Deans' stroke musings: International Classification of Functioning, Disability and Health-based rehabilitation program promotes activity and participation of post-stroke patients

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.

Wednesday, October 18, 2023

International Classification of Functioning, Disability and Health-based rehabilitation program promotes activity and participation of post-stroke patients

Survivors don't just want perceived improvements, they want actual improvements. Did you measure actual?

International Classification of Functioning, Disability and Health-based rehabilitation program promotes activity and participation of post-stroke patients

Ngai-Kiu Mabel Wong^{1, 2}

Mike Kwun-Ting Cheung³ Yuk-Mun Ng³ Huan-Ling Yuan¹

Bess Yin-Hung Lam⁴

Siu Ngor Fu¹

Chetwyn Che Hin Chan^5*

¹Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hong Kong, SAR China
²Department of Psychology, The Education University of Hong Kong, Hong Kong, SAR China
³The Hong Kong Society for Rehabilitation (HKSR), Hong Kong, SAR China
⁴Department of Counselling and Psychology, Faculty of Social Sciences, Hong Kong Shue Yan University, Hong Kong, SAR China
⁵The Education University of Hong Kong, Hong Kong, SAR China

The final, formatted version of the article will be published soon.

The International Classification of Functioning, Disability, and Health (ICF) model has been applied in post-stroke rehabilitation, yet limited studies explored its clinical application on enhancing patients' Activity and Participation (ICF-A&P) level.Purpose: This study gathered evidence of the effects of an ICF-based post-stroke rehabilitation program (ICF-PSRP) in enhancing community reintegration in terms of ICF-A&P of post-stroke patients.Methods: Fifty-two post-stroke patients completed an 8-to-12-week multidisciplinary ICF-PSRP after setting personal treatment goals in an outpatient community rehabilitation center. Intake and pre-discharge assessments were administered for primary outcomes of Body function (ICF-BF; e.g., muscle strength) and ICF-A&P (e.g., mobility), and secondary outcomes of perceived improvements in ability (e.g., goal attainment and quality of life).

Results: There were significantly higher levels in the ICF-BF and ICF-A&P domains, except cognitive function under the ICF-BF. Improvements in the primary outcomes predicted corresponding secondary outcomes. Firstly, expressive and receptive functions (ICP-BF) were mediated by the everyday language (ICF-A&P) which predicted patients' satisfaction with the language-related quality of life. Secondly, upper extremity function (ICP-BF) was mediated by the lower extremity mobility (ICF-A&P) predicting work and productivity-related quality of life. Content analyses showed that combined ICF-BF and ICF-A&P contents throughout the ICF-PSRP contributed to the positive treatment effects.The ICF-PSRP was effective in promoting body function, and activity and participation levels of post-stroke patients. Positive treatment effects are characterized by goal-setting process, cross-domain content design, and community-setting delivery.

Keywords: Goal-setting process1, multidisciplinary approach2, community reintegration3, resuming life roles4, stroke rehabilitation5

Received: 16 Jun 2023; Accepted: 12 Oct 2023.

Copyright: © 2023 Wong, Cheung, Ng, Yuan, Lam, Fu and Chan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Chetwyn Che Hin Chan, The Education University of Hong Kong, Tai Po, Hong Kong, SAR China