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Herrmann AA, Podgorski BB, Hatton SJ, Chrenka EA, Hanson LR, Jackson SD. Identifying Racial and Ethnic Disparities in Acute Inpatient Rehabilitation. Arch Phys Med Rehabil 2024; 105:1247-1254. [PMID: 38437895 DOI: 10.1016/j.apmr.2024.02.727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVE To investigate whether racial, ethnic, and linguistic disparities exist at discharge from an acute inpatient rehabilitation facility (IRF) by examining change in Functional Independence Measure (FIM) scores and discharge destination. DESIGN This is a retrospective study using our IRF's data from the Uniform Data System for Medical Rehabilitation from 2013-2019. FIM scores and discharge destination were compared between race, language, and ethnic groups, with adjustment for patient characteristics. SETTING An urban hospital with a level 1 trauma center, comprehensive stroke center, and IRF with Commission on Accreditation of Rehabilitation Facilities (CARF) certification. PARTICIPANTS 2518 patients admitted to the IRF from 2013-2019 (N=2518). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Change in FIM score and discharge destination. RESULTS After adjusting for covariates, non-White patients and patients with limited English proficiency had significantly lower functional recovery, as measured by smaller changes in FIM scores from IRF admission to discharge. Additionally, both groups were more likely to be discharged home with home health care than to a skilled nursing facility, compared with White and English-speaking patients. Disparities in discharge destination persisted within patients with noncommercial insurance (Medicaid or Medicare) and a stroke diagnosis but not within those who had commercial insurance or a nonstroke diagnosis. CONCLUSIONS Racial and linguistic disparities were identified within our CARF certified IRF; however, the organization is committed to reducing health care disparities. Next steps will include investigating interventions to reduce disparities.
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Affiliation(s)
- Amanda A Herrmann
- HealthPartners Institute, Minneapolis, MN; HealthPartners Neuroscience Center, St. Paul, MN.
| | | | | | - Ella A Chrenka
- HealthPartners Institute, Minneapolis, MN; HealthPartners Neuroscience Center, St. Paul, MN
| | - Leah R Hanson
- HealthPartners Institute, Minneapolis, MN; HealthPartners Neuroscience Center, St. Paul, MN
| | - Steven D Jackson
- HealthPartners Institute, Minneapolis, MN; HealthPartners Neuroscience Center, St. Paul, MN; Regions Hospital, St. Paul, MN
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Saygili F, Guclu‐Gunduz A, Eldemir S, Eldemir K, Ozkul C, Gursoy GT. Effects of modified-constraint induced movement therapy based telerehabilitation on upper extremity motor functions in stroke patients. Brain Behav 2024; 14:e3569. [PMID: 38873866 PMCID: PMC11177030 DOI: 10.1002/brb3.3569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 02/01/2024] [Accepted: 05/14/2024] [Indexed: 06/15/2024] Open
Abstract
INTRODUCTION The aim of this study is to investigate the effects of Modified-Constraint Induced Movement Therapy (m-CIMT) based telerehabilitation on upper extremity motor functions in stroke patients. METHODS Eighteen stroke patients were included and randomly allocated into two groups. The Tele-CIMT (modified-constraint induced movement therapy-based telerehabilitation) (n = 10) group received m-CIMT based telerehabilitation for 90 min a day, 5 weekdays for 3 weeks at home. Additionally, both the Tele-CIMT group and the control group (CG) (n = 8) underwent the home exercise program aimed at improving range of motion, active movement, balance, and walking every weekday for 3 weeks at home. The outcome measures were the Stroke Rehabilitation Assessment of Movement Scale (STREAM), Fugl-Meyer Upper Extremity Motor Evaluation Scale (FM-UE), Wolf Motor Function Test (WMFT), 9-Hole Peg Test (9-HPT), grip strengths, pinch strengths, Motor Activity Log-28 (MAL-28), and Functional Independence Measure (FIM). RESULTS Significant group-by-time interactions on STREAM, FM-UE, WMFT, grip strength, pinch strengths, MAL-28, and FIM were found to be in favor of the Tele-CIMT group. Additionally, post hoc analyses revealed that the Tele-CIMT group significantly improved in terms of these parameters (p > .05). CONCLUSION This is the first randomized controlled trial showing that Tele-CIMT improved upper extremity motor functions and activities of daily living in stroke patients. Tele-CIMT can help improve the upper extremities in stroke survivors who have difficulties reaching rehabilitation clinics.
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Affiliation(s)
- Fettah Saygili
- Faculty of Health Sciences, Department of Physiotherapy and RehabilitationAydın Adnan Menderes UniversityAydınTürkiye
| | - Arzu Guclu‐Gunduz
- Faculty of Health Sciences, Department of Physiotherapy and RehabilitationGazi UniversityAnkaraTürkiye
| | - Sefa Eldemir
- Faculty of Health Sciences, Department of Physiotherapy and RehabilitationSivas Cumhuriyet UniversitySivasTürkiye
| | - Kader Eldemir
- Faculty of Health Sciences, Department of Physiotherapy and RehabilitationOrdu UniversityOrduTürkiye
| | - Cagla Ozkul
- Faculty of Health Sciences, Department of Physiotherapy and RehabilitationGazi UniversityAnkaraTürkiye
| | - Gorkem Tutal Gursoy
- Department of Neurology, Health Ministry of Turkish RepublicAnkara Bilkent City HospitalAnkaraTürkiye
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Saltan A, Mert S, Topbaş Ö, Aksu B. The investigation of effect on foot plantar massage on functional recovery in older adults with general surgery, randomized clinical trial. Aging Clin Exp Res 2024; 36:118. [PMID: 38780814 PMCID: PMC11116172 DOI: 10.1007/s40520-024-02770-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE Foot massage is known to be effective on the emotional state (anxiety, depression, etc.) in the postoperative period. However, studies on its effect on functional level are insufficient. AIM The study aimed to investigate the impact of foot plantar massage on functional recovery in older adults undergoing general surgery, employing a randomized clinical trial design. METHODS A total of 70 older adults aged 65 years and above who underwent abdominal surgery were included. Various assessments were conducted, including pain levels (Visual Analogue Scale), fear of mobility (Tampa Scale for Kinesiophobia), functional independence (Functional Independence Measure), balance (Berg Balance Scale), basic mobility (Rivermead Mobility Index), mental function status (Standardized Mini-Mental State Examination), and delirium (Nu-DESC). RESULTS Statistically significant differences were observed in some assessment parameters within the groups during the 2nd and 3rd measurement times, with the intervention group demonstrating significant mean differences. DISCUSSIONS The literature underscores the increase in kinesiophobia scores post-general/abdominal surgery in older adults, emphasizing the importance of evaluating functional level and kinesiophobia to expedite discharge processes and potentially plan early post-discharge rehabilitation to mitigate readmissions for functional reasons. CONCLUSIONS Ultimately, foot massage was found to be effective in reducing kinesiophobia, improving balance, mobility, daily living skills, and mental status in older adults post-abdominal surgery, thereby advocating for the facilitation of post-discharge rehabilitation programs or the reduction of readmission rates. THE CLINICAL TRIALS NUMBER NCT05534490.
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Affiliation(s)
- Asuman Saltan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Yalova University, Yalova, Turkey.
| | - Selda Mert
- Department of Nursing, Faculty of Health Sciences, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Önder Topbaş
- Department of Medical Services and Techniques, Kocaeli Vocational School of Health Services, Kocaeli University, Kocaeli, Turkey
| | - Beyza Aksu
- Vocational School of Health Services, Kocaeli University Hospital, Kocaeli University, Kocaeli, Turkey
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Küçükakgün H, Tulek Z, Kılıçaslan K, Dursun Uncu J, Bayrak C, Soltanalizadeh R, Krespi Y. Validation of the Turkish version of the Neurological Fatigue Index for Stroke. Cogn Neuropsychiatry 2024; 29:141-153. [PMID: 38606870 DOI: 10.1080/13546805.2024.2337155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 03/12/2024] [Indexed: 04/13/2024]
Abstract
INTRODUCTION Post-stroke fatigue is an often overlooked problem that hinders recovery. Therefore, stroke patients should be evaluated for fatigue during the recovery period. This study aimed to adapt the Neurological Fatigue Index for Stroke (NFI-Stroke) into the Turkish language. METHODS This methodological study was carried out on 110 stroke patients admitted to a university hospital in Istanbul. In addition to the NFI-Stroke, Functional Independence Measure, National Institutes of Health Stroke Scale, modified-Rankin Scale, Fatigue Severity-Scale, and Stroke Self Efficacy Questionnaire were used to collect data. RESULTS Since the linguistic validity study of the scale has already been carried out, only psychometric properties were evaluated. The items in the scale were grouped under two factors. The Cronbach`s alpha coefficient was found to be 0.96 for the physical sub-dimension and 0.84 for the cognitive sub-dimension. Item-total correlation coefficients were found between 0.74-0.91 for the physical sub-dimension, and 0.82-0.91 for the cognitive sub-dimension. The test-retest evaluation confirmed the consistency of the responses to the scale against time. The scale was correlated with other scales used in the study as expected. CONCLUSIONS The NFI-Stroke will be useful in clinical practice in assessment of fatigue, which may affect the adaptation of patients to rehabilitation.
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Affiliation(s)
- Hilalnur Küçükakgün
- Institute of Graduate Studies, Medical Nursing Doctorate Program, Istanbul University-Cerrahpasa, Istanbul, Türkiye
- Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Zeliha Tulek
- Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Kimya Kılıçaslan
- Institute of Graduate Studies, Medical Nursing Doctorate Program, Istanbul University-Cerrahpasa, Istanbul, Türkiye
- Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Jbid Dursun Uncu
- Institute of Graduate Studies in Health Sciences, Advanced Neurological Sciences Doctorate Program, Istanbul University, Istanbul, Türkiye
- Department of Neurology, Stroke Center, Istinye University Liv Hospital Bahcesehir, Istanbul, Türkiye
| | - Ceren Bayrak
- Department of Neurology, Stroke Center, Istinye University Liv Hospital Bahcesehir, Istanbul, Türkiye
- Institute of Graduate Studies, Neurological Physiotherapy and Rehabilitation Master's Program, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Roya Soltanalizadeh
- Physical Medicine and Rehabilitation Clinic, Istinye University Liv Hospital Bahcesehir, Istanbul, Türkiye
| | - Yakup Krespi
- Department of Neurology, Stroke Center, Istinye University Liv Hospital Bahcesehir, Istanbul, Türkiye
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Elmas Bodur B, Erdoğanoğlu Y, Asena Sel S. Effects of robotic-assisted gait training on physical capacity, and quality of life among chronic stroke patients: A randomized controlled study. J Clin Neurosci 2024; 120:129-137. [PMID: 38241771 DOI: 10.1016/j.jocn.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/24/2023] [Accepted: 01/08/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND Even though robotic therapy is becoming more commonly used in research protocols for lower limb stroke rehabilitation, there still is a significant gap between research evidence and its use in clinical practice. Therefore, the present study was designed assuming that the wearable mobile gait device training for chronic stroke patients might have different effects on functional independence when compared to training with a stationary gait device. The present study aims to examine the effects of gait training with ExoAthlet exoskeleton and Lokomat Free-D on functional independence, functional capacity, and quality of life in chronic stroke patients. METHODS The present study included 32 chronic stroke patients. Participants were randomly divided into two groups. Functional independence of patients was evaluated by using Functional Independence Measure (FIM), physical function was assessed by using the 30-second chair stand test (30-CST), functional capacity was measured by using the 6-Minute Walk Test (6MWT), and quality of life was assessed by using Short Form 36 (SF36). All participants underwent a conventional physiotherapy program for eight weeks, three sessions per week, and each session lasted 60 min. After the physiotherapy program, one group received gait training by using ExoAthlet exoskeleton (ExoAtlet 1 model/2019, Russia), while the other group received training by using Lokomat Free-D (Hocoma, Lokomat Pro Free-D model/2015, Switzerland). Participants were assessed at baseline and post-intervention. RESULTS Results achieved in this study revealed that there was a statistically significant difference between FIM, 30-CST, 6MWT, and SF36 scores before and after the treatment in both groups (p < 0.05).There was no difference in FIM, 30-CST, and 6MWT results between Exoskeleton ExoAthlet and Lokomat Free-D groups (p > 0.05). However, there was a statistically significant difference between Exoskeleton ExoAthlet and Lokomat Free-D groups in terms of SF-36 sub-parameters "vitality", "mental health", "bodily pain", and "general health perception" (p < 0.05). CONCLUSIONS This study demonstrated that the use of ExoAthlet exoskeleton and Lokomat Free-D in addition to conventional physiotherapy, was effective in improving functional independence, physical function, functional capacity, and quality of life among chronic stroke patients. Incorporation of robotic gait aids into rehabilitation for chronic stroke patients might offer significant advantages.
