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Topics in Stroke Rehabilitation

Wouter J Harmsen, Gerard M Ribbers, Jorrit Slaman, Majanka H Heijenbrok-Kal, Ladbon Khajeh, Fop van Kooten, Sebastiaan J C M M Neggers, Rita J van den Berg-Emons
BACKGROUND: Peak oxygen uptake (VO2peak) established during progressive cardiopulmonary exercise testing (CPET) is the "gold-standard" for cardiorespiratory fitness. However, CPET measurements may be limited in patients with aneurysmal subarachnoid hemorrhage (a-SAH) by disease-related complaints, such as cardiovascular health-risks or anxiety. Furthermore, CPET with gas-exchange analyses require specialized knowledge and infrastructure with limited availability in most rehabilitation facilities...
December 5, 2016: Topics in Stroke Rehabilitation
Masashi Kanai, Masafumi Nozoe, Kazuhiro P Izawa, Yuka Takeuchi, Hiroki Kubo, Kyoshi Mase, Shinichi Shimada
BACKGROUND: Patients with acute stroke spend most of their hospital day inactive. However, a method to promote physical activity (PA) in stroke has not been established. OBJECTIVE: To evaluate the effectiveness of promoting PA by enhancing self-efficacy in hospitalized patients with mild ischemic stroke. DESIGN: Pre-post interventional study. METHODS: Hospitalized patients with mild ischemic stroke who could walk without assistance were recruited...
November 24, 2016: Topics in Stroke Rehabilitation
Kelvin Chan, Chetan P Phadke, Denise Stremler, Lynn Suter, Tim Pauley, Farooq Ismail, Chris Boulias
OBJECTIVE: Water-based exercises have been used in the rehabilitation of people with stroke, but little is known about the impact of this treatment on balance. This study examined the effect of water-based exercises compared to land-based exercises on the balance of people with sub-acute stroke. METHODS: In this single-blind randomized controlled study, 32 patients with first-time stroke discharged from inpatient rehabilitation at West Park Healthcare Centre were recruited...
November 3, 2016: Topics in Stroke Rehabilitation
Gisele Carla Dos Santos Palma, Tatiana Beline Freitas, Giordano Márcio Gatinho Bonuzzi, Marcos Antonio Arlindo Soares, Paulo Henrique Wong Leite, Natália Araújo Mazzini, Murilo Ruas Groschitz Almeida, José Eduardo Pompeu, Camila Torriani-Pasin
OBJECTIVE: This review determines the effects of virtual reality interventions for stroke subjects based on the International Classification of Functioning, Disability,and Health (ICF) framework. Virtual reality is a promising tool for therapy for stroke rehabilitation, but the effects of virtual reality interventions on post-stroke patients based on the specific ICF domains (Body Structures, Body Functions, Activity, and Participation) have not been investigated. METHOD: A systematic review was conducted, including trials with adults with a clinical diagnosis of a chronic, subacute, or acute stroke...
October 31, 2016: Topics in Stroke Rehabilitation
M Luz Sánchez-Sánchez, Maria-Arántzazu Ruescas-Nicolau, José-Antonio Pérez-Miralles, Elena Marqués-Sulé, Gemma-Victoria Espí-López
BACKGROUND: In chronic stroke, feasible physical therapy (PT) programs are needed to promote function throughout life. OBJECTIVE: This randomized controlled pilot trial investigated the feasibility and effect of a PT program composed of strengthening exercises with elastic bands and bimanual functional training, with clearly defined doses based on the rate of perceived exertion (Borg scale), to counteract inactivity in chronic stroke. METHODS: Fifteen subjects > 6 month post-stroke were randomized to three-month of UE function training (UE group), or to lower extremity function training (LE group)...
October 19, 2016: Topics in Stroke Rehabilitation
Dimitrios Theofanidis
BACKGROUND: Improving stroke outcomes by educating nurses in state-of-the-art stroke nursing skills is essential, but unfortunately, to date, there are limited validated stroke assessment scales for routine clinical and research use in Greece. OBJECTIVE: The aim of this paper is to validate and culturally adapt three internationally recognised stroke scales for use in Greece. METHODS: A critical appraisal of the international literature was undertaken to identify suitable scales to assess stroke impact: neurological, functional status and level of dependence...
