Rehabilitation processes after stroke - needs, interventions and outcomes
There is a lack of knowledge of the long-term impact on daily life in persons who have had a stroke and their significant others, as well as needs for rehabilitation and support in different phases of the rehabilitation process after stroke. There is also a lack of knowledge on how the long-term care and rehabilitation after stroke should be organised.
We have in different studies pursued projects with the aim to increase knowledge on needs for rehabilitation and support in people with stroke and their significant others, and if and how these needs vary over time.
Methods
To highlight various aspects of rehabilitation processes after stroke different methods are used: quantitative, qualitative and mixed methods. Data collection is carried out in different ways, through structured interviews and established measures of functioning, life satisfaction, perceived needs for and satisfaction with health-related services, contextual (personal and environmental) and disease specific factors. From significant others data on caregiver burden is collected. In qualitative interviews experiences of the rehabilitation process and needs for rehabilitation and support in patients and significant others are explored. Register based studies on use of health-related services after stroke are conducted. Several studies are performed in collaboration with the research group HELD at KI, University of Southern Denmark and the research group in Social Work at KI.
Importance
Since stroke often leads to lifelong impact on the life of the individual and his/her family it is important to develop evidence based sub-acute interventions, preferably through increased supply of health maintenance and health promoting activities and to identify factors that can contribute to meet the needs for rehabilitation in people with stroke and their significant others. An increased knowledge of the perceived needs in people with stroke and significant others is a starting point for model development of acute and sub-acute rehabilitation interventions.
Projektledare
Charlotte Ytterberg
Senior Lecturer/Physcial TherapistDoktorsavhandlingar
Dissertations that completely of partly address research questions within the aim described above.
Susanne Palmcrantz: Long-term effects of stroke seen in young individuals living in the community
Financial support
The research has received funding from Centrum för Vårdvetenskap, Karolinska University Hospital, National Health Care Science Postgraduate School, the Swedish Research Council, Hjärnfonden, the Swedish Stroke Association, Promobilia, KI funds, and the regional agreement on medical training and clinical research between Stockholm County Council and Karolinska Institutet (ALF).
Scientific publications
2023
Housing Accessibility at Home and Rehabilitation Outcomes After a Stroke: An Explorative Study.
Elf M, Slaug B, Ytterberg C, Heylighen A, Kylén M
HERD 2023 Jun;():19375867231178313
Health literacy is associated with less depression symptoms, higher perceived recovery, higher perceived participation, and walking ability one year after stroke - a cross-sectional study.
Flink M, Lindblom S, von Koch L, Carlsson AC, Ytterberg C
Top Stroke Rehabil 2023 Feb;():1-7
The Use of Teach Back at Hospital Discharge to Support Self-Management of Prescribed Medication for Secondary Prevention after Stroke-Findings from A Feasibility Study.
Lindblom S, Ytterberg C, Flink M, Carlsson AC, Stenberg U, Tistad M, von Koch L, Laska AC
Healthcare (Basel) 2023 Jan;11(3):
2022
Depression symptoms 6 years after stroke are associated with higher perceived impact of stroke, limitations in ADL and restricted participation.
Ytterberg C, Cegrell L, von Koch L, Wiklander M
Sci Rep 2022 May;12(1):7816
Referral-based transition to subsequent rehabilitation at home after stroke: one-year outcomes and use of healthcare services.
Lindblom S, Tistad M, Flink M, Laska AC, von Koch L, Ytterberg C
BMC Health Serv Res 2022 May;22(1):594
Use of Mobile/Tablet and Web-Based Applications to Support Rehabilitation After Stroke: A Scoping Review.
Marwaa MN, Guidetti S, Ytterberg C, Kristensen HK
J Rehabil Med 2022 Apr;54():jrm00269
Person-centred care transitions for people with stroke: study protocol for a feasibility evaluation of codesigned care transition support.
Flink M, Lindblom S, Tistad M, Laska AC, Bertilsson BC, Wärlinge C, Hasselström J, Elf M, von Koch L, Ytterberg C
BMJ Open 2021 12;11(12):e047329
The use of mobile and web-based applications to support rehabilitation after stroke: a scoping review.
Marwaa MN, Guidetti S, Ytterberg C, Kristensen HK
J Rehabil Med 2022 Feb;():
2021
How is the environment integrated into post-stroke rehabilitation? A qualitative study among community-dwelling persons with stroke who receive home rehabilitation in Sweden.
Kylén M, Ytterberg C, von Koch L, Elf M
Health Soc Care Community 2021 Sep;():
Person-centred care transitions for people with stroke: study protocol for a feasibility evaluation of codesigned care transition support.
Flink M, Lindblom S, Tistad M, Laska AC, Bertilsson BC, Wärlinge C, Hasselström J, Elf M, von Koch L, Ytterberg C
BMJ Open 2021 12;11(12):e047329
The manifestation of participation within a co-design process involving patients, significant others and health-care professionals.
Lindblom S, Flink M, Elf M, Laska AC, von Koch L, Ytterberg C
Health Expect 2021 Mar;():
2020
Perceptive Dialogue for Linking Stakeholders and Units During Care Transitions - A Qualitative Study of People with Stroke, Significant Others and Healthcare Professionals in Sweden.
Lindblom S, Ytterberg C, Elf M, Flink M
Int J Integr Care 2020 Mar;20(1):11
Perceptive Dialogue for Linking Stakeholders and Units During Care Transitions - A Qualitative Study of People with Stroke, Significant Others and Healthcare Professionals in Sweden.
