Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Wednesday, August 21, 2019

Motor imagery and stroke rehabilitation: a critical discussion

So 9 pages of discussion resulting in absolutely NO PROTOCOLS. Useless. Although you can look up the one use of the word protocol if you want. 

Motor imagery and stroke rehabilitation: a critical discussion


Motor disorders are a frequent consequence of stroke and much effort is invested in the re-acquisition of motor control. Although patients often regain some of their lost function after therapy, most remain chronically disabled. Functional recovery is achieved largely through reorganization processes in the damaged brain. Neural reorganization depends on the information provided by sensorimotor efferent-afferent feedback loops. it has, however, been shown that the motor system can also be activated ”offline” by imagining (motor imagery) or observing movements. the discovery of mirror neurones, which fire not only when an action is executed, but also when one observes another person performing the same action, also show that our action system can be used ”online” as well as offline. It is an intriguing question as to whether the information provided by motor imagery or motor observation can lead to functional recovery and plastic changes in patients after stroke. this article reviews the evidence for motor imagery or observation as novel methods in stroke rehabilitation. Key words: motor imagery, mirror neurones, rehabilitation, stroke.

J Rehabil Med 2007; 39: 5–13 Correspondence address: Sjoerd de Vries, Centre for Human Movement Sciences, University Medical Center Groningen, University of Groningen, PO Box 196, NL-9700 AD Groningen, The Netherlands. E-mail: s.j.de.vries@rug.nl Submitted August 24, 2006; accepted October 31, 2006

Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS)


You will have see if something in these 57 pages approaches a protocol and then check to see if your therapist has the capability to do it.  You could waste your time asking your doctor and therapists to read and implement this.

Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS)

abstract

A group of European experts was commissioned to establish guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS) from evidence published up until March 2014, regarding pain, movement disorders, stroke, amyotrophic lateral sclerosis, multiple sclerosis, epilepsy, consciousness disorders, tinnitus, depression, anxiety disorders, obsessive-compulsive disorder, schizophrenia, craving/addiction, and conversion. Despite unavoidable inhomogeneities, there is a sufficient body of evidence to accept with level A (definite efficacy) the analgesic effect of high-frequency (HF) rTMS of the primary motor cortex (M1) contralateral to the pain and the antidepressant effect of HF-rTMS of the left dorsolateral prefrontal cortex (DLPFC). A Level B recommendation (probable efficacy) is proposed for the antidepressant effect of low-frequency (LF) rTMS of the right DLPFC, HF-rTMS of the left DLPFC for the negative symptoms of schizophrenia, and LF-rTMS of contralesional M1 in chronic motor stroke. The effects of rTMS in a number of indications reach level C (possible efficacy), including LF-rTMS of the left temporoparietal cortex in tinnitus and auditory hallucinations. It remains to determine how to optimize rTMS protocols and techniques to give them relevance in routine clinical practice. In addition, professionals carrying out rTMS protocols should undergo rigorous training to ensure the quality of the technical realization, guarantee the proper care of patients, and maximize the chances of success. Under these conditions, the therapeutic use of rTMS should be able to develop in the coming years. 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Clipping affected hand fingernails, approaching failure

I clip my good hand by placing the toenail clipper on the bathroom countertop, insert fingernail and use my chin to push the handle down and clip the nail. So far minimal cutting into flesh. 

The affected hand is much harder, my wrist spasticity turns the hand/fingers down and away from my sight. This results in flesh being cut quite a few times. So far I haven't had to carry a clipper along with me and ask bar patrons to cut my fingernails, it would be well worth the cost of a beer. I do get a pedicure for my toenails every three months, maybe manicure?

The Neurobiology of Resilience Psychological Resilience is an Active, Distinct Neurobiological Process

You will need this since your doctor will completely fail you in providing any protocols that lead to any form of recovery. You are completely on your own to find other survivors who have found things that work. Not me, I can't get past my spasticity, I'm great at compensation and taking risks, not so good at recovery.

Resilience should never be necessary. If necessary, your doctor has completely failed you in getting you to 100% recovery. 

 

The Neurobiology of Resilience 



by Brenda Patoine
August 07, 2019


Resilience Briefing
Credit: Shutterstock
What makes one person more resilient to stress than another? How do some people seemingly take even extreme stress in stride while others succumb to depression or anxiety disorders when faced with trauma or tragedy? Could differences in brain structure or function explain it?
These questions have been asked by social scientists for decades, and a fairly comprehensive description has emerged of the kinds of emotional and behavioral characteristics that tend to describe a “stress-resilient” person–optimism, a strong social support system, an ability to find purpose in life, or a grounding in faith or spirituality, for example. A “glass-half-full” kind of person, in popular vernacular.
More recently, neuroscience has begun to tackle the question of what resilience looks like in the brain. The hope is that understanding the neurobiological mechanisms that contribute to resilience in humans will lead to better-targeted, more potent interventions. While treatment breakthroughs have been elusive, recent work has begun to shed light on what makes a brain resilient.
Eric Nestler, M.D., Ph.D., professor and chair of neuroscience at the Icahn School of Medicine at Mount Sinai and a member of the Dana Alliance for Brain Initiatives, has made the study of resilience a primary focus of his neuroscience research. “The question of what drives resilience neurobiologically or genetically has been really hard to get any kind of a handle on,” he says.
That’s beginning to change, albeit incrementally. One surprising finding of recent work is that contrary to what one might expect, resilient brains don’t look very different than vulnerable ones, at least on a whole-brain level. In 2016, Martin Teicher, M.D., Ph.D., and colleagues at Harvard Medical School/McLean Hospital reviewed some 30 imaging studies examining people who were abused as children, to identify differences in the brains of those who went on to develop psychological pathology versus those who did not, and found remarkably similar network architecture (that is, overall neural connectivity) in both groups. The finding was unexpected, and contrary to their hypothesis.
Digging deeper to try to understand this puzzling result, Teicher’s group used diffusion tensor imaging, which measures white matter integrity, to analyze structural connectivity in 192 young adults who had been maltreated as children, along with a large group of age-matched controls who had not been maltreated. These latest findings, reported in April 2019, showed reduced connectivity across the brains of resilient individuals compared to individuals with a history of psychological disorders. The most prominent changes were in the amygdala, a region strongly linked to fear learning, and suggested a sort of isolating of this key area for emotional reactions.
Hugh Garavan, Ph.D., a psychiatrist at the University of Vermont who wrote an invited commentary on the research, said in an interview that the work underscores the idea that “there are specific markers for resilience that are over and above the markers for maltreatment.” Resilience, he says, is a separate and distinct entity.
These kinds of data suggest a fundamental rethinking of resilience, Garavan says. “There has always been this implicit assumption that if you understand the disease and its cause, that resilient animals will probably have less of whatever goes wrong. I think the literature on resilience suggests that is not the case. Rather, some people have additional resources to combat disease, which we don’t understand.”
In light of this, he argues that therapeutic development needs to go beyond “just finding out what’s wrong in maltreatment and changing that, but should instead work to promote the resilience element.”
Stress Vulnerability as a ‘Failure of Plasticity’