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Affiliation(s)
| | - Yıldız Erdoğanoğlu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Antalya Bilim University, Antalya, Turkey.
| | - Sinem Asena Sel
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Antalya Bilim University, Antalya, Turkey
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Arcolin I, Godi M, Giardini M, Guglielmetti S, Bellotti L, Corna S. Minimal clinically important difference of the functional independence measure in older adults with hip fracture. Disabil Rehabil 2024; 46:812-819. [PMID: 36750763 DOI: 10.1080/09638288.2023.2175386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 01/28/2023] [Indexed: 02/09/2023]
Abstract
PURPOSE To investigate the responsiveness and minimal clinically important difference (MCID) of the Functional Independence Measure (FIM) from a clinician's perspective in hip-fractured elderly undergoing inpatient rehabilitation. MATERIALS AND METHODS Data of 701 hip-fractured elderly admitted to our rehabilitation institute were retrospectively collected. Ten a priori hypotheses were formulated. RESULTS The effect size of the FIM scores after treatment were large (total = 1.38, motor = 1.78). Moderate correlations were found between the change total score of FIM and Barthel Index (BI, rs = 0.51), Functional Ambulation Categories (FAC, rs = 0.52) and a checklist regarding participants' independence in transfers (rs = 0.59). The area under the receiving operating characteristics were 0.82, 0.81, and 0.85 when BI, FAC and checklist were used as anchors, respectively. Based on these findings, the FIM showed high responsiveness (9/10 hypotheses met). Triangulation of findings showed that MCIDs of 22 and 21 points were the most appropriate for the FIM total and motor score, respectively. CONCLUSIONS The FIM scale is appropriate for assessing independence and functional recovery in hip-fractured elderly. Improvements of 22 and 21 points at the total and motor FIM were identified as indicators of minimal clinical change in those admitted to a rehabilitation facility with an FIM total score between 40 and 80.
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Affiliation(s)
- Ilaria Arcolin
- Division of Physical Medicine and Rehabilitation, Istituti Clinici Scientifici Maugeri SpA SB, IRCCS, Scientific Institute of Veruno, Gattico-Veruno, Italy
| | - Marco Godi
- Division of Physical Medicine and Rehabilitation, Istituti Clinici Scientifici Maugeri SpA SB, IRCCS, Scientific Institute of Veruno, Gattico-Veruno, Italy
| | - Marica Giardini
- Division of Physical Medicine and Rehabilitation, Istituti Clinici Scientifici Maugeri SpA SB, IRCCS, Scientific Institute of Veruno, Gattico-Veruno, Italy
| | - Simone Guglielmetti
- Division of Physical Medicine and Rehabilitation, Istituti Clinici Scientifici Maugeri SpA SB, IRCCS, Scientific Institute of Veruno, Gattico-Veruno, Italy
| | - Lucia Bellotti
- Division of Physical Medicine and Rehabilitation, Istituti Clinici Scientifici Maugeri SpA SB, IRCCS, Scientific Institute of Veruno, Gattico-Veruno, Italy
| | - Stefano Corna
- Division of Physical Medicine and Rehabilitation, Istituti Clinici Scientifici Maugeri SpA SB, IRCCS, Scientific Institute of Veruno, Gattico-Veruno, Italy
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Sahbaz T, Medin-Ceylan C. Stroke severity to determine musculoskeletal symptoms in family caregivers. Rev Lat Am Enfermagem 2023; 31:e4004. [PMID: 37820216 PMCID: PMC10561800 DOI: 10.1590/1518-8345.6725.4004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/12/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVE the objective of this study is to examine the relationship between the musculoskeletal problems experienced by the family members who care for stroke patients, physical health and disability levels. METHOD the subjects included in the study were patients and family caregivers admitted to the Kanuni Sultan Suleyman Training and Research Hospital Physical Medicine and Rehabilitation outpatient clinic with a stroke diagnosis between May 30 th, 2019, and May 30 th, 2021. The caregivers were assessed using the Extended Nordic Musculoskeletal Questionnaire. Validated scales were employed to evaluate stroke patients' physical health and disability level. RESULTS a total of 104 stroke patients and 104 caregivers who met our inclusion criteria took part in this study. Low back complaints in the last month were associated with the patients' Functional Ambulation Score (FAS), Functional Independence Measure (FIM), Stroke Impact Scale (SIS) and Brunnstrom scores. Neck pain was the second musculoskeletal complaint, but was not statistically associated with patient-related factors. Upper limb problems were associated with FAS, FIM, SIS, Brunnstrom and the Modified Ashworth Scale scores. CONCLUSION according to our findings, the low back is the body area most affected by musculoskeletal complaints in family caregivers of stroke patients, closely related to the patients' functional capacity and disability levels. CLINICAL TRIALS NUMBER NCT04901637 (1) Stroke survivors highly depend on informal caregivers for daily living. (2) Family caregivers are at an increased risk of experiencing musculoskeletal problems. (3) The caregivers' musculoskeletal symptoms are related to the level of the patient disability. (4) Preventive medicine should become a part of nursing education for family caregivers.
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Affiliation(s)
- Tugba Sahbaz
- Beykent University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
| | - Cansın Medin-Ceylan
- University of Health Sciences, Istanbul Physical Therapy Rehabilitation Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
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Demir Avci Y, Gözüm S. Effects of Transitional Care Model-Based Interventions for Stroke Patients and Caregivers on Caregivers' Competence and Patient Outcomes: Randomized Controlled Trial. Comput Inform Nurs 2023; 41:805-814. [PMID: 36749850 DOI: 10.1097/cin.0000000000000991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
This study evaluated the effectiveness of the Transitional Care Model Stroke Turkey for stroke patients and caregivers as regards the competence of caregivers and patient outcomes. It is a parallel-group, assessor-blinded monocenter conducted with 126 participants in total (66 intervention included 33 stroke patients and 33 caregivers; 60 control groups included 30 stroke patients and 30 caregivers), between March and August 2018. The Transitional Care Model Stroke Turkey program lasts for 13 to 20 weeks. It includes a 12-week follow-up after discharge, a minimum of three hospital visits, one home visit, minimum 18 phone calls, and Web-based training. The intervention group exhibited better caregiver competence (13.48 ± 2.31), preparation for care (28.48 ± 4.74), and e-health literacy (34.42 ± 4.74) than the control group (respectively, 11.37 ± 2.48, 20.93 ± 7.10, 26.93 ± 8.53) ( P < .001). Emotional exhaustion and depersonalization increased in the control group, but remained the same in the intervention group. Personal accomplishment decreased in the intervention group, unlike in the control group. Within 12 weeks of discharge, five patients from the intervention group and seven patients from the control group were rehospitalized. There was no statistical difference between stroke patients in either group in terms of having previously used home healthcare services. The Transitional Care Model Stroke Turkey is a practical model for stroke patients transitioning from hospital to home.
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Affiliation(s)
- Yasemin Demir Avci
- Author Affiliations: Department of Public Health Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
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Ateş Sari Y, Aldeges W, Ünlüer NÖ. An investigation of upper extremity function, sleep quality, and functional independence in patients with poststroke shoulder pain: a cross-sectional study. Physiother Theory Pract 2023:1-8. [PMID: 37651602 DOI: 10.1080/09593985.2023.2253313] [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: 06/05/2023] [Revised: 08/23/2023] [Accepted: 08/23/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Poststroke shoulder pain (PSSP) is a common poststroke complication. Even though it is a common phenomenon, it is unclear how it impacts the patient's life. OBJECTIVE To investigate the differences in upper extremity function, sleep quality, and functional independence between patients with and without PSSP. METHODS This cross-sectional study included 63 participants with stroke (32 patients with PSSP and 31 patients without PSSP). Shoulder pain was evaluated with a Visual Analog Scale and the participants were divided into two groups as those with and without PSSP. The upper extremity function was assessed with the Disabilities of the Arm, Shoulder, and Hand Questionnaire, the Arm Motor Ability Test, and the Nine Hole Peg Test. Sleep quality was assessed with Pittsburgh Sleep Quality Index and the functional independence was assessed with the Functional Independence Measure. All data were analyzed using the program IBM SPSS Statistics 22.0. The Mann-Whitney U test was used to compare the non-normally distributed parameters, and the Chi-square test was used to compare the ordinal variables. The Spearman correlation test was used for the relationship and a linear regression test was used for regression. RESULTS Upper extremity function decreased (p < .05), only the sleep disturbance sub-parameter of sleep quality increased (p = .01), and functional independence increased in patients with PSSP (p < .001). There was a moderate relationship between pain and upper extremity function and a fair relationship between pain and sleep quality (use of sleep medications, daytime dysfunction sub-parameters) (p < .05). CONCLUSIONS PSSP impairs upper extremity functions, which play an important role in activities of daily living, and reduces functional independence. These results suggest that it is important to evaluate shoulder pain and examine the factors affecting pain in the rehabilitation of patients with stroke.
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Affiliation(s)
- Yasemin Ateş Sari
- Faculty of Health Science, Physiotherapy and Rehabilitation, Ankara Yıldırım Beyazıt University, Çubuk/Ankara, Turkey
| | - Wala'a Aldeges
- Institute of Health Sciences, Ankara Yıldırım Beyazıt University, Etlik/Ankara, Turkey
| | - Nezehat Özgül Ünlüer
- Gülhane Faculty of Physiotherapy and Rehabilitation, Health Sciences University, Keçiören/Ankara, Turkey
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Colomer C, Llorens R, Sánchez C, Ugart P, Moliner B, Navarro MD, Noé E, Ferri J. Reliability and validity of the Spanish adaptation of the Functional Independence Measure + Functional Assessment Measure. Eur J Phys Rehabil Med 2023; 59:452-457. [PMID: 37226445 PMCID: PMC10548398 DOI: 10.23736/s1973-9087.23.07841-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/05/2023] [Accepted: 05/09/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND The Functional Independence Measure + Functional Assessment Measure (FIM+FAM) Scale is one of the most widely used instruments to measure functional independence post-stroke, and features many cultural adaptations to various languages. AIM The aim of this study was to determine the psychometric properties of a Spanish cross-cultural adaptation of the FIM+FAM for use in the stroke population. DESIGN Observational study. SETTING Outpatient long-term service of a neurorehabilitation unit. POPULATION One hundred and twenty-two individuals with stroke. METHODS The functional independence of the participants was assessed with the adapted version of the FIM+FAM. Additionally, the functional, motor and cognitive condition of the participants was assessed with a battery of standardized clinical instruments. Finally, a group of 31 participants out of the total were evaluated a second time with the FIM+FAM by a different evaluator than the one who performed the first evaluation. Internal consistency, inter-rater reliability and convergent validity with other clinical instruments of the adapted version of the FIM+FAM were determined. RESULTS The internal consistency of the adapted version of the FIM+FAM was excellent, as evidenced by Cronbach's α values that exceeded 0.973. The inter-rater reliability was likewise excellent, with correlations above 0.990 in all domains and subscales. Additionally, the convergent validity of the scale adaptation with clinical instruments was variable, with values ranging from 0.264 to 0.983, but consistent with the construct assessed in the different instruments examined. CONCLUSIONS The internal consistency, inter-rater reliability and convergent validity of the Spanish-adapted version of the FIM+FAM Scale showed excellent reliability and validity of the adaptation, which supports its use to assess functional independence after stroke. CLINICAL REHABILITATION IMPACT Availability of a valid adaptation for the evaluation of functional independence after stroke in Spanish population.
