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Levi, Richard
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Publications (10 of 62) Show all publications
Flank, P., Ramnemark, A., Levi, R., Wahman, K. & Fahlström, M. (2017). Pain, anxiety and depression in spinal cord injured patients. Jacobs Journal of Physical Rehabilitation Medicine, 3(1), Article ID 028.
Open this publication in new window or tab >>Pain, anxiety and depression in spinal cord injured patients
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2017 (English)In: Jacobs Journal of Physical Rehabilitation Medicine, ISSN 2469-3103, Vol. 3, no 1, article id 028Article in journal (Refereed) Published
Abstract [en]

Objective: To assess the prevalence of pain, anxiety and depression in a sample of chronic SCI patients in Northern Sweden.

Design: Descriptive, cross-sectional study.

Setting: Specialist Clinic at a University Hospital.

Participants: 78 patients with chronic spinal cord injury, at different injury and functional level.

Outcome measures: Patients registered presented pain above, at or below injury level on a Visual Analogue Scale (VAS). Patients currently on pain medication were also registered as having pain. Depression and anxiety were assessed by the Hospital Anxiety and Depression Rating Scale (HADS).

Results: Out of 78 patients, 58 (74%) indicated current presence of pain or were on continuous pain medication. Pain above injury level was present in 32% of the patients, with a mean VAS of 15.9±20.1, range 0-60mm. Pain at injury level were present in 24% of the patients, mean VAS 11.0±17.0, range 0-50mm and 58% had pain below injury level with a mean VAS 31.4±22.3, range 0-80mm.

Clinically significant psychological disorders were reported in 4 patients (5%) for both anxiety and depression.

Conclusions: Pain is very common in persons with chronic SCI, but, at least in a drug-treated population, the pain is at a mild or moderate level. Anxiety and depression were found much less common than reported in other studies. Medication effects have been considered. Even in a presumably well-medicated and well-rehabilitated population, there is still a need for further optimization of pain management, including both pharmacological and non-pharmacological methods.

Keywords: Tetraplegia; Paraplegia; Psychological Disorders; Visual Analogue Scale; Hospital Anxiety and Depression Scale

Place, publisher, year, edition, pages
Jacobs Publishers, 2017
Keywords
Tetraplegia, Paraplegia, Psychological Disorders, Visual Analogue Scale, Hospital Anxiety and Depression Scale
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-125201 (URN)
Note

Originally included in thesis in manuscript form.

Available from: 2016-09-08 Created: 2016-09-08 Last updated: 2019-04-15Bibliographically approved
Stenberg, G., Henje, C., Levi, R. & Lindström, M. (2016). Living with an electric wheelchair: the user perspective. Disability and Rehabilitation: Assistive Technology, 11(5), 385-394
Open this publication in new window or tab >>Living with an electric wheelchair: the user perspective
2016 (English)In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 11, no 5, p. 385-394Article in journal (Refereed) Published
Abstract [en]

Purpose: To explore the experiences of using an electric wheelchair in daily living. Methods: Fifteen participants, eight women and seven men, living in different parts of a Nordic country were interviewed. The interviews were conducted in the home or at the workplace. Open-ended questions were used. The data were collected and analyzed according to the grounded theory. Results: Analysis resulted in one core category: "Integrating the electric wheelchair - a manifold process", describing a process commencing from initial resistance against use of an electric wheelchair, to acceptance with various extent of integration. Six categories emerged that represent this core process: incorporating the electric wheelchair into the self-identity process, calculating functional consequences, encountering the reactions of others, facing duality in movability, using proactive strategies, and being at the mercy of the system. Findings indicate that the integration process is complex and manifold. Practical, personal, and social dimensions were intertwined and significantly involved. Conclusions: Integrating an electric wheelchair is a process closely connected to symbolic value, usability, community mobility and identity. These aspects should be considered in the production, prescription, and adaptation processes. Implications for Rehabilitation Integrating an electric wheelchair is a process closely connected to symbolic value, usability, community mobility, and identity. These aspects should be considered in the wheelchair production, prescription, and adaptation processes.