The findings fit with the idea of resilience as an active progression of events. “The most important and interesting principle is that resilience is not a passive process,” Nestler says. He points to mouse studies that have examined the “social-defeat model,” in which animal are exposed over time to severe stress, resulting in a well-characterized syndrome of behaviors deemed comparable to depression in humans. Yet, about a third of the mice exhibit natural resilience.
“It’s not that the mice that are resilient simply don’t show the bad effects of stress that are seen in susceptible mice; some of those changes are seen,” he says. “But by far the most predominant phenomenon is that the resilient mice show a whole additional set of changes that help the animal cope with stress.”
Nestler conceptualizes the vulnerability to stress in susceptible mice as a “failure of plasticity.” Vulnerable individuals, mouse or human, suffer the consequences of a brain that has changed in response to stress or trauma but which, for reasons yet unknown, is unable to continue to adapt in ways that compensate for those damaging alterations. Put another way, they get the “bad” side of plasticity–stress-induced adaptations–but not the “good” side–compensatory adaptations. This leaves them stuck in a disordered psychological state.
A 2014 paper published in Science by Ming-Hu Han, Ph.D., and colleagues is a beautiful example of “active” resilience from a genetic perspective. Han, an assistant professor in pharmacology and systems therapeutics at Mount Sinai’s Icahn School, found in earlier work using the social-defeat model that global gene expression was vastly different in resilient vs. susceptible mice. For every 100 genes that changed in stress-susceptible mice, either up or down, 300 genes changed in resilient mice.
“This was a very interesting finding because it means that resilient animals are not actually insensitive to stress, but rather are actively using more genes during stress,” says Han.
Han and his team embarked on an investigative mission to hunt down the cause of these dramatic gene effects, eventually zeroing in on a particular ion channel, the Ih channel. Activity in the channel was markedly increased in susceptible mice but, to the researchers’ surprise, even more greatly increased in resilient mice. They went on to pinpoint a potassium channel that mediates the Ih channel’s increased activity in resilient animals only. This work suggests a clear neurobiological mechanism underlying resilience and elegantly demonstrates the active nature of resilience at the molecular level.
The finding attracted the attention of then-NIMH Director Thomas R. Insel, M.D., who in a statementhighlighted its potential to “hold clues to future antidepressants that would act through this counterintuitive resilience mechanism.”
Han’s group also showed that lamotrigine, a drug used to treat depressive episodes in bipolar disorder, increased Ih channel activity in stress-susceptible animals, effectively rendering them resilient. But there was a catch: before things got better, they got worse. Since depression already carries a risk of suicide, pushing patients into a physiological state that may represent more intense depression could carry an unacceptable risk, making lamotrigine an untenable treatment. Still, there was proof of concept.
A New Direction for Drug Discovery in Psychiatry?
Han’s findings have already informed drug-discovery efforts in psychiatric illness. Nestler’s team has identified a compound, cilopradine, that blocks the Ih channel and has shown promise in an animal model of depression. Nestler hopes to procure and clinically test the drug, a proprietary chemical that was previously studied in cardiovascular disease but abandoned by its manufacturer.
This approach is in line with a clinical effort currently underway with a different type of drug, a potassium channel blocker called ezogabine, which has shown promise in an open-label pilot study in people with depression. Ezogabine was identified as part of a large NIH-funded effort that screened chemical libraries of existing drugs to discover candidate molecules with specific actions and evaluate them in laboratory and animal models as a possible precursor to human clinical trials. The pilot trial published last year is the culmination of work dating back to 2007, when Nestler’s group showed in animal studies that a prominent mechanism of natural resilience is the induction of a potassium channel subtype in the ventral striatum, a brain area linked to reward processing.
The story of ezogabine demonstrates what a long, slow road drug discovery is, and how resilience research has the potential to take it in a new direction. “Most efforts in drug development for depression in the last half century have focused on looking for ways to undo the bad effects of stress,” says Nestler. “But based on what we’ve learned, maybe a better way is to look for new ways to induce resilience.”
Until such drugs are developed, behavioral therapies try to fill the gaps in therapy. In depression, cognitive behavioral therapy–a form of talk therapy conducted in concert with a trained psychotherapist–has been shown to be as effective as antidepressant medications in most patients. In post-traumatic stress disorder (PTSD), the gold standards of treatment are behavioral interventions: prolonged exposure therapy, in which survivors repeatedly re-experience their traumatic event in safe environments, and cognitive processing therapy, a talk therapy focused on challenging and modifying maladaptive beliefs related to the trauma.
Kathleen Chard, Ph.D., a Veteran’s Administration researcher and professor of psychiatry and behavioral neuroscience at the University of Cincinnati, is leading a large, multisite VA-funded study to try to determine which of these therapies works best in which people, an outstanding question that has hampered best practices. The study has just been completed and data are currently being analyzed.
As director of the Trauma Recovery Center at the Cincinnati VA Medical Center, Chard is interested in understanding which enlisted men and women are more susceptible to having a traumatic response to military service, and ensuring that those who are exposed to trauma get the right treatment to help prevent a downward cascade into chronic psychopathology. The “right” treatment might be different based on one’s genetic make-up and various interpersonal characteristics that seem to be linked to PTSD, such as temperament, the culture in which one is raised, and the environment that one is in after trauma occurs, she says.
“I think we have to be very cautious to adopt resiliency protocols that are actually proven to be effective in the area that we’re using them,” Chard says. “I don’t know that we can say that a resiliency protocol that’s good for high school students is good for police officers. We need to think about resilience as not being one size fits all.”
Updated April 2019; Originally Published July 2014

 

Effects of kinesio taping for stroke patients with hemiplegic shoulder pain: A double-blind, randomized, placebo-controlled study

I had kinesio taping for my upper arm, don't know if it helped at all.  Then there is this from 2006.

Kinesio taping in stroke: improving functional use of the upper extremity in hemiplegia

And this from May 2019;

Systematic Review on Effectiveness of shoulder taping in Hemiplegia

 

The latest here:

Effects of kinesio taping for stroke patients with hemiplegic shoulder pain: A double-blind, randomized, placebo-controlled study

Journal of Rehabilitation Medicine (formerly the Scandinavian Journal of Rehabilitation Medicine) , Volume 49(3) , Pgs. 208-215.

NARIC Accession Number: J81397.  What's this?
ISSN: 1650-1977.
Author(s): Huang, Yen-Chang; Chang, Kwang-Hwa; Liou, Tsan-Hon; Cheng, Chau-Wei; Lin, Li-Fong; Huang, Shih-Wei.
Publication Year: 2017.
Number of Pages: 8.
Abstract: Study investigated the effects of Kinesio taping for 21 stroke patients with hemiplegic shoulder pain within 6 months of stroke onset in the rehabilitation ward of a medical university hospital in Taiwan. Participants were randomly assigned to 2 groups: a therapeutic Kinesio taping group and a control group. A 3-week intervention involving a conventional rehabilitation protocol and therapeutic Kinesio taping was conducted with an experimental group of 11 stroke patients. The control group of 10 stroke patients underwent an identical conventional rehabilitation program and sham Kinesio taping on the hemiplegic shoulder. Numerical rating scale scores, the Shoulder Pain and Disability Index (SPADI), ultrasound findings, and pain-free passive range of motion (PROM) of the affected shoulder, were evaluated before and after the intervention. Mann-Whitney test was used to compare within-group continuous variables before and after the intervention. Wilcoxon signed-rank test was used to analyze the differences and changes in values between study and control groups. There was no statistical difference in demographic variables between the 2 groups. Both groups showed improvement in PROM of the shoulder and mean SPADI score after the intervention; however, no significant between-group differences were observed in the numerical rating scale score, pain-free PROM, and ultrasound findings for the shoulder after 3 weeks of treatment. Concerning the variables changes, the therapeutic Kinesio taping group showed more improvement in the numerical rating scale, shoulder flexion, external rotation, internal rotation, and the SPADI than the sham Kinesio taping group.
Descriptor Terms: DEVICES, HEMIPLEGIA, JOINTS, PAIN, PHYSICAL MEDICINE, STROKE.


