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da Fonsêca RDRG, de Melo LP, Silveira Fernandes ABG, Fernandes Campos T, da Costa Cavalcanti FA. Social rhythm and implications on functionality of patients after stroke. Chronobiol Int 2024; 41:1085-1092. [PMID: 39008033 DOI: 10.1080/07420528.2024.2379573] [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: 01/04/2024] [Revised: 05/09/2024] [Accepted: 07/08/2024] [Indexed: 07/16/2024]
Abstract
The study aimed to assess the regularity, intensity, frequency, and period of activities comprising social rhythm and associate them with the functionality of stroke patients. The sample consisted of 73 patients (41 men and 32 women) with a mean age of 60 years (±10). Social rhythm was assessed by Social Rhythm Metric (SRM) and Activity Level Index (ALI). The functionality was evaluated using the International Classification of Functioning, Disability, and Health (ICF). Data were analyzed using Student's t-test, ANOVA, and Chi-square test. The mean SRM was 5.1 ± 0.9, and ALI was 58.3 ± 14.9. Notably, 40% of the patients exhibited both low regularity and low intensity of activities. Six SRM activities, performed with low frequency (going outside, starting work, exercising, snacking, watching other TV programs, and going home), exhibited a tendency to have periods that deviated from the expected 24-hour daily cycle. ICF domains most associated with SRM were: d2-General tasks and demands, d3-Communication, d4-Mobility, d5-Self care, d8-Major life areas, and d9-Community, social and civic life. The results indicated changes in social rhythm with implications for patient functionality. Screening for disruptions in social rhythm could be part of the functional assessment during the rehabilitation process for post-stroke patients.
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Affiliation(s)
| | - Luciana Protásio de Melo
- Department of Physical Therapy, Human Movement Laboratory, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | - Tania Fernandes Campos
- Department of Physical Therapy, Human Movement Laboratory, Federal University of Rio Grande do Norte, Natal, Brazil
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2
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Rusowicz J, Szczepańska-Gieracha J, Kiper P. Neurologic Music Therapy in Geriatric Rehabilitation: A Systematic Review. Healthcare (Basel) 2022; 10:2187. [PMID: 36360527 PMCID: PMC9690210 DOI: 10.3390/healthcare10112187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/12/2022] [Accepted: 10/25/2022] [Indexed: 09/08/2024] Open
Abstract
(1) Introduction: Neurologic music therapy (NMT) is a non-pharmacological approach of interaction through the therapeutic use of music in motor, sensory and cognitive dysfunctions caused by damage or diseases of the nervous system. (2) Objective: This study aimed to critically appraise the available literature on the application of particular NMT techniques in the rehabilitation of geriatric disorders. (3) Methods: PubMed, ScienceDirect and EBSCOhost databases were searched. We considered randomized controlled trials (RCTs) from the last 12 years using at least one of the NMT techniques from the sensorimotor, speech/language and cognitive domains in the therapy of patients over 60 years old and with psychogeriatric disorders. (4) Results: Of the 255 articles, 8 met the inclusion criteria. All papers in the final phase concerned the use of rhythmic auditory stimulation (RAS) (sensorimotor technique) in the rehabilitation of both Parkinson's disease (PD) patients (six studies) and stroke patients (SPs) (two studies). (5) Conclusion: All reports suggest that the RAS technique has a significant effect on the improvement of gait parameters and the balance of PD patients and SPs, as well as the risk of falls in PD patients.
