Pettersson, Ingvor
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Elderly spouses experiences of powered scooters used by their next of kinManuscript (preprint) (Other academic)
  • 8.
    Fredriksson, Carin
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Hermansson, Liselotte M. N.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Hagberg, Lars
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Pettersson, Ingvor
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    The value of a powered wheelchair: spouses´ perspective2013In: Association for the Advancement of Assistive Technology in Europe Conference 2013 (AAATE 2013) / [ed] P Encarnação et al, Amsterdam, Netherlands: Elsevier, 2013, p. 222-225Conference paper (Refereed)
    Abstract [en]

    Research concerning the significance of assistive technology to spouses of persons who uses technology is sparse and the impact of a powered wheelchair on spouses' activity and participation is not at all researched. Thus, the aim was to explore how spouses experience the significance of a powered wheelchair prescribed to and used by their next of kin. A descriptive design with a qualitative approach focusing on the experiences of the spouses was used. The sample comprised of 10 spouses of elderly people that have been prescribed a powered wheelchair. Semi-structured interviews were conducted with the ten spouses (nine women and one man). The participants were 65-86 years of age. The questions posed during the interview concerned: i) the significance of the powered scooter for personal everyday activities, participation and quality of life; ii) the significance of the scooter for shared activity and participation; and iii) the significance of the next of kin using a scooter, from the perspective of the spouse. Interviews were transcribed verbatim and analyzed using qualitative content analysis. The results showed that the spouses experienced that their everyday life and life situation had changed in a positive way as their next of kin received a powered wheelchair. They experienced a sense of freedom that had an impact on their own activities as well as on the activities they performed together with their next of kin. The spouses expressed that they now to a larger extent shared responsibility for different tasks in the home and also how the powered wheelchair had made it possible to spontaneously do things together again and to do things with more ease. In conclusion, the narratives of the spouses of the elderly powered wheelchair users were to a great extent positive. The powered wheelchair was of great value and brought freedom to everyday life.

  • 9.
    Hagberg, Lars
    et al.
    Örebro University Hospital. Örebro University, School of Health Sciences.
    Hermansson, Liselotte M.
    Örebro University, School of Health Sciences.
    Fredriksson, Carin
    Örebro University, School of Health Sciences.
    Pettersson, Ingvor
    Örebro University, School of Health Sciences.
    Cost-effectiveness of powered mobility devices for elderly people with disability2017In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 12, no 2, p. 115-120Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to analyse the cost-effectiveness of prescribing powered mobility devices (PMDs) to elderly users.

    Methods: Forty-five persons participated in the preand post-intervention study with a follow-up at four months. All participants were prescribed a scooter model and were offered individual support to get started using the PMD. In the analysis, the use of the PMD was compared to the situation prior to its use. The cost-utility analysis takes a societal perspective and considers costs, savings and quality of life (QoL) using answers to the EQ-5D questionnaire.

    Results: Costs for the first year with the PMD were 1395 USD and then 592 USD per subsequent year. There was a significant decrease in transportation costs and in relatives' time use, but the increase in QoL of 0.041 was not significant. Costs per gained quality adjusted life year (QALY) were 12 400-14 700 USD/QALY if the value of time saved not was considered and 600-2900 USD/QALY when an hour was valued at 3.6 USD.

    Conclusion: Prescription of PMDs to elderly users might be cost-effective. However, there are shortcomings in measuring QALY gains from the use of a PMD, and it is unclear how time savings among relatives should be valued.

    Implications for Rehabilitation

    • Prescription of powered mobility devices for the elderly with disability seems to be cost effective and should be a standard intervention.

    • In economic evaluations of powered mobility devices and other assistive devices, the commonly used analyses methods are not always appropriate and therefore need to be adjusted.

  • 10.
    Hagberg, Lars
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Hermansson, Liselotte M. N.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Fredriksson, Carin
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Pettersson, Ingvor
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Värdet av en eldriven rullstol: hälsoekonomisk analys av förskrivning av eldrivna rullstolar till äldre personer med funktionsnedsättning2013Report (Other academic)
    Abstract [sv]

    Delresultat från en studie där man utvärderat om förskrivning av eldrivna rullstolar för äldre personer med bestående funktionsnedsättning och betydande förflyttningssvårigheter är kostnadseffektiv.

  • 11.
    Hermansson, Liselotte
    et al.
    Limb Deficiency and Arm Prosthesis Centre, Orebro Medical Centre Hospital, S-701 85 Orebro, Sweden; Karolinska Insititute, Stockhom, Sweden.
    Bodin, Lennart
    Örebro University, Department of Business, Economics, Statistics and Informatics. Limb Deficiency and Arm Prosthesis Centre, Orebro Medical Centre Hospital, S-701 85 Orebro, Sweden.
    Wranne, Lars
    Limb Deficiency and Arm Prosthesis Centre, Orebro Medical Centre Hospital, S-701 85 Orebro, Sweden.
    Upper limb deficiencies in Swedish children: a comparison between a population-based and a clinic-based register2001In: Early Human Development, ISSN 0378-3782, E-ISSN 1872-6232, Vol. 63, no 2, p. 131-144Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To validate information in the Swedish Register for Congenital Malformations (SRCM).

    METHODS: A comparison was made with a clinic-based register kept at the Limb Deficiency and Arm Prosthesis Centre (LDAPC). The report frequency and the quality of the information in SRCM were analysed. Cases were classified according to a detailed, clinically relevant classification, the ISO 8548-1:89 method.

    OUTCOME MEASURES: The completeness of SRCM was first estimated. The Kappa statistic was then used to assess the agreement between the two registers regarding individual categories and across all categories.

    RESULTS: For the period 1973-1987, we found 125 cases of upper limb reduction deficiencies (ULRD) in the clinic-based register, of which 117 was found in the national register. The completeness of SRCM was thus estimated to be 94% (95% confidence interval 89-98%). The inter-register agreement varied from almost perfect agreement in laterality of deficiency (Kappa 0.98) to substantial agreement in type and level of deficiency (Kappa 0.72-0.79). For specific levels of transverse deficiency, however, the agreement varied between -0.05 and 0.66.

    CONCLUSIONS: The results indicate that SRCM, with its calculated underestimation of 6%, can be used for studying the prevalence of ULRD in Sweden. However, as SRCM is a surveillance register, the quality of some information seems to be low, making detailed description of cases difficult. Use of the population register data for clinical purposes could therefore result in lower validity. Additional information and follow-up of specific cases are therefore recommended.

  • 12.
    Hermansson, Liselotte
    et al.
    Örebro University Hospital, Örebro, Sweden; Karolinska Institute, Stockholm, Sweden.
    Eliasson, A. C.
    Karolinska Institute, Stockholm, Sweden.
    Engström, Ingemar
    Örebro University, Department of Clinical Medicine.
    Psychosocial adjustment in Swedish children with upper-limb reduction deficiency and a myoelectric prosthetic hand2005In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 94, no 4, p. 479-88Article in journal (Refereed)
    Abstract [en]

    AIM: To study psychosocial adjustment and mental health in children with upper-limb reduction deficiency and a myoelectric prosthetic hand.

    METHODS: Sixty-two parents of children aged 8 to 18 y old answered a questionnaire concerning competence and behaviour/emotional problems in their children. Of the 62 children, 37 adolescents aged 11 to 18 y old answered questionnaires concerning competence, problems and mood state. The results were compared with Swedish normative data. The children were divided into five groups based on degree of myoelectric prosthetic use.

    RESULTS: Children with upper-limb reduction deficiency and a myoelectric prosthetic hand showed social competence and behaviour/emotional problems similar to Swedish standardized norms. However, withdrawn behaviour was significantly higher in all children, social competence was significantly lower in girls, and social activities were significantly lower in older children with upper-limb reduction deficiency. There was a significant difference between prosthetic use groups. Non-users had significantly more delinquent behaviour problems than full-time users. There was an interaction between gender and prosthetic use in their affect on competence and behaviour/emotional problems, yielding two contrasting patterns.

