1
|
Ribeiro Batista L, Silva SLAD, Cunha Polese J, Silva AC, Teixeira-Salmela LF, Faria CDCDM, Faria-Fortini I. Longitudinal associations between stroke-related neurologic deficits and course of basic activities of daily living up to six months after stroke. Disabil Rehabil 2024:1-7. [PMID: 38318868 DOI: 10.1080/09638288.2024.2313124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 01/27/2024] [Indexed: 02/07/2024]
Abstract
PURPOSE To investigate the course of basic activities of daily living (ADL) from admission up to six months after the stroke and the longitudinal associations between stroke-related neurological deficits at admission to the stroke unit and course of basic ADL. MATERIALS AND METHODS 180 individuals with a first-ever stroke were assessed at admission to the stroke unit and at follow-ups of three and six months. Stroke-related neurological deficits were assessed at admission with the National Institutes of Stroke Scale (NIHSS). Independence in basic ADL was assessed at admission and three and six months after the stroke by the Modified Barthel Index (MBI). Generalized Estimating Equations (GEE) were performed. RESULTS Dependence in basic ADL reduced overtime, with most changes occurring over the first three months. Individuals, who had moderate/severe stroke-related neurological deficits (NIHSS ≥6) at admission, had higher chances of becoming more dependent in activities related to feeding (OR:1.27;95%CI = 1.03-1.55;p = 0.021), bathing (OR:1.30;95%CI = 1.11-1.50;p = 0.0005), dressing (OR:1.19;95%CI = 1.04-1.36;p = 0.010), transfers (OR:1.24;95%CI = 1.05-1.46;p = 0.0072), stair climbing (OR:1.46;95%CI = 1.27-1.66;p < 0.0001), and ambulation (OR:1.21;95%CI = 1.02-1.43;p < 0.0001). CONCLUSIONS Decreases in dependence in basic ADL occurred mainly over three months after the stroke and showed different patterns for specific ADL. Baseline moderate/severe stroke-related neurological deficits were associated with poor functional status in basic ADL over the follow-up period.
Collapse
Affiliation(s)
- Ludmilla Ribeiro Batista
- Graduate Program in Occupational Studies, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Janaine Cunha Polese
- Department of Physiotherapy, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Aryane Carolina Silva
- Graduate Program in Rehabilitation Sicences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Iza Faria-Fortini
- Department of Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| |
Collapse
|
2
|
Lista-Paz A, Kuisma R, Canosa JLS, Sebio García R, González Doniz L. Pulmonary function in patients with chronic stroke compared with a control group of healthy people matched by age and sex. Physiother Theory Pract 2023; 39:918-926. [PMID: 35098873 DOI: 10.1080/09593985.2022.2031363] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 10/21/2021] [Accepted: 12/23/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Effects of chronic stroke on pulmonary function are largely unknown. AIM To compare lung volumes in people with chronic stroke with a control group of healthy people matched by age and sex, as well as to investigate the relationship between the lung volumes and functional capacity. METHODS A cross-sectional study involving people with chronic stroke. Cases were matched to a control group of healthy people. Lung function and the distance walked during the Six-Minute Walk Test (6MWD) were the main outcomes. Independent t-tests were used to compare pulmonary function between groups and the Pearson correlation coefficient was used to assess any relationship between lung volumes and the 6MWD in the stroke group. RESULTS Sixty-six participants (24 males in each group; 56.5 ± 15.5 years) were included. People with stroke presented significantly lower lung volumes when compared to the control group. The median of forced vital capacity (FVC) was 79% and peak expiratory flow was 64% of the reference value. The 6MWD was found to be weakly correlated with inspiratory reserve volume (r = 0.39, p = .03) and peak inspiratory flow (r = 0.35, p = .05). CONCLUSIONS People with chronic stroke show decreased lung volumes when compared with healthy people and this likely impacts on their functional capacity.