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Affiliation(s)
- Carolina Colomer
- Instituto de Rehabilitación Neurológica (IRENEA), Fundación Vithas, Valencia, Spain -
| | - Roberto Llorens
- Instituto de Rehabilitación Neurológica (IRENEA), Fundación Vithas, Valencia, Spain
- Neurorehabilitation and Brain Research Group, Instituto Universitario de Investigación en Tecnología Centrada en el Ser Humano, Universitat Politècnica de València, Valencia, Spain
| | - Clara Sánchez
- Instituto de Rehabilitación Neurológica (IRENEA), Fundación Vithas, Valencia, Spain
| | - Patricia Ugart
- Instituto de Rehabilitación Neurológica (IRENEA), Fundación Vithas, Valencia, Spain
| | - Belén Moliner
- Instituto de Rehabilitación Neurológica (IRENEA), Fundación Vithas, Valencia, Spain
| | - María D Navarro
- Instituto de Rehabilitación Neurológica (IRENEA), Fundación Vithas, Valencia, Spain
| | - Enrique Noé
- Instituto de Rehabilitación Neurológica (IRENEA), Fundación Vithas, Valencia, Spain
| | - Joan Ferri
- Instituto de Rehabilitación Neurológica (IRENEA), Fundación Vithas, Valencia, Spain
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Sarıçan Y, Erdoğanoğlu Y, Pepe M. The effect of body awareness on trunk control, affected upper extremity function, balance, fear of falling, functional level, and level of independence in patients with stroke. Top Stroke Rehabil 2023:1-10. [PMID: 36871579 DOI: 10.1080/10749357.2023.2185995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
OBJECTIVES This study was conducted to examine the effects of body awareness on trunk control, affected upper extremity function, balance, fear of falling, functional level, and level of independence in patients with stroke. METHODS 35 individuals between the ages of 21 and 78 who were diagnosed with stroke were included in the study. The body awareness of the individuals participating in the study was determined with the Body Awareness Questionnaire (BAQ), trunk control with Trunk Impairment Scale (TIS), the affected upper extremity functions with Motor Activity Log-28 (MAL,-28), and Fugl-Meyer Upper Extremity Assessment (FMUEA), balance with Berg Balance Scale (BBS), fear of falling with Tinetti Falls Efficacy Scale (TFES), functional level with Barthel Activities of Daily Living Index (BI) and level of independence with Functional Independence Measures (FIM). RESULTS For patients participating in the study, 26% were female, 74% were male and 43% showed left, 57% showed right hemisphere involvement. In simple linear regression analysis, BAQ measurement had a statistically significant effect on TIS (F = 25.439 p = 0.001), MAL-28 (F = 7.852 p = 0.008), FMUEA (F = 12.155 p = 0.001), BBS (F = 13.506 p = 0.001), TFES (F = 13.119 p = 0.001), BI (F = 19.977 p = 0.001) and FIM (F = 22.014 p = 0.001) in patients with stroke. CONCLUSIONS In conclusion, body awareness was found to be one of the factors affecting trunk control, affected upper extremity function, balance, fear of falling, functional level, and level of independence in patients with stroke. It was thought that there was a need for assessment of body awareness and include bodyawareness in rehabilitation programs in patients with stroke.
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Affiliation(s)
- Yusuf Sarıçan
- Physiotherapy and Rehabilitation Department, Institute of Health Sciences, Üsküdar University, İstanbul, Türkiye
| | - Yıldız Erdoğanoğlu
- Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, Antalya Bilim University, Antalya, Türkiye
| | - Murad Pepe
- Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, Antalya Bilim University, Antalya, Türkiye
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Aktas B, Naz I, Emuk Y, Varli U, Kirakli C. Turkish translation, cross-cultural adaptation, and assessment of psychometric properties of the Ottawa sitting scale for the intensive care unit survivors. Disabil Rehabil 2022; 44:7304-7311. [PMID: 34586925 DOI: 10.1080/09638288.2021.1983040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE To translate and cross-culturally adapt the Ottawa Sitting Scale (OSS) developed for acute care patients into Turkish and to examine its psychometric properties in intensive care unit (ICU) survivors. METHODS After translation process the Turkish version of the scale was adminstered to eighty-one patients aged 39-82 years after discharge from the ICU and videotape was recorded. Two physiotherapists watched the videotaped records during the evaluation and scored. Test-retest reliability was assesed by scoring the same video recordings 15 days after the initial scoring. Correlations of the OSS with Berg Balance Scale (BBS), Functional Independence Measurement (FIM), the ICU length of stay and, total mechanical ventilation duration were assessed for convergent validity. RESULTS The intra-class correlation coefficient for inter and intra-rater reliability was 0.989-0.994 and 0.998 respectively. The internal consistency was excellent (Cronbach's α = 0.998). The OSS score was highly correlated with the BBS total score (r = 0.716), the BBS unsupported sitting item score (r = 0.863), and moderately correlated with the total score of the FIM (r = 0.602), the number of days in ICU (r= -0.545), and total mechanical ventilation duration (r = -0.518). CONCLUSION The Turkish version of OSS has been found to be valid and reliable in assessment of sitting balance in patients discharged from intensive care unit.Implications For RehabilitationPhysiotherapeutic measurements are crucial and necessary to determine the functional status of the patients.Ottawa Sitting Scale was translated and culturally adapted to Turkish and showed good psychometric propertiesOttawa Sitting Scale is valid and reliable tool to evaluate sitting balance in intensive care unit survivors.Ottawa Sitting Scale can guide clinicians in establishing evaluation and rehabilitation programs for patients discharged from intensive care unit.
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Affiliation(s)
- Busra Aktas
- Institute of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
| | - Ilknur Naz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
| | - Yusuf Emuk
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
| | - Umit Varli
- Graduate from Institute of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
| | - Cenk Kirakli
- Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, University of Health Sciences Turkey, Izmir, Turkey
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Özcan F, Gürçay E, Kalem Özgen AN, Demir Y. Outcomes and predictors of stress among Turkish family caregivers of patients with acquired brain injury. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-9. [PMID: 36075221 DOI: 10.1080/23279095.2022.2115909] [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
OBJECTIVE This study examined family caregiver stress and factors predicting the stress among caregivers of patients with acquired brain injury (ABI). METHODS Sixty caregivers of patients with ABI took part in this study. All participants completed assessments of Caregiver Strain Index, Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Scale, Nottingham Health Profile (NHP), and Satisfaction with Life Scale (SWLS). The patients with ABI were also assessed on the Functional Independence Measure, Disability Rating Scale, Rancho Los Amigos Cognitive Scale-revised, Functional Ambulation Classification Scale, and Neurobehavioral Rating Scale-revised. Relationship between caregiver's stress and clinical outcomes was analyzed, together with factors significantly associated with stress. RESULTS Elevated levels of stress were determined in 40% of caregivers. Higher stress was seen in caregivers of patients with shorter disease duration, worse functioning, who had more depression and anxiety, poorer perceived health status particularly for pain and emotional reaction domains, and less life satisfaction. Linear regression analysis demonstrated that caregiver's stress was predicted by NHP pain domain (β = 0.062, p = 0.016) and SWLS (β = -0.133, p = 0.040). CONCLUSION Caregivers with more pain and less life satisfaction are at higher risk of developing stress. In order to overcome this difficult process and improve the quality of care, it would be appropriate to reveal predictors of stress and produce appropriate interventions/approaches.
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Affiliation(s)
- Fatma Özcan
- Gaziler Physical and Rehabilitation Medicine Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Eda Gürçay
- Gaziler Physical and Rehabilitation Medicine Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ayşe Naz Kalem Özgen
- Gaziler Physical and Rehabilitation Medicine Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Yasin Demir
- Gaziler Physical and Rehabilitation Medicine Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Onat ŞŞ, Polat CS, Gürçay E, Özcan DS, Orhan A. Muscle architecture and clinical parameters in stroke patients: An ultrasonographic study. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:713-718. [PMID: 35338498 DOI: 10.1002/jcu.23202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/06/2022] [Accepted: 02/09/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE To compare the lower extremity muscle architecture on both the affected side and healthy sides using ultrasound (US) imaging and examine the relationship between these measurements and clinical parameters in stroke patients. METHODS A cross-sectional analysis of 125 stroke patients (64 M, 61 F) was performed in this study. Timed up and go (TUG) test was used to evaluate balance, Fugl-Meyer assessment of lower extremity (FMA-LE) was used to evaluate motor function, functional independence measurement (FIM) was used to evaluate functional status. Muscle thicknesses (MT) of rectus femoris (RF), vastus intermedius (VI), vastus medialis (VM), vastus lateralis (VL), soleus, medial gastrocnemius (GC) muscles, the PA and the FL of GC were obtained using ultrasound (US) imaging. RESULTS The muscle thickness, PA and FL of the affected side decreased significantly compared to the healthy side (p = .0001) in stroke patients. Another clear result was that soleus and GC muscle thicknesses and PA of GC muscle were found to be associated with balance, motor function, and functional status. CONCLUSION The properties of muscles evaluated with US may provide recommendations for clinical assessments and also potentially contribute to clinicians designing a rehabilitation intervention program for stroke patients.
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Affiliation(s)
- Şule Şahin Onat
- Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey
| | - Cemile Sevgi Polat
- Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey
| | - Eda Gürçay
- Gaziler Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey
| | - Didem Sezgin Özcan
- Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey
| | - Ali Orhan
- Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey
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Eroğlu S, Solak S, Dündar Ü. The association of Type D personality with functional outcomes, quality of life and neuropathic pain in persons with spinal cord injury. Spinal Cord 2022; 60:567-573. [PMID: 35124701 DOI: 10.1038/s41393-022-00760-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVES This study aimed to investigate the association of Type D personality (TDP) with functional outcomes, health-related quality of life (HRQoL) and neuropathic pain in persons with spinal cord injury (SCI), using dichotomous and continuous analysis methods. SETTING Tertiary rehabilitation center. METHODS This study included 105 persons with SCI. Independence level was determined using the Functional Independence Measure (FIM)-motor subscale. The Short Form-36 questionnaire (SF-36) was used to assess HRQoL. TDP (combined existence of negative affectivity and social inhibition) was assessed using Type D Scale-14 (DS-14). Presence of chronic pain was questioned and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) Pain Scale was used to distinguish neuropathic pain from others. RESULTS In dichotomous method, the FIM-motor score was significantly lower in persons with TDP (41 persons, 39%) (p = 0.025). Persons with TDP had significantly lower scores in vitality, emotional role and mental health. There was no significant difference between the groups, regarding neuropathic pain and LANSS scores (p > 0.05 for all). Negative affectivity and total DS-14 scores had negative correlation with mental health and vitality. In continuous interaction method, TDP predicted mainly the mental health components of SF-36 (particularly, vitality and mental health). Negative affectivity was the driving factor. TDP was not associated with FIM-motor, VAS pain or LANSS scores. CONCLUSIONS Mental component of HRQoL is associated with Type D in persons with SCI in both analyses. Assessment of potential differences related with TDP may be beneficial to develop and apply person-specific goals in SCI rehabilitation.
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Affiliation(s)
- Selma Eroğlu
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
| | - Samed Solak
- Department of Physical Medicine and Rehabilitation, Kahta State Hospital, Adıyaman, Turkey
| | - Ümit Dündar
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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Sayilan AA, Saltan A, Mert S, Ankarali H. Identifying relationships between kinesiophobia, functional level, mobility, and pain in older adults after surgery. Aging Clin Exp Res 2022; 34:801-809. [PMID: 34708298 DOI: 10.1007/s40520-021-02011-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 10/18/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Further data on the causes of functional independence or disability after surgery are needed to explain the clinical decision-making process for older patients, their families, and policy-makers. There are a limited number of studies showing the relationship between kinesiophobia, functional status, pain and mobility in older adults after surgery. AIMS The study aims to investigate relationships among kinesiophobia, pain, mobility, and functional status in older adults after surgery. METHODS A comparative-descriptive and cross-sectional study. The research was conducted with 99 older adults in the general surgery clinic after surgery. A Visual Analogue Scale was used to evaluate pain levels, the Standardized Mini-Mental State Examination to evaluate mental function status, the Functional Independence Measure to assess functional independence in daily activities, the Rivermead Mobility Index to evaluate basic mobility in daily life, and the Tampa Scale for Kinesiophobia to assess fear of mobility. RESULTS Regression analysis revealed a significant negative correlation between social security and kinesiophobia, and also between functional level and type of anesthesia and mental status in older women (R2 = - 0.185, p = 0.005; R2 = - 0.167, p = 0.011 and p = 0.005, respectively). DISCUSSION In the literature, there are no standardized procedures during the evaluation and rehabilitation of older adults after abdominal or thoracic surgery, etc. operations. This study will contribute to the current literature by attracting interest in this field and increasing the evaluations performed. CONCLUSIONS The study findings emphasize the importance of evaluating the functional, mobility, mental and kinesiophobic status of older adults after surgery in clinics, rehabilitation centers, or research.