    CONCLUSION: Children with upper-limb reduction deficiency and a myoelectric prosthetic hand are as well adjusted psychosocially as their able-bodied peers. There are indications, however, of social stigmata related to the deficiency, which have to be considered differently in boys and girls.

  • 13.
    Hermansson, Liselotte
    et al.
    Örebro University, School of Health Sciences.
    Hill, Wendy
    Atlantic clinic for upper limb prosthetics, Institute of Biomedical Engineering, University of New Brunswick, Fredericton, Canada.
    Treatment for upper limb malformation in different areas of the world2019Conference paper (Refereed)
    Abstract [en]

    Children with upper limb malformation may present with deficiencies in many ways and the treatment that they are offered may vary greatly around the world. Handsmart is a volunteer organization with the mission to support and empower people world-wide who are engaged in this field of rehabilitation through www.handsmart.org. A web-based survey was used to gather data about treatment for children with upper limb malformation in different areas of the world. Sixty-eight respondents from 18 countries representing Oceania, Asia, Europe, and North America with 35 occupational therapists, 6 physiotherapists, 23 prosthetists, and four other health care professionals participated. Only five countries do not have governmental funding for the provision of care for people with upper limb loss. Intervention is guided by the presentation of the limb. Most surgical procedures are made for functional benefits. Not all respondents report that they fit body-powered prostheses for children. The majority of respondents stated that training is offered for use of the prosthesis in their country. In some clinics (12 of 68 respondents), no treatment other than functional prostheses is provided for these children. Overuse or repetitive strain injuries are common with this population, especially as children age into adolescence and adulthood. Many people stated they would like to see clear guidelines used by multi-disciplinary teams to fit children. Recommendations should include treatment guidelines and follow-up practices.

  • 14.
    Hermansson, Liselotte M
    The Arm Prosthetic Clinic, Örebro Medical Center, Örebro.
    Structured training of children fitted with myoelectric prostheses.1991In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 15, no 2, p. 88-92Article in journal (Refereed)
    Abstract [en]

    This paper presents an occupational therapy method for training children fitted with myoelectric prostheses. It is based upon a structured way of describing the accomplishments of a child fitted with a myoelectric prosthesis, called the Skill Index Ranking Scale (SIRS). By using the SIRS when designing the training session, the therapist can progressively increase the demands presented to the child. Furthermore, the SIRS facilitates for the therapist the documentation and communication of the childs ability with the myoelectric prosthesis.

  • 15.
    Hermansson, Liselotte M.
    et al.
    Limb Deficiency and Arm Prosthesis Centre, Orebro University Hospital, SE-701 85 Orebro, Sweden; Karolinska Institute, Stockholm, Sweden.
    Bodin, Lennart
    Limb Deficiency and Arm Prosthesis Centre, Orebro University Hospital, SE-701 85 Orebro, Sweden.
    Eliasson, Ann-Christin
    Karolinska Institute, Stockholm, Sweden.
    Intra- and inter-rater reliability of the assessment of capacity for myoelectric control2006In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 38, no 2, p. 118-23Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To examine the reliability of the Assessment of Capacity for Myoelectric Control (ACMC) in children and adults with a myoelectric prosthetic hand.

    DESIGN: Intra-rater and inter-rater reliability estimated from reported assessments by 3 different raters.

    PATIENTS: A sample of convenience of 26 subjects (11 males, 15 females) with upper limb reduction deficiency or amputation and myoelectric prosthetic hands were video-taped during a regular clinical visit for ACMC. Participants' ages ranged from 2 to 40 years.

    METHODS: After instruction, 3 occupational therapists with no, 10 weeks' and 15 years' clinical experience of myoelectric prosthesis training and follow-up independently rated the 30 ACMC items for each patient. The ratings were repeated after 2-4 weeks. Inter- and intra-rater reliability in items was examined by using weighted kappa statistics and Rasch-measurement analyses.

    RESULTS: The mean intra-rater agreement in items was excellent (kappa 0.81) in the more experienced raters. Fit statistics showed too much variation in the least experienced rater, who also had only good (kappa 0.65) agreement in items. The stability of rater calibrations between first and second assessment showed that no rater varied beyond chance (>0.50 logit) in severity. The mean inter-rater agreement in items was fair; kappa 0.60, between the experienced raters and kappa 0.47 between raters with no and 10 weeks' experience.

    CONCLUSION: Overall, the agreement was higher in the more experienced raters, indicating that reliable measures of the ACMC require clinical experience from myoelectric prosthesis training.

  • 16.
    Hermansson, Liselotte M.
    et al.
    Örebro University Hospital, Örebro, Sweden; Karolinska Institute, Stockholm, Sweden.
    Fisher, Anne G.
    Umeå University, Umeå, Sweden.
    Bernspång, Birgitta
    Umeå University, Umeå, Sweden.
    Eliasson, Ann-Christin
    Karolinska Institute, Stockholm, Sweden.
    Assessment of capacity for myoelectric control: a new Rasch-built measure of prosthetic hand control2005In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 37, no 3, p. 166-71Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To report the results from a Rasch rating scale analysis of the Assessment of Capacity for Myoelectric Control (ACMC) implemented to evaluate internal scale validity, person response validity, separation reliability, targeting and responsiveness of the measures over time.

    DESIGN: Longitudinal data (18 months) from a prospective study of development of capacity for myoelectric control in children and adults were used for the analysis.

    PATIENTS: A consecutive sample of 75 subjects (43 males, 32 females) with upper limb reduction deficiency or amputation and myoelectric prosthetic hands referred for occupational therapy from September 2000 to March 2002. Participants' ages ranged from 2 to 57 years.

    METHODS: Outcome measure was the ACMC. Occupational therapists completed 210 assessments at an arm prosthesis centre in Sweden. A two-faceted rating scale analysis of the data was performed.

    RESULTS: All 30 ACMC items and 96.2% of participants demonstrated goodness-of-fit to the rating scale model for the ACMC. Separation and SE values suggested adequate reliability of the item and person estimates.

    CONCLUSION: The items demonstrated internal scale validity and the participants demonstrated person response validity. The ACMC was well targeted and sensitive enough to detect expected change in ability.

  • 17.
    Hermansson, Liselotte M. N.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Observationsbaserat test av funktion med myoelektrisk armprotes : ACMC2015Conference paper (Other (popular science, discussion, etc.))
  • 18.
    Hermansson, Liselotte M. N.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Träning med myoelektrisk handprotes för barn med dysmeli2016In: Arbetsterapi för barn och ungdomar / [ed] Ann-Christin Eliasson, Helene Lidström, Marie Peny-Dahlstrand, Studentlitteratur AB, 2016, 1, p. 313-322Chapter in book (Other (popular science, discussion, etc.))
  • 19.
    Hermansson, Liselotte M. N.
    Institutionen för kvinnors och barns hälsa, Karolinska institutet.
    Upper limb reduction deficiencies in Swedish children: classification, prevalence and function with myoelectric prostheses2004Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Upper limb reduction deficiency (ULRD) is a rare condition that has been known ever since the 6th century B.C. This is a lifelong deficiency which in an afflicted child can lead to practical limitations, social restrictions and physical problems. The overall aim of this research was to increase the knowledge about children with upper limb reduction deficiencies from three perspectives: the deficiencies themselves, the use of prostheses and the well being of the affected children. To validate information regarding ULRD in the Swedish Register for Congenital Malformations (SRCM), all infants reported to this register during 1973-1987 were re-classified according to a more detailed classification. The result was compared with a clinic-based register at the Limb Deficiency and Arm Prostheses Centre in Örebro, Sweden. The findings indicate that SRCM, with its calculated underestimation of 6%, can be used for studying the prevalence of ULRD in Sweden. However, as SRCM is a surveillance register, the quality of some information seems to be low, making detailed description of cases difficult. Use of the population register data for clinical purposes could therefore result in lower validity. Additional information and follow-up of specific cases are therefore recommended.