Collapse
Affiliation(s)
- Ana Lista-Paz
- Faculty of Physiotherapy, The University of A Coruña. Campus Universitario de Oza, n°1, A Coruña, Spain
- Psychosocial and Functional Rehabilitation Intervention Research Group, The University of A Coruña. Campus Universitario de Oza, n°1, A Coruña, Spain
| | - Raija Kuisma
- Karelia University of Applied Sciences. Tikkarinne, Joensuu, Finland
| | - Jesús L Saleta Canosa
- Faculty of Physiotherapy, The University of A Coruña. Campus Universitario de Oza, n°1, A Coruña, Spain
- Department of Preventive Medicine, Complejo Hospitalario Universitario de A Coruña. As Xubias, A Coruña, Spain
| | - Raquel Sebio García
- Department of Rehabilitation. Hospital Clinic de Barcelona. Barcelona, Spain Casanova bis Barcelona, Spain
- Research Group in Attention to Chronicity and Innovation in Health (GRACIS). School of Health Sciences TecnoCampus - University Pompeu Fabra. Avinguda Ernest Lluch, Mataró, Spain
| | - Luz González Doniz
- Faculty of Physiotherapy, The University of A Coruña. Campus Universitario de Oza, n°1, A Coruña, Spain
- Psychosocial and Functional Rehabilitation Intervention Research Group, The University of A Coruña. Campus Universitario de Oza, n°1, A Coruña, Spain
| |
Collapse
|
3
|
Latarnik S, Stahl J, Vossel S, Grefkes C, Fink GR, Weiss PH. The impact of apraxia and neglect on early rehabilitation outcome after stroke. Neurol Res Pract 2022; 4:46. [PMID: 36154935 PMCID: PMC9511731 DOI: 10.1186/s42466-022-00211-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 08/03/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
This study aims to characterize the impact of apraxia and visuospatial neglect on stroke patients’ cognitive and functional outcomes during early rehabilitation. Prior work implies an unfavorable effect of visuospatial neglect on rehabilitation; however, previous findings remain ambiguous and primarily considered long-term effects. Even less is known about the impact of apraxia on rehabilitation outcomes. Although clinicians agree on the significance of the first few weeks after stroke for the course of rehabilitation, studies exploring the impact of neglect and apraxia in this early rehabilitation period remain scarce.
Methods
Based on a screening of 515 hospitalized stroke patients from an early rehabilitation ward, 150 stroke patients (75 left-hemispheric strokes, 75 right hemispheric strokes) fulfilled the inclusion criteria and were enrolled in this observational, longitudinal study. The patients’ cognitive and functional statuses were documented at admission to the early rehabilitation ward and discharge. Also, detailed apraxia and neglect assessments were performed at midterm. The predictive values of age and apraxia and neglect severity (as reflected in two components from a principal component analysis of the neglect and apraxia assessments) for cognitive and functional outcomes at discharge were evaluated by multiple regression analyses.
Results
Besides the expected influence of the respective variables at admission, we observed a significant effect of apraxia severity on the cognitive outcome at discharge. Moreover, neglect severity predicted the Early Rehabilitation Barthel Index (Frühreha-Barthel-Index) at discharge. Supplementary moderator analysis revealed a differential effect of neglect severity on the cognitive outcome depending on the affected hemisphere.
Conclusion
Data indicate a strong association between apraxia and visuospatial neglect and early rehabilitation outcomes after stroke.
Collapse
|
4
|
Ertas-Spantgar F, Müller SV, Korabova S, Gabel A, Schiering I, Pape AE, Hildebrandt H. Errorless learning and assistive technology did not improve the negative prognosis for severe dressing impairment after stroke if persisting for two weeks: A randomized controlled trial. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-9. [PMID: 35786077 DOI: 10.1080/23279095.2022.2090839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Following severe cerebrovascular accidents, patients are often unable to dress themselves. Little is known about the persistence and treatment of this impairment. Study 1 followed 23 patients who were (1) completely dependent on others for help with dressing (2) for two weeks continually until their discharge from the rehabilitation unit. Study 2, a randomized controlled trial of 24 patients, examined the effects of errorless learning and RehaGoal App-based dressing practice on recovery in dressing ability-impaired patients who also experienced visuospatial neglect and/or apraxia. The control and intervention groups both underwent a standard therapy in the rehab unit; the intervention group additionally received dressing training (seven sessions of 45 min). The primary outcome measure was the score on an adapted version of the Nottingham Stroke Dressing Assessment; secondary outcome measures were the Barthel Index and Functional Independence Measure. Less than one-third of the patients in Study1, showed improvement. In Study 2, the intervention produced no specific effect on patients' dressing ability. However, apraxia and neglect predicted improvement for both groups. If patients depend completely on assistance for dressing for two weeks, prospects for recovery are limited. Future studies should include additional intervention sessions and incorporate treatments for neglect or apraxia.
