Deans' stroke musings: Amount and Content of Sensorimotor Therapy Delivered in Three Stroke Rehabilitation Units in Quebec, Canada

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 523 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.

Tuesday, October 17, 2017

Amount and Content of Sensorimotor Therapy Delivered in Three Stroke Rehabilitation Units in Quebec, Canada

Once again proving that every single stroke patient is a one person clinical trial. NO protocols are referred to or objective diagnosis given.
http://www.utpjournals.press/doi/abs/10.3138/ptc.2016-66

Carol L. Richards, BScPT, PhDRelated information

* Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale
† Centre interdisciplinaire de recherche en réadaptation et intégration sociale
‡ Département de réadaptation, Université Laval, Québec

, Francine Malouin, BScPT, PhDRelated information

, Sylvie Nadeau, BScPT, PhDRelated information

§ Institut de réadaptation Gingras-Lindsay-de-Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal
¶ Centre interdisciplinaire de recherche en réadaptation
** École de réadaptation, Université de Montréal

, Joyce Fung, BScPT, PhDRelated information

¶ Centre interdisciplinaire de recherche en réadaptation
†† Jewish Rehabilitation Hospital, Centre intégré de santé et de services sociaux de Laval, Laval, Que.
‡‡ School of Physical and Occupational Therapy, McGill University, Montreal

, Line D'Amours, BScOT, MBARelated information

* Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale

, Claire Perez, BScPT, MScRelated information

‡‡ School of Physical and Occupational Therapy, McGill University, Montreal
†† Jewish Rehabilitation Hospital, Centre intégré de santé et de services sociaux de Laval, Laval, Que.

, Anne Durand, BScPT, PhDRelated information

* Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale

Contributors: All authors designed the study; or collected, analyzed, or interpreted the data; and drafted or critically revised the article and approved the final draft.

Competing Interests: None declared. This work was supported by a Canadian Institutes of Health Research SensoriMotor Rehabilitation Research Team grant and grants from the Institut de réadaptation en déficience physique de Québec, now integrated into the Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale and the Centre interdisciplinaire de recherche en réadaptation et intégration sociale.

Acknowledgements: The authors thank Dr. Marie-Eve Lamontagne for her assistance in the development of the questionnaire regarding clinician perceptions of their practice and Ms. France Pelletier for her technical assistance.

Correspondence to: Dr. Carol L. Richards, CIRRIS Research Center, 525 boul. Wilfrid-Hamel Est, Quebec, QC G1M 2S8; carol.richards@fmed.ulaval.ca.

https://doi.org/10.3138/ptc.2016-66

Abstract
PDF

Abstract

Purpose: This study creates a baseline clinical portrait of sensorimotor rehabilitation in three stroke rehabilitation units (SRUs) as a first step in implementing a multi-centre clinical research platform. Method: Participants in this cross-sectional, descriptive study were the patients and rehabilitation teams in these SRUs. Prospective (recording of therapy time and content and a Web-based questionnaire) and retrospective (chart audit) methods were combined to characterize the practice of the rehabilitation professionals.
Results: The 24- to 39-bed SRUs admitted 100–240 inpatients in the year audited. The mean combined duration of individual occupational and physical therapy was 6.3–7.5 hours/week/patient. When evening hours and the contributions of other professionals as well as group therapy and self-practice were included, the total amount of therapy was 13.0 (SD 3) hours/patient/week. Chart audit and questionnaire data revealed the Berg Balance Scale was the most often used outcome measure (98%–100%), and other outcome measure use varied. Clinicians favoured task-oriented therapy (35%–100%), and constraint-induced movement therapy (0%–15%), electrical stimulation of the tibialis anterior (0%–15%), and body weight–supported treadmill training (0%–1%) were less often used.
Conclusions: This study is the first to provide objective data on therapy time and content of stroke rehabilitation in Quebec SRUs.

Objectif : créer un portrait clinique de base de la réadaptation sensorimotrice dans trois unités de réadaptation après un accident vasculaire cérébral (URA) comme première étape en vue de la mise en œuvre d'une plateforme de recherche clinique multicentrique.
Méthodologie : les participants à cette étude descriptive transversale étaient des patients et des équipes de réadaptation de ces URA. Les chercheurs ont combiné la méthode prospective (consignation de la durée et du contenu du traitement et questionnaire en ligne) et la méthode rétrospective (examen des dossiers) pour caractériser la pratique des professionnels en réadaptation. Résultats : les URA de 29 à 39 lits ont accueilli de 100 à 240 patients hospitalisés pendant l'année de contrôle. Les interventions en ergothérapie et physiothérapie étaient d'une durée moyenne combinée de 6,3 à 7,5 heures par semaine par patient. Lorsqu'on incluait les soirées, l'apport d'autres professionnels, la thérapie de groupe et la pratique autonome, le total s'élevait à 13,0 heures (ÉT 3,0) par semaine par patient. Les données tirées du contrôle des dossiers et des questionnaires ont révélé que l'échelle d'évaluation de l'équilibre de Berg était la plus utilisée (98% à 100%), alors que le recours aux autres mesures était variable. Les cliniciens favorisaient les traitements orientés vers les tâches (35 % à 100 %), mais utilisaient moins la thérapie par contrainte induite (0 % à 15 %), la stimulation électrique du jambier antérieur (0 % à 15 %) et l'entraînement sur tapis roulant en décharge pondérale (0 % à 1 %).
Conclusions : la présente étude est la première à fournir des données objectives sur la durée et le contenu de la réadaptation après un accident vasculaire cérébral dans les URA du Québec.