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Affiliation(s)
- Aylin Aydin Sayilan
- Department of Nursing, Faculty of Health Sciences, Kırklareli University, Kırklareli, Turkey
| | - Asuman Saltan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Yalova University, Yalova, Turkey.
| | - Selda Mert
- Department of Medical Services and Techniques, Kocaeli Vocational School of Health Services, Kocaeli University, Kocaeli, Turkey
| | - Handan Ankarali
- Department of Medical Informatics, School of Medicine and Biostatistics, Medeniyet University, Istanbul, Turkey
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Ikbali Afsar S, Cosar SNS, Yemişçi OU, Bölük H. Inpatient rehabilitation outcomes in neoplastic spinal cord compression vs. traumatic spinal cord injury. J Spinal Cord Med 2022; 45:221-229. [PMID: 32701391 PMCID: PMC8986217 DOI: 10.1080/10790268.2020.1794713] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Objective: To compare neurological and functional outcomes, and complications of patients with neoplastic vs traumatic spinal cord injury (SCI) after in-patient rehabilitation.Design: This study is a retrospective analysis.Setting: In-patient rehabilitation unit of a tertiary research hospital.Participants: A total of 252 patients with a SCI were included; 43 with neoplastic SCI (mean age: 60.9 ± 15.7 years, 60.5% were males) and 209 with traumatic SCI (mean age: 43.1 ± 16.8 years, 71.3% were males).Outcome measures: Comparisons were made of demographic characteristics, etiology, American Spinal Injury Association (ASIA) impairment scale, functional independence measurement (FIM) and Functional Ambulation Categories (FAC) scores, length of stay (LOS), bladder independence, medical comorbidities and complications in both groups.Results: Patients with neoplastic SCI were significantly older than those with traumatic SCI (P < 0.01). No difference was present between the groups in terms of sex and lesion level (P > 0.05). Incomplete SCI was significantly higher in the neoplastic group when compared with the traumatic group (P < 0.01). The LOS was significantly shorter in the neoplastic group than traumatic group (34.8 ± 41.03 vs. 60.02 ± 53.1, P < 0.01). There were no differences in the admission FIM scores (69.3 ± 24.7 vs. 58.7 ± 18.9, P > 0.05), discharge FIM scores (82.1 ± 25.1 vs. 74.02 ± 23.3, P > 0.05) and FIM efficiencies (0.43 ± 0.72 vs. 0.36 ± 0.51, P > 0.05) for the neoplastic and traumatic groups, respectively. However, neoplastic SCI patients demonstrated lower FIM gains compared to traumatic patients (12.9 ± 11.9 vs. 15.4 ± 15.2, P < 0.05). During rehabilitation, urinary tract infection (48.4% vs. 69.4%) and decubitus ulcer (11.6% vs. 35.9%) were significantly more common in the traumatic group than the neoplastic group (P < 0.05).Conclusion: Neoplastic SCI patients who commonly present at rehabilitation units exhibit different characteristics from traumatic SCI patients but the rehabilitation results are similar. Similar functional development can be achieved in a shorter period of time with inpatient rehabilitation in the neoplastic SCI group.
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Affiliation(s)
- Sevgi Ikbali Afsar
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Sacide Nur Saraçgil Cosar
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Oya Umit Yemişçi
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Hüma Bölük
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Baskent University, Ankara, Turkey
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Ture SD, Ozkaya G, Sivrioglu K. Relationship between neurogenic bowel dysfunction severity and functional status, depression, and quality of life in individuals with spinal cord injury. J Spinal Cord Med 2022; 46:424-432. [PMID: 35108161 PMCID: PMC10114961 DOI: 10.1080/10790268.2021.2021043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES/CONTEXT To evaluate the relationship between severity of neurogenic bowel dysfunction (NBD) and functional status, depression, and quality of life in individuals with spinal cord injury (SCI) and to determine the factors associated with developing moderate-to-severe NBD. DESIGN Cross-sectional study. SETTING University hospital rehabilitation outpatient clinic. PARTICIPANTS Individuals with traumatic SCI, at least one year post-injury (N = 92). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Neurogenic Bowel Dysfunction Score, Functional Independence Measure (FIM), Beck Depression Inventory (BDI), and Short Form-36 (SF-36). RESULTS In the current sample, we found that half of the individuals with SCI had moderate-to-severe NBD. Individuals with moderate and severe NBD had lower motor FIM (P = 0.008 and P = 0.006, respectively) and SF-36 physical functioning (PF) scale (P = 0.020 and P = 0.031, respectively) scores than individuals with very minor NBD. There was no difference in the BDI scores among individuals with different levels of NBD. Individuals with American Spinal Injury Association Impairment Scale (AIS) A injuries were more likely to develop moderate-to-severe NBD than those with AIS C (odds ratio (OR) = 6.52; 95% confidence interval (CI) 1.13-37.79; P = 0.005) or AIS D (OR = 17.19; 95% CI 3.61-81.82; p < 0.001) injuries. CONCLUSION Individuals with moderate-to-severe NBD had higher levels of dependency in activities of daily living and lower SF-36 PF scale scores than individuals with very minor NBD. Among individuals with SCI, completeness of injury was a significant factor for developing moderate-to-severe NBD.
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Affiliation(s)
- Sevda Demir Ture
- Department of Physical Medicine and Rehabilitation, Bursa Uludag University School of Medicine, Bursa, Turkey
| | - Guven Ozkaya
- Department of Biostatistics, Bursa Uludag University School of Medicine, Bursa, Turkey
| | - Koncuy Sivrioglu
- Department of Physical Medicine and Rehabilitation, Bursa Uludag University School of Medicine, Bursa, Turkey
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Evaluation of an upper limb robotic rehabilitation program on motor functions, quality of life, cognition, and emotional status in patients with stroke: a randomized controlled study. Neurol Sci 2022; 43:1177-1188. [PMID: 34247295 DOI: 10.1007/s10072-021-05431-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/24/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE This study aims to find out whether including robotic therapy in addition to a conventional rehabilitation program affects the quality of life, motor function, cognition, and emotional status of hemiplegic patients. DESIGN Thirty-seven stroke patients recruited between April 2016 and April 2019 were included in the study. The patients were randomized into 2 groups (Robotic rehabilitation group-RR n:17, Control group n:20), RR was arranged to be 30-45 min, 5 days per week for 4 weeks. All patients were assessed at the beginning of therapy and the end of 4th week with Brunnstrom stages of motor recovery, Fugl-Meyer Assessment (FMA), handgrip strength, Purdue peg test, Minnesota manual dexterity test, Modified Ashworth Scale (MAS), Functional Independence Measure (FIM), Stroke Specific Quality of Life Scale (SS-QOL), Nottingham Extended Activities of Daily Living (NEADL) Scale, Montreal Cognitive Assessment (MoCA) and Center for Epidemiological Studies Depression Scale (CES- D). RESULTS Improvements in motor function scores, spasticity, general functioning, activities of daily living, cognitive assessment were better in the robotic group when compared to the control group but this difference was not statistically significant (p > 0.05). Improvement in the CES-D in the RR-group was better in comparison to the control group (p = 0.018). CONCLUSION Improvements in motor functions were observed after the treatment in both groups. Although RR group improved better in numbers, none of the outcomes except the CES-D scale were significant. Robotic rehabilitation provides a favorable alternative bringing slight benefits, and also is advantageous in terms of work power and psychological recovery, making its addition to conventional neurological rehabilitation effective and useful in patient management after stroke. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04393480.
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Özcan F, Özişler Z. The Relationship Between Urinary Symptom Severity And Functional Status İn Patients With Stroke. Scott Med J 2022; 67:64-70. [PMID: 34985348 DOI: 10.1177/00369330211072247] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Lower Urinary Tract Dysfunction (LUTD) is a condition that is common in stroke patients and affects their quality of life and psychological state. AIM To determine the factors affecting LUTD severity in stroke patients and to evaluate its relationship with functional status. METHOD 77 stroke patients were included in our study. Demographic and stroke characteristics of all patients were recorded. Functional Ambulation Scale (FAS), Functional Independence Measure (FIM), the Core Lower Urinary Tract Symptom Score (CLSS) Questionnaire, Beck Depression Scale were administered to the patient. 33 of 77 patients had urodynamic study and these patients constituted the subgroup of the study. Patients were grouped according to type of disorder, type of detrusor and detrusor sphincter dyssynergia (DSD) using urodynamic study findings. RESULT The mean CLSS of men was significantly higher than women (P = 0.017). A significant positive correlation was found between age and CLSS (P = 0.035 r = 0.24) and negative correlation was found between total FIM and all sub-parameter scores and mean of CLSS (P = 0.001 r = -0.467). CONCLUSION LUTD is common in stroke patients and the presence of urinary symptoms is associated with poor functional status. No significant relationship was observed between urodynamic data except maximum flow rate and CLSS.
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Affiliation(s)
- Fatma Özcan
- 111330Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Zuhal Özişler
- 162302Ankara City Hospital, Physical Therapy and Rehabilitation Hospital, Ankara, Turkey
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Arfianti L, Rochman F, Hidayati HB, Subadi I. The addition of mirror therapy improved upper limb motor recovery and level of independence after stroke: a randomized controlled trial. CADERNOS BRASILEIROS DE TERAPIA OCUPACIONAL 2022. [DOI: 10.1590/2526-8910.ctoao245932182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction In stroke survivors, the prevalence of upper motor disability remains high. There has not been much report on the success of post-stroke mirror therapy, especially in developing countries. Objective The focus of this research is to see how mirror therapy, in addition to standard rehabilitation for hand paresis, affects upper limb motor recovery and level of independence in self-care after stroke at an Indonesian teaching hospital. Method This was a randomized controlled trial with no assessor blinding. The study included 18 subacute stroke patients who did not have cognitive or visual impairment. The mirror group received a 20-minute mirror therapy session in addition to conventional rehabilitation, while the control group received only the standard program for 5 weeks (2 times per week). The Brunnstrom score and self-care level of independence elements of the Functional Independence Measure (FIM) were used as outcome measures. Results Baseline comparisons of lesion type and Brunnstrom score showed significant between-group differences. The ANACOVA test showed the difference had no effect on the FIM change in scores (P > 0.05). One patient (mirror group) was dropped out from the study. After 5 weeks (n=17), the mirror group showed improvement in both the Brunnstrom and FIM scores (P < 0.05) compared to the control group. Conclusions Mirror treatment improves upper limb motor recovery and level of independence in self-care after stroke when combined with standard hand paresis rehabilitation 2 times a week for 5 weeks.
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Arslan Ö, Tosun Z. Comparison of the psychometric properties of three commonly used fall risk assessment tools: a prospective observational study for stroke patients. Top Stroke Rehabil 2021; 29:430-437. [PMID: 34850668 DOI: 10.1080/10749357.2021.2008598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND A reliable tool recommendation is needed to identify the risk of falling in hospitalized stroke patients. OBJECTIVES The aim of this study was to identify the most reliable fall risk assessment tool among the Morse Fall Scale (MFS), Itaki Fall Risk Scale (Itaki FRS) and Hendrich II Fall Risk Model (HIIFRM) for stroke patients. METHODS The study was planned as an observational prospective study. It was carried out over the period July-December 2018 with 125 stroke patients. The Functional Independence Measure (FIM), Itaki FRS, HIIFRM, and MFS were used for the study data. The fall risk and incidents of falling were monitored on a daily basis over the course of the patients' stay at the hospital. The differentiation between the fall risk tools was assessed with sensitivity-specificity analysis and the ROC curve. RESULTS The mean age of the research participants was 71.47 ± 11.16 years. It was determined that 9.6% of the patients fell at least once during the follow-up period, which was 8.66 ± 1.80 days on average. The sensitivity and specificity rates of the fall risk assessment tools were respectively 75.0% and 63.7% for the Itaki FRS, 83.3% and 50.4% for the HIIFRM, and 91.7% and 73.5% for the MFS. The cutoff points on the tools were 14 for the Itaki FRS, 4.5 for the HIIFRM, and 66.2 for the MFS. CONCLUSION MFS is a more reliable tool than Itaki FRS or HIIFRM in determining fall risk in hospitalized stroke patients.