Collapse
Affiliation(s)
- Funda Ertas-Spantgar
- Faculty of Social Work, Ostfalia University of Applied Science, Wolfenbuttel, Germany
| | - Sandra Verena Müller
- Faculty of Social Work, Ostfalia University of Applied Science, Wolfenbuttel, Germany
| | - Sona Korabova
- Department of Geriatric, St.Bernward Krankenhaus, Hildesheim, Germany
| | - Alexander Gabel
- Faculty of Computer Science, Ostfalia University of Applied Science, Wolfenbuttel, Germany
| | - Ina Schiering
- Faculty of Computer Science, Ostfalia University of Applied Science, Wolfenbuttel, Germany
| | - Anna E Pape
- Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany
| | - Helmut Hildebrandt
- Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany
- Department of Psychology, Carl von Ossietzky, University of Oldenburg, Oldenburg, Germany
| |
Collapse
|
5
|
Melo LP, Oliveira DC, Dantas AATSG, Silva Júnior RA, Ribeiro TS, Campos TF. Predictive factors of functional independence in basic activities of daily living during hospitalization and after discharge of stroke patients. Brain Inj 2020; 35:26-31. [PMID: 33369484 DOI: 10.1080/02699052.2020.1861649] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: The aim of this study was to identify the predictive factors of functional independence in the basic activities of daily living during hospitalization, on the 10th and 28th day after stroke.Methods: A total of 433 patients (204 men and 229 women) took part. Functional independence data were collected using the Step 1 from an instrument called Stepwise. Analysis was conducted by logistic regression.Results: Due to the OR values below 1.0 we can verify that the age of 59 years or less and the presence of physiotherapy in the hospital were protective factors of functional independence. Other predictive factors were the number of stroke risk factors (bathing: OR = 0.4; p = .005, transfer: OR = 0.487; p = .025), the amount of medication used before stroke (bathing: OR = 1.7; p = .013), sex (grooming: OR = 1.6; p = .026); type of stroke (continence: OR = 2.2; p = .003-10th day; OR = 1.9; p = .013-28th day), previous strokes (eating: OR = 0.5; p = .036).Conclusions: According to the results, the risk of impaired functional independence decreased in bathing and eating and increased for dressing, grooming and transfer during clinical recovery suggesting the need for greater therapeutic intervention in different basic activities of daily living.
Collapse
Affiliation(s)
- Luciana Protásio Melo
- Departamento de Fisioterapia, Laboratório de Intervenção e Análise do Movimento Humano, Universidade Federal do Rio Grande do Norte, Natal, Brasil
| | - Débora Carvalho Oliveira
- Departamento de Fisioterapia, Laboratório de Intervenção e Análise do Movimento Humano, Universidade Federal do Rio Grande do Norte, Natal, Brasil
| | | | | | - Tatiana Souza Ribeiro
- Departamento de Fisioterapia, Laboratório de Intervenção e Análise do Movimento Humano, Universidade Federal do Rio Grande do Norte, Natal, Brasil
| | - Tania Fernandes Campos
- Departamento de Fisioterapia, Laboratório de Intervenção e Análise do Movimento Humano, Universidade Federal do Rio Grande do Norte, Natal, Brasil
| |
Collapse
|
6
|
Embrechts E, Van Criekinge T, Schröder J, Nijboer T, Lafosse C, Truijen S, Saeys W. The association between visuospatial neglect and balance and mobility post-stroke onset: A systematic review. Ann Phys Rehabil Med 2020; 64:101449. [PMID: 33152521 DOI: 10.1016/j.rehab.2020.10.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 10/09/2020] [Accepted: 10/11/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although previous narrative reviews have highlighted a potential association between visuospatial neglect (VSN) and balance disorders, to what extent different areas of balance and mobility could be affected is still unclear. OBJECTIVES This systematic review updates previous literature findings and systematically reviews sitting balance, standing balance and mobility outcomes. METHODS PubMed, Web of Science, ScienceDirect, Naric-Rehabdata, PEDro and the Cochrane Trials Library were systematically searched. Methodological quality was assessed by the National Heart, Lung, and Blood Institute Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The association between VSN and sitting balance, standing balance and mobility (walking, stair climbing/descending and transfers) was investigated. RESULTS In total, 48 studies were included (4595 stroke survivors): at least 1319 (29%) showed symptoms of VSN. VSN was associated with less independence during sitting, with an asymmetric posture toward the affected body side. For standing balance, we revealed a significant negative association between VSN and mediolateral stability and weight shifting, whereas only activities of daily living-related VSN was associated with weight-bearing asymmetry during static stance. While walking, patients with VSN laterally deviated from their path. Results were inconclusive regarding other aspects of mobility. The association between VSN and balance/mobility seemed to decrease over time. CONCLUSIONS Despite great heterogeneity in results, this study suggests that stroke survivors with VSN show specific deviations in posture and movement in the mediolateral direction. Although the association between VSN and balance/mobility has been extensively investigated, explanatory studies evaluating underlying mechanisms of the frequently present association are lacking. Future studies should address this by combining clinical and instrumented assessment of balance and gait performance, preferably longitudinally to investigate the associations over time.