    The presence of scoliosis and trunk asymmetry was studied in 60 persons with transverse ULRD. Nineteen persons (31%) had a scoliosis of between 10 and 19º and 30 persons had minor curves of between 5 and 10º. There was a significant correlation between leg length inequality and side of the convexity, with the convexity directed towards the side of the shorter leg in 21 of 28 persons. This indicates that children with transverse ULRD may have a transient scoliosis of postural origin of no clinical significance.

    A new observation-based test, the Assessment of Capacity for Myoelectric Control (ACMC), which measures a person’s capacity to control a myoelectric prosthetic hand during the performance of ordinary daily tasks, was developed. Occupational therapists completed 210 assessments of 75 persons. Rasch rating scale analysis was used for validation and reliability estimations. The results demonstrate internal scale and person response validity.

    The external reliability of ACMC was established by scorings from three raters with different degrees of experience on 27 videotapes of client performance. The major finding in this study was that in order to obtain reliable measures from the ACMC the raters have to have some experience of this group of clients. Until the ACMC can adjust for rater severity, the same rater should perform the ACMC when it is used for follow-up or clinical trials.

    In a study of 62 children we found that, overall, children with ULRD who have been fitted with a myoelectric prosthetic hand are just as well adjusted psychosocially as their able-bodied peers. There are indications, however, of social stigmata related to the deficiency which have to be considered differently in boys and girls. Most children who have been provided with a myoelectric prosthesis at an early age continue to use the prosthesis.

    List of papers
    1. Upper limb deficiencies in Swedish children: a comparison between a population-based and a clinic-based register
    Open this publication in new window or tab >>Upper limb deficiencies in Swedish children: a comparison between a population-based and a clinic-based register
    2001 (English)In: Early Human Development, ISSN 0378-3782, E-ISSN 1872-6232, Vol. 63, no 2, p. 131-144Article in journal (Refereed) Published
    Abstract [en]

    OBJECTIVE: To validate information in the Swedish Register for Congenital Malformations (SRCM).

    METHODS: A comparison was made with a clinic-based register kept at the Limb Deficiency and Arm Prosthesis Centre (LDAPC). The report frequency and the quality of the information in SRCM were analysed. Cases were classified according to a detailed, clinically relevant classification, the ISO 8548-1:89 method.

    OUTCOME MEASURES: The completeness of SRCM was first estimated. The Kappa statistic was then used to assess the agreement between the two registers regarding individual categories and across all categories.

    RESULTS: For the period 1973-1987, we found 125 cases of upper limb reduction deficiencies (ULRD) in the clinic-based register, of which 117 was found in the national register. The completeness of SRCM was thus estimated to be 94% (95% confidence interval 89-98%). The inter-register agreement varied from almost perfect agreement in laterality of deficiency (Kappa 0.98) to substantial agreement in type and level of deficiency (Kappa 0.72-0.79). For specific levels of transverse deficiency, however, the agreement varied between -0.05 and 0.66.

    CONCLUSIONS: The results indicate that SRCM, with its calculated underestimation of 6%, can be used for studying the prevalence of ULRD in Sweden. However, as SRCM is a surveillance register, the quality of some information seems to be low, making detailed description of cases difficult. Use of the population register data for clinical purposes could therefore result in lower validity. Additional information and follow-up of specific cases are therefore recommended.

    National Category
    Surgery Orthopaedics
    Research subject
    Orthopaedics
    Identifiers
    urn:nbn:se:oru:diva-27830 (URN)10.1016/S0378-3782(01)00163-3 (DOI)000169376200007 ()11408102 (PubMedID)2-s2.0-0034983416 (Scopus ID)
    Available from: 2013-03-04 Created: 2013-03-04 Last updated: 2018-01-11Bibliographically approved
    2. Scoliosis and trunk asymmetry in upper limb transverse dysmelia
    Open this publication in new window or tab >>Scoliosis and trunk asymmetry in upper limb transverse dysmelia
    1997 (English)In: Journal of Pediatric Orthopaedics, ISSN 0271-6798, E-ISSN 1539-2570, Vol. 17, no 6, p. 769-72Article in journal (Refereed) Published
    Abstract [en]

    The incidence of scoliosis and trunk asymmetry were studied in 60 patients with upper limb dysmelia of the transverse type. The evaluations were based on radiographic measurements of the spine and scoliometer readings of the angle of trunk rotation (ATR), which were correlated with the side and level of the limb deficiency and also with leg length-inequality (LLI). Nineteen patients (31%) had a scoliosis between 10 and 19 degrees, whereas the curves were between 5 and 10 degrees in another 30 patients and the remainder had no measurable curve. The scoliosis seemed at least partly to be of postural origin as LLI significantly correlated with the direction of the curves, but there was no correlation between the Cobb angles and the magnitude of LLI. The scoliometer readings did not correlate with the scoliosis or LLI. Our findings indicate that most patients with upper limb transverse amputations do not develop a significant scoliosis. A scoliometer screen has a low positive predictive rate for scoliosis and the diagnosis of scoliosis requires a radiograph of the spine.

    National Category
    Orthopaedics Surgery
    Research subject
    Orthopaedics
    Identifiers
    urn:nbn:se:oru:diva-27825 (URN)10.1097/00004694-199711000-00013 (DOI)A1997YH42400013 ()9591980 (PubMedID)2-s2.0-0031405891 (Scopus ID)
    Available from: 2013-03-04 Created: 2013-03-04 Last updated: 2018-01-11Bibliographically approved
    3. Assessment of capacity for myoelectric control: a new Rasch-built measure of prosthetic hand control
    Open this publication in new window or tab >>Assessment of capacity for myoelectric control: a new Rasch-built measure of prosthetic hand control
    2005 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 37, no 3, p. 166-71Article in journal (Refereed) Published
    Abstract [en]

    OBJECTIVE: To report the results from a Rasch rating scale analysis of the Assessment of Capacity for Myoelectric Control (ACMC) implemented to evaluate internal scale validity, person response validity, separation reliability, targeting and responsiveness of the measures over time.

    DESIGN: Longitudinal data (18 months) from a prospective study of development of capacity for myoelectric control in children and adults were used for the analysis.

    PATIENTS: A consecutive sample of 75 subjects (43 males, 32 females) with upper limb reduction deficiency or amputation and myoelectric prosthetic hands referred for occupational therapy from September 2000 to March 2002. Participants' ages ranged from 2 to 57 years.

    METHODS: Outcome measure was the ACMC. Occupational therapists completed 210 assessments at an arm prosthesis centre in Sweden. A two-faceted rating scale analysis of the data was performed.

    RESULTS: All 30 ACMC items and 96.2% of participants demonstrated goodness-of-fit to the rating scale model for the ACMC. Separation and SE values suggested adequate reliability of the item and person estimates.

    CONCLUSION: The items demonstrated internal scale validity and the participants demonstrated person response validity. The ACMC was well targeted and sensitive enough to detect expected change in ability.

    National Category
    Surgery Orthopaedics
    Research subject
    Orthopaedics
    Identifiers
    urn:nbn:se:oru:diva-27826 (URN)10.1080/16501970410024280 (DOI)000229479000007 ()16040474 (PubMedID)
    Available from: 2013-03-04 Created: 2013-03-04 Last updated: 2018-01-11Bibliographically approved
    4. Intra- and inter-rater reliability of the assessment of capacity for myoelectric control
    Open this publication in new window or tab >>Intra- and inter-rater reliability of the assessment of capacity for myoelectric control
    2006 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 38, no 2, p. 118-23Article in journal (Refereed) Published
    Abstract [en]

    OBJECTIVE: To examine the reliability of the Assessment of Capacity for Myoelectric Control (ACMC) in children and adults with a myoelectric prosthetic hand.

    DESIGN: Intra-rater and inter-rater reliability estimated from reported assessments by 3 different raters.

    PATIENTS: A sample of convenience of 26 subjects (11 males, 15 females) with upper limb reduction deficiency or amputation and myoelectric prosthetic hands were video-taped during a regular clinical visit for ACMC. Participants' ages ranged from 2 to 40 years.

    METHODS: After instruction, 3 occupational therapists with no, 10 weeks' and 15 years' clinical experience of myoelectric prosthesis training and follow-up independently rated the 30 ACMC items for each patient. The ratings were repeated after 2-4 weeks. Inter- and intra-rater reliability in items was examined by using weighted kappa statistics and Rasch-measurement analyses.