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Affiliation(s)
- Özge Arslan
- Republic of Turkey, Health Ministry, Tekirdag State Hospital, Tekirdag, Turkey
| | - Zeynep Tosun
- Health College Nursing Department, Tekirdag Namik Kemal University, Tekirdag, Turkey
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Measuring self-reported ability to perform activities of daily living: a Rasch analysis. Health Qual Life Outcomes 2021; 19:243. [PMID: 34663347 PMCID: PMC8522042 DOI: 10.1186/s12955-021-01880-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/11/2021] [Indexed: 11/15/2022] Open
Abstract
Background Since the number of persons diagnosed with multi-morbidity is increasing, there is a need for generic instruments to be able to assess, measure and compare ADL ability across diagnoses. Accordingly, the ADL-Interview (ADL-I) was developed to be used in rehabilitation research and clinical practice. The aim of this study was to investigate if the ADL-I can be used to provide valid and reliable ADL ability measures across gender and diagnostic groups. Methods ADL-I data were extracted from an existing research database on persons with chronic conditions including medical, rheumatological, oncological, neurological, geriatric and psychiatric diagnoses. Data were analysed based on Rasch Measurement methods to examine: the psychometric properties of the rating scale; ADL item and person fit to the Rasch model; if the difficulty of the ADL tasks differs across gender and diagnostic groups, and if the ADL-I provides precise and reliable measures of ADL ability. Results Data on n = 2098 persons were included in the final analysis. Initial evaluation of the 0–3 rating scale revealed threshold disordering between categories 1 and 2. After removal of 16 underfitting items, the variance explained by the Rasch dimension increased from 54.3 to 58.0%, thresholds were ordered, but the proportion of persons with misfitting ADL-I measures increased slightly from 8.7 to 9.1%. The person separation index improved slightly from 2.75 to 2.99 (reliability = 0.90). Differential test function analysis, however, supported that the 16 underfitting items did not represent a threat to the measurement system. Similarly, ADL items displaying differential item functioning across gender and diagnoses did not represent a threat to the measurement system. The ADL items and participants were well distributed along the scale, with item and person measures well targeted to each other, indicating a small ceiling effect and no floor effect. Conclusions The study results overall suggest that the ADL-I is producing valid and reliable measures across gender and diagnostic groups among persons within a broad range of ADL ability, providing evidence to support generic use of the ADL-I. Trial registration N/A.
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Ģiga L, Pētersone A, Čakstiņa S, Bērziņa G. Comparison of content and psychometric properties for assessment tools used for brain tumor patients: a scoping review. Health Qual Life Outcomes 2021; 19:234. [PMID: 34625062 PMCID: PMC8501604 DOI: 10.1186/s12955-021-01863-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 09/15/2021] [Indexed: 01/28/2023] Open
Abstract
AIMS To determine the most frequently utilized functional status assessment instruments for patients with brain tumors, compare their contents, using the International Classification of Functioning, Disability and Health (ICF), and their psychometric properties. METHODS A scoping review was conducted to explore possible assessment instruments and summarize the evidence. A systematic literature search was performed for identification of the frequently used functional assessment tool in clinical trials in PubMed, ScienceDirect, and ProQuest databases. The content of most used instruments was linked to the ICF categories. The psychometric qualities of these assessment tools were systematically searched and analyzed. RESULTS Nine most used assessment tools in clinical trials were identified. The most frequently used assessment instrument is the Karnofsky Performance Scale, which is developed for a general assessment of oncological patients. Out of four self-assessment tools, two were disease-specific (EORTC QLQ-BN20 and FACT-Br), EORTC QLQ-C30 has been shown good psychometric properties in patients with brain tumors as well as in patients with various oncological diseases, similar to the SF-36, it is used in patients with brain tumors as well as in patients with various diseases. The Functional Independence Measure and the Barthel Index were two objective assessment tools that described functioning, but two were neuropsychological tests (MMSE and Trial Making Test). Two hundred eighty-three meaningful concepts were identified and linked to 102 most relevant second-level categories covering all components of the ICF. Forty-nine studies reporting psychometric properties of those nine assessment tools were identified, indicating good reliability and validity for all the instruments. CONCLUSION Nine most frequently utilized functional status assessment instruments for patients with brain tumors represent all components of the ICF and have good psychometric properties. However, the choice of the tool depends on the clinical question posed and the aim of its use.
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Affiliation(s)
| | - Anete Pētersone
- Riga Stradiņš University, Riga, Latvia.,Riga East University Hospital, Riga, Latvia
| | | | - Guna Bērziņa
- Riga Stradiņš University, Riga, Latvia. .,Riga East University Hospital, Riga, Latvia. .,Department of Rehabilitation, Riga Stradiņš University, Anniņmuižas Boulevard 26a, Riga, 1067, Latvia.
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Batur EB, Ozyemisçi-Taskiran O, Yuksel S, Cengiz M, Karatas GK. Validity and reliability of the fatigue impact scale in stroke. Top Stroke Rehabil 2021; 29:526-537. [PMID: 34542023 DOI: 10.1080/10749357.2021.1978629] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Fatigue is one of the significant problems of post-stroke patients as it causes a decreased quality of life. Although the fatigue impact scale (FIS) is used in stroke, it lacks validation studies. OBJECTIVE This study evaluates the psychometric properties of the FIS in patients with stroke. SUBJECTS AND METHODS A total of 41 subjects with stroke and 41 control subjects admitted to Physical Medicine and Rehabilitation Department were included. Convergent validity was assessed using the SF-36 vitality (SF-36 v) scale and the fatigue severity scale (FSS). Divergent validity was assessed using the Hospital Anxiety and Depression Scale (HADS). RESULTS All subscores of the FIS were significantly higher in the stroke group than in the control group (p < .05). FIS showed excellent internal consistency in stroke patients (Cronbach's alpha = 0.946). There was a negative correlation among FIS and SF-36 v (r = -0.506, p = .001), and a positive correlation between the HADS anxiety score (r = 0.356, p = .026) and the HADS depression score (r = 0.293, p = .071). FIS total scores were weakly correlated with the FSS (r = 0.323, p = 0.039). The test-retest reliability of FIS was good in terms of its cognitive, physical, and psychosocial subscales and total scores, with ICC values of 0.78, 0.73, 0.80, and 0.83, respectively. CONCLUSION FIS is a valid and reliable multidimensional scale that sensitively discriminated fatigue in the stroke patients from that in the control subjects.
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Affiliation(s)
- Elif Balevi Batur
- Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Selcuk University, Konya, Turkey
| | - Ozden Ozyemisçi-Taskiran
- School of Medicine, Department of Physical Medicine and Rehabilitation, Koc University, Istanbul, Turkey
| | - Selcen Yuksel
- Faculty of Medicine, Department of Biostatistics, Yildirim Beyazit University, Ankara, Turkey
| | - Mustafa Cengiz
- Department of Physical Medicine and Rehabilitation, Batman Research and Training Hospital, Batman, Turkey
| | - Gulcin Kaymak Karatas
- Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Gazi University, Ankara, Turkey
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Tarakci E, Tarakci D, Hajebrahimi F, Budak M. Supervised exercises versus telerehabilitation. Benefits for persons with multiple sclerosis. Acta Neurol Scand 2021; 144:303-311. [PMID: 33961295 DOI: 10.1111/ane.13448] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/05/2021] [Accepted: 04/16/2021] [Indexed: 01/24/2023]
Abstract
OBJECTIVES The purpose of this study was to investigate the effectiveness of structured telerehabilitation on fatigue, health status, quality of life (QoL), and activities of daily living (ADL) and compare the possible effects with structured supervised exercise programs in patients with Multiple Sclerosis. MATERIALS AND METHODS This study was a randomized, single-blind trial. Thirty patients with relapsing-remitting Multiple Sclerosis were included in the study and randomly divided into two groups; structured supervised exercise group (Group 1) and telerehabilitation group (Group 2). Group 1 (n = 15) completed a 12 week structured supervised exercise program. Group 2 (n = 15) completed a 12 week structured home-based exercise program. Patients were evaluated with functional independence measure (FIM), first section of Nottingham Health Profile (NHP-I), fatigue severity scale (FSS), and quality of life scale (QoLS) before and after the intervention. RESULTS Significant differences were found in all parameters in both groups after the treatment (p < .05). No significant difference was found between groups regarding FIM-total, FIM-motor, FIM-cognitive, NHP sub-parameters, and QoLS (p > .05). Between-group differences revealed a significant difference in FSS and NHP total in favor of Group 1 (p < .05). CONCLUSION A structured home-based exercise program can be an alternative to supervised exercises with no side effects in patients with multiple sclerosis. Home-based rehabilitation exercises that are checked and controlled through telerehabilitation can help patients improve their health-related QoL and ADL. However, supervised exercises can be more beneficial regarding the fatigue and health profile compared to the home-based exercises.
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Affiliation(s)
- Ela Tarakci
- Department of Physiotherapy and Rehabilitation Faculty of Health Sciences Istanbul University Cerrahpaşa Istanbul Turkey
| | - Devrim Tarakci
- Department of Ergotherapy School of Health Sciences Istanbul Medipol University Istanbul Turkey
| | - Farzin Hajebrahimi
- Department of Physical Therapy and Rehabilitation School of Health Sciences Istanbul Medipol University Istanbul Turkey
| | - Miray Budak
- Department of Ergotherapy School of Health Sciences Istanbul Medipol University Istanbul Turkey
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Köçe K, Atıcı E, Buran Çırak Y, Dürüstkan Elbaşı N, Tütüneken YE. Cultural adaptation and Turkish version of Physical Activity Scale for Individuals with Physical Disabilities in individuals with spinal cord injury: a reliability and validity study. Disabil Rehabil 2021; 44:6414-6423. [PMID: 34415222 DOI: 10.1080/09638288.2021.1964624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To translate the "Physical Activity Scale for Individuals with Physical Disabilities (PASIPD)" into Turkish, to make a cultural adaptation, and to examine the psychometric properties including validity and reliability. METHODS During the translation period cross-cultural adaptation design proposed by guideline was used. Patients completed the Turkish version of the PASIPD and it was applied again a week later. To determine the reliability and internal consistency, Cronbach's alpha coefficient was calculated. Test-retest reliability was determined by using intraclass correlation coefficient (ICC) and Pearson's correlation analysis. Construct validity was examined with factor analysis. Convergent validity was examined by comparing PASIPD with Functional Independent Measurement (FIM), Nottingham Health Profile (NHP), and Craig Handicap Assessment and Reporting Technique Short (CHART-SF), and criterion validity was examined by comparing PASIPD with Manual wheelchair propulsion tests scores. RESULTS Cronbach's alpha coefficient was 0.725. The ICC coefficient for the test-retest reliability was 0.851. PASIPD was explained by three factors. The ratio of explaining the total variance of these 3 factors was determined as 51.66%. FIM (r = 0.307, p = 0.040) and CHART-SF were moderately positively correlated with PASIPD total score. The correlation between the total score of PASIPD and NHP was r = -0.443 (p = 0.002). 20 Meters Propulsion (r = -0.404, p = 0.005) and Slalom Tests (r = -0.305, p = 0.037) were highly negative and 6 min Push Propulsion (r = 0.456, p = 0.001) were moderately positive with PASIPD total score. CONCLUSION The Turkish version of the PASIPD is a valid and reliable scale in patients with spinal cord injury. IMPLICATIONS FOR REHABILITATIONThe Turkish and cross-culturally adapted version of PASIPD is a useful physical activity scale to evaluate the physical activity level of SCI.The Turkish version of the PASIPD is a valid and reliable scale and can be used in Turkish patients with SCI.PASIPD can be used to compare physical activity levels between disability types and groups with and without disabilities.PASIPD can be used to evaluate the effectiveness of attempts to increase physical activity in patients with SCI.
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Affiliation(s)
- Kübra Köçe
- Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Istinye University, Istanbul, Turkey
| | - Emine Atıcı
- Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Istanbul Okan University, Istanbul, Turkey
| | - Yasemin Buran Çırak
- Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Istinye University, Istanbul, Turkey
| | - Nurgül Dürüstkan Elbaşı
- Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Istinye University, Istanbul, Turkey
| | - Yunus Emre Tütüneken
- Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Istinye University, Istanbul, Turkey
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Unal N, Guvenc G, Ilkin Naharci M. Evaluation of the effectiveness of delirium prevention care protocol for the patients with hip fracture: A randomised controlled study. J Clin Nurs 2021; 31:1082-1094. [PMID: 34302312 DOI: 10.1111/jocn.15973] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 06/20/2021] [Accepted: 07/05/2021] [Indexed: 01/09/2023]
Abstract
AIMS AND OBJECTIVES This study aimed to investigate the effectiveness of a delirium prevention care protocol on pain, functional status, sleep quality and delirium prevention in patients with hip fractures. BACKGROUND The development of delirium following hip fracture is common among older patients. According to the National Institute for Health and Care Excellence, 30% of delirium cases are preventable. The prevention of delirium, a multifactorial syndrome, can be achieved through a multicomponent care protocol that targets specific risk factors for delirium. DESIGN A randomised controlled study was conducted according to the CONSORT 2010 guidelines. The Clinical Trial Registry number is NCT04188795. METHODS A total of 84 patients were assigned to two groups by block randomisation. The intervention group (n = 41) received nursing care according to a protocol and the control group (n = 43) received standard nursing care. Study data were collected using the demographic information form, the Confusion Assessment Method-Intensive Care Unit (CAM-ICU), the Barthel Index, the Mini Nutritional Assessment-short form and the Richards-Campbell Sleep Questionnaire (RCSQ). The pain of the patients was assessed by using a Visual Analog Scale (VAS). RESULTS The mean age of the patients was 80.6 years (standard deviation 8.0; range 65.0- 97.5 years), and the percentage of the male patients were 36.3%. No statistically significant differences were found between the groups in terms of pain and functional status in the preoperative period, on the first postoperative day, or in the predischarge period (p > 0.05 for each). The sleep quality of patients in the intervention group was significantly better than in the control group for all three time measurements (p < 0.05 for each). While 15% of patients in the control group developed delirium, no patient in the intervention group developed delirium (x2 =6.486, p = 0.026). CONCLUSION This study demonstrated that a delirium prevention care protocol may reduce the incidence of delirium and improve sleep quality. RELEVANCE TO PRACTICE The study highlighted that nurses can contribute to preventing patients' delirium using nonpharmacologic and independent nursing interventions.