Collapse
Affiliation(s)
- Elissa Embrechts
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium.
| | - Tamaya Van Criekinge
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Jonas Schröder
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Tanja Nijboer
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands; Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Christophe Lafosse
- Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
| | - Steven Truijen
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Wim Saeys
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium; Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
| |
Collapse
|
7
|
Worthington E, Whitehead P, Li Z, Golding-Day M, Walker M. An audit of dressing practice by occupational therapists in acute stroke settings in England. Br J Occup Ther 2020. [DOI: 10.1177/0308022620926103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Dressing independence is commonly affected after stroke, with clinical guidelines recommending that dressing practice should routinely be provided for those with dressing difficulties. The aim of this study was to update the literature on current practice in the treatment of dressing problems in stroke rehabilitation units. Method A questionnaire survey of occupational therapists experienced in stroke care was sent to 157 stroke units in England. Results Responses were received from 70 stroke units. Frequency and duration of dressing practice varied substantially between units, with respondents typically providing dressing practice for six to 10 patients per week and spending 30 to 45 minutes per treatment session. Only 17 respondents (24.3%) stated that they regularly used standardised assessments of dressing ability. The functional approach was used more widely than the remedial approach. Service priorities, working environment and limitations of time and staffing were reported to influence dressing practice. Conclusion There is widespread variability in dressing practice. There is a lack of use of standardised dressing assessments, and therapists’ rationale for their choice of approach is unclear.
Collapse
Affiliation(s)
- Esme Worthington
- Division of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Nottingham, UK
| | - Phillip Whitehead
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | - Zhaoying Li
- Division of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Nottingham, UK
| | - Miriam Golding-Day
- Division of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Nottingham, UK
| | - Marion Walker
- Division of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Nottingham, UK
| |
Collapse
|
8
|
The Impact of One's Sex and Social Living Situation on Rehabilitation Outcomes After a Stroke. Am J Phys Med Rehabil 2020; 99:48-55. [PMID: 31343498 DOI: 10.1097/phm.0000000000001276] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to investigate sex differences and the impact of social living situation on individual functional independence measure outcomes after stroke rehabilitation. DESIGN A retrospective observational study using Medicare fee-for-service beneficiaries (N = 125,548) who were discharged from inpatient rehabilitation facilities in 2013 and 2014 after a stroke. Discharge individual functional independence measure score, dichotomized as ≥5 and <5, was the primary outcome measure. A two-step generalized linear mixed model was used to measure the effect of sex on each functional independence measure item while controlling for many clinical and sociodemographic covariates. RESULTS After adjusting for sociodemographic and clinical factors, females had higher odds of reaching a supervision level for 14 of 18 functional independence measure items. Males had higher odds of reaching a supervision level on 2 of 18 functional independence measure items. Individuals who lived alone before their stroke had higher odds of reaching a supervision level than individuals who lived with a caregiver or with family for all functional independence measure items. CONCLUSIONS When sociodemographic and clinical factors are controlled, females are more likely to discharge from inpatient rehabilitation at a supervision level or better for most functional independence measure items. Individuals who live alone before their stroke have higher odds of discharging at a supervision level or better.
Collapse
|
9
|
Functional Performance and Discharge Setting Predict Outcomes 3 Months After Rehabilitation Hospitalization for Stroke. J Stroke Cerebrovasc Dis 2020; 29:104746. [PMID: 32151479 DOI: 10.1016/j.jstrokecerebrovasdis.2020.104746] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 01/03/2020] [Accepted: 02/06/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Some clinical features of patients after stroke may be modifiable and used to predict outcomes. Identifying these features may allow for refining plans of care and informing estimates of posthospital service needs. The purpose of this study was to identify key factors that predict functional independence and living setting 3 months after rehabilitation hospital discharge by using a large comprehensive national data set of patients with stroke. METHODS The Uniform Data System for Medical Rehabilitation was queried for the records of patients with a diagnosis of stroke who were hospitalized for inpatient rehabilitation from 2005 through 2007. The system includes demographic, administrative, and clinical variables collected at rehabilitation admission, discharge, and 3-month follow-up. Primary outcome measures were the Functional Independence Measure score and living setting 3 months after rehabilitation hospital discharge. RESULTS The sample included 16,346 patients (80% white; 50% women; mean [SD] age, 70.3 [13.1] years; 97% ischemic stroke). The strongest predictors of Functional Independence Measure score and living setting at 3 months were those same factors at rehabilitation discharge, despite considering multiple other predictor variables including age, lesion laterality, initial neurologic impairment, and stroke-related comorbid conditions. CONCLUSIONS These data can inform clinicians, patients with stroke, and their families about what to expect in the months after hospital discharge. The predictive power of these factors, however, was modest, indicating that other factors may influence postacute outcomes. Future predictive modeling may benefit from the inclusion of educational status, socioeconomic factors, and brain imaging to improve predictive power.