September 29, 2016: Topics in Stroke Rehabilitation
Fumihiro Matsuda, Masahiko Mukaino, Kei Ohtsuka, Hiroki Tanikawa, Kazuhiro Tsuchiyama, Toshio Teranishi, Yoshikiyo Kanada, Hitoshi Kagaya, Eiichi Saitoh
BACKGROUND: The toe clearance of a paretic limb in the swing phase of gait is related to tripping, which is considered a major cause of falls. The biomechanical factors for obtaining toe clearance are more complicated in hemiparetic gait than that in normal gait because of the compensatory movements during swing phase. Understanding the biomechanical factors should help in targeting the point for rehabilitative interventions. OBJECTIVE: To clarify the biomechanical factors behind toe clearance during swing phase in hemiparetic gait...
September 27, 2016: Topics in Stroke Rehabilitation
V Prakash, Mohan Ganesan, R Vasanthan, K Hariohm
OBJECTIVES: In India, post-stroke outcomes are determined using functional outcome measures (FOMs), the contents of which have not been validated for their relevance to the Indian population. In this study, we aimed to evaluate the cultural validity of five frequently used stroke-specific FOMs by comparing their contents with the problems reported by patients with stroke in India. METHODS: Face-to-face structured interviews were conducted with 152 patients diagnosed with stroke in India...
September 27, 2016: Topics in Stroke Rehabilitation
Ashlee Dunn, Dianne L Marsden, Paulette Van Vliet, Neil J Spratt, Robin Callister
BACKGROUND: Most exercise interventions for stroke survivors are designed for those who have substantial motor and functional disabilities. There remains a group of well-recovered stroke survivors who have yet to be investigated in terms of their physical capacity and fitness levels. OBJECTIVE: To assess and compare the physical capacities of independently ambulant, community-dwelling stroke survivors to age- and gender-matched comparison participants. METHODS: Data were obtained from 17 stroke survivors participating in the How FITSS? Trial, all with functional ambulatory category of ≥4 and a self-selected walking speed ≥0...
September 27, 2016: Topics in Stroke Rehabilitation
Camila Caminha Caro, Paulo Vinicius Braga Mendes, Jacqueline Denubila Costa, Lauren Jane Nock, Daniel Marinho Cezar da Cruz
BACKGROUND: Stroke is a chronic disease responsible for changes in the functional capacity of the patients. Patient care is usually provided by family caregivers, but with great burden and negative impact on their quality of life. OBJECTIVES: (1) To investigate whether a correlation existed between the levels of independence and cognition in stroke patients and the burden and quality of life of their caregivers; (2) to assess whether periods of injury, rehabilitation and care, and age of the stroke patients interfered with these correlations...
September 19, 2016: Topics in Stroke Rehabilitation
Monica C Serra, Elizabeth Balraj, Beth L DiSanzo, Frederick M Ivey, Charlene E Hafer-Macko, Margarita S Treuth, Alice S Ryan
BACKGROUND: Accelerometers can objectively measure steps taken per day in individuals without gait deficits, but accelerometers also have the ability to estimate frequency, intensity, and duration of physical activity. However, thresholds to distinguish varying levels of activity intensity using the Actical brand accelerometer are standardized only for the general population and may underestimate intensity in stroke. OBJECTIVE: To derive Actical activity count thresholds specific to stroke disability for use in more accurately gauging time spent at differing activity levels...
January 2017: Topics in Stroke Rehabilitation
Jun-Fa Wu, Hai-Jue Wang, Yi Wu, Fang Li, Yu-Long Bai, Peng-Yu Zhang, Chetwyn C H Chan
BACKGROUND AND AIMS: Transcranial alternating current stimulation (tACS) offers another method of non-invasive brain stimulation in post-stroke rehabilitation. Because it is not known if tACS over bilateral mastoids (tACSbm) can promote the functional recovery in subacute post-stroke patients, we wish to learn the effect of tACSbm on improving neurological function and intracranial hemodynamics of subacute post-stroke patients. METHODS: Sixty subacute post-stroke patients (mean age: 65...
December 2016: Topics in Stroke Rehabilitation
Joanna Seniów, Katarzyna Polanowska, Marcin Leśniak, Anna Członkowska
BACKGROUND: Left-sided transcutaneous electrical nerve stimulation (TENS) increases right hemispheric activity, which may improve the rehabilitative outcome of hemispatial neglect. OBJECTIVE: To examine the behavioral effect of electrical stimulation of the nerve afferents of the left hand during early neuropsychological rehabilitation of post-stroke patients with hemispatial neglect. METHODS: This randomized, controlled, double-blind study included 29 patients (enrolled in the experimental or control group) with left hemispatial neglect after right hemispheric stroke...