    RESULTS: The mean intra-rater agreement in items was excellent (kappa 0.81) in the more experienced raters. Fit statistics showed too much variation in the least experienced rater, who also had only good (kappa 0.65) agreement in items. The stability of rater calibrations between first and second assessment showed that no rater varied beyond chance (>0.50 logit) in severity. The mean inter-rater agreement in items was fair; kappa 0.60, between the experienced raters and kappa 0.47 between raters with no and 10 weeks' experience.

    CONCLUSION: Overall, the agreement was higher in the more experienced raters, indicating that reliable measures of the ACMC require clinical experience from myoelectric prosthesis training.

    National Category
    Orthopaedics Surgery
    Research subject
    Orthopaedics
    Identifiers
    urn:nbn:se:oru:diva-27827 (URN)10.1080/16501970500312222 (DOI)000236049600007 ()16546769 (PubMedID)
    Available from: 2013-03-04 Created: 2013-03-04 Last updated: 2018-01-11Bibliographically approved
    5. Psychosocial adjustment in Swedish children with upper-limb reduction deficiency and a myoelectric prosthetic hand
    Open this publication in new window or tab >>Psychosocial adjustment in Swedish children with upper-limb reduction deficiency and a myoelectric prosthetic hand
    2005 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 94, no 4, p. 479-88Article in journal (Refereed) Published
    Abstract [en]

    AIM: To study psychosocial adjustment and mental health in children with upper-limb reduction deficiency and a myoelectric prosthetic hand.

    METHODS: Sixty-two parents of children aged 8 to 18 y old answered a questionnaire concerning competence and behaviour/emotional problems in their children. Of the 62 children, 37 adolescents aged 11 to 18 y old answered questionnaires concerning competence, problems and mood state. The results were compared with Swedish normative data. The children were divided into five groups based on degree of myoelectric prosthetic use.

    RESULTS: Children with upper-limb reduction deficiency and a myoelectric prosthetic hand showed social competence and behaviour/emotional problems similar to Swedish standardized norms. However, withdrawn behaviour was significantly higher in all children, social competence was significantly lower in girls, and social activities were significantly lower in older children with upper-limb reduction deficiency. There was a significant difference between prosthetic use groups. Non-users had significantly more delinquent behaviour problems than full-time users. There was an interaction between gender and prosthetic use in their affect on competence and behaviour/emotional problems, yielding two contrasting patterns.

    CONCLUSION: Children with upper-limb reduction deficiency and a myoelectric prosthetic hand are as well adjusted psychosocially as their able-bodied peers. There are indications, however, of social stigmata related to the deficiency, which have to be considered differently in boys and girls.

    National Category
    Surgery Orthopaedics
    Research subject
    Orthopaedics
    Identifiers
    urn:nbn:se:oru:diva-27824 (URN)10.1080/08035250410022512 (DOI)000228451400018 ()16092464 (PubMedID)2-s2.0-16844384199 (Scopus ID)
    Available from: 2013-03-04 Created: 2013-03-04 Last updated: 2018-01-11Bibliographically approved
  • 20.
    Hermansson, Liselotte M. N.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    What if? Prosthetic fitting solutions for children to prevent future consequences2015Conference paper (Other (popular science, discussion, etc.))
  • 21.
    Hermansson, Liselotte M. N.
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Amer, Ahmed
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Eliasson, Ann-Christine
    Dept of Woman and Childrens Health, Karolinska Institutet, Stockholm, Sweden.
    Peny-Dahlstrand, Marie
    Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Validitet och test-retest reliabilitet av Children’s Hand-use Experience Questionnaire för barn med unilateral CP2015Conference paper (Refereed)
  • 22.
    Hermansson, Liselotte M. N.
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Andrén, Martin
    School of Health and Medical Sciences, Örebro University.
    Johansson, David
    School of Health and Medical Sciences, Örebro University.
    Swedish normative data for the Southampton Hand Assessment Procedure – SHAP2014In: MEC'14: Redefining the Norm, Frederiction, New Brunswick, Canada: University of New Brunswick; Fredericton, Canada , 2014Conference paper (Refereed)
    Abstract [sv]

    Introduction: Today there is an increasing awareness of the need for validated instruments in upper limb prosthetics outcome assessments. One of the instruments suggested is the Southampton Hand Assessment Procedure (SHAP). In order for the clinicians to know how to interpret the results from the assessments, norms for different age groups are needed. Previously, normative data for SHAP has been reported for an English sample and work is underway from Slovenia. However, norms are only available for people up to 75 years of age, and no normative data is available for Sweden. Hence, the aim was to collect  data also from people age 75 and older, and from Sweden.

    Methods: Participants and procedure — 58 persons (md age 52.5, range 20-92 years) participated in the study. Participants were recruited among students at Örebro University, staff at Örebro University Hospital, and people attending a community-based centre for senior citizens. Inclusion criteria were self-determined normal hand-function and no hand-impairment at time of testing. Data was collected according to the standardized procedure in the manual, and by one single "assessor" an OT-student. Instrumentation — The SHAPconsists of 26 tasks: 6 abstract objects in both lightweight and heavyweight form, and 14 simulated ADL-tasks. All tasks are representing one out of six grip-patterns. The subject is instructed to start and stop the timer before and after performing the task. An overall score, the Index of Functionality (IOF), is calculated based on the resulting times.

    Results: Mean IOF was 96.7. One-way ANOVA with index of functionality as dependent variable showed a statistical significant difference in dominant hand function between age groups.

  • 23.
    Hermansson, Liselotte M. N.
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Carlsson, Christina
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Amilon, Anders
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Effect of a multifunctional prosthetic hand on hand functioning, activity, and psychosocial adjustment2009In: Trent International Prosthetic Symposium, 2009Conference paper (Refereed)
  • 24.
    Hermansson, Liselotte M. N.
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Hagberg, Lars
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Fredriksson, Carin
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Pettersson, Ingvor
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    The impact of powered wheelchairs on activity, participation and health related quality of life in older people2013In: Special Session Power mobility: User experiences and Outcomes, Association for the Advancement of Assistive Technology in Europe , 2013Conference paper (Refereed)
  • 25.
    Hermansson, Liselotte M. N.
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Krumlinde Sundholm, Lena
    Karolinska institutet, Stockholm, Sweden.
    Eliasson, Ann-Christine
    Dept of Woman and Childrens Health, Karolinska Institutet, Stockholm, Sweden.
    The Children’s Hand-use Experience Questionnaire – CHEQ2012In: Trent International Prosthetic Symposium, 2012Conference paper (Refereed)
  • 26.
    Hermansson, Liselotte M. N.
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Krumlinde Sundholm, Lena
    Karolinska institutet, Stockholm, Sweden.
    Ragnö, Christina
    Armprotesenheten, Bräcke Diakoni, Gothenburg, Sweden.
    Stockselius, Anita
    Armprotesenheten, Bräcke Diakoni, Gothenburg, Sweden.
    Development of the Assisting Hand Assessment-PAD: A Rasch-built performance measure for people with unilateral upper limb prosthesis, amputation or reduction deficiency2015Conference paper (Refereed)
  • 27.
    Hermansson, Liselotte M. N.
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Lindner, Helen Y N
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Langius-Eklöf, Ann
    Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Test-retest reliability and rater agreements of the Assessment of Capacity for Myoelectric Control version 2.0.2014In: MEC'14: Redefining the Norm, Frederiction, New Brunswick, Cananda: University of New Brunswick, Fredericton, Canada , 2014Conference paper (Refereed)
    Abstract [en]

    Introduction: The Assessment of Capacity for Myoelectric Control (ACMC) is an observation-based tool that evaluates ability to control a myoelectric prosthetic hand [1]. Validity evidence led to ACMC version 2.0, but test - retest reliability and minimal detectable change (MDC) of ACMC have never been evaluated. For instruments that have an evaluative purpose, such as ACMC, the MDC is a useful clinical value to suggest whether a change is due to measurement error or true change. Investigation of rater agreements in this version was also needed because it has new definitions in certain rating categories and items.