Collapse
|
10
|
Pedra EDFP, Pontes VL, Mourão AM, Braga MA, Vicente LCC. Post-stroke patients with and without thrombolysis: analysis of deglutition in the acute phase of the disease. Codas 2020; 32:e20180229. [PMID: 32022220 DOI: 10.1590/2317-1782/20192018229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 05/03/2019] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To verify the frequency and severity of dysphagia after ischemic stroke with or without thrombolysis in the acute phase; and the association among dysphagia, demographic characteristics, neurological and functional impairments and thrombolysis. METHODS A retrospective study of the medical records of 94 patients who suffered from ischemic stroke during the acute phase of the disease. From these, 52 patients received thrombolytic therapy and 42 patients did not receive such therapy. We collected data on age, sex, comorbidities, therapeutic time window of thrombolytic therapy, level of consciousness, degree of neurological impairment, level of functional dependency and clinical swallowing examination. A descriptive analysis included categorical and continuous variables, and an analysis of the association using the Pearson's Chi-Square Test, in which the value of p ≤ 0.05 was considered as a statistically significant association. RESULTS The frequency of dysphagia in the thrombolytic patients was 67.3%, the odds ratio was 4.6 higher than the non-thrombolysed patients. The severity of dysphagia was not associated with thrombolysis. There was an association between the presence of dysphagia and functional dependence. Demographic characteristics and neurological impairment were not associated with dysphagia. CONCLUSION Thrombolytic patients were more likely to develop dysphagia than non-thrombolysed patients in the acute phase of stroke, with dysphagia associated to functional dependence.
Collapse
Affiliation(s)
| | - Vanessa Laís Pontes
- Hospital das Clínicas, Universidade Federal Minas Gerais - UFMG - Belo Horizonte (MG), Brasil
| | | | | | | |
Collapse
|
11
|
Fujita T, Iokawa K, Sone T, Yamane K, Yamamoto Y, Ohira Y, Otsuki K. Effects of the Interaction among Motor Functions on Self-care in Individuals with Stroke. J Stroke Cerebrovasc Dis 2019; 28:104387. [DOI: 10.1016/j.jstrokecerebrovasdis.2019.104387] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/10/2019] [Accepted: 08/28/2019] [Indexed: 12/30/2022] Open
|
12
|
Bosma MS, Nijboer TCW, Caljouw MAA, Achterberg WP. Impact of visuospatial neglect post-stroke on daily activities, participation and informal caregiver burden: A systematic review. Ann Phys Rehabil Med 2019; 63:344-358. [PMID: 31200080 DOI: 10.1016/j.rehab.2019.05.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/25/2019] [Accepted: 05/08/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Visuospatial neglect (VSN) is a common cognitive disorder after stroke. The primary aim of this systematic review was to provide an overview of the impact of VSN in 3 aspects: (1) activities of daily living (ADL), (2) participation, and (3) caregiver burden. The second aim was to investigate the differences in studies focusing on populations with mean age<65 versus≥65 years. METHODS PubMed, EMBASE, Web of Science, Cochrane Library, Emcare, PsychINFO, Academic Search Premier and CENTRAL were searched systematically. Quality was assessed with the Mixed Methods Appraisal Tool. RESULTS Of the 115 included studies, 104 provided outcomes on ADL, 15 on participation (4 studies with mean age≥65), and 2 on caregiver burden (1 study with mean age≥65). Quality assessment yielded scores ranging from 0 to 100%. VSN had a negative impact on ADL (i.e., independence during ADL and performance in self-care, household tasks, reading, writing, walking, wheelchair navigation) and participation (i.e., driving, community mobility, orientation, work). The impact of VSN on fulfilling social roles was unclear. VSN had a negative effect on caregiver burden. We found no clear age-related differences. CONCLUSIONS AND IMPLICATIONS VSN has a negative impact not only on patients' independence but particularly on the performance of ADL. Despite the far fewer studies of VSN as compared with ADL, VSN also seems to hamper participation and increase caregiver burden, but further research is needed. Because of the large impact, VSN should be systematically and carefully assessed during rehabilitation. A considerable number of different instruments were used to diagnose VSN. Diagnosing VSN at more than one level [function (i.e., pen-and-paper test), activities, and participation] is strongly recommended. Consensus is needed on how to assess VSN and its negative impact for research and rehabilitation practice. SYSTEMATIC REVIEW REGISTRATION NO PROSPERPO Registration No. CRD42018087483.