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Affiliation(s)
- Nursemin Unal
- Faculty of Health Sciences, School of Nursing, Ankara Medipol University, Ankara, Turkey
| | - Gulten Guvenc
- Gulhane Faculty of Nursing, University of Health Sciences Turkey, Ankara, Turkey
| | - Mehmet Ilkin Naharci
- Geriatrics Department, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Altuntaş O, Taş S, Çetin A. An investigation of the factors that influence functional improvement in stroke rehabilitation. Turk J Med Sci 2021; 51:1448-1454. [PMID: 33705646 PMCID: PMC8283450 DOI: 10.3906/sag-2101-94] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/11/2021] [Indexed: 11/03/2022] Open
Abstract
Background/aim The purpose of this study was to determine effect of age, sex, affected extremity, disability severity, treatment type, cerebrovascular accident (CVA) etiology, number of treatment sessions, and CVA duration on the functional improvement of the stroke patients who participated in a physical medicine and rehabilitation program. Materials and methods The research sample consisted of 322 stroke patients. Clinical and demographic features including age, sex, affected extremity, disability severity, treatment type, CVA etiology, number of treatment sessions, and CVA duration were recorded. Functional status was evaluated retrospectively by using the functional independence measure (FIM) at admission and discharge. Results It was detected that discharge FIM score of the patients exhibited an increase of significance level (p < 0.05). It was found that age, number of treatment sessions, CVA duration and FIM admission score were determinative parameters in FIM gain level (p < 0.05) while sex, affected extremity, and CVA etiology were not effective in FIM gain level (p > 0.05). Conclusion Results show that functional improvement after rehabilitation was better in the younger ages, shorter CVA durations and moderate functional disturbances. The findings obtained may be useful for stroke rehabilitation triage.
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Affiliation(s)
- Onur Altuntaş
- Department of Occupational Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Serkan Taş
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | - Alp Çetin
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Gurcay E, Karaahmet OZ, Cankurtaran D, Nazlı F, Umay E, Güzel Ş, Gurcay AG. Functional electrical stimulation cycling in patients with chronic spinal cord injury: a pilot study. Int J Neurosci 2021; 132:421-427. [PMID: 33998960 DOI: 10.1080/00207454.2021.1929212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To examine the therapeutic value of lower extremity functional electrical stimulation (FES) - evoked cycling on functional independence, health status, gait parameters, pulmonary functions, and biochemical values in patients with chronic complete/incomplete spinal cord injury (SCI). MATERIALS AND METHODS Fifteen patients with SCI (duration of more than 6 months) who were able to stand up and walk with long leg braces or assistive devices and had stable neurological status and trunk balance undertook FES cycling for 6 weeks (three times per week). The main outcomes were: Functional Independence Measure (FIM), Nottingham Health Profile (NHP), 6-minute walk test (6MWT), and 20-meter walk test (20MWT). Secondary outcomes include measurements of pulmonary function tests and biochemical values. All parameters were evaluated at the beginning and end of the program. RESULTS Improvements were seen in motor and total scores of FIM (p = 0.007), physical mobility subscale of NHP (p = 0.011), 6MWT (p = 0.001), and 20MWT (p = 0.011). In pulmonary functions, only forced vital capacity (FVC) levels demonstrated a significant increase compared with baseline (p = 0.011). Biochemical values reached no significant level. CONCLUSION The results of this study showed that the FES cycling exercise program improves motor and total FIM scores, gait parameters, and FVC values of pulmonary functions in patients with chronic SCI experience. The FES cycle might be a valuable and well-tolerated intervention in clinical rehabilitation.
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Affiliation(s)
- Eda Gurcay
- Gaziler Physical Therapy and Rehabilitation Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ozgur Zeliha Karaahmet
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Damla Cankurtaran
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Fatma Nazlı
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Ebru Umay
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Şükran Güzel
- Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Baskent University, Ankara, Turkey
| | - Ahmet Gurhan Gurcay
- School of Medicine, Department of Neurosurgery, Yıldırım Beyazıt University, Ankara, Turkey
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Mustafa E, Aytür YK. Assessment for cardiovascular fitness in patients with stroke: which cardiopulmonary exercise testing method is better? Top Stroke Rehabil 2021; 29:347-355. [PMID: 34027834 DOI: 10.1080/10749357.2021.1929010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Assessment for cardiovascular disease (CVD) is important in stroke patients, both being one of the main factors limiting success in stroke rehabilitation and its increased risk in stroke patients. Reduced exercise capacity after stroke decreases patients' functionality and further increases the risk of CVD. Carefully selected cardiopulmonary exercise testing (CPET) can be safely used to determine the risk of CVD and to prescribe exercise program in stroke rehabilitation.Objectives: The primary purpose of this study is to determine the most appropriate CPET in patients with stroke. The secondary aim is to determine the relationship between cardiorespiratory fitness and functional status of the patients.Methods: Two CPETs using treadmill and bicycle ergometer protocols determined with a preliminary study were performed on participants. The main outcome measure was VO2peak. Patients were also evaluated according to Brunnstrom motor staging, Modified Ashworth Scale, Berg Balance Scale, and Functional Independence Measure.Results: In total, 38 patients reached higher VO2peak values at treadmill test compared to bicycle test (p < 0.001). The mean VO2peak reached at treadmill CPET was 62% of the control group where mean VO2peak reached at bicycle was 76% of the control group. No significant correlation was found between Brunnstrom staging, spasticity, Berg Balance Scale, and VO2peak .Discussion: The results of this study indicate that CPET can be performed safely in stroke patients when appropriate protocol was selected and that treadmill was more appropriate to determine cardiorespiratory fitness in this study population.
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Affiliation(s)
- Esra Mustafa
- Department of Physical Medicine & Rehabilitation, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Yesim Kurtais Aytür
- Department of Physical Medicine & Rehabilitation, Faculty of Medicine, Ankara University, Ankara, Turkey
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Demir Avcı Y, Gözüm S. Effect of Transitional Care Model-Based Interventions for Patients with Stroke and Their Caregivers on Increasing Caregiver Competence and Patient Outcomes: A Study Protocol for a Randomized Controlled Trial. Florence Nightingale Hemsire Derg 2021; 29:176-185. [PMID: 34263236 PMCID: PMC8245027 DOI: 10.5152/fnjn.2021.19214] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 12/17/2020] [Indexed: 11/26/2022] Open
Abstract
AIM This is a study protocol designed to evaluate the effect of transitional care model based interventions for patients with stroke and their caregivers on the caregivers’ perceived competency, their preparedness for caregiving, increasing their electronic health literacy, reducing burnout, the rate of patients’ hospital readmissions, and the frequency of pressure injuries. METHOD The study protocol was planned as a randomized controlled trial with parallel arms. The study will include 70 patients with stroke and their caregivers. Multiple interventions (TEMpEST-Transitional Care Model Stroke Turkey), including at least 3 face-to-face interviews at the hospital, distance education via web, and telephone communications for 3 months, and 1 home visit within 7 days of discharge will be applied to the study group. The control arm will receive routine care. RESULTS Findings will give after then when completed the study protocol. CONCLUSION This study will evaluate the feasibility of interventions TEMpEST and its effect on patients with stroke and their caregivers. Trial Registration The trial was registered with the ClinicalTrials.gov protocol registration and results system (PRS) (ClinicalTrials.gov reference NCT03708835).
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Affiliation(s)
- Yasemin Demir Avcı
- Department of Public Health Nursing, Akdeniz University, Faculty of Nursing, Antalya, Turkey
| | - Sebahat Gözüm
- Department of Public Health Nursing, Akdeniz University, Faculty of Nursing, Antalya, Turkey
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Tekeoglu Tosun A, Ipek Y, Razak Ozdincler A, Saip S. The efficiency of mirror therapy on drop foot in Multiple Sclerosis Patients. Acta Neurol Scand 2021; 143:545-553. [PMID: 33270229 DOI: 10.1111/ane.13385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/09/2020] [Accepted: 11/25/2020] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Although the effectiveness of mirror therapy (MT) has been proved in stroke persons, there is no scientific evidence about the results in people with multiple sclerosis. The aim was to investigate whether adding MT to exercise training and neuromuscular electrical stimulation (NMES) has any effect on clinical measurements, mobility, and functionality in people with multiple sclerosis (MS). METHODS Ambulatory people with MS, with unilateral drop foot, were included. MT group (n = 13) applied bilateral ankle exercise program with mirror following NMES for 3 days a week at hospital and exercise program for 2 days a week at home. Control group (n = 13) performed same treatment without mirror box (6 weeks). The later 6 weeks both groups performed only exercise program. Clinical measurements included proprioception, muscle tone of plantar flexor muscles (MAS), muscle strength of dorsiflexor, ankle angular velocity, and range of motion (ROM) of ankle. Functionality (Functional Independence Measurement-FIM), mobility (Rivermead Mobility Index-RMI), ambulation (Functional Ambulation Scale-FAS), duration of stair climb test, and 25-foot walking velocity were assessed at the beginning, in 6th and 12th weeks. RESULTS More positive improvements were obtained in MT group than control group in terms of range of motion (0.012), muscle strength (0.008), proprioception (0.001), 25 feet walking duration (0.015), step test duration (0.001), FAS (0.005), RMI (0.001), and FIM (0.001) after 6 weeks treatment. It was seen that this improvement maintained to 12th week on all clinical and functional measurements (p < .05). CONCLUSION The trial revealed that adding MT to exercise training and NMES has more beneficial effects on clinical measurements, mobility, and functionality in people with multiple sclerosis with unilateral drop foot.
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Affiliation(s)
- Anıl Tekeoglu Tosun
- Division of Physiotherapy and Rehabilitation Faculty of Health Sciences Fenerbahce University Istanbul Turkey
| | - Yeldan Ipek
- Division of Physiotherapy and Rehabilitation Faculty of Health Sciences Istanbul University‐Cerrahpasa Istanbul Turkey
| | - Arzu Razak Ozdincler
- Division of Physiotherapy and Rehabilitation Faculty of Health Sciences Biruni University Istanbul Turkey
| | - Sabahattin Saip
- Department of Neurology Medical School of Cerrahpasa Istanbul University‐Cerrahpasa Istanbul Turkey
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Kuzu Ö, Adiguzel E, Kesikburun S, Yaşar E, Yılmaz B. The Effect of Sham Controlled Continuous Theta Burst Stimulation and Low Frequency Repetitive Transcranial Magnetic Stimulation on Upper Extremity Spasticity and Functional Recovery in Chronic Ischemic Stroke Patients. J Stroke Cerebrovasc Dis 2021; 30:105795. [PMID: 33887662 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105795] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/07/2021] [Accepted: 03/28/2021] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE This randomized controlled study examined the effect of continuous theta burst stimulation (cTBS) and low frequency repetitive transcranial magnetic stimulation (rTMS) on upper extremity spasticity and functional recovery in chronic ischemic stroke patients. MATERIALS AND METHODS Twenty chronic ischemic stroke patients were randomized into three groups as real rTMS group (n = 7), real cTBS group (n = 7) and sham cTBS group (n = 6), in which real rTMS with physical therapy (PT), real cTBS with PT and sham cTBS with PT were applied in 10 sessions, respectively. The evaluation parameters were assessed at pre-treatment, post-treatment and follow up at 4 weeks. RESULTS Ten sessions of real rTMS or real cTBS combined with PT were found beneficial in motor functional recovery and daily living activities both at post-treatment and follow up at 4 weeks (p ˂ 0.05). In the sham cTBS group, functional improvement was not significant (p > 0.05). In addition, in the real rTMS group, elbow flexor, pronator, wrist flexor and finger flexor spasticity were significantly decreased; in the real cTBS group, significant decrease was observed in the elbow flexor and wrist flexor spasticity (p ˂ 0.05). In comparison with sham cTBS group, only in the real cTBS group, significant improvement was observed in the level of wrist flexor spasticity at follow up at 4 weeks (p ˂ 0.017). CONCLUSIONS In this study, it was observed that real cTBS or real rTMS combined with PT provided improvement on upper extremity motor functions and daily living activities in chronic ischemic stroke patients, but improvement in spasticity was limited.