    Methods: Upper limb prosthesis users (n=25, 13/12 male/female, 15/10 congenital/acquired; mean age 27.5, range 7-72, years) performed one standardized activity twice, 2–5 weeks apart. Activity performances were video-recorded and assessed by two ACMC raters. The item raw scores were converted to Rasch interval ability measures. Ordinal data were analyzed by weighted κ; interval data were analyzed by intraclass correlation coefficient (ICC) and Bland–Altman limit of agreement (LOA) method.

    Results: For test–retest reliability, ICC2,1 was 0.94. Average weighted κ was 0.76 and percentage agreement (PA) was 85%. In individual items, weighted κ agreements were fair to excellent (0.52・1.00) and PAs were ≥6・100%. MDC95 was ≤.55 logits (1 rater) and 0.69 logits (2 raters). All MDC95 values were ≤5% of the total ability logit range. In the Bland-Altman plot the upper and lower LOA were 0.86 and -0.88 respectively. All except one participant were within the 95% LOA. For inter-rater reliability, weighted κ agreements were fair to excellent in both sessions (0.44–1.00), and ICC2,1 was 0.95 (test) and 0.92 (retest). Intra-rater agreement (rater 1) was excellent (ICC3,1 0.98). The weighted κ values of the test session were all >0.80 and the PAs for each item were ≥6%.

    Conclusion: The results of the present study demonstrate different aspects of the reliability of ACMC 2.0. Based on these results, we can recommend ACMC as a tool to follow the progress of users in controlling their myoelectric prostheses. The MDC is clinically useful for ACMC raters as a guideline when following the client’s changes over time.

  • 28.
    Hermansson, Liselotte M N
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Lindner, Helen Y N
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Sjöberg, Lis
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Intensive training camp for children with a myoelectric prosthetic hand2013In: ISPO 2013 World Congress: Inclusion, Participation & Empowerment, International Society for Prosthetics and Orthotics , 2013Conference paper (Refereed)
    Abstract [en]

    Since 1978, the Limb Deficiency and Arm Prosthetic Centre (LDAPC) at Örebro University Hospital in Sweden offers a 5-day training camp for paediatric myoelectric prosthesis users1. The aim of the camp is to support the establishment of a regular prosthesis wearing pattern, increase capacity for control of the device, and establish prosthesis use in everyday tasks. Every year in August paediatric myoelectric hand users and their parents are invited to attend this intensive training. The camp consists of around 8 hours of scheduled training each day, both in everyday tasks and outdoor play activities. A structured programme with training of fine motor skills in the mornings and gross motor skills later in the days is prepared by the occupational therapists. The aim was to evaluate the effectiveness of this training procedure on children’s ability to operate the myoelectric hand.During 8-13 August, 2010, 11 children (aged 6-9, 6 boys) with unilateral below-elbow deficiency participated in the camp. The Assessment of Capacity for Myoelectric Control (ACMC)2 was used to evaluate the effectiveness of intensive training on ability to operate the hand. Every child performed an ACMC activity on the first and the last day of the camp (packing suitcase). Their performances were videotaped and scored by an ACMC rater that did not take part in training of the participants at the camp. An ability score for each child was calibrated by Winsteps program. The average ability scores changed from 2.45 logits to 5.04 logits. Most of the children (n=8) had a big change in the ACMC items that measure timing in grasping and releasing objects. The Conclusion is that the training camp is effective in improving the children’s ability to operate a myoelectric hand. The long-term effects on wearing time, skill and bimanual performance from intensive training camps need further studies.

  • 29.
    Hermansson, Liselotte M. N.
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Lindner, Helen Y N
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Sjöberg, Lis
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Intensive training camp for children with a myoelectric prosthetic hand2012In: Trent International Prosthetic Symposium, 2012Conference paper (Refereed)
  • 30.
    Hermansson, Liselotte M N
    et al.
    Örebro University, School of Health and Medical Sciences.
    Sjöberg, Lis
    Örebro University, School of Health and Medical Sciences.
    Long term results of early myoelectric fittings2011In: MEC'11: Raising the Standard, 2011Conference paper (Refereed)
  • 31.
    Hermansson, Liselotte M N
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Sjöberg, Lis
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Long term results of early myoelectric fittings : a prospective longitudinal case-control study2012In: Trent International Prosthetic Symposium, 2012Conference paper (Refereed)
  • 32.
    Hermansson, Liselotte M N
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Sköld, Annika
    Karolinska Institutet, Stockholm, Sweden.
    Eliasson, Ann-Christine
    Karolinska Institutet, Stockholm, Sweden.
    Bimanual hand use in children with unilateral hand dysfunction: – differences related to diagnosis investigated by the Children’s Hand-use Experience Questionnaire2013In: Pediatrics and Therapeutics, ISSN 2161-0665, Vol. 169, no 3Article in journal (Refereed)
  • 33.
    Hermansson, Liselotte M. N.
    et al.
    Örebro University, School of Health and Medical Sciences.
    Sköld, Annika
    Department of Woman and Childrens Health, Karolinska institutet, Stockholm, Sweden.
    Krumlinde Sundholm, Lena
    Karolinska institutet, Stockholm, Sweden.
    Eliasson, Ann-Christine
    Dept of Woman and Childrens Health, Karolinska Institutet, Stockholm, Sweden.
    Development and Validity of the Children’s Hand-use Experience Questionnaire2010In: 13th ISPO World Congress, 2010Conference paper (Refereed)
  • 34.
    Hermansson, Liselotte N
    Örebro University, School of Health Sciences. Department of Prosthetics and Orthotics, Region Örebro County, Örebro, Sweden; University Health Care Research Centre, Region Örebro County, Örebro, Sweden .
    Forming an international consortium for sharing resources of upper limb absence worldwide: the handsmart group2016In: “Advances in our Understanding”: The Compendium, 2016, p. 22-23Conference paper (Other academic)
    Abstract [en]

    Introduction: An exciting and constantly changing environment in the upper limb prosthetics field challenges clinical teams on a daily basis. Prosthetic devices and control systems, as well as individual’s requirements and expectations, have changed and developed over the past several years. To meet or exceed expectations, and to obtain the best outcomes in a coordinated clinical care continuum, therapists need to have foundational skills and knowledge. The aim of this work is to determine best clinical practice and to provide resources for therapists.

    Methods: The prosthetic company Ottobock initiated a meeting in Berlin, Germany, in February 2016. Twelve independent international experts consisting of 11 therapists (4 physical and 7 occupational therapists) and 1 prosthetist, from different parts of the world, participated. The clinicians are all either independent practitioners or working with a company and specialized in upper limb loss/difference rehabilitation, either in clinical or research settings. Discussions were facilitated by an independent moderator. Decisions were made based on voting and consensus agreements.

    Results: The international consortium of expert clinicians were united in the vision to provide the most holistic rehabilitation approach for every person with upper limb loss or upper limb difference, now and in the future. Based on this agreement the “handsmart group” was formed and further discussions took place.

    The vision was operationalized by the mission to support and empower clinicians and patients worldwide by creating and updating an open access, easily understandable resource based on evidence, for those engaged in upper limb loss/difference rehabilitation. The consortium formed working groups to address the following objectives; 1) create an online platform for networking, sharing information, communicating and accessing resources for supporting clinical practice internationally; 2) search and apply for financial support for the future activities in the group; and, 3) search, compile and recommend interventions for different rehabilitation phases, in adults and children with upper limb absence.

    Discussion: Some clinicians have difficulty accessing information or relevant findings in upper limb loss/difference rehabilitation. They usually receive their knowledge from peers, by trial and error over the years or reading materials in some special fields. The handsmart platform will provide evidence based resources that are easy to understand and accessible worldwide. Hopefully this will improve the quality of upper limb rehabilitation.

    The handsmart group is a non-profit group, and the members are working on a voluntary basis. We invite external parties involved in upper limb loss/difference rehabilitation (e.g. patients organizations, commercial companies, professional organizations, other team members) to collaborate and support the group. This may enable successful work in promotion of our mission and vision.