Collapse
Affiliation(s)
- Martine S Bosma
- Department of public health and primary care, Leiden university medical center, Post zone V0-P, P.O. Box 9600, 2300 RC, Leiden, The Netherlands; Zorggroep Florence, Laan van Vredenoord 1, 2289 DA, Rijswijk, The Netherlands.
| | - Tanja C W Nijboer
- Center of excellence for rehabilitation medicine, UMC Utrecht brain center, university medical center Utrecht, and De Hoogstraat rehabilitation, Utrecht, The Netherlands; Utrecht university, department of experimental psychology, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands
| | - Monique A A Caljouw
- Department of public health and primary care, Leiden university medical center, Post zone V0-P, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - Wilco P Achterberg
- Department of public health and primary care, Leiden university medical center, Post zone V0-P, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| |
Collapse
|
13
|
Kimura T. The items and level contributing to improve in less than 50 motor functional independence measure upon admission in the stroke recovery rehabilitation ward. J Phys Ther Sci 2019; 31:418-423. [PMID: 31164778 PMCID: PMC6511508 DOI: 10.1589/jpts.31.418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 02/01/2019] [Indexed: 11/30/2022] Open
Abstract
[Purpose] To determine the motor Functional Independence Measure item and level that contribute to improvement in Functional Independence Measure gain in the recovery rehabilitation ward. [Participants and Methods] This study analyzed the data of 1,866 participants who were selected based on four criteria: age, number of days from onset to admission, length of hospital stay, and motor Functional Independence Measure upon admission. Moreover, all items examined were recorded. The participants were divided into two groups, the non-improving and improving group, based on a motor Functional Independence Measure gain of 22 points. The degree of contribution of each item was analyzed based on the median motor Functional Independence Measure. Logistic regression analysis was performed, with the two groups as dependent variables and the item with high contribution as independent variable; receiver operating characteristic analysis was performed. [Results] The items that highly contributed to motor Functional Independence Measure gain were bathing (level 3), dressing (lower body) (level 4), bladder management (level 5), and stair climbing (level 3). [Conclusion] The results of this study were suggested that the items that contribute to the improvement in motor Functional Independence Measure gain in stroke patients with a motor Functional Independence Measure of less than 50 were related to self-care and at least over moderate assistance.
Collapse
Affiliation(s)
- Takashi Kimura
- Department of Physical Therapy, ASO Rehabilitation College:
3-2-1 Higashi-Hie, Hakata-ku, Fukuoka-shi, Fukuoka 812-0007, Japan
- Department of Rehabilitation Medicine, Saga University
Hospital, Japan
| |
Collapse
|
14
|
Morone G, Matamala-Gomez M, Sanchez-Vives MV, Paolucci S, Iosa M. Watch your step! Who can recover stair climbing independence after stroke? Eur J Phys Rehabil Med 2018; 54:811-818. [PMID: 30156082 DOI: 10.23736/s1973-9087.18.04809-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND After discharge, most patients who have suffered a stroke remain with some limitations in their stair climbing ability. This is a critical factor in order to be independent in real-life mobility. Although there are several studies on prognostic factors for gait recovery, few of them have focused on the recovery of stair climbing. AIM The aim of this study was to identify prognostic risk factors for the recovery of stair climbing ability in a large sample of subjects with subacute stroke. DESIGN Observational study. SETTING Neurorehabilitation Inpatient Unit. POPULATION Subjects within the first month after stroke that had been admitted to an inpatient rehabilitation unit and discharged after an intensive inpatient rehabilitation. METHODS Demographical and clinical data were collected. Barthel Index (BI), Trunk Control Test and Motricity Index (MI) scores were recorded at admission and at discharge. Patients received two daily 40-minute sessions of motor rehabilitation, six days per week, during approximately two months. Forward Binary Logistic regressions were used to identify the role of risk factors, using as dependent variables the recovery of stair climbing ability and walking ability at discharge. As independent variables we used age, gender, onset-to-admission interval, side of hemiparesis, trunk control, Motricity Index (MI), presence of obesity, presence of neglect, presence of depression, classification of cerebral infarction (total anterior circulation, partial anterior circulation, posterior circulation or lacunar infarcts), degree of independence in activities of daily living, and cognitive state, all assessed at admission. RESULTS A total of 257 subjects were enrolled. BI-Score, MI-Score and presence of unilateral spatial neglect at admission were able to explain 83% of variance for the recovery of stair climbing ability. Subjects with a BI >40 at admission were about 17 times more likely to be able to climb stairs again than other patients, and those with MI ≥25 were about 9 times more likely than the rest. The presence of unilateral spatial neglect reduced this possibility of recovering stair climbing ability by about 5.5 times. Of these factors, only MI ≥25, together with a score at Trunk Control Test >12, significantly predicted also walking recovery. CONCLUSIONS This study highlights the different prognostic factors for recovering stair climbing and walking abilities, with a major role of unilateral spatial neglect in the former. CLINICAL REHABILITATION IMPACT There is a need for specific rehabilitation of stair climbing, also for improving the independence in activities of daily living, especially in patients who the clinical staff already knows should manage stairs in their community after being discharged.