Keywords
Community mobility, daily life, embodiment, participation, qualitative research, social identity, wheelchair
National Category
Other Medical Sciences
Identifiers
urn:nbn:se:umu:diva-100820 (URN)10.3109/17483107.2014.968811 (DOI)000386457900004 ()25270614 (PubMedID)
Available from: 2015-03-11 Created: 2015-03-11 Last updated: 2018-06-07Bibliographically approved
Engman Bredvik, S., Carballeira Suarez, N., Levi, R. & Nilsson, K. (2016). Multi-family therapy in anorexia nervosa: a qualitative study of parental experiences. In: Stuart Murray, Leslie Anderson, and Leigh Cohn (Ed.), Innovations in family therapy for eating disorders: novel treatment developments, patient insights, and the role of carers (pp. 236-248). New York: Routledge
Open this publication in new window or tab >>Multi-family therapy in anorexia nervosa: a qualitative study of parental experiences
2016 (English)In: Innovations in family therapy for eating disorders: novel treatment developments, patient insights, and the role of carers / [ed] Stuart Murray, Leslie Anderson, and Leigh Cohn, New York: Routledge, 2016, p. 236-248Chapter in book (Refereed)
Place, publisher, year, edition, pages
New York: Routledge, 2016
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-138079 (URN)9781138648982 (ISBN)9781315626086 (ISBN)
Available from: 2017-08-08 Created: 2017-08-08 Last updated: 2018-10-24Bibliographically approved
Engman-Bredvik, S., Carballeira Suarez, N., Levi, R. & Nilsson, K. (2016). Multi-family therapy in anorexia nervosa: a qualitative study of parental experiences. Eating Disorders, 24(2), 186-197
Open this publication in new window or tab >>Multi-family therapy in anorexia nervosa: a qualitative study of parental experiences
2016 (English)In: Eating Disorders, ISSN 1064-0266, E-ISSN 1532-530X, Vol. 24, no 2, p. 186-197Article in journal (Refereed) Published
Abstract [en]

This qualitative study from northern Sweden investigated experiences of multi-family therapy (MFT) in 12 parents of children with anorexia nervosa (AN). The main reported benefit was the opportunity to talk to others in a similar situation, thereby sharing experiences and struggles. MFT resulted in new perspectives and insights that improved family dynamics and enabled new constructive behaviors. In conclusion, MFT seems to be a useful therapeutic modality in the treatment of AN in a northern European setting.

Place, publisher, year, edition, pages
Taylor & Francis, 2016
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-118758 (URN)10.1080/10640266.2015.1034053 (DOI)000372083800006 ()25879257 (PubMedID)
Available from: 2016-04-04 Created: 2016-04-04 Last updated: 2018-06-07Bibliographically approved
Svensson, E., Nilsson, K., Levi, R. & Carballeira Suarez, N. (2016). Parent's experiences of having and caring for a child with an eating disorder. In: Stuart Murray, Leslie Anderson, and Leigh Cohn (Ed.), Innovations in family therapy for eating disorders: novel treatment developments, patient insights, and the role of carers (pp. 249-260). New York: Routledge
Open this publication in new window or tab >>Parent's experiences of having and caring for a child with an eating disorder
2016 (English)In: Innovations in family therapy for eating disorders: novel treatment developments, patient insights, and the role of carers / [ed] Stuart Murray, Leslie Anderson, and Leigh Cohn, New York: Routledge, 2016, p. 249-260Chapter in book (Refereed)
Place, publisher, year, edition, pages
New York: Routledge, 2016
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-138081 (URN)9781138648982 (ISBN)9781315626086 (ISBN)
Available from: 2017-08-08 Created: 2017-08-08 Last updated: 2018-10-24Bibliographically approved
Stenberg, M., Godbolt, A. K., Nygren De Boussard, C., Levi, R. & Stålnacke, B.-M. (2015). Cognitive impairment after severe traumatic brain injury, clinical course and impact on outcome: a Swedish-Icelandic study. Behavioural Neurology, Article ID 680308.
Open this publication in new window or tab >>Cognitive impairment after severe traumatic brain injury, clinical course and impact on outcome: a Swedish-Icelandic study
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2015 (English)In: Behavioural Neurology, ISSN 0953-4180, E-ISSN 1875-8584, article id 680308Article in journal (Refereed) Published
Abstract [en]

Objective. To assess the clinical course of cognitive and emotional impairments in patients with severe TBI (sTBI) from 3 weeks to 1 year after trauma and to study associations with outcomes at 1 year.

Methods. Prospective, multicenter, observational study of sTBI in Sweden and Iceland. Patients aged 18-65 years with acute Glasgow Coma Scale 3-8 were assessed with the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) and the Hospital Anxiety and Depression Scale (HADS). Outcome measures were Glasgow Outcome Scale Extended (GOSE) and Rancho Los Amigos Cognitive Scale-Revised (RLAS-R).