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Affiliation(s)
- Ömer Kuzu
- Kastamonu Rehabilitation Centre, Kastamonu, Turkey.
| | - Emre Adiguzel
- Ankara City Hospital, Physical Medicine and Rehabilitation Hospital, Ankara, Turkey; University of Health Sciences, Gulhane Medical School, Department of Physical Medicine and Rehabilitation, Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Serdar Kesikburun
- University of Health Sciences, Gulhane Medical School, Department of Physical Medicine and Rehabilitation, Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Evren Yaşar
- Ankara City Hospital, Physical Medicine and Rehabilitation Hospital, Ankara, Turkey; University of Health Sciences, Gulhane Medical School, Department of Physical Medicine and Rehabilitation, Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Bilge Yılmaz
- University of Health Sciences, Gulhane Medical School, Department of Physical Medicine and Rehabilitation, Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Turkey
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Risk factors for venous thromboembolism in patients with spinal cord injury: A single-center Turkish study. JOURNAL OF CONTEMPORARY MEDICINE 2021. [DOI: 10.16899/jcm.900384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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D'Souza AN, Said CM, Leggett NE, Tomkins MS, Kay JE, Granger CL. Assessment tools and factors used to predict discharge from acute general medical wards: a systematic review. Disabil Rehabil 2021; 44:3373-3387. [PMID: 33463383 DOI: 10.1080/09638288.2020.1867906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To identify assessment tools and patient factors statistically associated with discharge destination in general medical inpatients. MATERIALS AND METHOD A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. Four electronic databases were searched. Studies were eligible if they were a quantitative study design, had adult acute general medical inpatients and published in English. Outcomes of interest were tools or factors with statistical correlations with discharge destination (home, subacute or residential care). Articles were screened by two independent assessors. Data were extracted by one reviewer and independently checked by a second reviewer. Data were analysed/described descriptively. RESULTS Twenty-three studies were included. Twenty-three tools and 44 factors were identified, which spanned Health Condition, Body Structure and Function, Activity, Participation, Environment and Personal concepts of the World Health Organisation International Classification of Function, Disability and Health (WHO ICF). CONCLUSIONS The large number of tools and factors found and their distribution across several WHO ICF concepts exemplifies the complexities of predicting discharge. No single assessment tool that best predicts discharge destination was identified, but rather there were a variety of potential tools identified. Further research is needed to determine the psychometric properties of the identified assessment tools as well as additional predictors of subacute care (including rehabilitation). This is important as it may allow for timely clinical decision making. TRIAL REGISTRATION A priori, PROSPERO (CRD42017064209).IMPLICATIONS FOR REHABILITATIONThis systematic review identified a large number of assessment tools and patient factors associated with discharge destination (home, subacute and residential care) in general medical inpatients.All of the domains of the WHO ICF framework are associated with discharge destination and must be considered.Clinicians in the acute setting can use these findings to assist selection of assessment tools to identify patients likely to need rehabilitation or subacute care.Early identification of patients who are unable to return to their place of residence is essential as it allows for provision of early rehabilitation and subsequent discharge planning.
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Affiliation(s)
- Aruska N D'Souza
- Department of Physiotherapy, University of Melbourne, Carlton, Victoria, Australia.,Department of Physiotherapy, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Catherine M Said
- Department of Physiotherapy, University of Melbourne, Carlton, Victoria, Australia.,Western Health, Sunshine Hospital, Department of Physiotherapy, St Albans, Victoria, Australia.,Australian Institute of Musculoskeletal Science, St Albans, Victoria, Australia
| | - Nina E Leggett
- Western Health, Sunshine Hospital, Department of Physiotherapy, St Albans, Victoria, Australia
| | - Melanie S Tomkins
- Western Health, Sunshine Hospital, Department of Physiotherapy, St Albans, Victoria, Australia
| | - Jacqueline E Kay
- Department of Physiotherapy, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Catherine L Granger
- Department of Physiotherapy, University of Melbourne, Carlton, Victoria, Australia.,Department of Physiotherapy, Royal Melbourne Hospital, Parkville, Victoria, Australia
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Erol BN, Aydoğan Arslan S, Yaşar E, Keskin ED, Demirci CS. Reliability and validity of the Turkish version of Function in Sitting Test (FIST-T) in stroke. Top Stroke Rehabil 2021; 29:49-57. [PMID: 33438519 DOI: 10.1080/10749357.2020.1871284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Trunk control in sitting position after stroke is one of the most important determinants of independence in daily living activities and there is no gold standard assessment used to measure sitting postural control.Objectives: The aim of this study is to determine the reliability and validity of the Turkish version of Function in Sitting Test (FIST-T).Methods: After translation was conducted, Function in Sitting Test, Berg Balance Scale, Functional Independent Measure and Trunk Impairment Scale were applied to 72 stroke patients (mean age was 59.26 ± 16.38 years; post-stroke time was 95.93 ± 59.64 days). For reliability and validity analysis the spearman correlation analysis was used.Results: A positive, high correlation was found between the first application and repetition of Function in Sitting Test-T (ICC = 0.97, r = 0.95, p = .001). The internal consistency was high (Cronbach Alpha = 0.97), interrater correlation was high (Cronbach Alpha = 0.98) and a positive, high correlation was found with the scores obtained from the Berg Balance Scale (r = 0.82, p = .001), Functional Independent Measure (r = 0.84, p = .001) and Trunk Impairment Scale (r = 0.80, p = .001).Conclusions: It is concluded that the Turkish version of Function in Sitting Test is a valid and reliable scale for use in stroke patients, in clinical and scientific researches.
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Affiliation(s)
- Büşra Nur Erol
- Vocational School of Haymana, Physiotherapy Programme, Ankara University, Ankara, Turkey
| | - Saniye Aydoğan Arslan
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Kırıkkale University, Kırıkkale, Turkey
| | - Evren Yaşar
- Gülhane Faculty of Medicine, Department of Physical Medicine and Rehabilitation, University of Health Sciences, Ankara, Turkey
| | - Esra Dilek Keskin
- Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Kırıkkale University, Kırıkkale, Turkey
| | - Cevher Savcun Demirci
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Balıkesir University, Balıkesir, Turkey
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Tyner CE, Kisala PA, Heinemann AW, Fyffe D, Tate DG, Slavin MD, Jette AM, Tulsky DS. Validation of the Spinal Cord Injury Functional Index for Use in Community-Dwelling Individuals With SCI. Arch Phys Med Rehabil 2021; 103:191-198. [PMID: 33453193 DOI: 10.1016/j.apmr.2020.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 12/03/2020] [Accepted: 12/07/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the psychometric properties of the Spinal Cord Injury Functional Index (SCI-FI) instruments in a community-dwelling sample. DESIGN Cross-sectional study. SETTING Community setting. PARTICIPANTS Individuals (N=269) recruited from 6 SCI Model Systems sites. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Participants completed computer adaptive test and short form versions of 4 SCI-FI/Capacity (C) banks (ie, Ambulation, Basic Mobility, Fine Motor, Self-Care) and 1 SCI-FI/Assistive Technology (AT) bank (Wheelchair Mobility) at baseline and after 2 weeks. The Self-Report Functional Measure (SRFM) and the clinician-rated motor FIM were used to evaluate evidence of convergent validity. RESULTS Pearson correlations, intraclass correlation coefficients, minimal detectable change, and Bland-Altman plots supported the test-retest reliability of the SCI-FI instruments. Correlations were large with the SRFM (.69-.89) and moderate-to-large for the FIM instrument (.44-.64), supporting convergent validity. Known-groups validity was demonstrated by a significant main effect of injury level on all instruments and a main effect of injury completeness on the SCI-FI/C instruments. A ceiling effect was detected for individuals with incomplete paraplegia on the Fine Motor/C and Self-Care/C Short Forms. CONCLUSION Findings support the test-retest reliability, convergent validity, and known-groups validity of the SCI-FI/C instruments and the SCI-FI/AT Wheelchair Mobility instruments for use by community-dwelling individuals.
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Affiliation(s)
- Callie E Tyner
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE.
| | - Pamela A Kisala
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE
| | - Allen W Heinemann
- Shirley Ryan AbilityLab, Chicago, IL; Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Denise Fyffe
- Kessler Foundation, West Orange, NJ; New Jersey Medical School, Newark, NJ
| | - Denise G Tate
- Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, MI
| | - Mary D Slavin
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA; Massachusetts General Hospital, Institute of Health Professions, Boston, MA
| | - Alan M Jette
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA; Massachusetts General Hospital, Institute of Health Professions, Boston, MA
| | - David S Tulsky
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE; Department of Physical Therapy, University of Delaware, Newark, DE; Department of Psychological and Brain Sciences, University of Delaware, Newark, DE
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Deveci H. Evaluation of the Effectiveness of Treatment with Botulinum Toxin on Sleep Quality in Stroke-Related Spasticity. J Stroke Cerebrovasc Dis 2020; 29:105160. [PMID: 32912522 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105160] [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: 05/30/2020] [Revised: 06/26/2020] [Accepted: 07/11/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND AND PURPOSE Botulinum toxin (BoNT) is a commonly used agent in the treatment of stroke-related spasticity. Sleep disorders can often be seen as a comorbidity or complication in stroke patients. Based on the data that spasticity is associated with sleep disorders, in this study, we aimed to evaluate whether sleep quality has changed in patients with stroke treated with BoNT. METHODS Thirty five (17 female / 18 male) stroke patients with gastrocnemius and / or soleus spasticity were included in this observational cross-sectional study. In clinical evaluation before and three months after BoNT injection; for spasticity evaluation modified Ashworth scale (MAS), pain assessment visual analog scale (VAS), functional evaluation; passive joint range of motion (ROM) measurement, functional independence measurement (FIM), lower limb Brunstrom staging, life quality assessment short form-36 (SF-36) quality of life scale, and sleep quality assessment Pittsburgh sleep quality index (PSQI) scales were used. RESULTS After the BoNT injection, there was a statistically significant decrease in MAS and VAS scores, a significant increase in passive ROM measurements, FIM, lower limb Brunstrom staging, and SF-36 physical function sub parameter. There was also a significant decrease in PSQI scores. Before and after treatment, there was no correlation found between PSQI values with pain and spasticity. However, there was a weak negative correlation between post-treatment PSQI values, passive ROM, SF-36 physical function and SF-36 physical role sub parameters (respectively: r: -0.335 p: 0.049, r: -0.364, 0.032, r: -0.404, p: 0.016). Conlusion: The results of our study suggest that BoNT, which is frequently used in the treatment of spasticity in stroke patients, has positive effects on sleep quality.
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Affiliation(s)
- Hulya Deveci
- Department of Physical Medicine and Rehabilitation, Tokat Gaziosmanpasa University Medical Faculty, 60100 Tokat, Turkey.
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Uchida H, Hiragaki Y, Nishi Y, Nakahara S, Koumoto J, Onmyoji Y, Fujimoto N, Kawakami K, Ishii M, Hirao K. An iPad application-based intervention for improving post-stroke depression symptoms in a convalescent rehabilitation ward: A pilot randomized controlled clinical trial protocol. Internet Interv 2020; 21:100340. [PMID: 32944505 PMCID: PMC7481559 DOI: 10.1016/j.invent.2020.100340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/28/2020] [Accepted: 07/02/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Post-stroke depression (PSD) is a neuropsychiatric sequela that causes serious adverse effects on the prognosis of stroke patients. Our developed iPad application is a very innovative approach designed to improve participants' depressive symptoms by presenting positive words stimuli in a video. Although this application has fewer side effects than existing pharmacological and non-pharmacological interventions and is likely less burdensome for patients and caregivers, its efficacy for PSD has not been investigated. Here we present a pilot randomized controlled trial (RCT) protocol to investigate the therapeutic potential of this application intervention for PSD patients. METHODS This study is designed as a 5-week, single-center, open-label, parallel-group, pilot RCT. Thirty-two patients with PSD will be randomly assigned to a combination of the iPad application and usual rehabilitation or usual rehabilitation alone (1:1 allocation ratio). The iPad application intervention lasts 3 min a day, and the usual rehabilitation lasts 3 h a day. The primary outcome is the change from baseline in The Center for Epidemiologic Studies Depression Scale score at the end of the 5-week intervention. DISCUSSION This pilot RCT is the first study to investigate the potential of iPad application interventions to reduce depressive symptoms in PSD patients. This pilot RCT determines whether this is a viable and effective intervention and informs the design for a full-scale trial. If our hypothesis is correct, this trial can provide evidence to augment the standard practice of iPad application interventions to improve depressive symptoms in patients with PSD.