    Disclosure: Though Ottobock initiated and was in charge of organizing and supporting the first meeting, the handsmart group is independent and follows international needs and interests of all people. There are no financial interests of this group

  • 35.
    Hermansson, Liselotte
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of Prosthetics and Orthotics, Örebro University Hospital, Örebro, Sweden; University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Turner, Kristi
    Center for Bionic Medicine, Rehabilitation Institute of Chicago, Chicago, USA.
    Occupational Therapy for prosthetic rehabilitation in adults with acquired upper limb loss: body-powered and myoelectric control systems2017In: Journal of prosthetics and orthotics, ISSN 1040-8800, E-ISSN 1534-6331, Vol. 29, no 4S, p. P45-P50Article, review/survey (Refereed)
    Abstract [en]

    There is uncertainty as to whether occupational therapy differs between patients fitted with upper-limb prostheses using different control systems. The aim was to describe occupational therapy in upper-limb prosthetic rehabilitation and discuss potential differences in therapy between patients fitted with body-powered or myoelectric control systems. An overview and description of occupational therapy methods for upper-limb prosthetic rehabilitation is provided based on literature and clinical experience from two independent occupational therapists. Ultimately, the same phased approach to occupational therapy is used for both control systems for upper-limb rehabilitation, inclusive of the evaluation, the pre- and postsurgery phase; preprosthetic therapy; prosthetic training including both controls and functional use training; and discharge planning. The one thing that differed between control systems was the methods for evaluation and training of controls, based on the underlying nature of the systems. The time required to acquire functional use skills differed between control systems—users of myoelectric devices, especially at transhumeral level or higher, and patients with bilateral limb loss often need more time in therapy in order to learn to operate the terminal device and perform bilateral activities. Occupational therapy for prosthetic rehabilitation in adults with acquired upper-limb loss follows a basic structure that is common to several types of prosthetic control systems. Increased time is required for functional use training with myoelectric systems. The shortage of validated outcome measures restricts the ability to cover all aspects of upper-limb prosthesis use. Further studies to provide evidence in support of different training methods for upper-limb prosthesis users are warranted.

  • 36.
    Hill, Wendy
    et al.
    Institute of Biomedical Engineering, University of New Brunswick, Fredericton, Canada.
    Hermansson, Liselotte M N
    Örebro University, School of Health and Medical Sciences.
    Assessment of Capacity for Myoelectric Control2008In: Association of Childrens Prosthetic Orthothic Clinics (APOC), 2008Conference paper (Refereed)
  • 37.
    Hill, Wendy
    et al.
    Institute of Biomedical Engineering, University of New Brunswick, Fredericton, Canada.
    Kyberd, Peter
    Institute of Biomedical Engineering, University of New Brunswick, Fredericton, Canada.
    Hermansson, Liselotte M. N.
    Department of Prosthetics and Orthotics, Centre for Rehabilitation Research, Örebro University Hospital, Örebro.
    Hubbard, Sheila
    Bloorview Kids Rehab, Toronto, Canada .
    Stavdahl, Øyvind
    Department of Engineering Cybernetics, Norwegian University of Science and Technology.
    Swanson, Shawn
    Advanced Arm Dynamics, Redondo Beach, CA, United States.
    Cooper, Molly Frances
    Upper Limb Prosthetic Outcome Measures (ULPOM): A Working Group and Their Findings2009In: Journal of prosthetics and orthotics, ISSN 1040-8800, E-ISSN 1534-6331, ISSN 10408800, Vol. 21, no 4S, p. P69-P82Article in journal (Refereed)
    Abstract [en]

    Rapid improvements in materials, design, and treatment in upper limb prosthetics makes assessment an important area. After meetings at international conferences and workshops, a special interest group of professionals concerned with the provision of upper limb prostheses was formed to create a systematic approach to measurement of function for upper limb prostheses. They used the World Health Organization's International Classification of Functioning, Disability and Health (ICF) model to identify a series of tests that could cover the cycle of prosthetic use from research to application in the field. It is suggested that a unified approach throughout the profession would allow better communication between the respective groups. The group analyzed literature on the subject and identified which existing tools have the psychometric properties that allow for valid comparison of data between practitioners. The group proposes that a toolkit of different validated measures has been identified, along with gaps within the kit that need additional attention.

  • 38.
    Hill, Wendy
    et al.
    Institute of Biomedical Engineering, University of New Brunswick, Fredericton, Canada.
    Stavdahl, Øyvind
    Department of Engineering Cybernetics, Norwegian University of Science and Technology, Norway.
    Hermansson, Liselotte M. N.
    Department of Prosthetics and Orthotics, Centre for Rehabilitation Research, Örebro University Hospital, Örebro.
    Kyberd, Peter
    Institute of Biomedical Engineering, University of New Brunswick, Fredericton, Canada.
    Swanson, Shawn
    Otto Bock Health Care, Minneapolis, MN, United States.
    Hubbard, Sheila
    Bloorview Kids Rehab, Toronto, Canada.
    Functional Outcomes in the WHO-ICF Model: Establishment of the Upper Limb Prosthetic Outcome Measures Group2009In: Journal of prosthetics and orthotics, ISSN 1040-8800, E-ISSN 1534-6331, Vol. 21, no 2, p. 115-119Article in journal (Refereed)
    Abstract [en]

    A need for a systematic measurement of function for upper limb prosthetics has been identified. Using the World Health Organization-International Classification of Functioning, Disability and Health (WHO-ICF) model, it was clear that no single test was able to cover the entire cycle of prosthetic use from research to application in the field, but it was believed that a unified approach throughout the profession would allow better communication between the contributors to this process. Through a series of meetings, such an approach has been formulated and a special interest group formed that aims to analyze the current literature on the subject, and identify which tools already in existence have the psychometric properties that allow for valid comparison of data between centers and countries. After this analysis, recommendations for a toolkit of different validated tools will be made, along with identifying any gaps within the kit that need additional attention.

  • 39.
    Hill, Wendy
    et al.
    Institute of Biomedical Engineering, University of New Brunswick, Fredericton, Canada.
    Swanson, Shawn
    Advanced Arm Dynamics, Houston TX, USA.
    Kyberd, Peter
    Institute of Biomedical Engineering, University of New Brunswick, Fredericton, Canada.
    Hermansson, Liselotte M. N.
    Örebro University, School of Health and Medical Sciences.
    Miller, Laura
    Rehabilitation Institute, Northwestern University, Chicago, USA.
    Heckathorne, Craig W
    Rehabilitation Institute, Northwestern University, Chicago, USA.
    Outcome Measures in Upper Limb Prosthetics2010In: 13th ISPO World Congress, 2010Conference paper (Refereed)
  • 40.
    Jarl, Gustav
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Rehabilitation Research, Örebro County Council, Örebro, Sweden.
    Heinemann, Allen W.
    Rehabilitation Institute of Chicago, USA.
    Lindner, Helen Y.N.
    Centre for Rehabilitation Research, Örebro County Council, Örebro, Sweden.
    Norling Hermansson, Liselotte M.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Northwestern University Feinberg School of Medicine, Chicago, USA.
    Cross-cultural validity and differential item functioning of theOrthotics and Prosthetics Users’ Survey with Swedish and Americanusers of lower limb prosthesisManuscript (preprint) (Other academic)
    Abstract [en]

    Objective: To investigate the cross-cultural validity of the Orthotics and Prosthetics Users’ Survey (OPUS), to investigate differential item functioning (DIF) in the OPUS related to sex, age, amputation level and amputated sides (unilateral or bilateral), and to determine the known-group validity of the OPUS.

    Design: Cross-sectional study design.

    Setting: 2 outpatient clinics in Sweden and 7 outpatient clinics in the United States.

    Participants: A total of 195 Swedish and 126 American adults using lower limb prosthesis.

    Interventions: Not applicable.

