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stroke rehabilitation

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181. Accelerating Stroke Recovery: Body Structures and Functions, Activities, Participation, and Quality of Life Outcomes From a Large Rehabilitation Trial. (Full text)

Accelerating Stroke Recovery: Body Structures and Functions, Activities, Participation, and Quality of Life Outcomes From a Large Rehabilitation Trial. Task-oriented therapies have been developed to address significant upper extremity disability that persists after stroke. Yet, the extent of and approach to rehabilitation and recovery remains unsatisfactory to many.To compare a skill-directed investigational intervention with usual care treatment for body functions and structures, activities (...) study-related improvements in quality of life. By end of study, all groups reached similar levels with only limited group differences.Customized task-oriented training can be implemented to accelerate gains across a full spectrum of patient-reported outcomes. While group differences for most outcomes disappeared at 1 year, ASAP participants achieved these outcomes on average 8 months earlier (ClinicalTrials.gov: Interdisciplinary Comprehensive Arm Rehabilitation Evaluation [ICARE] Stroke Initiative

2019 Neurorehabilitation and neural repair Controlled trial quality: uncertain PubMed abstract

182. Game analysis and clinical use of the Xbox-Kinect for stroke rehabilitation. (Abstract)

Game analysis and clinical use of the Xbox-Kinect for stroke rehabilitation. Whole-body movement is required to interact (play) with Microsoft Xbox with the 3D Kinect sensor (Xbox-Kinect) and, therefore, may be suitable for encouraging and practicing movements as part of stroke rehabilitation. We aimed to describe (i) game analysis, (ii) clinical use, and (iii) to characterize the Xbox-Kinect game experience with individuals with chronic stroke. Four therapists played the Xbox-Kinect games (...) with the participants is presented. Participants reported high enjoyment and 'somewhat-high' perceived exertion after playing the two games and stated that overall the console suited their therapeutic goals. This information can assist clinicians with their clinical reasoning and decision-making for incorporating the Xbox-Kinect into stroke rehabilitation. Potentially, the Xbox-Kinect could be used as an on-going tool to facilitate whole-body movement and physical activity of individuals with chronic stroke.

2019 International Journal of Rehabilitation Research. Internationale Zeitschrift Fur Rehabilitationsforschung. Revue Internationale De Recherches De Readaptation Controlled trial quality: uncertain

183. Effect of oral hygiene programmes on oral opportunistic pathogens during stroke rehabilitation. (Abstract)

Effect of oral hygiene programmes on oral opportunistic pathogens during stroke rehabilitation. This study was to assess the effectiveness of a conventional oral hygiene care programme (COHCP) and an advanced oral hygiene care programme (AOHCP) on prevalence and viable counts of oral opportunistic pathogens among patients undergoing stroke rehabilitation.A total of 94 patients were randomized to two groups. Subjects were block randomized to either (a) COHCP: manual toothbrushing with oral

2019 Oral diseases Controlled trial quality: uncertain

184. The Effects of Naturalistic Light on Diurnal Plasma Melatonin and Serum Cortisol Levels in Stroke Patients during Admission for Rehabilitation: A Randomized Controlled Trial. (Full text)

The Effects of Naturalistic Light on Diurnal Plasma Melatonin and Serum Cortisol Levels in Stroke Patients during Admission for Rehabilitation: A Randomized Controlled Trial. Background: Stroke patients admitted for rehabilitation often lack sufficient daytime blue light exposure due to the absence of natural light and are often exposed to light at unnatural time points. We hypothesized that artificial light imitating daylight, termed naturalistic light, would stabilize the circadian rhythm (...) of plasma melatonin and serum cortisol levels among long-term hospitalized stroke patients. Methods: A quasi-randomized controlled trial. Stroke patients in need of rehabilitation were randomized between May 1, 2014, and June 1, 2015 to either a rehabilitation unit equipped entirely with always on naturalistic lighting (IU), or to a rehabilitation unit with standard indoor lighting (CU). At both inclusion and discharge after a hospital stay of at least 2 weeks, plasma melatonin and serum cortisol levels

