Topics in Stroke Rehabilitation

BACKGROUND: Most stroke survivors have ongoing deficits and report unmet needs. Despite evidence that rehabilitation improves stroke survivors' function, access to occupational and physical therapy is limited. Describing access to care for disadvantaged communities for different levels of stroke severity will provide proportions used to create Markov economic models to demonstrate the value of rehabilitation. OBJECTIVES: The objective of this study was to explore differences in the frequency of rehabilitation evaluations via outpatient therapy and home health for Medicare Part B ischemic stroke survivors in rural and socially disadvantaged locations...

OBJECTIVES: The aim of this study was to investigate the effect of hippotherapy simulator on balance, postural control, mobility, functional capacity and independence level in people with stroke. METHODS: This study involved 26 people with stroke aged 18-65, who were randomly assigned to a Hippotherapy Simulator Group (HSG; n  = 13) and a Conventional Exercise Group (CEG; n  = 13). Patients underwent assessments using the Berg Balance Scale (BBS), Postural Assessment Scale for Stroke (PAS-S), Timed Up and Go Test (TUG), Rivermead Mobility Index (RMI), 2-Minute Walking Test (2-MWT), and Barthel Daily Living Activity Index (BI) to evaluate balance, postural control, mobility, functional capacity, and independence before and after treatment...

BACKGROUND: People post-stroke experience increased loneliness, compared to their healthy peers and loneliness may have increased during COVID due to social distancing. How social distancing affected loneliness among people after stroke is unknown. Bandura's self-efficacy theory suggests that self-efficacy may be a critical component affecting individuals' emotions, behaviors, attitudes, and interpretation of everyday situations. Additionally, previous studies indicate that self-efficacy is associated with both loneliness and social participation...

BACKGROUND: The Patient-Reported Outcomes Measurement Information System® (PROMIS) Profile Computer Adaptive Testing (CAT) consists of seven CATs and one single item measuring most relevant aspects of health-related quality of life (HRQoL). The aim of our study was to determine construct validity and floor and ceiling effects of the PROMIS Profile CAT in Dutch people with stroke. METHODS: People with stroke receiving rehabilitation completed the PROMIS Profile CAT and the EuroQol-5 dimensions (EQ5D)...

BACKGROUND: determinants of access to rehabilitation professionals after stroke in middle-income countries, where the burden of this disease is higher, are little known. OBJECTIVES: To identify the determinants of access to rehabilitation professionals by individuals with stroke at one, three, and six months after hospital discharge in Brazil and compare referral and access rates after discharge. METHODS: Longitudinal and prospective study, with individuals with primary stroke, without previous disabilities...

BACKGROUND: Exercise after stroke has the potential to increase survivors' physical function and decrease disability. However, despite health professional reporting they recommend exercise to stroke survivors, the majority are physically inactive. Stroke survivors have previously expressed a lack of adequate knowledge and skills to engage in exercise. OBJECTIVES: The aim of this study was to understand why active stroke survivors chose to (re)engage in exercise and how they went about doing so...

OBJECTIVE: To evaluate the evidence of high-intensity locomotor training on outcomes related to gait and balance for patients with stroke in inpatient rehabilitation. METHODS: Four databases were searched (PubMed, CINAHL, Web of Science, and MedLINE) for articles published prior to 13 June 2023. Studies of adults (>18 years old) with a diagnosis of stroke who received a high-intensity locomotor intervention while admitted to an inpatient rehabilitation facility were included...

INTRODUCTION: Ecological momentary assessment (EMA) is a methodological approach to studying intraindividual variation over time. This study aimed to use EMA to determine the variability of cognition in individuals with chronic stroke, identify the latent classes of cognitive variability, and examine any differences in daily activities, social functioning, and neuropsychological performance between these latent classes. METHODS: Participants ( N  = 202) with mild-to-moderate stroke and over 3-month post-stroke completed a study protocol, including smartphone-based EMA and two lab visits...

INTRODUCTION: Balance assessments are an important component of rehabilitation. Considering the increasing use of telemedicine to meet rehabilitation needs, it is important to examine the feasibility of such assessments. This study aimed to examine the reliability and validity of the Tinetti Performance-Oriented Mobility Assessment Balance Subscale (POMA-B) when applied via synchronous and asynchronous tele-assessment. METHODS: Twenty-five patients with chronic stroke were included in the study...