Can this document be ordered through NARIC's document delivery service*?: Y.
Get this Document: https://www.medicaljournals.se/jrm/content/abstract/10.2340/16501977-2197.

Citation: Huang, Yen-Chang, Chang, Kwang-Hwa, Liou, Tsan-Hon, Cheng, Chau-Wei, Lin, Li-Fong, Huang, Shih-Wei. (2017). Effects of kinesio taping for stroke patients with hemiplegic shoulder pain: A double-blind, randomized, placebo-controlled study.  Journal of Rehabilitation Medicine (formerly the Scandinavian Journal of Rehabilitation Medicine) , 49(3), Pgs. 208-215. Retrieved 8/20/2019, from REHABDATA database.

Tuesday, August 20, 2019

Association of Lifestyle and Genetic Risk With Incidence of Dementia

You will need this, so DEMAND your doctor give you protocols to prevent dementia.  You get to guess what a favorable lifestyle is or read the full text.

Your chances of getting dementia.

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.

2. Then this study came out and seems to have a range from 17-66%. December 2013.

3. A 20% chance in this research.   July 2013. 

4. Dementia Risk Doubled in Patients Following Stroke September 2018  

5. Parkinson’s Disease May Have Link to Stroke March 2017

 

Association of Lifestyle and Genetic Risk With Incidence of Dementia

JAMA. 2019;322(5):430-437. doi:10.1001/jama.2019.9879
Key PointsQuestion  Is a healthy lifestyle associated with lower risk of dementia, regardless of genetic risk?
Findings  In this retrospective cohort study that included 196 383 participants of European ancestry aged at least 60 years without dementia at baseline, participants with a high genetic risk and unfavorable lifestyle score had a statistically significant hazard ratio for incident all-cause dementia of 2.83 compared with participants with a low genetic risk and favorable lifestyle score. A favorable lifestyle was associated with a lower risk of dementia and there was no significant interaction between genetic risk and healthy lifestyle.
Meaning  A healthy lifestyle was associated with lower risk of dementia among participants with low or high genetic risk.

Abstract

Importance  Genetic factors increase risk of dementia, but the extent to which this can be offset by lifestyle factors is unknown.
Objective  To investigate whether a healthy lifestyle is associated with lower risk of dementia regardless of genetic risk.
Design, Setting, and Participants  A retrospective cohort study that included adults of European ancestry aged at least 60 years without cognitive impairment or dementia at baseline. Participants joined the UK Biobank study from 2006 to 2010 and were followed up until 2016 or 2017.
Exposures  A polygenic risk score for dementia with low (lowest quintile), intermediate (quintiles 2 to 4), and high (highest quintile) risk categories and a weighted healthy lifestyle score, including no current smoking, regular physical activity, healthy diet, and moderate alcohol consumption, categorized into favorable, intermediate, and unfavorable lifestyles.
Main Outcomes and Measures  Incident all-cause dementia, ascertained through hospital inpatient and death records.
Results  A total of 196 383 individuals (mean [SD] age, 64.1 [2.9] years; 52.7% were women) were followed up for 1 545 433 person-years (median [interquartile range] follow-up, 8.0 [7.4-8.6] years). Overall, 68.1% of participants followed a favorable lifestyle, 23.6% followed an intermediate lifestyle, and 8.2% followed an unfavorable lifestyle. Twenty percent had high polygenic risk scores, 60% had intermediate risk scores, and 20% had low risk scores. Of the participants with high genetic risk, 1.23% (95% CI, 1.13%-1.35%) developed dementia compared with 0.63% (95% CI, 0.56%-0.71%) of the participants with low genetic risk (adjusted hazard ratio, 1.91 [95% CI, 1.64-2.23]). Of the participants with a high genetic risk and unfavorable lifestyle, 1.78% (95% CI, 1.38%-2.28%) developed dementia compared with 0.56% (95% CI, 0.48%-0.66%) of participants with low genetic risk and favorable lifestyle (hazard ratio, 2.83 [95% CI, 2.09-3.83]). There was no significant interaction between genetic risk and lifestyle factors (P = .99). Among participants with high genetic risk, 1.13% (95% CI, 1.01%-1.26%) of those with a favorable lifestyle developed dementia compared with 1.78% (95% CI, 1.38%-2.28%) with an unfavorable lifestyle (hazard ratio, 0.68 [95% CI, 0.51-0.90]).
Conclusions and Relevance  Among older adults without cognitive impairment or dementia, both an unfavorable lifestyle and high genetic risk were significantly associated with higher dementia risk. A favorable lifestyle was associated with a lower dementia risk among participants with high genetic risk.

Training and orthotic effects related to functional electrical stimulation of the peroneal nerve in stroke

I see no written protocol, so useless for other survivors. With no objective starting point none of this is repeatable. 

 

Training and orthotic effects related to functional electrical stimulation of the peroneal nerve in stroke

Journal of Rehabilitation Medicine (formerly the Scandinavian Journal of Rehabilitation Medicine) , Volume 49(2) , Pgs. 113-119.

NARIC Accession Number: J81387.  What's this?
ISSN: 1650-1977.
Author(s): Street, Tamsyn; Swain, Ian; Taylor, Paul.
Publication Year: 2017.
Number of Pages: 7.
Abstract: Study examined the evidence for a training effect of functional electrical stimulation (FES) on the lower limb in 104 patients more than six month post stroke. An “orthotic effect” describes the immediate improvement in walking observed with FES compared with that without FES. A “training or therapeutic effect” describes a long-term improvement in walking without the FES after using FES for several weeks. Training and orthotic effects were determined from walking speed over 10 meters, associated minimal (>0.05 meters per second [m/s]) and substantial (>0.10 m/s) clinically important differences, and Functional Ambulation Category (FAC), ranging from household walking to independent walking in the community. An overall significant training effect was found that was not a clinically important difference (0.02 m/s); however, "community" FAC (≥ 0.8 m/s) and "most limited community walkers" FAC (0.4-0.58 m/s), but not "household walkers" (< 0.4 m/s), benefitted from a clinically important difference. A highly significant, substantial clinically important orthotic effect (0.10 m/s) was found. In terms of overall improvement of one or more FACs, 23 percent achieved this due to a training effect, compared with 43 percent due to an orthotic effect. The findings suggest that FES provides a training effect in those who are less impaired. Further work, which optimizes the use of the device for restoration of function, rather than as an orthotic device, will provide greater clarity on the effectiveness of FES for eliciting a training effect.
Descriptor Terms: AMBULATION, ELECTRICAL STIMULATION, MOBILITY IMPAIRMENTS, NERVES, OUTCOMES, STROKE, THERAPEUTIC TRAINING.