2019 International journal of medical sciences Controlled trial quality: uncertain PubMed abstract

185. Guided Self-rehabilitation Contract vs conventional therapy in chronic stroke-induced hemiparesis: NEURORESTORE, a multicenter randomized controlled trial. (Full text)

Guided Self-rehabilitation Contract vs conventional therapy in chronic stroke-induced hemiparesis: NEURORESTORE, a multicenter randomized controlled trial. After discharge from hospital following a stroke, prescriptions of community-based rehabilitation are often downgraded to "maintenance" rehabilitation or discontinued. This classic therapeutic behavior stems from persistent confusion between lesion-induced plasticity, which lasts for the first 6 months essentially, and behavior-induced (...) plasticity, of indefinite duration, through which intense rehabilitation might remain effective. This prospective, randomized, multicenter, single-blind study in subjects with chronic stroke-induced hemiparesis evaluates changes in active function with a Guided Self-rehabilitation Contract vs conventional therapy alone, pursued for a year.One hundred and twenty four adult subjects with chronic hemiparesis (> 1 year since first stroke) will be included in six tertiary rehabilitation centers. For each

2019 BMC Neurology Controlled trial quality: predicted high PubMed abstract

186. Access to rehabilitation for patients with stroke in Australia. (Full text)

Access to rehabilitation for patients with stroke in Australia. To identify factors associated with receiving acute goal-directed treatment, being assessed for ongoing rehabilitation, and receiving post-acute rehabilitation after having a stroke.Retrospective analysis of National Stroke Audit data for patients with acute stroke treated at Australian hospitals during 1 September 2014 - 28 February 2015.112 Australian hospitals that admit adults with acute stroke.Associations between patient (...) -related and organisational factors and the provision of rehabilitation interventions.Data for 3462 patients were eligible for analysis; their median age was 74 years, 1962 (57%) were men, and 2470 (71%) had received care in a stroke unit. 2505 patients (72%) received goal-directed treatment during their acute admission; it was not provided to 364 patients (10.5%) who were responsive, had not fully recovered, and did not refuse treatment. Factors associated with higher odds of receiving goal-directed

2019 Medical Journal of Australia PubMed abstract

187. Long-Term Improvements After Multimodal Rehabilitation in Late Phase After Stroke: A Randomized Controlled Trial (Full text)

Long-Term Improvements After Multimodal Rehabilitation in Late Phase After Stroke: A Randomized Controlled Trial Treatments that improve function in late phase after stroke are urgently needed. We assessed whether multimodal interventions based on rhythm-and-music therapy or horse-riding therapy could lead to increased perceived recovery and functional improvement in a mixed population of individuals in late phase after stroke.Participants were assigned to rhythm-and-music therapy, horse-riding (...) therapy, or control using concealed randomization, stratified with respect to sex and stroke laterality. Therapy was given twice a week for 12 weeks. The primary outcome was change in participants' perception of stroke recovery as assessed by the Stroke Impact Scale with an intention-to-treat analysis. Secondary objective outcome measures were changes in balance, gait, grip strength, and cognition. Blinded assessments were performed at baseline, postintervention, and at 3- and 6-month follow-up.One

2017 EvidenceUpdates PubMed abstract

188. Goal-oriented instructions increase the intensity of practice in stroke rehabilitation compared with non-specific instructions: a within-participant, repeated measures experimental study. (Full text)

Goal-oriented instructions increase the intensity of practice in stroke rehabilitation compared with non-specific instructions: a within-participant, repeated measures experimental study. In stroke rehabilitation, do goal-oriented instructions increase the intensity of practice during therapy compared to a non-specific instruction? Is one type of goal-oriented instruction more effective at increasing the intensity of practice achieved by stroke survivors during therapy?A within-participant (...) , repeated measures experimental study.Twenty-four adults undertaking stroke rehabilitation at a metropolitan hospital as an inpatient or outpatient.Participants were observed performing exercises across 3 days. On each day, they performed an exercise with a non-specific instruction ('do some [exercise]') as a baseline measure and the same exercise with one of three goal-oriented instructions, delivered in a randomised order. The three goal-oriented instructions were: 'do [exercise] 25 times

