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Topics in Stroke Rehabilitation

Katie L Meadmore, Emma Hallewell, Chris Freeman, Ann-Marie Hughes
BACKGROUND: Training of the upper limb (UL) is limited in stroke rehabilitation, and about 50% of stroke survivors do not regain useful function in their upper limb. OBJECTIVES: This study explored what factors affect rehabilitation and use of upper limb after stroke from a stroke survivor and healthcare professional perspective to better understand low engagement in UL rehabilitation in the chronic stages of stroke. METHOD: Eight chronic stroke survivors and 21 healthcare professionals took part in semi-structured interviews or in one of three focus groups, respectively...
November 13, 2018: Topics in Stroke Rehabilitation
Eric Johns, Carol Wamsley, Anne Whiting
BACKGROUND: Balance is a common mobility limitation following stroke, but determination of the most effective balance-related plan of care can be difficult due to multiple balance impairments that vary between individuals. The Brief-BESTest is a validated outcome measure for balance based on six systems of postural control. It may also be a useful tool to guide clinicians in their balance plan of care design. OBJECTIVE: The objective of this study was to determine the feasibility of a quantitative balance plan of care for patients with subacute stroke, using a novel algorithm that utilizes the scoring design of the Brief-BESTest...
November 10, 2018: Topics in Stroke Rehabilitation
Lizet Van Ewijk, Nicole Ter Wal, Gisella Okx, Paulien Goossens, Iris Groeneveld
BACKGROUND: The psychometric properties of the Dutch version of the Stroke and Aphasia Quality Of Life-scale (SAQOL-39NL) have previously been assessed for people with aphasia after stroke, but not yet for stroke survivors without aphasia. OBJECTIVE: The objective is to evaluate the psychometric properties of the SAQOL-39NL in a stroke sample with and without aphasia. METHODS: The SAQOL-39NL was administered to survivors of stroke (N = 141) who received rehabilitation in specialized rehabilitation facilities, 3 and 6 months after the start of rehabilitation...
October 31, 2018: Topics in Stroke Rehabilitation
Rodrigo Rodrigues Gomes Costa, Jefferson Rosa Cardoso, Clarice Bacelar Rezende, Gustavo Christofoletti, Rodrigo Luiz Carregaro
BACKGROUND: The functional hamstrings/quadriceps ratio (FH/Q) is useful to detect muscle imbalances after stroke. However, is necessary to investigate possible differences between men and women affected by stroke and controls. OBJECTIVES: To compare the FH/Q between men and women with stroke and matched controls. METHOD: Cross-sectional study. Fifty-six participants (10 men - MSTK and 18 women - WSTK with stroke; and 10 men - MCONT and 18 women - WCONT , matched controls) were recruited...
October 30, 2018: Topics in Stroke Rehabilitation
Chien-Chih Chen, Yu-Ching Tang, Miao-Ju Hsu, Sing-Kai Lo, Jau-Hong Lin
BACKGROUND: Neuromuscular electrical stimulation (NMES) and noxious thermal stimulation (NTS) have been developed and incorporated in stroke rehabilitation. OBJECTIVE: This study aimed to compare the effects of NMES, NTS, and the hybrid of NMES and NTS ("Hybrid") on motor recovery of upper extremity (UE) for patients with stroke. METHODS: We conducted a prospective, single-blind randomized controlled trial with concealed allocation...
October 27, 2018: Topics in Stroke Rehabilitation
Kazuaki Iokawa, Toshimasa Sone, Takaaki Fujita, Tetsu Tsukada, Mariko Kaneda, Keiichi Hasegawa
BACKGROUND: The factors necessary for successful use of chopsticks or a spoon, by patients with a paretic upper extremity (UE) following stroke are unknown. OBJECTIVES: We identified the functional capacities and interactions related to chopsticks or spoon use in patients with right hemiplegia following stroke. METHODS: Participants were 139 stroke patients with right hemiplegia who required rehabilitation, divided into the following three categories: able to use chopsticks, able to use a spoon, or unable to use a spoon...