Collapse
Affiliation(s)
- Giovanni Morone
- Clinical Laboratory of Experimental Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy -
| | - Marta Matamala-Gomez
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Event-Lab, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Maria V Sanchez-Vives
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Event-Lab, Faculty of Psychology, University of Barcelona, Barcelona, Spain.,ICREA, Barcelona, Spain.,Departament of General Psychology, University of Barcelona, Barcelona, Spain
| | - Stefano Paolucci
- Clinical Laboratory of Experimental Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Marco Iosa
- Clinical Laboratory of Experimental Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| |
Collapse
|
15
|
Bonnechère B, Sholukha V, Omelina L, Van Sint Jan S, Jansen B. 3D Analysis of Upper Limbs Motion during Rehabilitation Exercises Using the Kinect TM Sensor: Development, Laboratory Validation and Clinical Application. SENSORS 2018; 18:s18072216. [PMID: 29996533 PMCID: PMC6069223 DOI: 10.3390/s18072216] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 06/29/2018] [Accepted: 07/06/2018] [Indexed: 01/05/2023]
Abstract
Optoelectronic devices are the gold standard for 3D evaluation in clinics, but due to the complexity of this kind of hardware and the lack of access for patients, affordable, transportable, and easy-to-use systems must be developed to be largely used in daily clinics. The KinectTM sensor has various advantages compared to optoelectronic devices, such as its price and transportability. However, it also has some limitations: (in)accuracy of the skeleton detection and tracking as well as the limited amount of available points, which makes 3D evaluation impossible. To overcome these limitations, a novel method has been developed to perform 3D evaluation of the upper limbs. This system is coupled to rehabilitation exercises, allowing functional evaluation while performing physical rehabilitation. To validate this new approach, a two-step method was used. The first step was a laboratory validation where the results obtained with the KinectTM were compared with the results obtained with an optoelectronic device; 40 healthy young adults participated in this first part. The second step was to determine the clinical relevance of this kind of measurement. Results of the healthy subjects were compared with a group of 22 elderly adults and a group of 10 chronic stroke patients to determine if different patterns could be observed. The new methodology and the different steps of the validations are presented in this paper.
Collapse
Affiliation(s)
- Bruno Bonnechère
- Laboratory of Anatomy, Biomechanics and Organogenesis (LABO), Université Libre de Bruxelles, 1050 Brussels, Belgium.
- Department of Electronics and Informatics-ETRO, Vrije Universiteit Brussel, 1050 Brussels, Belgium.
- International Medical Equipment Collaborative (IMEC), Kapeldreef 75, B-3001 Leuven, Belgium.
| | - Victor Sholukha
- Laboratory of Anatomy, Biomechanics and Organogenesis (LABO), Université Libre de Bruxelles, 1050 Brussels, Belgium.
- Department of Applied Mathematics, Peter the Great St. Petersburg Polytechnic University (SPbPU), 195251 Sankt-Peterburg, Russia.
| | - Lubos Omelina
- Department of Electronics and Informatics-ETRO, Vrije Universiteit Brussel, 1050 Brussels, Belgium.
- International Medical Equipment Collaborative (IMEC), Kapeldreef 75, B-3001 Leuven, Belgium.