2019 Journal of physiotherapy Controlled trial quality: uncertain PubMed abstract

189. Family-led rehabilitation after stroke in India (ATTEND): a randomised controlled trial. (Full text)

Family-led rehabilitation after stroke in India (ATTEND): a randomised controlled trial. Most people with stroke in India have no access to organised rehabilitation services. The effectiveness of training family members to provide stroke rehabilitation is uncertain. Our primary objective was to determine whether family-led stroke rehabilitation, initiated in hospital and continued at home, would be superior to usual care in a low-resource setting.The Family-led Rehabilitation after Stroke (...) sustainability, our results do not support investment in new stroke rehabilitation services that shift tasks to family caregivers, unless new evidence emerges. A future avenue of research should be to investigate the effects of task shifting to health-care assistants or team-based community care.The National Health and Medical Research Council of Australia.Copyright © 2017 Elsevier Ltd. All rights reserved.

2017 Lancet Controlled trial quality: predicted high PubMed abstract

190. Assessment of the quality and content of clinical practice guidelines for post-stroke rehabilitation of aphasia. (Full text)

Assessment of the quality and content of clinical practice guidelines for post-stroke rehabilitation of aphasia. The purpose of this study was to evaluate the quality of guidelines for rehabilitation of post-stroke aphasia using the Appraisal of Guidelines for Research and Evaluation (AGREE-II) instrument and identify consistency of different guidelines.A systematic search was undertaken from inception to October 2018. Two reviewers independently screened all titles and abstracts, and assessed (...) was observed (ICC ranged from 0.60 to 0.99). The speech language therapy was recommended in 3 guidelines. Four guidelines described group treatment was beneficial for the continuum of care. However, other therapies for aphasia varied in the level of detail across guidelines.Our study indicated the quality of guidelines for post-stroke aphasia needed to be improved. Moreover, the treatment recommendations of aphasia existed discrepancy among the included guidelines. Therefore, it is suggested to pay more

2019 Medicine PubMed abstract

191. Rehabilitation for balance impairment in patients after stroke: a protocol of a systematic review and network meta-analysis. (Full text)

Rehabilitation for balance impairment in patients after stroke: a protocol of a systematic review and network meta-analysis. Multiple rehabilitation therapies have been reported to be effective for poststroke balance impairment. However, the comparative effectiveness of these rehabilitation therapies is still unclear. Therefore, the aim of this study is to summarise evidence and identify the most effective rehabilitation therapy for poststroke balance impairment.The following databases (...) will be searched: China Biology Medicine, China National Knowledge Infrastructure, Wan Fang Data, the Chinese Science and Technology Periodical Database, Medline, Excerpt Medical Database (EMBASE), Web of Science, the Cochrane Library, from inception to June 2019. All randomised controlled trials that have used rehabilitation interventions to treat poststroke balance impairment will be included. The primary outcomes are the Berg Balance Scale, the Fugl-Meyer Assessment (balance), the Postural Assessment Scale

2019 BMJ open PubMed abstract

192. Nuanced effects of music interventions on rehabilitation outcomes after stroke: a systematic review. (Abstract)

Nuanced effects of music interventions on rehabilitation outcomes after stroke: a systematic review. Background: Music is affordable and easily integrated in rehabilitation exercises, and has demonstrated different effects on the brain. We hypothesized that music interventions could improve rehabilitation outcomes after stroke. Objective: the aim of our review is to determine the effectiveness of different types of music interventions according to the rehabilitation objectives after stroke (...) . Method: A systematic review of randomized controlled trials, clinical controlled trials and cross-over design performed on PubMed and PEDro in May 2018. All of these studies focus on acute, sub-acute or chronic stroke rehabilitation with music or rhythmic auditory stimulation intervention in adults during clinical outcomes. Two independent reviewers extracted the data and assessed the risk of bias before bringing it together. Results: Twenty-seven studies were included and analyzed. Our review found