Can this document be ordered through NARIC's document delivery service*?: Y.
Get this Document: https://www.medicaljournals.se/jrm/content/abstract/10.2340/16501977-2181.

Citation: Street, Tamsyn, Swain, Ian, Taylor, Paul. (2017). Training and orthotic effects related to functional electrical stimulation of the peroneal nerve in stroke.  Journal of Rehabilitation Medicine (formerly the Scandinavian Journal of Rehabilitation Medicine) , 49(2), Pgs. 113-119. Retrieved 8/20/2019, from REHABDATA database.

Clinical feasibility of Xbox Kinect™ training for stroke rehabilitation: A single-blind randomized controlled pilot study

You mean all this earlier research was not enough to write stroke protocols on this? That you had to do your own research?

  • Kinect (33 posts back to June 2012)
  • Xbox (5 posts back to June 2012)

 

Clinical feasibility of Xbox Kinect™ training for stroke rehabilitation: A single-blind randomized controlled pilot study

Journal of Rehabilitation Medicine (formerly the Scandinavian Journal of Rehabilitation Medicine) , Volume 49(1) , Pgs. 22-29.

NARIC Accession Number: J81377.  What's this?
ISSN: 1650-1977.
Author(s): Turkbey, Tuba A.; Kutlay, Sehim; Gok, Haydar.
Publication Year: 2017.
Number of Pages: 8.
Abstract: Study evaluated the feasibility and safety of Xbox Kinect™ training of the upper extremity in subacute stroke rehabilitation. Twenty patients with stroke were randomly assigned to 2 groups: the control group received conventional therapy and the experimental group received additional Xbox Kinect training for 20 sessions. Feasibility and safety were evaluated by treatment attendance rate, patient feedback, proportion of adverse events, and the Borg Scale (Borg CR10). Data for 19 patients were analyzed. The treatment attendance ratio for total training time and training time/session was 87 percent and 90 percent, respectively. All participants reported that training with the Xbox Kinect was enjoyable and beneficial. No serious adverse events occurred. Fatigue was the most common adverse event. The mean Borg CR10 score was 7.80, reflecting a very high level of fatigue. The experimental group showed significantly greater improvement than the control group in the Box and Blocks Test, Wolf Motor Function Test, and Brunnstrom motor recovery stages. Xbox Kinect training appears feasible and safe in upper extremity rehabilitation after stroke. It could enhance motor and functional recovery of the affected upper extremity as an adjunctive method.
Descriptor Terms: COMPUTER APPLICATIONS, DEXTERITY, FEASIBILITY STUDIES, LIMBS, MOTOR SKILLS, REHABILITATION TECHNOLOGY, SAFETY, STROKE, THERAPEUTIC TRAINING.


Can this document be ordered through NARIC's document delivery service*?: Y.
Get this Document: https://www.medicaljournals.se/jrm/content/abstract/10.2340/16501977-2183.

Citation: Turkbey, Tuba A., Kutlay, Sehim, Gok, Haydar. (2017). Clinical feasibility of Xbox Kinect™ training for stroke rehabilitation: A single-blind randomized controlled pilot study.  Journal of Rehabilitation Medicine (formerly the Scandinavian Journal of Rehabilitation Medicine) , 49(1), Pgs. 22-29. Retrieved 8/20/2019, from REHABDATA database.

End-point kinematics using virtual reality explaining upper limb impairment and activity capacity in stroke

No fucking clue what this could be used for. 

End-point kinematics using virtual reality explaining upper limb impairment and activity capacity in stroke

Journal of NeuroEngineering and Rehabilitation , Volume 16(82)

NARIC Accession Number: J81350.  What's this?
ISSN: 1743-0003.
Author(s): Hussain, Netha; Sunnerhagen, Katharina S.; Murphy, Margit A..
Publication Year: 2019.
Number of Pages: 9.
Abstract: Study examined the extent to which end-point kinematic variables obtained from the target-to-target pointing task were associated with upper-limb impairment or activity limitation as assessed by traditional clinical scales in individuals with stroke. Sixty-four individuals, from acute stage up to one year after stroke, performed a target-to-target pointing task in a virtual environment using a haptic stylus which also captured the kinematic parameters. Multiple linear regression was performed to determine the amount of variance explained by kinematic variables on Fugl-Meyer Assessment of Upper Extremity (FMA-UE) and Action Research Arm Test (ARAT) scores after controlling for confounding variables. Mean velocity and number of velocity peaks explained 11 percent and 9 percent of the FMA-UE score uniquely, and 16 percent when taken together. Movement time and number of velocity peaks explained 13 percent and 10 percent of the ARAT score, respectively. The kinematic variables of movement time, velocity, and smoothness explain only a part of the variance captured by using clinical observational scales, reinforcing the importance of multi-level assessment using both kinematic analysis and clinical scales in upper-limb evaluation after stroke.
Descriptor Terms: BIOENGINEERING, BODY MOVEMENT, COMPUTER APPLICATIONS, LIMBS, MEASUREMENTS, MOBILITY, MOTOR SKILLS, OUTCOMES, PERFORMANCE STANDARDS, STROKE.


Can this document be ordered through NARIC's document delivery service*?: Y.
Get this Document: https://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-019-0551-7.

Citation: Hussain, Netha, Sunnerhagen, Katharina S., Murphy, Margit A.. (2019). End-point kinematics using virtual reality explaining upper limb impairment and activity capacity in stroke.  Journal of NeuroEngineering and Rehabilitation , 16(82) Retrieved 8/20/2019, from REHABDATA database.

What is the impact of user affect on motor learning in virtual environments after stroke? A scoping review

If your stroke protocol said you had to do 1 million repetitions to get this result you would be motivated to do them. Right now with NO PROTOCOLS, everything in stroke is a total guess. No one knows anything about how to get you recovered. Everything is a wild guess and shot in the dark. 

What is the impact of user affect on motor learning in virtual environments after stroke? A scoping review

Journal of NeuroEngineering and Rehabilitation , Volume 16(79)

NARIC Accession Number: J81347.  What's this?
ISSN: 1743-0003.
Author(s): Rohrbach, Nina; Chicklis, Emily; Levac, Danielle E..
Publication Year: 2019.
Number of Pages: 14.
Abstract: This scoping review explored how motivation, enjoyment, engagement, immersion, and presence are measured or described in virtual reality and active video gaming (AVG) interventions for patients with stroke; identified directional relationships between these constructs; evaluated their impact on motor learning outcomes. A literature search was conducted in Medline, PEDro and CINAHL databases for relevant studies published between 2007 and 2017. Following screening, reviewers used an iterative charting framework to extract data about construct measurement and description. A numerical and thematic analytical approach adhered to established scoping review guidelines. One hundred fifty-five studies were included in the review. Although the majority (89 percent) of studies described at least one of the five constructs within their text, construct measurement took place in only 50 studies (32 percent). The most frequently described construct was motivation (79 percent) while the most frequently measured construct was enjoyment (27 percent). A summative content analysis of the 50 studies in which a construct was measured revealed that constructs were described either as a rationale for the use of virtual reality/AVGs in rehabilitation or as an explanation for intervention results. Thirty-eight studies (76 percent) proposed relational links between two or more constructs and/or between any construct and motor learning. No study used statistical analyses to examine these links. Findings indicate a discrepancy between the theoretical importance of affective constructs within virtual reality/AVG interventions and actual construct measurement. Standardized terminology and outcome measures are required to better understand how enjoyment, engagement, motivation, immersion and presence contribute individually or in interaction to virtual reality/AVG intervention effectiveness.
Descriptor Terms: CLIENT SATISFACTION, COMPUTER APPLICATIONS, LEARNING, LITERATURE REVIEWS, MOTIVATION, MOTOR SKILLS, REHABILITATION TECHNOLOGY, STROKE.