October 24, 2018: Topics in Stroke Rehabilitation
Hiba Souissi, Raphael Zory, Julien Boudarham, Didier Pradon, Nicolas Roche, Pauline Gerus
BACKGROUND AND OBJECTIVE: Individuals who survive a stroke often display considerable gait impairments that occur in part due to inadequate muscle force production. This study aimed to investigate lower limb muscle forces in poststroke patients during walking. METHODS: Kinematics, kinetics, and electromyographic (EMG) measurements were performed on nine poststroke and healthy individuals walking at natural speed in a cross-sectional study. Recorded parameters were used in an EMG-driven model to estimate the forces exerted by the muscles around the knee and ankle joints during the stance (braking and propulsion) and swing phases...
October 24, 2018: Topics in Stroke Rehabilitation
Susanne G R Klotz, Corinna Petersen-Ewert, Gesche Ketels, Martin Scherer, Anne Barzel
BACKGROUND: Community ambulation is often affected after a stroke. However, no validated assessment in German to measure community ambulation on a participation level exists. OBJECTIVES: The purpose was to translate and cross-culturally adapt the Functional Walking Categories (FWC) into German and to assess its validity and reliability in patients with stroke. METHODS: Cross-cultural adaptation guidelines were used for translation. Face and content validity were established with the aid of an expert committee...
October 22, 2018: Topics in Stroke Rehabilitation
Heather M MacKenzie, Danielle Rice, Robert Teasell, Steven Macaluso
BACKGROUND: Post stroke depression (PSD) is common, and the transition home following discharge may be especially challenging for stroke survivors. OBJECTIVES: This study aimed to determine how well specific Canadian Best Practice Recommendations for PSD screening were adopted within a stroke rehabilitation outpatient clinic before and after the utilization of a standardized clinical form. METHODS: Practices were evaluated through retrospective chart review before and after the implementation of the standardized form which cued physicians to administer the Patient Health Questionnaire 9 (PHQ-9) at the first outpatient visit...
October 22, 2018: Topics in Stroke Rehabilitation
Maribeth Anne P Gelisanga, Edward James R Gorgon
BACKGROUND: Previous studies have distilled the Upright Motor Control Test Knee Extension and Knee Flexion subscales (UMCT-KE and UMCT-KF, respectively) from the original 6-item instrument and examined these as stand-alone rapid tests of voluntary movement control in the standing position. Systematic review evidence suggests that the UMCT-KE and UMCT-KF may have value in predicting walking ability after stroke. OBJECTIVE: To examine the interrater and intrarater reliability, and concurrent validity of the UMCT-KE and UMCT-KF, and associations with walking ability in adults with subacute stroke...
October 16, 2018: Topics in Stroke Rehabilitation
Marie-Eve Lamontagne, Carol Richards, Leila Azzaria, Mélany Rosa-Goulet, Louise Clément, France Pelletier
BACKGROUND: The unique perspectives of patients and caregivers on their experiences as users of rehabilitation services help identify areas for improvement for the continuum from acute care to community integration. OBJECTIVE: This study reports perceptions of persons with stroke and their caregivers in an existing continuum of stroke care, social services, and rehabilitation in the Province of Quebec. METHODS: A total of 10 focus groups were held, 5 with persons with stroke (n = 37, mean age 59...
October 15, 2018: Topics in Stroke Rehabilitation
Eunice Ho, Stephanie Hc Cheung, Michael Denton, Brian Dh Kim, Fraser Stephenson, Joyce Ching, Karl Boyle, Sandy Lyeo, Nancy M Salbach
BACKGROUND: Early mobilization (EM) post-stroke is recommended; however, the ideal timing and nature of EM, and factors that may influence EM practice are unclear. OBJECTIVES: The primary objective was to describe the type and extent of mobilization 0-48 h post-stroke admission to acute hospital care. A secondary objective was to evaluate whether pre-stroke functional level, stroke severity, tissue plasminogen activator (tPA) administration, and level of consciousness (LOC) predicted any passive, any active, and out-of-bed mobilization (i...
October 15, 2018: Topics in Stroke Rehabilitation
Sarah E Wallace, Elena V Donoso Brown, Anna Saylor, Erica Lapp
BACKGROUND: Upper extremity impairments post-stroke impact participation in valued occupations. Home programs are used to extend the frequency and amount of upper extremity practice for people post-stroke, but novel ways of increasing adherence to these programs is needed to ensure intense repetitive practice. OBJECTIVES: The purpose of this process evaluation, was to examine the perceptions of people with aphasia as it relates to modifications to home programs that could influence participation, specifically listening to music and aphasia-friendly adaptations of written materials...