    Main Outcome Measure: 4 modules from the OPUS were used in this study, including the Lower extremity functional status (LEFS), Client satisfaction with device (CSD), Client satisfaction with services (CSS), and Health-related quality of life (HRQoL) modules. Items were scored on 4- or 5-level Likert scales, and a Rasch measure was calculated for each person and module.

    Results: The cross-cultural validity was satisfactory. Many items demonstrated DIF related to country and demographic characteristics, but the impact on mean person measures was negligible. The rating scales of the CSD and CSS needed adjustments, and the unidimensionality of the CSD and CSS was weak. The differences between the mean measures of known patient groups were statistically significant for age in the LEFS and for the level of amputation in the CSD.

    Conclusions: This study supports the validity of comparing OPUS measures between Sweden and USA and between patient groups with different demographic characteristics. The OPUS can, to some extent, discriminate between patient groups known to be different. The unidimensionality of the CSD and CSS modules is weaker than the other modules and these need further development and evaluation.

  • 41.
    Jarl, Gustav
    et al.
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Prosthetics and Orthotics.
    Hermansson, Liselotte
    Örebro University, School of Health Sciences. Department of Prosthetics and Orthotics.
    A modified walk-in system versus scheduled appointments in a secondary-care prosthetic and orthotic clinic2018In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 42, no 5, p. 483-489Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Waiting is common in health care, delays intervention, and has negative effects on satisfaction with services.

    OBJECTIVES: To evaluate effects of a modified walk-in system, where patients were invited consecutively from the waiting list to attend the clinic on a walk-in basis, on waiting times, services, and work environment.

    STUDY DESIGN: Parallel-group trial.

    METHODS: In all, 1286 consecutive patients in need of shoe insoles were randomized to waiting lists for modified walk-in ( n = 655) or a scheduled appointment ( n = 631). Seven staff members also participated.

    RESULTS: The median indirect waiting time to first appointment was 40 days shorter for modified walk-in (135 days) than for scheduled appointment (175 days; p < 0.001); 17% of those randomized to modified walk-in did not attend the clinic compared to 6% for scheduled appointment ( p < 0.001). Mean direct waiting time in the waiting room was 9.9 min longer for modified walk-in than for scheduled appointment ( p < 0.001). Patients attending modified walk-in or a scheduled appointment reported similar levels of satisfaction with services. Staff reported more support from co-workers with modified walk-in than with scheduled appointment ( p = 0.041).

    CONCLUSION: The modified walk-in can reduce indirect waiting times without any substantial worsening of direct waiting times, service quality, or work environment. Studies are needed to investigate why many patients drop out from modified walk-in. Clinical relevance A modified walk-in system can cut the queues and create more timely interventions by reducing indirect waiting times. This system can therefore be recommended in secondary-care prosthetic and orthotic clinics to reduce patients' suffering from their health condition.

  • 42.
    Jarl, Gustav
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Centre for Rehabilitation Research, Örebro University, Örebro, Sweden; Department of Prosthetics and Orthotics, Örebro University Hospital, Örebro, Sweden.
    Holmefur, Marie
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Rehabilitation Research, Örebro University, Örebro, Sweden; Department of Prosthetics and Orthotics, Örebro University Hospital, Örebro, Sweden.
    Hermansson, Liselotte M. N.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Rehabilitation Research, Örebro University, Örebro, Sweden; Department of Prosthetics and Orthotics, Örebro University Hospital, Örebro, Sweden.
    Test-retest reliability of the Swedish version of the Orthotics and Prosthetics Users' Survey2014In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 38, no 1, p. 21-26Article in journal (Refereed)
    Abstract [en]

    Background: The Orthotics and Prosthetics Users' Survey consists of five modules to assess outcomes of orthotic and prosthetic interventions: lower extremity functional status, upper extremity functional status, client satisfaction with device, client satisfaction with services and health-related quality of life.

    Objectives: To investigate the test-retest reliability and calculate the smallest detectable difference for all modules of the Swedish Orthotics and Prosthetics Users' Survey.

    Study design: Test-retest reliability study design.

    Methods: A total of 69 patients at a Department of Prosthetics and Orthotics completed Orthotics and Prosthetics Users' Survey on two occasions separated by a 2-week interval, giving 18 answers on lower extremity functional status, 41 on upper extremity functional status, 53 on client satisfaction with device, 12 on client satisfaction with services and 67 answers on health-related quality of life. Raw scores were converted into Orthotics and Prosthetics Users' Survey units on a 0-100 scale. Intra-class correlation coefficients, Bland-Altman plots, common person linking plots and t-tests of person mean measures were used to investigate the reliability. The 95% confidence level smallest detectable differences were calculated.

    Results: The intra-class correlation coefficients ranged from 0.77 to 0.96 for the modules, and no systematic differences were detected between the response occasions. The smallest detectable differences ranged from 7.4 to 16.6 units.

    Conclusions: The test-retest reliability was satisfactory for all Orthotics and Prosthetics Users' Survey modules. The smallest detectable difference was large on all modules except the health-related quality of life module.

    Clinical relevance: The Orthotics and Prosthetics Users' Survey modules are reliable and, thus, can be recommended for repeated measurements of patients over time. Relatively large changes are needed to achieve statistical significance when assessing individual patients.

  • 43.
    Jarl, Gustav M.
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Heinemann, Allen W
    Rehabilitation Institute of Chicago, Chicago IL, United States; Feinberg School of Medicine, Northwestern University, Chicago IL, United States.
    Lindner, Helen Y
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Hermansson, Liselotte M N
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Cross-cultural validity and differential item functioning of the Orthotics and Prosthetics Users’ Survey with Swedish and American users of lower-limb prosthesis2015In: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 96, no 9, p. 1615-1626Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate the cross-cultural validity of the Orthotics and Prosthetics Users’ Survey (OPUS), to evaluate differential item functioning (DIF) related to country, sex, age, amputation level, and amputated side (unilateral, bilateral), and to determine known-group validity of the OPUS.

    Design: Survey.

    Setting: Outpatient clinics.

    Participants: The sample (NZ321) consisted of Swedish (nZ195) and U.S. (nZ126) adults using lower-limb prostheses.

    Interventions: Not applicable.

    Main Outcome Measures: Four OPUS modules were used: lower extremity functional status, client satisfaction with device (CSD), client satisfaction with services (CSS), and health-related quality of life. Rasch analysis was used to calculate measures for persons and items.

    Results: The cross-cultural validity was satisfactory. Many items demonstrated DIF related to country and demographic characteristics, but the impact on mean person measures was negligible. The rating scales of CSD and CSS needed adjustments, and the unidimensionality of CSD and CSS was weak. The differences between the mean measures of known patient groups were statistically significant for 2 out of 6 comparisons.

    Conclusions: This study supports the validity of OPUS measure comparisons between Sweden and the United States and between subgroups with different demographic characteristics. Some of the country-related DIF may reflect the different health care financing systems. The findings demonstrate that the OPUS can discriminate between certain patient groups. The results also challenge some of our preconceptions about persons with bilateral amputation, indicating that we might know these persons less well than we think.

  • 44.
    Jarl, Gustav M.
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Rehabilitation Research, Örebro County Council, Örebro, Sweden; Department of Prosthetics and Orthotics, Örebro County Council, Örebro, Sweden.
    Heinemann, Allen W.
    Rehabilitation Institute, Chicago, USA; Nortwestern University Feinberg School of Medicine, Chicago, USA.
    Norling Hermansson, Liselotte M. N.
    Örebro University, School of Health and Medical Sciences. Centre for Rehabilitation Research, Örebro County Council, Örebro, Sweden; Department of Prosthetics and Orthotics, Örebro County Council, Örebro, Sweden.
    Validity evidence for a modified version of the Orthotics and Prosthetics Users' Survey2012In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 7, no 6, p. 469-478Article in journal (Refereed)
    Abstract [en]

    Purpose: To evaluate the validity of a modified version of the Orthotics and Prosthetics Users' Survey (OPUS) with persons using different prosthetic and orthotic (P&O) devices.