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Key Words
- API, Application Programming Interface
- CBT, Cognitive Behavioral Therapy
- CRW, Convalescent Rehabilitation Ward
- Depression
- Mobile applications
- OT, Occupational Therapists
- PSD, Post-stroke Depression
- PT, Physical Therapists
- RCT, Randomized Controlled Trial
- Rehabilitation
- SPSRS, Subliminal Priming with Supraliminal Reward Stimulation
- ST, Speech Therapists
- Stroke
- rTMS, Repetitive Transcranial Magnetic Stimulation
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Affiliation(s)
- Hiroyuki Uchida
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Yoshiya Hiragaki
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Yuta Nishi
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Shiori Nakahara
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Junki Koumoto
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Yusuke Onmyoji
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Norimasa Fujimoto
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Kazuho Kawakami
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Masato Ishii
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Kazuki Hirao
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
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The effect of mirror therapy on lower extremity motor function and ambulation in post-stroke patients: A prospective, randomized-controlled study. Turk J Phys Med Rehabil 2020; 66:154-160. [PMID: 32760892 DOI: 10.5606/tftrd.2020.2719] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 12/12/2018] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to evaluate the effects of mirror therapy (MT) on lower extremity motor function and ambulation in post-stroke patients. Patients and methods A total of 42 post-stroke patients (25 males, 17 females; mean age 58 years; range, 32 to 71 years) were included. All patients were randomly divided into two groups as the control group (n=21) receiving a conventional rehabilitation program for four weeks (60 to 120 min/day for five days a week) and as the MT group (n=21) receiving MT for 30 min in each session in addition to the conventional rehabilitation program. The Brunnstrom stages of stroke recovery, Functional Independence Measure (FIM), Berg Balance Scale (BBS) and Motricity Index (MI) scores, six-minute walking test (6MWT), Functional Ambulation Category (FAC), and the degree of ankle plantar flexion spasticity using the Modified Ashworth Scale (MAS) were evaluated at baseline (Day 0), at post-treatment (Week 4), and eight weeks after the end of treatment (Week 12). Results There were significant differences in all parameters between the groups, except for the degree of ankle plantar flexion spasticity, and in all time points between Week 0 and 4 and between Week 0 and 12 (p<0.05). Conclusion These results suggest that MT in addition to conventional rehabilitation program yields a greater improvement in the lower extremity motor function and ambulation, which sustains for a short period of time after the treatment.
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Post-stroke bilateral heterotopic ossification: An acute problem with long-lasting consequences. Jt Dis Relat Surg 2020; 31:386-389. [PMID: 32584742 PMCID: PMC7489164 DOI: 10.5606/ehc.2020.72081] [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: 11/04/2019] [Accepted: 02/05/2020] [Indexed: 11/21/2022] Open
Abstract
Heterotopic ossification (HO) is a complication of injury to the central nervous system in which production of lamellar bone within the soft tissues occurs resulting in pain, reduced range of motion (ROM) and loss of functional capacity. Heterotopic ossification is rarely seen in stroke patients and mostly affects the paretic side. In this article, we present a case of established bilateral HO of the hips soon after stroke onset. A 77-year-old female patient with a five-month history of stroke presented to our rehabilitation clinic. Physical examination revealed sensorimotor aphasia, right-sided hemiplegia, bilateral painful limited ROM of the hips and left knee contracture. An anteroposterior X-ray of the pelvis revealed previously undiagnosed bilateral HO of the hips. The patient and her relatives declined operative interventions. The patient was discussed in the departmental meeting and it was agreed that she would not be able to partake in an active inpatient rehabilitation program. She was discharged with a home exercise plan. This case highlights the importance of HO, of both the paretic and non-paretic side, being included in the differential diagnosis of post-stroke patients presenting with joint pain and reduced ROM, both acutely and in the long-term. This may aid the timely diagnosis and management of HO, a pathology which has detrimental effects on functionality.
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Isik EI, Yilmaz S, Uysal I, Basar S. Adaptation of the Lawton Instrumental Activities of Daily Living Scale to Turkish: Validity and Reliability Study. Ann Geriatr Med Res 2020; 24:35-40. [PMID: 32743320 PMCID: PMC7370782 DOI: 10.4235/agmr.19.0051] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/27/2020] [Accepted: 03/04/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The Lawton Instrumental Activities of Daily Living (IADL) scale is the most widely used scale for the assessment of IADL in the elderly population. The aim of this study was to adapt the Lawton IADL Scale in Turkish and to investigate the validity and the reliability of the scale in older adults. METHODS A total of 80 participants with a mean age of 71.6±5.8 years were included in the study. The independent living skills of the older adults were measured using Lawton IADL, Hodkinson Mental Test, Functional Independence Scale, Barthel Index, Katz Index, and visual analog scale. Lawton IADL was translated into Turkish, validated by professional reviewers, translated back into English, and then tested. Cronbach's alpha was used to measure reliability in a group of 34 participants and test-retest was performed 1 week after the first test. Pearson correlation analysis was used to show the relationship between Lawton IADL and other scales and indexes. RESULTS Internal consistency (Cronbach's alpha) value was 0.843 for the whole scale. The intraclass correlation coefficient value of the scale was 0.915. CONCLUSION These results confirm that the Turkish version of the Lawton IADL scale has excellent reliability and validity.
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Affiliation(s)
- Emir Ibrahim Isik
- Department of Therapy and Rehabilitation, Abdi Sutcu Vocational School of Health Services, Cukurova University, Adana, Turkey
| | - Seyda Yilmaz
- Department of Physiotherapy, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Ismail Uysal
- Fethiye Vocational School of Health Services, Mugla Sitki Kocman University, Mugla, Turkey
| | - Selda Basar
- Department of Physiotherapy, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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Impact of vitamin D on mobilization, pulmonary function tests, grip strength and functionality in patients with spinal cord injury: A cross-sectional study. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.689130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Alisar DC, Ozen S, Sozay S. Effects of Bihemispheric Transcranial Direct Current Stimulation on Upper Extremity Function in Stroke Patients: A randomized Double-Blind Sham-Controlled Study. J Stroke Cerebrovasc Dis 2019; 29:104454. [PMID: 31699572 DOI: 10.1016/j.jstrokecerebrovasdis.2019.104454] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/18/2019] [Accepted: 09/27/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND PURPOSE Transcranial direct current stimulation (tDCS) is a treatment used in the rehabilitation of stroke patients aiming to improve functionality of the plegic upper extremity. Currently, tDCS is not routinely used in post stroke rehabilitation. The aim of this study was to establish the effects of bihemspheric tDCS combined with physical therapy (PT) and occupational therapy (OT) on upper extremity motor function. METHODS Thirty-two stroke inpatients were randomised into 2 groups. All patients received 15 sessions of conventional upper extremity PT and OT over 3 weeks. The tDCS group (n = 16) also received 30 minutes of bihemispheric tDCS and the sham group (n = 16) 30 minutes of sham bihemispheric tDCS simultaneously to OT. Patients were evaluated before and after treatment using the Fugl Meyer upper extremity (FMUE), functional independence measure (FIM), and Brunnstrom stages of stroke recovery (BSSR) by a physiatrist blind to the treatment group RESULTS: The improvement in FIM was higher in the tDCS group compared to the sham group (P = .001). There was a significant within group improvement in FMUE, FIM and BSSR in those receiving tDCS (P = .001). There was a significant improvement in FIM in the chronic (> 6months) stroke sufferers who received tDCS when compared to those who received sham tDCS and when compared to subacute stroke (3-6 months) sufferers who received tDCS/sham. CONCLUSIONS Upper extremity motor function in hemiplegic stroke patients improves when bihemispheric tDCS is used alongside conventional PT and OT. The improvement in functionality is greater in chronic stroke patients.
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Affiliation(s)
- Dilek Cetinkaya Alisar
- Baskent University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Bahçelievler Ankara, Turkey.
| | - Selin Ozen
- Baskent University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Bahçelievler Ankara, Turkey
| | - Seyhan Sozay
- Baskent University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Bahçelievler Ankara, Turkey
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Validation and application of the International Classification of Functioning core set for spinal cord injury in the Turkish patients. Turk J Phys Med Rehabil 2019; 65:244-258. [PMID: 31663073 DOI: 10.5606/tftrd.2019.3045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 09/02/2018] [Indexed: 11/21/2022] Open
Abstract
Objectives The aim of this study was to apply the Comprehensive International Classification of Functioning, Disability and Health (ICF)- Core Set for spinal cord injury (SCI) -early post-acute-situation in the Turkish SCI patients and to investigate its construct validity. Patients and methods One-hundred and twenty patients with SCI were included in this prospective and descriptive study. ICF data were primarily collected by conducting interviews with patients as well as from their acute medical management records, physical examination findings and laboratory measurements. The percentage of participants and the frequency of the problems encountered at each level of ICF category were reported. Furthermore, the construct validity was evaluated by calculating the Spearman correlation between the ICF categories and other generic and disease specific measures. Results The study illustrated that 55 of the 63 ICF categories of the Component Body Functions (CBF) and each and every category for the Component Body Structures (CBS) as well as the Component Activities and Participation (CAP) were reported as a problem among the Turkish patients with SCI. Furthermore, 24 ICF categories for the Component Environmental Factors (CEF) were determined as a facilitator while 6 ICF categories were identified as a barrier. The ICF-Core Set for SCI illustrated a high construct validity with some of the generic and disease-specific measures. Conclusion Our results identified the common problems, complications and special needs in a Turkish population with SCI. We suggest that the application of ICF-Core Set in our patients provided us with a unique capability to assess their every aspect of disability, health and functioning.
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Factors affecting functional outcome in patients with traumatic brain injury sequelae: Our single-center experiences on brain injury rehabilitation. Turk J Phys Med Rehabil 2019; 65:67-73. [PMID: 31453545 DOI: 10.5606/tftrd.2019.2281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 07/01/2018] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to investigate the effect of rehabilitation on functional level of traumatic brain injury (TBI) patients and to examine the associated factors on functional gain in this patient population. Patients and methods Between October 2010 and November 2015, a total of 71 patients (63 males, 8 females; mean age 26.6±8.1 years; range, 18 to 56 years) who were admitted to our rehabilitation clinic with moderate-to-severe TBI were retrospectively analyzed. Functional recovery was assessed using the Functional Independence Measure (FIM) and Functional Ambulation Classification (FAC) scales. The patients were divided into two groups according to time from TBI to the initiation of rehabilitation: early (<6 months) and late (≥6 months). Possible predictive factors associated with FIM gain were evaluated. Results There was a significant improvement in the FIM scores from admission to discharge (p<0.001). There was a statistically significant difference in the FIM gain and FIM efficiency between the patient groups according to the initiation of rehabilitation (p<0.001). The FAC scores increased from admission to discharge, showing statistical significance (p<0.001). Duration of rehabilitation, early rehabilitation, heterotopic ossification, and deep venous thrombosis were found to be significant factors associated with FIM gain (p<0.001). Conclusion Our study results suggest that rehabilitation is effective for functional gain, particularly in the early period in patients with moderate- to-severe TBI and duration of rehabilitation, early rehabilitation, heterotopic ossification, and deep venous thrombosis are also predictors of functional improvement.
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The Effectiveness of Fluidotherapy in Poststroke Complex Regional Pain Syndrome: A Randomized Controlled Study. J Stroke Cerebrovasc Dis 2019; 28:1578-1585. [DOI: 10.1016/j.jstrokecerebrovasdis.2019.03.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 02/22/2019] [Accepted: 03/01/2019] [Indexed: 11/18/2022] Open
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Akyurek G, Bumin G, Crowe TK. The factors associated with community participation: Employment and education of people with disabilities in Turkey. Scand J Occup Ther 2019; 27:28-38. [DOI: 10.1080/11038128.2019.1587502] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Gokcen Akyurek
- Faculty of Health Sciences, Department of Occupational Therapy, Hacettepe University, Ankara, Turkey
| | - Gonca Bumin
- Faculty of Health Sciences, Department of Occupational Therapy, Hacettepe University, Ankara, Turkey
| | - Terry K. Crowe
- School of Medicine, Occupational Therapy, University of New Mexico, Albuquerque, NM, USA
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Karaahmet OZ, Gurcay E, Unal ZK, Cankurtaran D, Cakci A. Effects of functional electrical stimulation-cycling on shoulder pain and subluxation in patients with acute–subacute stroke: a pilot study. Int J Rehabil Res 2019; 42:36-40. [DOI: 10.1097/mrr.0000000000000319] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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