Results. Cognition was assessed with the BNIS assessed for 42 patients out of 100 at 3 weeks, 75 patients at 3 months, and 78 patients at 1 year. Cognition improved over time, especially from 3 weeks to 3 months. The BNIS subscales "orientation" and "visuospatial and visual problem solving" were associated with the GOSE and RLAS-R at 1 year.

Conclusion. Cognition seemed to improve over time after sTBI and appeared to be rather stable from 3 months to 1 year. Since cognitive function was associated with outcomes, these results indicate that early screening of cognitive function could be of importance for rehabilitation planning in a clinical setting.

Place, publisher, year, edition, pages
New York: Hindawi Publishing Corporation, 2015
Keywords
Brain Injuries, Cognitive Science, Population, Treatment Outcome
National Category
Clinical Medicine
Identifiers
urn:nbn:se:umu:diva-114043 (URN)10.1155/2015/680308 (DOI)000366850100001 ()
Available from: 2016-01-11 Created: 2016-01-11 Last updated: 2018-06-07Bibliographically approved
Flank, P., Ramnemark, A., Levi, R., Wahman, K. & Fahlström, M. (2015). Dyslipidemia is common after spinal cord injury - independent of clinical measures. Jacobs Journal of Physical Rehabilitation Medicine, 1(1)
Open this publication in new window or tab >>Dyslipidemia is common after spinal cord injury - independent of clinical measures
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2015 (English)In: Jacobs Journal of Physical Rehabilitation Medicine, ISSN 2469-3103, Vol. 1, no 1Article in journal (Refereed) Published
Abstract [en]

Objective: To survey the incidence of clinical risk markers and its correlation with established clinical measurements for cardiovascular disease (CVD) in a heterogeneous spinal cord injured (SCI) patient population.

Design: Descriptive, cross-sectional study.

Subjects: 78 patients with SCI, at different injury and functional level.

Methods: Anthropometric data, blood pressure, a blood lipid panel, blood glucose and a questionnaire were analyzed.

Results: Eighty-one percent of all patients had dyslipidemia (DL) and a majority of the patients with abdominal measures below the recommended cut-off levels had DL. Self-reported physical activity above the cut-off level was reported by 32.1%of the patients. There were no differences in clinical measures, serum lipid values and blood glucose between physically active and not active patients. No differences were seen between men/women, tetraplegia/paraplegia and wheelchair dependent/not wheelchair dependent patients.

Conclusion: DL is common and seems to be not treated or undertreated in the studied SCI patient group with different neurological lesion and functional levels. General anthropometric clinical measures do not seem to be valid for evaluating risk for CVD in this patient group.

Keywords
Cardiovascular Disease, Tetraplegia, Paraplegia, Blood Lipids, Blood Glucose, Anthropometry, BMI, Physical Activity
National Category
Neurology Cardiac and Cardiovascular Systems Health Sciences
Identifiers
urn:nbn:se:umu:diva-118527 (URN)
Available from: 2016-03-22 Created: 2016-03-22 Last updated: 2018-06-07Bibliographically approved
Awad, A., Levi, R., Lindgren, L., Hultling, C., Westling, G., Nyberg, L. & Eriksson, J. (2015). Preserved somatosensory conduction in a patient with complete cervical spinal cord injury. Journal of Rehabilitation Medicine, 47(5), 426-431
Open this publication in new window or tab >>Preserved somatosensory conduction in a patient with complete cervical spinal cord injury
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2015 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 47, no 5, p. 426-431Article in journal (Refereed) Published
Abstract [en]

Objective: Neurophysiological investigation has shown that patients with clinically complete spinal cord injury can have residual motor sparing ("motor discomplete"). In the current study somatosensory conduction was assessed in a patient with clinically complete spinal cord injury and a novel ethodology for assessing such preservation is described, in this case indicating "sensory discomplete" spinal cord injury. Methods: Blood oxygenation level-dependent functional magnetic resonance imaging (BOLD fMRI) was used to examine the somatosensory system in a healthy subject and in a subject with a clinically complete cervical spinal cord injury, by applying tactile stimulation above and below the level of spinal cord injury, with and without visual feedback. Results: In the participant with spinal cord injury, somatosensory stimulation below the neurological level of the lesion gave rise to BOLD signal changes in the corresponding areas of the somatosensory cortex. Visual feedback of the stimulation strongly modulated the somatosensory BOLD signal, implying that cortico-cortical rather than spino-cortical connections can drive activity in the somatosensory cortex. Critically, BOLD signal change was also evident when the visual feedback of the stimulation was removed, thus demonstrating sensory discomplete spinal cord injury. Conclusion: Given the existence of sensory discomplete spinal cord injury, preserved but hitherto undetected somatosensory conduction might contribute to the unexplained variability related to, for example, the propensity to develop decubitus ulcers and neuropathic pain among patients with clinically complete spinal cord injury.