- Institute of Computer Science and Mathematics, Slovak University of Technology, 81237 Bratislava, Slovakia.
| | - Serge Van Sint Jan
- Laboratory of Anatomy, Biomechanics and Organogenesis (LABO), Université Libre de Bruxelles, 1050 Brussels, Belgium.
| | - Bart Jansen
- Department of Electronics and Informatics-ETRO, Vrije Universiteit Brussel, 1050 Brussels, Belgium.
- International Medical Equipment Collaborative (IMEC), Kapeldreef 75, B-3001 Leuven, Belgium.
| |
Collapse
|
16
|
Fujita T, Sato A, Iokawa K, Yamane K, Yamamoto Y, Tsuchiya K, Ohira Y, Otsuki K. A path analysis model for grooming performance in stroke patients. Disabil Rehabil 2018; 41:2958-2964. [DOI: 10.1080/09638288.2018.1483431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Takaaki Fujita
- Department of Rehabilitation, Faculty of Health Sciences, Tohoku Fukushi University, Sendai, Japan
| | - Atsushi Sato
- The Database Center of the National University Hospitals, University of Tokyo Hospital, Bunkyo-ku, Japan
| | - Kazuaki Iokawa
- Preparing Section for New Faculty of Medical Science, Fukushima Medical University, Fukushima, Japan
| | - Kazuhiro Yamane
- Department of Rehabilitation, Kita-Fukushima Medical Center, Date, Japan
| | - Yuichi Yamamoto
- Department of Rehabilitation, Kita-Fukushima Medical Center, Date, Japan
| | - Kenji Tsuchiya
- Department of Rehabilitation Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Japan
| | - Yoko Ohira
- Department of Rehabilitation, Kita-Fukushima Medical Center, Date, Japan
| | - Koji Otsuki
- Department of Rehabilitation, Kita-Fukushima Medical Center, Date, Japan
| |
Collapse
|
17
|
Fujita T, Sato A, Tsuchiya K, Ohashi T, Yamane K, Yamamoto Y, Iokawa K, Ohira Y, Otsuki K, Tozato F. Relationship between Grooming Performance and Motor and Cognitive Functions in Stroke Patients with Receiver Operating Characteristic Analysis. J Stroke Cerebrovasc Dis 2017; 26:2828-2833. [DOI: 10.1016/j.jstrokecerebrovasdis.2017.06.054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 06/22/2017] [Accepted: 06/30/2017] [Indexed: 10/19/2022] Open
|
18
|
Selected Factors Against Functional Performance in Patients in the Early Period After Stroke. TOPICS IN GERIATRIC REHABILITATION 2017. [DOI: 10.1097/tgr.0000000000000160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|
19
|
Dell'Uomo D, Morone G, Centrella A, Paolucci S, Caltagirone C, Grasso MG, Traballesi M, Iosa M. Effects of scapulohumeral rehabilitation protocol on trunk control recovery in patients with subacute stroke: A pilot randomized controlled trial. NeuroRehabilitation 2017; 40:337-343. [PMID: 28222555 DOI: 10.3233/nre-161421] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Despite upper limb rehabilitation is widely investigated in patients with stroke, the effects of scapulohumeral rehabilitation on trunk stabillization are mainly unknown. OBJECTIVE To test the effects of scapulohumeral rehabilitation protocol on trunk control recovery in patients with subacute stroke. METHODS A pilot randomized controlled trial with two groups of 14 patients each one performing 20 minutes per day, 5 days a week, for 6 weeks in add on to standard therapy. Experimental group performed a specific scapulohumeral rehabilitation protocol aiming to improve trunk competencies whereas control group performed conventional arm rehabilitation. Clinical scale tests and accelerometric evaluations were performed pre- and post-treatment. RESULTS Experimental groups showed better scores at discharge at Trunk impairment Scale (p < 0.001), Barthel Index (p = 0.024), Trunk Control Test (p = 0.002), Sitting Balance Scale (p = 0.002), but neither at Fugl-Meyer Scale (p = 0.194) nor Modified Ashworth Scale (p = 0.114). Accelerometric analysis showed higher stability of trunk for experimental group especially during static and dynamic items. CONCLUSIONS The recovery of scapulohumeral functions also acts on trunk stabilization post-stroke.
Collapse
Affiliation(s)
| | | | - Antonio Centrella
- Corso di Laurea in Fisioterapia, Università di Roma Tor Vergata, sede Fondazione Santa Lucia, Rome, Italy
| | | | - Carlo Caltagirone
- Università di Roma Tor Vergata, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | | | | | - Marco Iosa
- IRCCS Fondazione Santa Lucia, Rome, Italy
| |
Collapse
|