Can this document be ordered through NARIC's document delivery service*?: Y.
Get this Document: https://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-019-0546-4.

Citation: Rohrbach, Nina, Chicklis, Emily, Levac, Danielle E.. (2019). What is the impact of user affect on motor learning in virtual environments after stroke? A scoping review.  Journal of NeuroEngineering and Rehabilitation , 16(79) Retrieved 8/20/2019, from REHABDATA database.

How effective are treatments for anxiety after stroke? -- A Cochrane review summary with commentary

Anxiety is a secondary problem after stroke. You wouldn't have to treat for this if you had effective stroke rehab protocols leading to 100% recovery.  Survivors have anxiety because their doctors and therapists have no fucking clue how to get them recovered and survivors pick that up. 

How effective are treatments for anxiety after stroke? -- A Cochrane review summary with commentary

Neurorehabilitation , Volume 44(3) , Pgs. 457-458.

NARIC Accession Number: J81317.  What's this?
ISSN: 1053-8135.
Author(s): Knapp, Peter.
Publication Year: 2019.
Number of Pages: 2.
Abstract: This commentary discusses, from a rehabilitation perspective, a published Cochrane Review that assessed the effectiveness of pharmaceutical and psychological interventions in treating stroke patients with anxiety disorders or symptoms. The review included three studies. The authors concluded that the available evidence was of low quality, with small numbers of participants and subject to high risk of biases. From a rehabilitation perspective, detailed information on functional outcomes would be noteworthy. Only one study included in the review measured functional outcomes.
Descriptor Terms: ANXIETY DISORDERS, DRUGS, INTERVENTION, OUTCOMES, PHARMACOLOGY, PSYCHOLOGICAL ASPECTS, PSYCHOTHERAPY, REHABILITATION SERVICES, RESEARCH REVIEWS, STROKE.


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Get this Document: https://content.iospress.com/articles/neurorehabilitation/nre189006.

Citation: Knapp, Peter. (2019). How effective are treatments for anxiety after stroke? -- A Cochrane review summary with commentary.  Neurorehabilitation , 44(3), Pgs. 457-458. Retrieved 8/20/2019, from REHABDATA database.

The comparison of clinical and computerized measurement of sitting balance in stroke patients and healthy individuals

So what the hell is the rehab needed to improve sitting balance? This was useless for that purpose. The purpose of stroke research is stroke rehab protocols. Or do your mentors and senior researchers need remedial training in that concept? 

The comparison of clinical and computerized measurement of sitting balance in stroke patients and healthy individuals

Neurorehabilitation , Volume 44(3) , Pgs. 361-368.

NARIC Accession Number: J81308.  What's this?
ISSN: 1053-8135.
Author(s): Ozdil, Aytul; Iyigun, Gozde; Kalyoncu, Cem.
Publication Year: 2019.
Number of Pages: 8.
Abstract: Study compared the results of computerized and clinical sitting balance measurements in stroke patients and healthy individuals and to identify the agreement and relationship between the two measurement methods in stroke patients. This study included 30 chronic stroke patients and 30 age-matched healthy individuals. A force platform chair was used for the computerized measurement and the Function in Sitting Test (FIST) was used for the clinical sitting balance measurement. The sitting balance of the stroke patients, measured with computerized and clinical measurements, were still affected in the chronic phase. The CoP deviation (eyes-open and eyes-closed) was higher whereas the FIST score was lower in the stroke group than the healthy group. The computerized sitting balance measurement CoP deviation was not correlated with the FIST scores. However, there was an excellent agreement (96.6 percent) between the methods. The results suggest that both the computerized and clinical sitting balance measurements can be used objectively for the assessment of sitting balance but the computerized methods might be preferable due to requiring shorter time with less intra-tester variability.
Descriptor Terms: CLINICAL MANAGEMENT, COMPUTER APPLICATIONS, EQUILIBRIUM, EVALUATION TECHNIQUES, MEASUREMENTS, MOBILITY, PERFORMANCE STANDARDS, POSTURE, STROKE, TESTS.


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Get this Document: https://content.iospress.com/articles/neurorehabilitation/nre182634.

Citation: Ozdil, Aytul, Iyigun, Gozde, Kalyoncu, Cem. (2019). The comparison of clinical and computerized measurement of sitting balance in stroke patients and healthy individuals.  Neurorehabilitation , 44(3), Pgs. 361-368. Retrieved 8/20/2019, from REHABDATA database.

Circadian activity rhythm and fragmentation are associated with sleep-wake patterns and sleep quality in patients with stroke

My conclusion being a sleep protocol needs to be written up. 

Circadian activity rhythm and fragmentation are associated with sleep-wake patterns and sleep quality in patients with stroke

Neurorehabilitation , Volume 44(3) , Pgs. 353-360.

NARIC Accession Number: J81307.  What's this?
ISSN: 1053-8135.
Author(s): de Oliveira, Debora C.; Ferreira, aula R. C.; Fernandes, Aline B. G. S.; Pacheco, Thaiana B. F.; Avelino, Matheus M. L.; Cavalcanti, Fabricia A. C.; Vieira, Edgar R.; Fernandes, Tania.
Publication Year: 2019.
Number of Pages: 8.
Abstract: Study evaluated the circadian activity rhythm and its influence on sleep-wake patterns in patients with stroke. Ten adults with and 10 without stroke participated in the study; they were matched on age, sex and educational level. Neurological status, motor function, sleep quality, and activity levels were measured. The groups were compared using Student t-tests and the association between the measures was assessed using Pearson’s correlation. Compared to people without stroke, those with stroke had worse sleep quality, twice as low 24-hour activity levels, higher inter-daily stability and intra-daily variability, lower activity during the most active 10  hours and during the least active 5  hours. Sleep quality was associated with activity level and with within-day activity variability. The results indicate poorer quality of sleep in patients with stroke. Activity rhythm and fragmentation can alter the sleep-wake pattern and impair quality of sleep in patients with stroke, thus it needs be considered in the rehabilitation process.
Descriptor Terms: DAILY LIVING, SLEEP DISORDERS, STROKE.


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Get this Document: https://content.iospress.com/articles/neurorehabilitation/nre182665.