2019 Topics in stroke rehabilitation

193. Use of Kinesio taping in lower-extremity rehabilitation of post-stroke patients: A systematic review and meta-analysis. (Abstract)

Use of Kinesio taping in lower-extremity rehabilitation of post-stroke patients: A systematic review and meta-analysis. and purpose: The benefits of Kinesio taping (KT) in post-stroke rehabilitation have not been determined. This study aimed to evaluate its effects on lower-extremity rehabilitation in patients after a stroke.A literature search was performed using EBSCOhost, Embase, Physiotherapy Evidence Database (PEDro), PubMed, Cochrane, Web of Science, China National Knowledge (...) Infrastructure (CNKI), SinoMed, and Wanfang Data through June 2018. Randomized controlled trials (RCTs) on the use of KT during lower-extremity, post-stroke rehabilitation were selected. Meta-analysis was conducted.A total of 14 RCTs of low to moderate quality were reviewed and included 783 participants. Results indicated that KT significantly improved patients' lower extremity spasticity, motor function, balance, ambulation, gait parameters, and daily activities, with few adverse effects.KT may have

2019 Complementary Therapies in Clinical Practice

194. Subacute stroke physical rehabilitation evidence in activities of daily living outcomes: A systematic review of meta-analyses of randomized controlled trials. (Full text)

Subacute stroke physical rehabilitation evidence in activities of daily living outcomes: A systematic review of meta-analyses of randomized controlled trials. Stroke is a leading cause of disabilities worldwide. One of the key disciplines in stroke rehabilitation is physical therapy which is primarily aimed at restoring and maintaining activities of daily living (ADL). Several meta-analyses have found different interventions improving functional capacity and reducing disability.To (...) systematically evaluate existing evidence, from published systematic reviews of meta-analyses, of subacute physical rehabilitation interventions in (ADLs) for stroke patients.Umbrella review on meta-analyses of RCTs ADLs in MEDLINE, Web of Science, Scopus, Cochrane, and Google Scholar up to April 2018. Two reviewers independently applied inclusion criteria to select potential systematic reviews of meta-analyses of randomized controlled trials (RCTs) of physical rehabilitation interventions (during subacute

2019 Medicine PubMed abstract

195. Home-based technologies for stroke rehabilitation: A systematic review. (Full text)

Home-based technologies for stroke rehabilitation: A systematic review. Many forms of home-based technology targeting stroke rehabilitation have been devised, and a number of human factors are important to their application, suggesting the need to examine this information in a comprehensive review.The systematic review aims to synthesize the current knowledge of technologies and human factors in home-based technologies for stroke rehabilitation.We conducted a systematic literature search (...) in three electronic databases (IEEE, ACM, PubMed), including secondary citations from the literature search. We included articles that used technological means to help stroke patients conduct rehabilitation at home, reported empirical studies that evaluated the technologies with patients in the home environment, and were published in English. Three authors independently conducted the content analysis of searched articles using a list of interactively defined factors.The search yielded 832 potentially

2019 International journal of medical informatics PubMed abstract

196. Brain-machine interface of upper limb recovery in stroke patients rehabilitation: A systematic review. (Abstract)

Brain-machine interface of upper limb recovery in stroke patients rehabilitation: A systematic review. Technologies such as brain-computer interfaces are able to guide mental practice, in particular motor imagery performance, to promote recovery in stroke patients, as a combined approach to conventional therapy.The aim of this systematic review was to provide a status report regarding advances in brain-computer interface, focusing in particular in upper limb motor recovery.The databases PubMed (...) found that the most common interface used was non-invasive electroencephalography, and the main neurofeedback, in stroke rehabilitation, was usually visual abstract or a combination with the control of an orthosis/robotic limb. Moreover, the Fugl-Meyer Assessment Scale was a major outcome measure in eight out of nine studies. In addition, the benefits of functional electric stimulation associated to an interface were found in three studies.Neurofeedback training with brain-computer interface systems