December 2016: Topics in Stroke Rehabilitation
Gilles Hoffmann, Megan O Conrad, Dan Qiu, Derek G Kamper
BACKGROUND: Hemiparetic stroke survivors often exhibit profound weakness in the digits of the paretic hand, but the relative contribution of potential biomechanical and neurological impairment mechanisms is not known. Establishing sources of impairment would help in guiding treatment. OBJECTIVE: The present study sought to quantify the role of diminished capacity to voluntarily active finger flexor and extensor muscles as one possible neurological mechanism. METHODS: Two groups of stroke survivors with "severe" (N = 9) or "moderate" (N = 9) hand impairment and one group of neurologically intact individuals (N = 9) participated...
December 2016: Topics in Stroke Rehabilitation
Ruth E Taylor-Piliae, M Jane Mohler, Bijan Najafi, Bruce M Coull
BACKGROUND: Stroke survivors often have persistent neural deficits related to motor function and sensation, which increase their risk of falling, most of which occurs at home or in community settings. The use of wearable technology to monitor fall risk and gait in stroke survivors may prove useful in enhancing recovery and/or preventing injuries. OBJECTIVE: Determine the feasibility of using wearable technology (PAMSys™) to objectively monitor fall risk and gait in home and community settings in stroke survivors...
December 2016: Topics in Stroke Rehabilitation
Keng-He Kong, Yong-Joo Loh, Ernest Thia, Audrey Chai, Chwee-Yin Ng, Yan-Ming Soh, Shirlene Toh, Soon-Yin Tjan
OBJECTIVE: To compare the efficacy of a virtual reality commercial gaming device, Nintendo wii (NW) with conventional therapy and customary care in facilitating upper limb recovery after stroke. DESIGN: Randomized, controlled, single-blinded study. SETTING: Tertiary rehabilitation center. PARTICIPANTS: 105 subjects admitted to in inpatient rehabilitation program within 6 weeks of stroke onset. INTERVENTIONS: Subjects were randomly assigned to one of three groups of upper limb exercises: (1) NW gaming; (2) conventional therapy; (3) control...
October 2016: Topics in Stroke Rehabilitation
Eun-Ju Kuk, Jong-Man Kim, Duck-Won Oh, Han-Jeong Hwang
BACKGROUND: Previous reports have suggested that action observation training (AOT) is beneficial in enhancing the early learning of new motor tasks; however, EEG-based investigation has received little attention for AOT. OBJECTIVE: The purpose of this study was to illustrate the effects of AOT on hand dexterity and cortical activation in patients with post-stroke hemiparesis. METHOD: Twenty patients with post-stroke hemiparesis were randomly divided into either the experimental group (EG) or control group (CG), with 10 patients in each group...
October 2016: Topics in Stroke Rehabilitation
Stephen L Parsons, Avril Mansfield, Elizabeth L Inness, Kara K Patterson
OBJECTIVES: Stroke rehabilitation best practices recommend interventions to address individual deficits, guided by a comprehensive assessment to identify specific impairments. The relationship of motor impairments to balance has been well investigated, but the role of impaired plantar cutaneous sensation is less understood, despite the fact that 41% of individuals post-stroke have this deficit. The study objectives were to (1) characterize the relationship between plantar sensation and measures of standing balance control and (2) determine the threshold of sensory impairment related to balance impairment post-stroke...
October 2016: Topics in Stroke Rehabilitation
Hiroki Tanikawa, Kei Ohtsuka, Masahiko Mukaino, Keisuke Inagaki, Fumihiro Matsuda, Toshio Teranishi, Yoshikiyo Kanada, Hitoshi Kagaya, Eiichi Saitoh
BACKGROUND: Gait assessment is important to determine the most effective strategy to regain gait function during stroke rehabilitation. To understand the mechanisms that cause abnormal gait patterns, it is useful to objectively identify and quantify the abnormal gait patterns. Objective assessment also helps evaluate the efficacy of treatments and can be used to provide suggestions for treatment. OBJECTIVE: To evaluate the validity of quantitative indices for retropulsion of the hip, excessive hip external rotation, and excessive lateral shift of the trunk over the unaffected side in hemiplegic patients...
October 2016: Topics in Stroke Rehabilitation
Karen Salter, Amie Musovic, Nicholas F Taylor
BACKGROUND Progressive resistance training (PRT) can improve strength and function in people with chronic stroke, but less is known about whether this intervention is safe and beneficial during the first 3 months following stroke. OBJECTIVE To systematically review the evidence about the safety and effectiveness of PRT to improve activity in people within the first 3 months after stroke. METHODS After database searching and selection of studies a risk of bias assessment was conducted. Data for the primary outcome of safety was synthesised descriptively and meta-analyses for other outcomes were conducted using a random effects model...
October 2016: Topics in Stroke Rehabilitation
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