Lindblom S, Ytterberg C, Elf M, Flink M
Int J Integr Care 2020 Mar;20(1):11
Healthcare Utilization After Stroke: A 1-Year Prospective Study.
Minet LR, Peterson E, von Koch L, Ytterberg C
J Am Med Dir Assoc 2020 Jul;():
Factors related to met needs for rehabilitation 6 years after stroke.
Ytterberg C, Kristensen HK, Tistad M, von Koch L
PLoS ONE 2020 ;15(1):e0227867
2019
Closeness and life satisfaction after six years for persons with stroke and spouses.
Fugl-Meyer KS, Nilsson MI, von Koch L, Ytterberg C
J Rehabil Med 2019 Jul;51(7):492-498
Abandoned to the strains of daily life: a qualitative study of the long-term experiences in partners to persons after a mild to moderate stroke.
Ytterberg C, von Koch L, Erikson A
Disabil Rehabil 2019 03;41(6):649-655
2017
Discourses in stroke rehabilitation as they present themselves in current physiotherapy and occupational therapy.
Kristensen HK, Præstegaard J, Ytterberg C
Disabil Rehabil 2017 02;39(3):223-235
Association between satisfaction and participation in everyday occupations after stroke.
Bergström A, Guidetti S, Tham K, Eriksson G
Scand J Occup Ther 2017 Sep;24(5):339-348
Experiences of Sexuality Six Years After Stroke: A Qualitative Study.
Nilsson MI, Fugl-Meyer K, von Koch L, Ytterberg C
J Sex Med 2017 06;14(6):797-803
Perceived impact of stroke six years after onset, and changes in impact between one and six years.
Ytterberg C, Dybäck M, Bergström A, Guidetti S, Eriksson G
J Rehabil Med 2017 Aug;49(8):637-643
2016
Research-based evidence in stroke rehabilitation: an investigation of its implementation by physiotherapists and occupational therapists.
Kristensen HK, Ytterberg C, Jones DL, Lund H
Disabil Rehabil 2016 12;38(26):2564-74
Self-Reported Fatigue and Associated Factors Six Years after Stroke.
Elf M, Eriksson G, Johansson S, von Koch L, Ytterberg C
PLoS ONE 2016 ;11(8):e0161942
The Importance of Patient Involvement in Stroke Rehabilitation.
Kristensen HK, Tistad M, Koch Lv, Ytterberg C
PLoS ONE 2016 ;11(6):e0157149
2015
Participation in everyday life and life satisfaction in persons with stroke and their caregivers 3-6 months after onset.
Bergström AL, von Koch L, Andersson M, Tham K, Eriksson G
J Rehabil Med 2015 Jun;47(6):508-15
Participation in Complex and Social Everyday Activities Six Years after Stroke: Predictors for Return to Pre-Stroke Level.
Singam A, Ytterberg C, Tham K, von Koch L
PLoS One 2015 ;10(12):e0144344
Achieving a holistic perspective in stroke rehabilitation: An overview of the use of the ICF by Danish physiotherapists and occupational therapists.
Kristensen HK, Lund H, Jones DL, Ytterberg C.
INT J THER REHABIL), Oct2015; 22(10): 460-469.
Occurrence and Predictors of Falls in People With Stroke: Six-Year Prospective Study.
Minet LR, Peterson E, von Koch L, Ytterberg C
Stroke 2015 Sep;46(9):2688-90
The combined perceptions of people with stroke and their carers regarding rehabilitation needs 1 year after stroke: a mixed methods study.
Ekstam L, Johansson U, Guidetti S, Eriksson G, Ytterberg C
BMJ Open 2015 Feb;5(2):e006784
2014
Changes in the impact of stroke between 3 and 12 months post-stroke, assessed with the Stroke Impact Scale.
Guidetti S, Ytterberg C, Ekstam L, Johansson U, Eriksson G
J Rehabil Med 2014 Nov;46(10):963-8
2013
What aspects of rehabilitation provision contribute to self-reported met needs for rehabilitation one year after stroke--amount, place, operator or timing?
Tistad M, von Koch L, Sjöstrand C, Tham K, Ytterberg C
Health Expect 2013 Sep;16(3):e24-35
2012
Differences between younger and older individuals in their use of care and rehabilitation but not in self-perceived global recovery 1year after stroke.
Palmcrantz S, Susanne P, Holmqvist LW, Lotta WH, Sommerfeld DK, K SD, Tistad M, Malin T, Ytterberg C, Charlotte Y, von Koch L, Lena vK
J Neurol Sci 2012 Oct;321(1-2):29-34
Unfulfilled rehabilitation needs and dissatisfaction with care 12 months after a stroke: an explorative observational study.
Tistad M, Tham K, von Koch L, Ytterberg C
BMC Neurol 2012 Jun;12():40
Poor concurrence between disabilities as described by patients and established assessment tools three months after stroke: a mixed methods approach.
Tistad M, Ytterberg C, Tham K, von Koch L
J Neurol Sci 2012 Feb;313(1-2):160-6
Shorter length of stay in the stroke unit: comparison between the 1990s and 2000s.
Tistad M, Ytterberg C, Sjöstrand C, Holmqvist LW, von Koch L
Top Stroke Rehabil ;19(2):172-81