2019 Physiotherapy research international : the journal for researchers and clinicians in physical therapy

197. Transcranial direct current stimulation in post-stroke aphasia rehabilitation: A systematic review. (Full text)

Transcranial direct current stimulation in post-stroke aphasia rehabilitation: A systematic review. Transcranial direct current stimulation (tDCS) is a non-invasive tool that induces neuromodulation in the brain. Several studies have shown the effectiveness of tDCS in improving language recovery in post-stroke aphasia. However, this innovative technique is not currently used in routine speech and language therapy (SLT) practice.This systematic review aimed to summarise the role of tDCS (...) in aphasia rehabilitation.We searched MEDLINE via PubMed and Scopus on October 5, 2018 for English articles published from 1996 to 2018. Eligible studies involved post-stroke aphasia rehabilitation with tDCS combined or not with SLT.We retained 5 meta-analyses and 48 studies. Among the 48 studies, 39 were randomised controlled trials (558 patients), 2 prospective studies (56 patients), and 5 case studies (5 patients). Two articles were sub-analyses of a randomised clinical trial. Methods used

2019 Annals of physical and rehabilitation medicine PubMed abstract

198. The effects of computer-based cognitive rehabilitation in patients with visuospatial neglect following stroke: a systematic review. (Abstract)

The effects of computer-based cognitive rehabilitation in patients with visuospatial neglect following stroke: a systematic review. To identify studies concerning the effects of computer based cognitive rehabilitation (CBCR) on visuospatial neglect (VN) after stroke to summarize the current state of knowledge in this research field and make recommendations for future research.Four electronic databases were systematically searched. Authors of relevant studies were contacted to detect unpublished (...) data or articles not found by searching databases. Data was extracted from included studies using predefined coding schemes and characteristics and results of individual studies were summarized qualitatively.Studies were included if at least 50% of the included patients had a stroke, if the studies explored the effects of CBCR as a primary intervention for rehabilitation of VN and if they included neuropsychological outcome measures for the presence of VN.Seven studies were included. Six

2019 Topics in stroke rehabilitation

199. A systematic review and meta-analysis of the effects of cardiac rehabilitation interventions on cognitive impairment following stroke. (Abstract)

of rehabilitation on post-stroke cognitive function. Method: Five electronic databases were searched from inception to 1 May 2019, namely: MEDLINE, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Central Register of Controlled Trials, and the Web of Science. Eligible studies included both randomized and non-randomized studies of cardiac rehabilitation-type interventions which measured cognitive function in patients with transient ischemic attack (TIA) or stroke. Results (...) A systematic review and meta-analysis of the effects of cardiac rehabilitation interventions on cognitive impairment following stroke. Purpose: The cardiac rehabilitation model has potential as an approach to providing rehabilitation following stroke. This review aims to identify evidence for the participation of stroke patients in cardiac/cardiovascular rehabilitation programs internationally, whether or not such programs offer a cognitive intervention as part of treatment, and the impact

2019 Disability and rehabilitation

200. Mental practice for upper limb rehabilitation after stroke: a systematic review and meta-analysis. (Abstract)

Mental practice for upper limb rehabilitation after stroke: a systematic review and meta-analysis. Mental practice (MP) is usually provided in combination with other therapies, and new developments for neurofeedback to support MP have been made recently. The objectives of this study were to evaluate the effectiveness of MP and to investigate the intervention characteristics including neurofeedback that may affect treatment outcome. The Cochrane Central Register of Controlled Trials, PubMed (...) , Embase, KoreaMed, Scopus, Web of Science, PEDro, and CIRRIE were searched from inception to March 2017 for randomized controlled trials to assess the effect of MP for upper limb rehabilitation after stroke. Fugl-Meyer Assessment (FMA) was used as the outcome measure for meta-analysis. Twenty-five trials met the inclusion criteria, and 15 trials were eligible for meta-analysis. Among the trials selected for meta-analysis, MP was added to conventional therapy in eight trials or to modified constraint

2019 International Journal of Rehabilitation Research. Internationale Zeitschrift Fur Rehabilitationsforschung. Revue Internationale De Recherches De Readaptation

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