BACKGROUND: Fatigue, a common problem following a stroke, can have negative effects on a person's daily life. There are no good interventions thus far for alleviating fatigue among those affected. OBJECTIVE: This review aimed to evaluate the effects of non-pharmacological interventions on fatigue among people with stroke. METHODS: A search was conducted for articles in seven databases, clinical trial registry, and backward and forward citations of included publications...

BACKGROUND: Unstable board intervention for patients with stroke improves sitting balance and trunk function. However, because patients with severe stroke are at high risk of falling, it is mostly adapted in mild cases. OBJECTIVE: We aimed to examine the effect of standing unstable board intervention for the non-paralyzed lower limbs on sitting balance in patients with hemiplegia. METHODS: The participants were 42 patients with stroke who were randomly assigned to a control or intervention group...

BACKGROUND: After stroke, the effects of focused scapulo-humeral training with simultaneous assessment of the changes in shoulder subluxation, related muscle thicknesses and upper limb performance have not been studied in the literature. OBJECTIVES: This study aimed to investigate the effects of an 8-week scapulo-humeral training program in addition to conventional rehabilitation on upper extremity/trunk functions, shoulder pain, and sonographic measurements of the shoulder joint and periscapular muscles...

BACKGROUND: The independent predictive power of fatigue for community integration has not been investigated, although there is an increasing amount of literature that recognizes the importance of fatigue in people with stroke. OBJECTIVES: To examine the correlation between community integration and fatigue, walking endurance, and fear of falling; and to quantify the relative contribution of fatigue to community integration in people with stroke. METHODS: This was a cross-sectional study with 75 community-dwelling people with stroke...

OBJECTIVE: To investigate the usefulness of inertial measurement units (IMUs) in the assessment of motor function of the upper limb (UL) in accordance with the international classification of functioning (ICF). DATA SOURCES: PubMed; Scopus; Embase; WoS and PEDro databases were searched from inception to 1 February 2022. METHODS: The current systematic review follows PRISMA recommendations. Articles including IMU assessment of UL in stroke individuals have been included and divided into four ICF categories (b710, b735, b760, d445)...

BACKGROUND: High-intensity Constraint-Induced Aphasia Therapy Plus (CIAT-Plus) and Multi-Modality Aphasia Therapy (M-MAT) are effective interventions for chronic post-stroke aphasia but challenging to provide in clinical practice. Providing these interventions may be more feasible at lower intensities, but comparative evidence is lacking. We therefore explored feasibility, acceptability, and preliminary efficacy of the treatments at a lower intensity. METHODS: A multisite, single-blinded, randomized Phase II trial was conducted within the Phase III COMPARE trial...

BACKGROUND: Little is known about the association between fatigue and physical activity in patients hospitalized with subacute stroke. OBJECTIVES: The aim of this study was to investigate the association between fatigue and physical activity in patients hospitalized with subacute stroke. METHODS: This cross-sectional study enrolled 244 consecutive patients with stroke who were admitted to a subacute rehabilitation ward at our hospital. We assessed fatigue with the Fatigue Assessment Scale (FAS) and used an accelerometer (Active style Pro HJA750-C, OMRON) to record the mean duration of sedentary behavior, light-intensity physical activity (LIPA), and moderate-to-vigorous-intensity physical activity (MVPA)...

BACKGROUND: People with communication differences are known to have poorer hospital outcomes than their peers. However, the combined impact of aphasia and cultural/linguistic differences on care and outcomes after stroke remains unknown. OBJECTIVES: To investigate the association between cultural/linguistic differences, defined as those requiring an interpreter, and the provision of acute evidence-based stroke care and in-hospital outcomes for people with aphasia...

BACKGROUND: Frailty in older individuals is an underappreciated condition that affects the incidence and/or prognosis of stroke. OBJECTIVES: We evaluated the prevalence of pre-onset frailty in patients with acute first-onset and recurrent strokes and association between pre-onset frailty and functional disability at hospital discharge. METHODS: This prospective cohort study included 210 acute stroke patients admitted to the Stroke Unit of Nippon Medical School Hospital during November 2021-June 2022...

BACKGROUND: Few studies have examined changes in skeletal muscle physiology post-stroke. This study examined changes in tissue oxygen saturation (StO2 ) of the vastus lateralis (VL) muscle of stroke survivors and age-matched control participants during maximal and submaximal isometric contractions of the knee extensor muscles. OBJECTIVES: We hypothesized that tissue oxygen desaturation (ΔStO2 ) during knee extensor muscle contractions would be less in the VL in the paretic vs...

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