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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
Evaluating the effectiveness of aquatic therapy on mobility, balance, and level of functional independence in strokerehabilitation: a systematic review and meta-analysis To meta-analyze and systematically review the effectiveness of aquatic therapy in improving mobility, balance, and functional independence after stroke.Articles published in Medline, Embase, CINAHL, PsycINFO, and Scopus up to 20 August 2019.Studies met the following inclusion criteria: (1) English, (2) adult stroke population
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
Moving strokerehabilitation evidence into practice: a systematic review of randomized controlled trials The aim of this study was to investigate the effectiveness of interventions aimed at moving research evidence into strokerehabilitation practice through changing the practice of clinicians.EMBASE, CINAHL, Cochrane and MEDLINE databases were searched from 1980 to April 2019. International trial registries and reference lists of included studies completed our search.Randomized controlled (...) trials that involved interventions aiming to change the practice of clinicians working in strokerehabilitation were included. Bias was evaluated using RevMan to generate a risk of bias table. Evidence quality was evaluated using GRADE criteria.A total of 16 trials were included (250 sites, 14,689 patients), evaluating a range of interventions including facilitation, audit and feedback, education and reminders. Of which, 11 studies included multicomponent interventions (using a combination
Robot-assisted therapy for balance function rehabilitation after stroke: A systematic review and meta-analysis To identify the rehabilitative effects of robot-assisted therapy on balance function among stroke patients.A systematic review and meta-analysis of randomized controlled trials.Thirteen electronic databases were systematically searched from inception to March 2018: Web of Science, PubMed, EMBase, The Cochrane Library, Science Direct, CINAHL, MEDLINE, AMED, Physiotherapy Evidence (...) Database, SPORTDiscus, WanFang Data, China National Knowledge Infrastructure and Chinese Scientific Journal Database.Randomized controlled trials were retrieved for identifying the effects of robot-assisted therapy on balance function among stroke patients. Two authors independently searched databases, screened studies, extracted data, and evaluated the methodological quality and risk bias of each included study. A standardized protocol and data-collection form were used to extract information. Effect
Group rehabilitation activities improve walking after stroke Group rehabilitation activities improve walking after stroke Discover Portal Discover Portal Group rehabilitation activities improve walking after stroke Published on 12 September 2017 doi: Group-based circuit class therapy (CCT) focused on repetitive mobility, and functional tasks improved walking ability in people after stroke. People walked on average 61m further during six minutes than those receiving comparison interventions. CCT (...) involves stroke survivors practising different activities at workstations in sight of each other. This Cochrane review identified 17 trials of group-based CCT, given at least weekly for four weeks, compared with other physical therapies or no intervention. Those receiving CCT showed clinically meaningful improvements in walking distance and speed, as well as independence and balance. Regular multidisciplinary team rehabilitation is a central component of post-stroke care. However, there are no specific
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
Action observation for upper limb rehabilitation after stroke. Action observation (AO) is a physical rehabilitation approach that facilitates the occurrence of neural plasticity through the activation of the mirror-neural system, promoting motor recovery in people with stroke.To assess whether action observation enhances motor function and upper limb motor performance and cortical activation in people with stroke.We searched the Cochrane Stroke Group Trials Register (last searched 4 September (...) 2017), the Central Register of Controlled Trials (24 October 2017), MEDLINE (1946 to 24 October 2017), Embase (1974 to 24 October 2017) and five additional databases. We also searched trial registries and reference lists.Randomized controlled trials (RCTs) of AO, alone or associated with physical practice in adults after stroke. The primary outcome was upper limb motor function. Secondary outcomes included dependence on activities of daily living (ADL), motor performance, cortical activation
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
Self-directed therapy programmes for arm rehabilitation after stroke: a systematic review To investigate the effectiveness of self-directed arm interventions in adult stroke survivors.A systematic review of Medline, EMBASE, CINAHL, SCOPUS and IEEE Xplore up to February 2018 was carried out. Studies of stroke arm interventions were included where more than 50% of the time spent in therapy was initiated and carried out by the participant. Quality of the evidence was assessed using the Cochrane (...) 0.21-0.82) but not at 0-3, 3-6 or 6-12 months.Self-directed interventions can enhance arm recovery after stroke but the effect varies according to the approach used and timing. There were benefits identified from self-directed delivery of constraint-induced movement therapy, electrical stimulation and therapy programmes that increase practice without using additional technology.
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