    Method: Two-hundred-and-eighty-two adults using prosthesis, orthosis, shoe insoles or orthopaedic shoes completed OPUS. OPUS comprises five modules - Lower and Upper Extremity Functional Status, respectively (LEFS and UEFS), Client Satisfaction with Device and Services, respectively (CSD and CSS), and, Health-Related Quality of Life (HRQoL). Eight new items were added to LEFS and six to UEFS. Rasch analysis was used for data analyses.

    Results: Rating scales functioned satisfactory after some modifications. All modules demonstrated a ceiling effect. Unidimensionality was satisfactory after deleting some items and dividing HRQoL into two subscales, although somewhat weak on CSD and CSS. Item reliability was excellent for all modules and person reliability good for all but CSD and CSS. Some items demonstrated differential item functioning related to sex and age, but the impact on person measures was small.

    Conclusions: This study supports the validity of a modified version of OPUS for persons using different P&O devices, but also reveals limitations to be addressed in future studies. OPUS could be useful in clinical rehabilitation and research to evaluate P&O outcomes.

  • 45.
    Jarl, Gustav M.
    et al.
    Örebro University, School of Health and Medical Sciences.
    Heinemann, Allen W
    Rehabilitation Institute, Chicago and Northwestern University Feinberg School of Medicine, Chicago, USA.
    Norling Hermansson, Liselotte M. N.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Validity of the Swedish version of Orthotics and Prosthetics Users’ Survey2010Conference paper (Refereed)
  • 46.
    Jarl, Gustav M
    et al.
    Örebro University, School of Health and Medical Sciences.
    Hermansson, Liselotte M
    Örebro University, School of Health and Medical Sciences.
    Translation and linguistic validation of the Swedish version of Orthotics and Prosthtics User’s Survey2008In: 5th Regional Central European ISPO Conference, 2008Conference paper (Refereed)
  • 47.
    Jarl, Gustav M.
    et al.
    Örebro University, School of Health and Medical Sciences.
    Hermansson, Liselotte M. N.
    Örebro University, School of Health and Medical Sciences.
    Översättning och språklig validering av svenska versionen av Orthotics and Prosthetics Users' Survey2009In: 8:e Nordiska ortopedtekniska kongressen 2009, 2009Conference paper (Refereed)
  • 48.
    Jarl, Gustav M.
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Holmefur, Marie
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Hermansson, Liselotte M N
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Test-retest reliability of the Orthotics and prosthetics users´ survey2013In: ISPO 2013 World Congress: Inclusion, Participation & Empowerment, 2013Conference paper (Refereed)
  • 49.
    Jarl, Gustav M.
    et al.
    Örebro University, School of Health and Medical Sciences.
    Norling Hermansson, Liselotte
    Örebro University, School of Health and Medical Sciences.
    Translation and linguistic validation of the Swedish version of Orthotics and prosthetics users’ survey2008Conference paper (Refereed)
    Abstract [en]

    There is a lack of Swedish instruments assessing outcome of orthotic and prosthetic services. The North American derived Orthotics and Prosthetics Users’ Survey (OPUS) consists of five questionnaires assessing common rehabilitation goals. It was translated to Swedish and validated linguistically. Thirty-nine persons answered the questionnaires and were systematically debriefed. In most cases the items were understood as intended. Words and expressions were changed if misunderstood or interpreted in different ways. The resulting Swedish version of OPUS showed acceptable linguistic validity. A study on construct validity and test-retest reliability is in process.

     

    1      Introduction

    Historically, Orthotic and Prosthetic (O&P) services in Sweden have been based on hands-on experience rather than science. Self-report instruments could be used to systematically evaluate the practice, but most of them are developed in English speaking countries and cannot be used in Sweden without translation and validation. Moreover, the only instruments available in Swedish are limited to the smaller group in O&P practice, namely prosthetic clients.

     

    The Orthotics and Prosthetics Users´ Survey (OPUS) was developed and validated in the USA to assess the outcome in both prosthetic and orthotic users [1]. The OPUS consists of five questionnaires assessing i) health related quality of life, ii) satisfaction with device, iii) satisfaction with services, iv) upper extremity function, and v) lower extremity function. If translated, OPUS could be a useful tool for studying the outcome of O&P services in Sweden. Still, validity problems can arise by using direct translations. Therefore, translations’ validity must be tested in the new cultural context.

     

    The aim was to translate OPUS to Swedish and test the linguistic validity in a Swedish context.

     

    2      Methods and subjects

    2.1. Methods

    A modified version of the translation process suggested by the WHO [2] was used. Four medical professionals (P/O, OT, PT, orthopaedic surgeon) independently translated OPUS to Swedish. The translations were merged to a single document by one of the authors (GJ). Translators and authors met twice to discuss the translations and a consensus version was created. A professional translator performed a back-translation to English. The English original, the Swedish consensus version, and the back-translation, were compared by one of the authors (GJ) and a new Swedish version was created.

     

    One intention with the Swedish version of OPUS was to use it for evaluation of insoles. However, many of these clients are relatively fit and a high ceiling effect could be expected in the lower extremity function part of OPUS. Therefore, eight new items assumed to be more difficult were added to the Swedish version of this particular questionnaire.

     

    Linguistic validation was performed by systematically debriefing the clients who answered the five questionnaires. Ten subjects answered each questionnaire (each subject completed one or two different questionnaires).

     

    2.2. Subjects

    Thirty-nine clients (27 women, 12 men, mean age 59,8) at the Department of Prosthetics and Orthotics, Örebro University Hospital, participated. Clients younger than 18 years, and clients unable to understand written Swedish, were excluded. The study was approved by the Regional Ethics Committee review board.

     

    3      Results

    Minor linguistic changes were made during the translation process. Most items were understood as intended but some words and expressions were changed because of misunderstandings or cultural differences between Sweden and the USA.

     

    4      Discussion

    The translation procedure used is well established and has been used in several studies. The quality of the translation was improved by involving people of different professions and experiences.

     

    5      Conclusion

    The translation and validation resulted in a Swedish version of OPUS that may be a reliable and useful contribution to outcome studies in Swedish O&P service. A study assessing construct validity and test-retest reliability is in process and preliminary results will be presented.

     

    6      References

    1.      Heinemann AW, Bode RK, et al. (2003). "Development and measurement properties of the Orthotics and Prosthetics Users' Survey (OPUS): a comprehensive set of clinical outcome instruments." Prosthet Orthot Int 27;3:191-206

     

    2.      WHO (2007). "Process of translation and adaptation of instruments."  2007: http://www.who.int/substance_abuse/research_tools/translation/en/.

     

  • 50.
    Jarl, Gustav M.
    et al.
    Örebro University, School of Health and Medical Sciences. Institution for Rehabilitation, Centre for Rehabilitation Research, Örebro; Örebro University Hospital, Örebro .
    Norling Hermansson, Liselotte Maria
    Institution for Rehabilitation, Centre for Rehabilitation Research, Örebro; Örebro University Hospital, Örebro.
    Translation and linguistic validation of the Swedish version of Orthotics and Prosthetics Users' Survey2009In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 33, no 4, p. 329-338Article in journal (Refereed)
    Abstract [en]

    There is an increasing need for outcome measures in the orthotic and prosthetic field and specifically a lack of outcome measures in Swedish. The Orthotics and Prosthetics Users' Survey (OPUS) was developed in the USA for assessment of the outcome of orthotic and prosthetic interventions, and could potentially also be used for shoe insoles and orthopaedic shoes. The aims of this study were to translate OPUS into Swedish and test the translated version's linguistic validity in a Swedish context. The Orthotic and Prosthetic Users' Survey was translated into Swedish and back-translated into English, following a modified version of the World Health Organization guidelines. After revision of the Swedish version, 39 Swedish clients (12 men, 27 women) answered the OPUS questionnaires and were systematically debriefed afterwards. Most items were understood correctly by the respondents, but some words and expressions had to be changed to avoid misunderstandings or unintended interpretations. The resulting Swedish version of OPUS, OPUS-Swe, showed acceptable linguistic validity and has potential for use in both clinical practice and scientific settings. Nevertheless, before OPUS-Swe can be fully implemented, its psychometric properties need to be evaluated.

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