October 8, 2018: Topics in Stroke Rehabilitation
Anna Fehér-Kiss, Edit Nagy, Andrea Domján, Katalin Jakab, János Kránicz, Gyöngyi Horváth
OBJECTIVES: Weight-bearing (WB) on the lower extremities is an important outcome parameter in the rehabilitation of poststroke hemiparesis. However, the patients often regain this ability by compensatory movement patterns. METHODS: Our goal was to characterize with a simple method the trunk alignment of healthy subjects and stroke patients (n = 17 for both groups) during standing and following lateral weight shift (WS). To describe trunk alignment, five markers were placed on the subjects' back, and the angles of the trunk at both sides were defined by the lines drawn from the posterior angle of the acromion and the iliac crest on the same body side to the seventh thoracic spinal process...
October 3, 2018: Topics in Stroke Rehabilitation
Bilal A Mateen, Karen Baker, E Diane Playford
BACKGROUND: Stroke is a leading cause of disability worldwide. The most common impairment resulting from stroke is upper-limb weakness. OBJECTIVES: To determine the usefulness and psychometric validity of the upper-limb subscale of the STREAM in an acute stroke population. METHODS: Rasch Analysis, including unidimensionality assumption testing, determining model fit, and analysis of: reliability, residual correlations, and differential item functioning...
October 3, 2018: Topics in Stroke Rehabilitation
Zainab Magdon-Ismail, Tatiana Ledneva, Mingzeng Sun, Lee H Schwamm, Barry Sherman, Feng Qian, Janet Prvu Bettger, Ying Xian, Joel Stein
OBJECTIVE: To evaluate factors associated with 1-year mortality after discharge for acute stroke. METHODS: In this retrospective cohort study, we studied 305 patients with ischemic stroke or intracerebral hemorrhage discharged in 2010/2011. We linked Get With The Guidelines®-Stroke clinical data with New York State administrative data and used multivariate regression models to examine variables related to 1-year all-cause mortality poststroke. RESULTS: The mean age was 68...
October 3, 2018: Topics in Stroke Rehabilitation
Kristina M Kelly, Alexandra L Borstad, David Kline, Lynne V Gauthier
BACKGROUND: Constraint-induced movement therapy (CI therapy) is one of few treatments for upper extremity (UE) hemiparesis that has been shown to result in motor recovery and improved quality of life in chronic stroke. However, the extent to which treatment-induced improvements in motor function versus daily use of the more affected arm independently contribute to improved quality of life remains largely unexplored. OBJECTIVE: The objective of this study is to identify whether motor function or daily use of a hemiparetic arm has a greater influence on quality of life after CI therapy...
September 22, 2018: Topics in Stroke Rehabilitation
L Tedesco Triccas, J H Burridge, A M Hughes, K L Meadmore, M Donovan-Hall, J C Rothwell, G Verheyden
Background Neurorehabilitation technologies used mainly in research such as robot therapy (RT) and transcranial direct current stimulation (tDCS) can promote upper limb motor recovery after stroke. Understanding the feasibility and efficacy of stroke rehabilitation technologies for upper limb impairments is crucial for effective implementation in practice. Small studies have explored views of RT by people with stroke; however experiences of people receiving tDCS in combination with RT have never been explored...
September 20, 2018: Topics in Stroke Rehabilitation
Fernanda Maria Faturi, Gabriela Lopes Santos, Gabriela Nagai Ocamoto, Thiago Luiz Russo
BACKGROUND: Stroke is a leading cause of disability in the adult population, impairing upper limb (UL) movements affecting activities of daily living. Muscle weakness has been associated to disabilities in this population, but much attention is given to central nervous system alterations and less to skeletal muscles. OBJECTIVE: The objective of this review is to carry out a systematic literature review to identify structural muscle alterations in the UL of poststroke individuals...
September 17, 2018: Topics in Stroke Rehabilitation
Stacey E Aaron, Chris M Gregory
BACKGROUND: Improvement in overground walking speed reduces dependency and is a central focus in post-stroke rehabilitation. Previous studies have shown that high-intensity interval training (HIT) can significantly improve functional and health-related outcomes in neurologically health individuals more so than traditional approaches. Emerging evidence suggests the same may be true post-stroke. OBJECTIVE: The purpose of this study was to assess the feasibility of a single session, novel HIT design...
September 17, 2018: Topics in Stroke Rehabilitation
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