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Latest & greatest articles for stroke rehabilitation
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be costly, or forgo super- vised therapy and potentially not meet their rehabilita- tion and recovery potential. The 2019 update of the Canadian Stroke Best Practice Recommendations (CSBPR): Rehabilitation and Recovery following Stroke module is a comprehen- sive summary of current evidence-based recommenda- tions, focusing primarily on the management of people who have already had a moderately or severely dis- abling stroke. People with milder stroke or transientischemicattack may not require (...) for select patients with acute stroke (for instance, people with more mild strokesor transientischemicattack) butcautionisadvised, andclinical judgmentshouldbeused(Evidence Level C). (iv) Once deemed to be medically and neurologically stable, patients should receive a recommended three hours perdayof directtask-specific therapy, five days aweek, delivered by the interdisciplinary stroke team (Evidence Level C); more therapy results in better outcomes (Evidence Level A). (v) Individualized
The impact of a patient-directed activity program on functional outcomes and activity participation after stroke during inpatient rehabilitation-a randomized controlled trial Individuals post stroke are inactive, even during rehabilitation, contributing to ongoing disability and risk of secondary health conditions. Our aims were to (1) conduct a randomized controlled trial to examine the efficacy of a "Patient-Directed Activity Program" on functional outcomes in people post stroke during (...) inpatient rehabilitation and (2) examine differences three months post inpatient rehabilitation discharge.Randomized control trial.Inpatient rehabilitation facility.Patients admitted to inpatient rehabilitation post stroke.Patient-Directed Activity Program (PDAP) or control (usual care only). Both groups underwent control (three hours of therapy/day), while PDAP participants were prescribed two additional 30-minute activity sessions/day.Outcomes (StrokeRehabilitation Assessment of Movement Measure
Unilateral vs Bilateral Hybrid Approaches for Upper Limb Rehabilitation in Chronic Stroke: A Randomized Controlled Trial To investigate the effects of unilateral hybrid therapy (UHT) and bilateral hybrid therapy (BHT) compared with robot-assisted therapy (RT) alone in patients with chronic stroke.A single-blind, randomized controlled trial.Four hospitals.Outpatients with chronic stroke and mild to moderate motor impairment (N=44).UHT combined unilateral RT (URT) and modified constraint-induced (...) therapy. BHT combined bilateral RT (BRT) and bilateral arm training. The RT group received URT and BRT. The intervention frequency for the 3 groups was 90 min/d 3 d/wk for 6 weeks.Fugl-Meyer Assessment (FMA, divided into the proximal and distal subscale) and Stroke Impact Scale (SIS) version 3.0 scores before, immediately after, and 3 months after treatment and Wolf Motor Function Test (WMFT) and Nottingham Extended Activities of Daily Living (NEADL) scale scores before and immediately after
The Management of StrokeRehabilitation: A Synopsis of the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline. In June 2019, the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) approved an update of the joint clinical practice guideline for rehabilitation after stroke. This synopsis summarizes the key recommendations from this guideline.In February 2018, the VA/DoD Evidence-Based Practice Work Group convened a joint (...) and their family members were invited to share their perspectives to further inform guideline development.The guideline recommendations provide evidence-based guidance for the rehabilitation care of patients after stroke. The recommendations are applicable to health care providers in both primary care and rehabilitation. Key features of the guideline are recommendations in 6 areas: timing and approach; motor therapy; dysphagia; cognitive, speech, and sensory therapy; mental health therapy; and other functions
in Patients with Stroke and TransientIschemicAttack  Abbreviations: AHA: American Heart Association; ASA: American Stroke Association Sidebar 2: Assessment of Impairments and Disabilities ? Assessment of impairments • Auditory/hearing • Bowel and bladder function • Cognition • Communication • Emotion and behavior • Inattention/neglect • Motor/mobility • Swallowing and nutrition • Tactile/touch • Vision function and formal visual field ? Assessment of barriers to participation in therapy • Cognitive (...) in the form of medical, surgical, or rehabilitation interventions is essential to help reduce disability severity, decrease the risk of further complications, and lessen potentially life-long deficits.[5,6] Unfortunately, in approximately 30% of ischemicstroke cases, the cause of the stroke remains unknown. Ischemicstrokes with no obvious cause are labelled as “cryptogenic” strokes and are more common in younger patients than in the elderly. This is largely due to the lack of comorbidities