Citation: de Oliveira, Debora C., Ferreira, aula R. C., Fernandes, Aline B. G. S., Pacheco, Thaiana B. F., Avelino, Matheus M. L., Cavalcanti, Fabricia A. C., Vieira, Edgar R., Fernandes, Tania. (2019). Circadian activity rhythm and fragmentation are associated with sleep-wake patterns and sleep quality in patients with stroke.  Neurorehabilitation , 44(3), Pgs. 353-360. Retrieved 8/20/2019, from REHABDATA database.

An exploratory investigation of the effect of naturalistic light on depression, anxiety, and cognitive outcomes in stroke patients during admission for rehabilitation: A randomized controlled trial

You wouldn't need to address any of these secondary problems if you had protocols leading to 100% recovery. 

An exploratory investigation of the effect of  on depression, anxiety, and cognitive outcomes in stroke patients during admission for rehabilitation: A randomized controlled trial

Neurorehabilitation , Volume 44(3) , Pgs. 341-351.

NARIC Accession Number: J81306.  What's this?
ISSN: 1053-8135.
Author(s): West, Anders; Simonsen, Sofie A.; Zielinski, Alexander; Cyril, Niklas; Schonsted, Marie; Jennum, Poul; Sander, Birgit; Iversen, Helle K..
Publication Year: 2019.
Number of Pages: 11.
Abstract: Study examined the effect of naturalistic lighting (i.e., artificial light imitating the sunlight rhythm and spectrum) on depression, anxiety, and cognition in a hospital setting among patients admitted for post-stroke rehabilitation. Ninety stroke patients in need of rehabilitation were randomized to either a rehabilitation unit equipped entirely with always-on naturalistic lighting (IU) or to a rehabilitation unit with standard indoor lighting (CU). Examinations were performed at inclusion and discharge. The following changes were investigated: depressive mood based on the Hamilton Depression scale and Major Depression Inventory scale, anxiety based on the Hospital Anxiety and Depression Scale, cognition based on the Montreal Cognitive Assessment and well-being based on the Well-being Index. Depressive mood and anxiety was reduced, and well-being was increased, in the IU at discharge compared to the CU. No difference was found in cognition. This study is the first to demonstrate that exposure to naturalistic light during admission may significantly improve mental health in rehabilitation patients. Further studies are needed to confirm these findings.
Descriptor Terms: ANXIETY DISORDERS, COGNITION, DEPRESSION, INTERVENTION, MENTAL HEALTH, REHABILITATION SERVICES, STROKE, THERAPY.


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Get this Document: https://content.iospress.com/articles/neurorehabilitation/nre182565.

Citation: West, Anders, Simonsen, Sofie A., Zielinski, Alexander, Cyril, Niklas, Schonsted, Marie, Jennum, Poul, Sander, Birgit, Iversen, Helle K.. (2019). An exploratory investigation of the effect of naturalistic light on depression, anxiety, and cognitive outcomes in stroke patients during admission for rehabilitation: A randomized controlled trial.  Neurorehabilitation , 44(3), Pgs. 341-351. Retrieved 8/20/2019, from REHABDATA database.

Chronicity of stroke does not affect outcomes of somatosensory stimulation paired with task-oriented motor training: A secondary analysis of a randomized controlled trial

Chronicity: The state of being chronic, having a long duration. And lazily asking for more studies.  Something improved so you will have to ask your doctor to get the protocol. 

Chronicity of stroke does not affect outcomes of somatosensory stimulation paired with task-oriented motor training: A secondary analysis of a randomized controlled trial

Archives of Rehabilitation Research and Clinical Translation , Volume 1(1-2) , Pgs. 100005.

NARIC Accession Number: J81286.  What's this?
ISSN: 2590-1095.
Author(s): Carrico, Cheryl; Annichiarico, Nicholas; Powell, Elizabeth S.; Westgate, Philip M.; Sawaki, Lumy.
Publication Year: 2019.
Number of Pages: 6.
Abstract: Study examined whether chronicity influences outcomes of somatosensory stimulation paired with task-oriented motor training for participants with severe-to-moderate upper extremity hemiparesis. Fifty-five adults, ranging between 3 and 12 months post stroke, were randomly assigned to receive 18 sessions pairing either 2 hours of active or sham somatosensory stimulation with 4 hours of intensive task-oriented motor training. The Wolf Motor Function Test, Action Research Arm Test, Stroke Impact Scale, and Fugl-Meyer Assessment were collected as outcome measures. Analyses evaluated whether within-group chronicity correlated with pre-post changes on primary and secondary outcome measures of motor performance. Both groups exhibited improvements on all outcome measures. No significant correlations between chronicity post stroke and the amount of motor recovery were found. Somatosensory stimulation improved motor recovery compared with sham treatment in cases of severe-to-moderate hemiparesis between 3 and 12 months post stroke; the extent of recovery did not correlate with baseline levels of stroke chronicity. Future studies should investigate a wider period of inclusion, patterns of corticospinal reorganization, differences between cortical and subcortical strokes, and include long-term follow-up periods.
Descriptor Terms: BODY MOVEMENT, ELECTRICAL STIMULATION, INTERVENTION, LIMBS, MOTOR SKILLS, OCCUPATIONAL THERAPY, STROKE, TASK ANALYSIS.


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Get this Document: https://www.sciencedirect.com/science/article/pii/S2590109519300047.

Citation: Carrico, Cheryl, Annichiarico, Nicholas, Powell, Elizabeth S., Westgate, Philip M., Sawaki, Lumy. (2019). Chronicity of stroke does not affect outcomes of somatosensory stimulation paired with task-oriented motor training: A secondary analysis of a randomized controlled trial.  Archives of Rehabilitation Research and Clinical Translation , 1(1-2), Pgs. 100005. Retrieved 8/20/2019, from REHABDATA database.

Assessment of backward walking unmasks mobility impairments in post-stroke community ambulators

Other research already out there: I bet your doctor and stroke hospital  are totally incompetent in not having this intervention already being used. My god, 13 and 14 years ago this research came out, bet your doctor doesn't even know about it.

Gait outcomes after additional backward walking training in patients with stroke: a randomized controlled trial - May 2005

Effectiveness of backward walking treadmill training in lower extremity function after stroke - Oct. 2006


“A Backward Walking Training Program to Improve Balance and Mobility in Acute Stroke: A Pilot Randomized Controlled Trial” Oct. 2017 

Walking backwards boosts creativity April 2015

 

 

The latest here:

Assessment of backward walking unmasks mobility impairments in post-stroke community ambulators

Topics in Stroke Rehabilitation , Volume 26(5) , Pgs. 382-388.