Place, publisher, year, edition, pages
Foundation of Rehabilitation Information, 2015
Keywords
fMRI, spinal cord injury, complete, non-conscious, somatosensory cortex
National Category
Sport and Fitness Sciences Physiotherapy
Identifiers
urn:nbn:se:umu:diva-105263 (URN)10.2340/16501977-1955 (DOI)000355371600006 ()25808357 (PubMedID)
Available from: 2015-06-22 Created: 2015-06-22 Last updated: 2018-06-07Bibliographically approved
Flank, P., Fahlström, M., Boström, C., Lewis, J. E., Levi, R. & Wahman, K. (2014). Self-reported physical activity and risk markers for cardiovascular disease after spinal cord injury. Journal of Rehabilitation Medicine, 46(9), 886-890
Open this publication in new window or tab >>Self-reported physical activity and risk markers for cardiovascular disease after spinal cord injury
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2014 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, no 9, p. 886-890Article in journal (Refereed) Published
Abstract [en]

Objective:

To examine whether self-reported physical activity of a moderate/vigorous intensity influences risk markers for cardiovascular disease in persons with paraplegia due to spinal cord injury.

Design:

Descriptive, cross-sectional study.

Subjects:

A total of 134 wheelchair-dependent individuals (103 men, 31 women) with chronic (>= 1 year) post-traumatic spinal cord injury with paraplegia.

Methods:

Cardiovascular disease markers (hypertension, blood glucose and a blood lipid panel) were analysed and related to physical activity.

Results:

One out of 5 persons reported undertaking physical activity >= 30 min/day. Persons who were physically active >= 30 min/day were significantly younger than inactive persons. Systolic and diastolic blood pressures were lower in the physically active group. When adjusting for age, the association between systolic blood pressure and physical activity disappeared. Physical activity >= 30 min/day had a tendency to positively influence body mass index and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio. Men had significantly higher systolic and diastolic blood pressures than women, lower high-density lipoprotein cholesterol, higher low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio and higher triglycerides. No other significant differences between men and women were found.

Conclusion:

Self-reported physical activity >= 30 min/day in persons with spinal cord injury positively influenced diastolic blood pressure. No other reductions in cardiovascular disease risk markers were seen after controlling for age. These results indicate a positive effect of physical activity, but it cannot be concluded that recommendations about physical activity in cardiovascular disease prevention for the general population apply to wheelchair-dependent persons with spinal cord injury.

Keywords
prevention, paraplegia, blood pressure
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-96621 (URN)10.2340/16501977-1857 (DOI)000343076800009 ()25211062 (PubMedID)
External cooperation:
Available from: 2014-11-27 Created: 2014-11-24 Last updated: 2018-06-07Bibliographically approved
Svensson, E., Nilsson, K., Levi, R. & Suarez, N. C. (2013). Parents' experiences of having and caring for a child with an eating disorder. Eating Disorders, 21(5), 395-407
Open this publication in new window or tab >>Parents' experiences of having and caring for a child with an eating disorder
2013 (English)In: Eating Disorders, ISSN 1064-0266, E-ISSN 1532-530X, Vol. 21, no 5, p. 395-407Article in journal (Refereed) Published
Abstract [en]

Eating disorders (ED) are serious conditions that affect both patients and their families. Little is known about the influence of these disorders on family life in a Swedish population and the ways that affected families actually attempt to cope. The aim of this study was to specifically investigate parental experiences of having and caring for a child with ED. A qualitative approach was used and rich narratives were obtained from interviews with 10 parents. Results promote insights into lived experiences concerning social disruption, emotional impact, and coping strategies related to ED. This knowledge can be utilized to further develop programs to help affected families.

National Category
Other Health Sciences
Identifiers
urn:nbn:se:umu:diva-80794 (URN)10.1080/10640266.2013.827537 (DOI)000337503300002 ()24044596 (PubMedID)
Available from: 2013-09-26 Created: 2013-09-26 Last updated: 2018-06-08Bibliographically approved
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