Effects of Home-Based Versus Clinic-Based Rehabilitation Combining Mirror Therapy and Task-Specific Training for Patients With Stroke: A Randomized Crossover Trial We investigated the treatment effects of a home-based rehabilitation program compared with clinic-based rehabilitation in patients with stroke.A single-blinded, 2-sequence, 2-period, crossover-designed study.Rehabilitation clinics and participant's home environment.Individuals with disabilities poststroke.During each intervention (...) period, each participant received 12 training sessions, with a 4-week washout phase between the 2 periods. Participants were randomly allocated to home-based rehabilitation first or clinic-based rehabilitation first. Intervention protocols included mirror therapy and task-specific training.Outcome measures were selected based on the International Classification of Functioning, Disability and Health. Outcomes of impairment level were the Fugl-Meyer Assessment, Box and Block Test, and Revised
Effect of health empowerment intervention for stroke self-management on behaviour and health in strokerehabilitation patients. 29938651 2018 12 11 2018 12 11 1024-2708 24 Suppl 2 1 2018 02 Hong Kong medical journal = Xianggang yi xue za zhi Hong Kong Med J Effect of health empowerment intervention for stroke self-management on behaviour and health in strokerehabilitation patients. 12-15 Sit J Wh JW The Nethersole School of Nursing, The Chinese University of Hong Kong. Chair S Y SY (...) of Medicine and Rehabilitation, Tung Wah Eastern Hospital. eng Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't China Hong Kong Med J 9512509 1024-2708 IM Adult Aged Female Hong Kong Humans Male Middle Aged Power (Psychology) Regression Analysis Self-Management methods Stroke psychology therapy StrokeRehabilitation methods Treatment Outcome 2018 6 26 6 0 2018 6 26 6 0 2018 12 12 6 0 ppublish 29938651
Virtual Reality Rehabilitation With Functional Electrical Stimulation Improves Upper Extremity Function in Patients With Chronic Stroke: A Pilot Randomized Controlled Study To compare virtual reality (VR) combined with functional electrical stimulation (FES) with cyclic FES for improving upper extremity function and health-related quality of life in patients with chronic stroke.A pilot, randomized, single-blind, controlled trial.Stroke rehabilitation inpatient unit.Participants (N=48 (...) ) with hemiplegia secondary to a unilateral stroke for >3 months and with a hemiplegic wrist extensor Medical Research Council scale score ranging from 1 to 3.FES was applied to the wrist extensors and finger extensors. A VR-based wearable rehabilitation device was used combined with FES and virtual activity-based training for the intervention group. The control group received cyclic FES only. Both groups completed 20 sessions over a 4-week period.Primary outcome measures were changes in Fugl-Meyer Assessment
Adoption of StrokeRehabilitation Technologies by the User Community: Qualitative Study Using technology in strokerehabilitation is attractive. Devices such as robots or smartphones can help deliver evidence-based levels of practice intensity and automated feedback without additional labor costs. Currently, however, few technologies have been adopted into everyday rehabilitation.This project aimed to identify stakeholder (therapists, patients, and caregivers) priorities for stroke (...) rehabilitation technologies and to generate user-centered solutions for enhancing everyday adoption.We invited stakeholders (n=60), comprising stroke survivors (20/60, 33%), therapists (20/60, 33%), caregivers, and technology developers (including researchers; 20/60, 33%), to attend 2 facilitated workshops. Workshop 1 was preceded by a national survey of stroke survivors and therapists (n=177) to generate an initial list of priorities. The subsequent workshop focused on identifying practical solutions
Preferred rehabilitation setting among stroke survivors in Nigeria and associated personal factors Incorporating patients' preferences in the care they receive is an important component of evidence-based practice and patient-centred care.This study assessed stroke patients' preferences regarding rehabilitation settings.A cross-sectional design was used to examine preferences of stroke patients receiving physiotherapy at three hospitals in Northern Nigeria. Personal factors and preferred (...) rehabilitation setting data were obtained using the Modified Rankin Scale (to assess global disability) and a researcher-developed questionnaire. Associations between preferences and personal factors were explored using bivariate statistics.Sixty stroke patients whose mean age was 53.6 ± 14.8 years participated in the study. Most of the participants (38.3%) preferred an outpatient setting, 19 (31.7%) preferred rehabilitation in their homes, 14 chose inpatient rehabilitation (23.3%), while 4 (6.7%) preferred
Person-Generated Health Data in Simulated Rehabilitation Using Kinect for Stroke: Literature Review Person- or patient-generated health data (PGHD) are health, wellness, and clinical data that people generate, record, and analyze for themselves. There is potential for PGHD to improve the efficiency and effectiveness of simulated rehabilitation technologies for stroke. Simulated rehabilitation is a type of telerehabilitation that uses computer technologies and interfaces to allow the real-time (...) simulation of rehabilitation activities or a rehabilitation environment. A leading technology for simulated rehabilitation is Microsoft's Kinect, a video-based technology that uses infrared to track a user's body movements.This review attempts to understand to what extent Kinect-based strokerehabilitation systems (K-SRS) have used PGHD and to what benefit.The review is conducted in two parts. In part 1, aspects of relevance for PGHD were searched for in existing systematic reviews on K-SRS