NARIC Accession Number: J81273.  What's this?
ISSN: 1074-9357.
Author(s): Hawkins, Kelly A.; Balasubramanian, Chitralakshmi K.; Vistamehr, Arian; Conroy, Christy; Rose, Dorian K.; Clark, David J.; Fox, Emily J..
Publication Year: 2019.
Number of Pages: 7.
Abstract: Study assessed spatiotemporal and kinematic backward walking (BW) characteristics in post-stroke community ambulators and compared their performance to controls. Fifteen post-stroke individuals and 12 healthy adults performed forward walking (FW) and BW during a single session. Step characteristics and peak lower-extremity joint angles were extracted using three-dimensional motion analysis and analyzed with mixed-method analyses of variance (group, walking condition). The stroke group demonstrated greater reductions in speed, step length, and cadence and a greater increase in double-support time during BW compared to FW. Compared to FW, the post-stroke group demonstrated greater reductions in hip extension and knee flexion during BW. The control group demonstrated decreased plantarflexion and increased dorsiflexion during BW, but these increases were attenuated in the post-stroke group. Assessment of BW can unmask post-stroke walking impairments not detected during typical FW. BW impairments may contribute to the mobility difficulties reported by adults following a stroke. Therefore, BW should be assessed when determining readiness for home and community ambulation.
Descriptor Terms: AMBULATION, EVALUATION TECHNIQUES, MOBILITY IMPAIRMENTS, STROKE.


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Citation: Hawkins, Kelly A., Balasubramanian, Chitralakshmi K., Vistamehr, Arian, Conroy, Christy, Rose, Dorian K., Clark, David J., Fox, Emily J.. (2019). Assessment of backward walking unmasks mobility impairments in post-stroke community ambulators.  Topics in Stroke Rehabilitation , 26(5), Pgs. 382-388. Retrieved 8/20/2019, from REHABDATA database.
 

Inter-rater reliability of the Swedish modified version of the postural assessment scale for stroke patients (SwePASS) in the acute phase after stroke

If you are doing inter-rater reliability it means your are not using an objective diagnosis. With no objective diagnosis you can't match protocols to an objective starting point and have efficacy ratings for that protocol. So useless crapola again.  Two strikes against this; assessment, inter-ratings.

Inter-rater reliability of the Swedish modified version of the postural assessment scale for stroke patients (SwePASS) in the acute phase after stroke

Topics in Stroke Rehabilitation , Volume 26(5) , Pgs. 366-372.

NARIC Accession Number: J81272.  What's this?
ISSN: 1074-9357.
Author(s): Bergqvist, Gunilla M.; Nasic, Salmir; Persson, Carina U..
Publication Year: 2019.
Number of Pages: 7.
Abstract: Study examined the inter-rater reliability of the Swedish modified version of the Postural Assessment Scale for Stroke Patients (SwePASS) in the acute phase after stroke. Postural control refers to the ability to stabilize the body in everyday activities in lying, sitting, and standing. Day 3 to day 7 after admission to a stroke unit, 64 patients with stroke were assessed twice, using the SwePASS, by two physiotherapists. Inter-rater reliability was determined using percentage-agreement and the rank-invariant method: relative position, relative concentration, and relative rank variance. The raters showed a percentage agreement of at least 75 percent in the assessments using the SwePASS. For 9 of the 12 items, the percentage agreement was greater than 80 percent. For 8 of the 12 items, there was a statistically significant change in position, revealed in relative position values between 0.08 and 0.15. Three items had statistically significant positive relative concentration values between −0.11 and 0.10. Except for a statistically significant negligible relative variance value of 0.01 for the items 1 and 8, there was no relative variance. Overall, the SwePASS shows an acceptable inter-rater reliability, albeit with potential for improvement. The reliability can be improved by a consensus how to interpret the scale between the raters prior to implementation in the clinic.
Descriptor Terms: EQUILIBRIUM, INTERNATIONAL REHABILITATION, MEASUREMENTS, MOTOR SKILLS, OUTCOMES, PERFORMANCE STANDARDS, POSTURE, STROKE.


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Citation: Bergqvist, Gunilla M., Nasic, Salmir, Persson, Carina U.. (2019). Inter-rater reliability of the Swedish modified version of the postural assessment scale for stroke patients (SwePASS) in the acute phase after stroke.  Topics in Stroke Rehabilitation , 26(5), Pgs. 366-372. Retrieved 8/20/2019, from REHABDATA database.
 

The trunk control: Which is the best in very acute stroke patients?

Oh fuck. ASSESSMENT CRAPOLA AGAIN.  Not a single stroke survivor in the world cares about assessment. They want stroke protocols that deliver rehab results leading to 100% recovery. I'd fire the mentors and senior researchers involved in this. 

The trunk control: Which is the best in very acute stroke patients?

Topics in Stroke Rehabilitation , Volume 26(5) , Pgs. 359-365.

NARIC Accession Number: J81271.  What's this?
ISSN: 1074-9357.
Author(s): Balkan, Ayla F.; Salci, Yeliz; Keklicek, Hilal; Cetin, Baris; Adin, Ridvan M.; Armutlu, Kadiye.
Publication Year: 2019.
Number of Pages: 7.
Abstract: Study determined the most appropriate scale used for trunk control assessment in very acute stroke patients in terms of time and ease of implementation. Sixty-five patients with very acute stroke were recruited from a hospital in Ankara, Turkey. All patients received physiotherapy program tailored to meet their needs during hospitalization. The patients were assessed with the Trunk Impairment Scale-1 (VTIS), the Trunk Impairment Scale-2 (FTIS), the Motor Assessment Scale trunk subscale (T-MAS) and the Trunk Control Test (TCT), and Functional Impairment Measure (FIM). Floor/ceiling effects, reliability, validity responsiveness of the four trunk-control scales analyzed. The correlation between the scales and FIM were calculated. All scales had similar reliability, responsiveness and construct validity level. T-MAS and TCT were more advantageous than other scales according to time. TCT and VTIS showed floor effect. The best predictive validity values were observed for the T-MAS and TCT. Findings indicate that the four scales investigated in this study can be used to evaluate the patients with very acute stroke. However, the advantages and disadvantages of the scales should be thoroughly assessed and researchers can use one of four scales after considering their aim, patient populations, and clinical characteristics of patients.
Descriptor Terms: ACUTE CARE, BODY MOVEMENT, MEASUREMENTS, MOTOR SKILLS, OUTCOMES, STROKE.


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Citation: Balkan, Ayla F., Salci, Yeliz, Keklicek, Hilal, Cetin, Baris, Adin, Ridvan M., Armutlu, Kadiye. (2019). The trunk control: Which is the best in very acute stroke patients?.  Topics in Stroke Rehabilitation , 26(5), Pgs. 359-365. Retrieved 8/20/2019, from REHABDATA database.

Walking speed as a predictor of community mobility and quality of life after stroke

I could walk much faster than I currently do if my spasticity was cured. Hell, I'd be running by now. 

Walking speed as a predictor of community mobility and quality of life after stroke

Topics in Stroke Rehabilitation , Volume 26(5) , Pgs. 349-358.

