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      “The car is my extra legs” – Experiences of outdoor mobility amongst immigrants in Sweden with late effects of polio

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          Abstract

          Background

          The aim of the study was to describe the experience of outdoor mobility among immigrants with late effects of polio living in Sweden. There is a need to understand more about this young group of persons since they often have problems with mobility and gait, but they may also face participation restrictions due to issues associated with integration into a new community and culture.

          Method

          A total of 14 young immigrants with late effects of polio participated and were interviewed individually. The study used a qualitative method to explore personal experiences and the interviews were analyzed through an inductive approach, using qualitative content analysis.

          Results

          The analysis led to a major theme; s elf-image and acceptance, that comprised a changeable process and experiences of cultural, social, and gender-specific barriers, but also of environmental and personal factors that impacted their outdoor mobility. By using a car, the participants felt they could come across as normal which also increased their self-esteem.

          Conclusions

          Independent mobility is a major enabler for ongoing employment and being able to use a car increases the chances for integration into society for young immigrants with late effects of polio. Public transport is not considered to be adequate or efficient enough due to the participants’ mobility impairments, but driving can prevent involuntary isolation and facilitate participation. A car can increase quality of life but may also be a facilitator for work and reduce the demand for societal support.

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          Most cited references32

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          Mobility devices to promote activity and participation: a systematic review.

          To determine the effectiveness of mobility device interventions in terms of activity and participation for people with mobility limitations. Systematic review. Search of 7 databases during the period 1996 to 2008. Controlled studies and non-controlled follow-up studies were included if they covered both baseline and follow-up data and focused on activity and participation. Study participants had to be aged over 18 years with mobility limitations. Mobility device interventions encompassed crutches, walking frames, rollators, manual wheelchairs and powered wheelchairs (including scooter types). Two reviewers independently selected the studies, performed the data extraction, and 4 reviewers assessed the studies' methodological quality. Disagreements were resolved by consensus. Eight studies were included: one randomized controlled trial, 4 controlled studies, and 3 follow-up studies that included before and after data. Two studies dealt with the effects of powered wheelchair interventions and the other studies with various other types of mobility device. Two studies were of high, internal and external methodological quality. Interventions were found to be clinically effective in terms of activity and participation in 6 studies. The results did not, however, give a unanimous verdict on the effectiveness of mobility devices in enhancing the activity and participation of mobility impaired people. Interventions and outcome measurement methods varied between the studies; consequently, it was not possible to draw any general conclusions about the effectiveness of mobility device interventions. However, evidence was found that mobility devices improve users' activity and participation and increase mobility. A lack of high-quality research hampers conclusions about effectiveness. More original, well-designed research is required.
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            Post-poliomyelitis syndrome.

            Post-poliomyelitis syndrome (PPS) is a common neurological disorder that occurs in a large proportion of individuals who have recovered from paralytic poliomyelitis. The main clinical features are new weakness, muscular fatigability, general fatigue, and pain. The primary criteria necessary for the diagnosis of PPS are a history of paralytic poliomyelitis, partial or complete recovery of neurological function followed by a period of stability (usually several decades), persistent new muscle weakness or abnormal muscle fatigability, and the exclusion of other causes of new symptoms. The cause of PPS remains unclear, but is likely due to a distal degeneration of enlarged post-poliomyelitis motor units. Contributing factors to PPS may be aging (with motor neuron loss), overuse, and disuse. PPS is usually a slowly progressive neuromuscular disease. Although there is no specific treatment for PPS, an interdisciplinary management program can be useful in controlling symptoms. (c) 2005 Wiley Periodicals, Inc.
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              In the driving seat: psychosocial benefits from private motor vehicle transport compared to public transport

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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: MethodologyRole: Project administrationRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: MethodologyRole: SupervisionRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                31 October 2019
                2019
                : 14
                : 10
                : e0224685
                Affiliations
                [1 ] Rehabilitation Medicine, Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg, Sweden
                [2 ] The Swedish National Road and Transport Research Institute (VTI), Gothenburg, Sweden
                [3 ] Department of Occupational Therapy and Physiotherapy, The Sahlgrenska University Hospital, Gothenburg, Sweden
                Chinese Academy of Medical Sciences and Peking Union Medical College, CHINA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0001-8026-5591
                Article
                PONE-D-19-17453
                10.1371/journal.pone.0224685
                6822759
                31671130
                db2bd62d-157c-4eee-991a-f8e564dabc9c
                © 2019 Selander et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 20 June 2019
                : 19 October 2019
                Page count
                Figures: 1, Tables: 2, Pages: 15
                Funding
                Funded by: King Gustav V’s 80-years Foundation
                Award ID: FAB-2016-0250
                Award Recipient :
                This study was supported by the King Gustav V’s 80-years Foundation (to KSS), grant number FAB-2016-0250. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Infectious Diseases
                Viral Diseases
                Poliomyelitis
                People and places
                Geographical locations
                Europe
                European Union
                Sweden
                Medicine and Health Sciences
                Public and Occupational Health
                Disabilities
                Biology and Life Sciences
                Bioengineering
                Biotechnology
                Medical Devices and Equipment
                Assistive Technologies
                Wheelchairs
                Engineering and Technology
                Bioengineering
                Biotechnology
                Medical Devices and Equipment
                Assistive Technologies
                Wheelchairs
                Medicine and Health Sciences
                Medical Devices and Equipment
                Assistive Technologies
                Wheelchairs
                Biology and Life Sciences
                Physiology
                Biological Locomotion
                Walking
                Medicine and Health Sciences
                Physiology
                Biological Locomotion
                Walking
                Social Sciences
                Sociology
                Culture
                Engineering and Technology
                Transportation
                Biology and Life Sciences
                Psychology
                Emotions
                Social Sciences
                Psychology
                Emotions
                Custom metadata
                Complete interview data cannot be made publicly available for ethical and legal reasons, according to the Swedish regulations [ http://www.epn.se/en/start/regulations/]. Public availability would compromise participant confidentiality or privacy. Upon request a list of condensed meaning units or codes can be made available after removal of details that may risk the confidentiality of the participants. To access such data please contact the University of Gothenburg, Sahlgrenska Academy, Institute of Neuroscience and Physiology, Department of Clinical Neuroscience to the Swedish National Data Service, SND: snd@ 123456gu.se , or Dr. Margit Alt Murphy: margit.alt-murphy@ 123456neuro.gu.se .

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