Virtual Reality for Upper Limb Rehabilitation in Subacute and Chronic Stroke: A Randomized Controlled Trial To evaluate the effectiveness of reinforced feedback in virtual environment (RFVE) treatment combined with conventional rehabilitation (CR) in comparison with CR alone, and to study whether changes are related to stroke etiology (ie, ischemic, hemorrhagic).Randomized controlled trial.Hospital facility for intensive rehabilitation.Patients (N=136) within 1 year from onset of a single (...) stroke (ischemic: n=78, hemorrhagic: n=58).The experimental treatment was based on the combination of RFVE with CR, whereas control treatment was based on the same amount of CR. Both treatments lasted 2 hours daily, 5d/wk, for 4 weeks.Fugl-Meyer upper extremity scale (F-M UE) (primary outcome), FIM, National Institutes of Health Stroke Scale (NIHSS), and Edmonton Symptom Assessment Scale (ESAS) (secondary outcomes). Kinematic parameters of requested movements included duration (time), mean linear
Evolution of Cognitive Rehabilitation After Stroke From Traditional Techniques to Smart and Personalized Home-Based Information and Communication Technology Systems: Literature Review Neurological patients after stroke usually present cognitive deficits that cause dependencies in their daily living. These deficits mainly affect the performance of some of their daily activities. For that reason, stroke patients need long-term processes for their cognitive rehabilitation. Considering (...) for the assessment of stroke patients and cognitive rehabilitation. This study puts together traditional methods and the most recent personalized platforms based on ICT technologies and Internet of Things.A literature review has been distributed to a multidisciplinary team of researchers from engineering, psychology, and sport science fields. The systematic review has been focused on published scientific research, other European projects, and the most current innovative large-scale initiatives in the area
A Very Early Rehabilitation Trial after stroke (AVERT): a Phase III, multicentre, randomised controlled trial A Very Early Rehabilitation Trial after stroke (AVERT): a Phase III, multicentre, randomised controlled trial A Very Early Rehabilitation Trial after stroke (AVERT): a Phase III, multicentre, randomised controlled trial Langhorne P, Wu O, Rodgers H, Ashburn A & Bernhardt J Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA (...) . No evaluation of the quality of this assessment has been made for the HTA database. Citation Langhorne P, Wu O, Rodgers H, Ashburn A & Bernhardt J. A Very Early Rehabilitation Trial after stroke (AVERT): a Phase III, multicentre, randomised controlled trial. Health Technology Assessment 2017; 21(54) Authors' objectives Mobilising patients early after stroke [early mobilisation (EM)] is thought to contribute to the beneficial effects of stroke unit care but it is poorly defined and lacks direct evidence
Effects of Transcranial Direct Current Stimulation With Sensory Modulation on Stroke Motor Rehabilitation: A Randomized Controlled Trial To test whether a multistrategy intervention enhanced recovery immediately and longitudinally in patients with severe to moderate upper extremity (UE) paresis.Double-blind, randomized controlled trial with placebo control.Outpatient department of a local medical center.People (N=25) with chronic stroke were randomly assigned to 1 of 2 groups: a transcranial (...) with the control group, the tDCS-SM group had a trend of a small immediate effect (ηp2=.02-.04) on reducing spasticity, but no long-term effect. A trend of small immediate and long-term effects in favor of tDCS-SM was found on UE function and daily function recovery (ηp2=.02-.09).Accompanied with traditional rehabilitation, tDCS-SM had a nonsignificant trend of having immediate and longitudinal effects on voluntary UE movement recovery in patients with severe to moderate UE paresis after stroke, but its
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
Stroke recovery and rehabilitation in 2016: a year in review of basic science and clinical science 29507783 2018 11 14 2059-8696 2 4 2017 Dec Stroke and vascular neurology Stroke Vasc Neurol Stroke recovery and rehabilitation in 2016: a year in review of basic science and clinical science. 222-229 10.1136/svn-2017-000069 Zheng Haiqing H Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. Cao Ning N Department of Physical Medicine (...) and Rehabilitation, MosRehab, Elkins Park, Pennsylvania, USA. Yin Yu Y Department of Rehabilitation Medicine, Hebei Provincial General Hospital, Shijiazhuang, China. Feng Wuwei W Department of Neurology, Medical University of South Carolina, Charleston, SC 29425, USA. Department of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA. eng P20 GM109040 GM NIGMS NIH HHS United States Journal Article Review 2017 07 06 England Stroke Vasc Neurol 101689996 2059-8696 basis science clinical