NARIC Accession Number: J81270.  What's this?
ISSN: 1074-9357.
Author(s): Grau-Pellicer, Montserrat; Chamarro-Lusar, Andres; Medina-Sasanovas, Josep; Ferrer, Bernat-Carles S..
Publication Year: 2019.
Number of Pages: 10.
Abstract: Study investigated whether gait speed is a predictor of community mobility (CM) and quality of life (QoL) in patients with stroke following a multimodal rehabilitation program (MRP). CM is considered a part of community reintegration that enhances QoL. Achieving an appropriate gait speed is essential in attaining an independent outdoor ambulation and satisfactory CM. This was a baseline control trial with 6-months follow-up in an outpatient rehabilitation setting at a university hospital. Twenty-six stroke survivors completed the MRP (24 one-hour sessions, 2 days per week). The MRP consisted of aerobic exercise, task-oriented exercises, balance exercises and stretching. Participants also performed an ambulation program at home. Outcome variables were: walking speed (10-Meter Walking Test) and QoL (physical and psychosocial domains of Euroquol and Sickness Impact Profile). At the end of the intervention, comfortable and fast walking speed increased by an average of 0.16 and 0.40 meters per second, respectively. After the intervention, all participants achieved independent outdoor ambulation with an increase of 34.14 of walking minutes per day in the community and a decrease of sitting time of 95.45 minutes per day. Regarding QoL, there were increased mean scores on the physical and psychosocial dimensions of Euroquol and the Sickness Impact Profile, respectively. The results suggest that improved walking speed after the MRP is associated with CM and higher scores in QoL. These findings support the need to implement rehabilitation programs to promote increased speed.
Descriptor Terms: AMBULATION, COMMUNITY INTEGRATION, EXERCISE, OUTCOMES, PHYSICAL THERAPY, QUALITY OF LIFE, REHABILITATION, STROKE.


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Citation: Grau-Pellicer, Montserrat, Chamarro-Lusar, Andres, Medina-Sasanovas, Josep, Ferrer, Bernat-Carles S.. (2019). Walking speed as a predictor of community mobility and quality of life after stroke.  Topics in Stroke Rehabilitation , 26(5), Pgs. 349-358. Retrieved 8/20/2019, from REHABDATA database.

Factors associated with quality of life early after ischemic stroke: The role of resilience

Resilience should never be necessary. If necessary, your doctor has completely failed you in getting to 100% recovery. 

Factors associated with quality of life early after ischemic stroke: The role of resilience

Topics in Stroke Rehabilitation , Volume 26(5) , Pgs. 335-341.

NARIC Accession Number: J81269.  What's this?
ISSN: 1074-9357.
Author(s): Liu, Zhihui; Zhou, Xuan; Zhang, Wei; Zhou, Lanshu.
Publication Year: 2019.
Number of Pages: 7.
Abstract: Study estimated the prevalence and association of resilience with quality of life (QOL) among patients at hospitalization and whether the association was independent of physical function, anxiety, depression, and other population characteristics. A cross-sectional study at a tertiary hospital included 215 individuals. The Chinese version of the Connor-Davidson Resilience Scale was used to evaluate resilience. Stroke Scale Quality of life was used to measure QOL. Other validated questionnaires were used to assess physical function (Functional Independency Measure), and anxiety and depression (Hospital Anxiety and Depression Scale). Hierarchical regression analysis was applied to determine the association between psychological factors and QOL. Multiple linear regression was also used to examine whether resilience independently affects QOL. The mean score of the 215 participants’ resilience was 62.36. Resilience, anxiety, and depression were separately significantly associated with QOL. Resilience was negatively associated with anxiety and depression. Subjects with high scores of resilience showed a higher QOL at patients’ hospitalization, independent of physical function, anxiety, depression, disease-related characteristics, and sociodemographic characteristics. In this study, resilience was found to be an independent predictor of QOL beyond anxiety and depression in patients with ischemic stroke. Interventions aimed at improving resilience at acute hospitalization might be a worthwhile addition to improve QOL early after stroke.
Descriptor Terms: ADJUSTMENT, ANXIETY DISORDERS, DEPRESSION, OUTCOMES, PSYCHOLOGICAL ASPECTS, QUALITY OF LIFE, STROKE.


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Citation: Liu, Zhihui, Zhou, Xuan, Zhang, Wei, Zhou, Lanshu. (2019). Factors associated with quality of life early after ischemic stroke: The role of resilience.  Topics in Stroke Rehabilitation , 26(5), Pgs. 335-341. Retrieved 8/20/2019, from REHABDATA database.
 

Identifying factors associated with sedentary time after stroke. Secondary analysis of pooled data from nine primary studies

STOP BLAMING THE PATIENT! The doctor is the failure point for not contacting researchers to get every stroke patient 100% recovered. 

Identifying factors associated with sedentary time after stroke. Secondary analysis of pooled data from nine primary studies

Topics in Stroke Rehabilitation , Volume 26(5) , Pgs. 327-334.

NARIC Accession Number: J81268.  What's this?
ISSN: 1074-9357.
Author(s): Hendrickx, Wendy; Riveros, Carlos; Askim, Torunn; Bussmann, Johannes B. J.; Callisaya, Michele L.; Chastin, Sebastien F. M.; Dean, Catherine M.; Ezeugwu, Victor E.; Jones, Taryn M.; Kuys, Suzanne S.; Mahendran, Niruthikha; Manns, Trish J.; Mead, Gillian; Moore, Sarah A.; Paul, Lorna; Pisters, Martijn F.; Saunders, David H.; Simpson, Dawn B.; Tieges, Zoe; Verschuren, Olaf; English, Coralie.
Publication Year: 2019.
Number of Pages: 8.
Abstract: Study identified factors associated with high sedentary time in community-dwelling people with stroke. For this data pooling study, authors of published and ongoing trials that collected sedentary time data, using the activPAL monitor, in community-dwelling people with stroke were invited to contribute their raw data. The data was reprocessed; algorithms were created to identify sleep-wake time and determine the percentage of waking hours spent sedentary. Linear regressions (adjusting for age, gender, and study) were conducted to determine the association of demographic and stroke-related factors with percentage of total sedentary time, percentage of sedentary time in bouts greater than 30 minutes, and percentage of sedentary time in bouts greater than 60 minutes. The 274 included participants were from Australia, Canada, and the United Kingdom, and spent, on average, 69 percent of their waking hours sedentary. Of the demographic and stroke-related factors evaluated, only slower walking speeds were significantly and independently associated with a higher percentage of waking hours spent sedentary and uninterrupted sedentary bouts greater than 30 minutes and greater than 60 minutes. Regression models explained 11 to 19 percent of the variance in total sedentary time and time in prolonged sedentary bouts. This study found that variability in sedentary time of people with stroke was largely unaccounted for by demographic and stroke-related variables. Behavioral and environmental factors are likely to play an important role in sedentary behavior after stroke. Further work is required to develop and test effective interventions to address sedentary behavior after stroke.
Descriptor Terms: BEHAVIOR, BODY MOVEMENT, CLIENT CHARACTERISTICS, MOBILITY, OUTCOMES, PREDICTION, STROKE.


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Citation: Hendrickx, Wendy, Riveros, Carlos, Askim, Torunn, Bussmann, Johannes B. J., Callisaya, Michele L., Chastin, Sebastien F. M., Dean, Catherine M., Ezeugwu, Victor E., Jones, Taryn M., Kuys, Suzanne S., Mahendran, Niruthikha, Manns, Trish J., Mead, Gillian, Moore, Sarah A., Paul, Lorna, Pisters, Martijn F., Saunders, David H., Simpson, Dawn B., Tieges, Zoe, Verschuren, Olaf, English, Coralie. (2019). Identifying factors associated with sedentary time after stroke. Secondary analysis of pooled data from nine primary studies.  Topics in Stroke Rehabilitation , 26(5), Pgs. 327-334. Retrieved 8/20/2019, from REHABDATA database.