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Affiliation(s)
- Jagoda Rusowicz
- Department of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland
| | | | - Paweł Kiper
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, 30126 Venezia, Italy
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3
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Xu C, He Z, Shen Z, Huang F. Potential Benefits of Music Therapy on Stroke Rehabilitation. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:9386095. [PMID: 35757506 PMCID: PMC9217607 DOI: 10.1155/2022/9386095] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/15/2022] [Accepted: 05/24/2022] [Indexed: 11/17/2022]
Abstract
Stroke is associated with a high rate of disability and mortality, and survivors are usually accompanied with dysphagia, aphasia, motor dysfunction, cognitive impairment, depression, and other complications. In the past decades, many studies have been conducted to reveal the pathogenesis and pathological mechanisms of stroke. Furthermore, treatment methods have been developed that contribute to the elevated survival rate of stroke patients. Early rehabilitation poststroke is starting to be recognized as important and has been receiving increasing attention in order to further improve the quality of life of the patients. As an emerging method of poststroke rehabilitation, music therapy can help attenuate dysphagia and aphasia, improve cognition and motor function, alleviate negative moods, and accelerate neurological recovery in stroke patients. This review helps summarize the recent progress that has been made using music therapy in stroke rehabilitation and is aimed at providing clinical evidence for the treatment of stroke patients.
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Affiliation(s)
- Chengyan Xu
- Department of Neurosurgery, The Children's Hospital Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Zixia He
- Department of Outpatient, The Children's Hospital Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Zhipeng Shen
- Department of Neurosurgery, The Children's Hospital Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Fei Huang
- Department of Science and Education, Hangzhou Women's Hospital, Hangzhou Maternity and Child Health Care Hospital, Hangzhou, China
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Anderson J, Levy DS, Lumry W, Koochaki P, Lanar S, Henry Li H. Letting the patients speak: an in-depth, qualitative research-based investigation of factors relevant to health-related quality of life in real-world patients with hereditary angioedema using subcutaneous C1 inhibitor replacement therapy. Allergy Asthma Clin Immunol 2021; 17:60. [PMID: 34176500 PMCID: PMC8237414 DOI: 10.1186/s13223-021-00550-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 05/01/2021] [Indexed: 11/16/2022] Open
Abstract
Background While many studies of effective hereditary angioedema (HAE) therapy have demonstrated improved health-related quality of life (HRQoL) using validated instruments, specific reasons behind the improved scores have never been investigated using qualitative methods. A non-interventional, qualitative research study was designed to investigate the reasons for improvements in HRQoL while using effective prophylaxis, in this case subcutaneous C1INH (C1INH[SC]) replacement therapy. Methods Adult patients with HAE-C1INH type 1 or 2 who had been using C1INH(SC) for ≥ 3 consecutive months were recruited through four HAE specialty practices in the US to participate in a 60-min phone interview performed by a trained qualitative research specialist (ICON plc) using a semi-structured interview guide with open-ended questions developed with the Angioedema Quality of Life (AE-QoL) items in mind. Interview transcripts were analyzed using thematic analysis methods to identify concepts (specific symptoms/impacts) and themes (higher-level categories grouping related concepts). A cross-mapping exercise was performed between interview-identified concepts and items included in the AE-QoL. Results Fourteen patients were interviewed and included in the analysis (age range, 28–82 years [mean 47.5 years]; 64% female; 93% white). In 10 interviews, patients mentioned having no or nearly no HAE attacks, no longer feeling limited by HAE, less HAE-related anxiety/worry and depression, an improved ability to travel, fewer emergency room/hospital visits, and ease of administration of C1INH(SC), including not requiring assistance from others. Other commonly expressed concepts included: increased feelings of confidence, independence, optimism, and normalcy; less absence from work/school; better productivity; improved sleep and energy; healthier family relationships; and improved cognition. While all AE-QoL items emerged from patient interviews, a number of identified concepts were not addressed by the AE-QoL, including sensitivity to various potential attack-triggers (e.g., stress/anxiety, sports), attack frequency, not having to cancel social plans, improvements in ability to perform day-to-day tasks, and a lower burden from medical visits. Conclusions From these interviews, a large number of common themes and concepts emerged: a greater sense of freedom and normalcy, increased productivity, and improved interpersonal relationships while using convenient and effective prophylaxis. These findings provide insights into real-world experiences and the many facets of HRQoL that are important to patients with HAE-C1INH. Supplementary Information The online version contains supplementary material available at 10.1186/s13223-021-00550-5.
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Affiliation(s)
- John Anderson
- Clinical Research Center of Alabama, Birmingham, AL, USA.
| | | | | | | | | | - H Henry Li
- Institute for Asthma and Allergy, Chevy Chase, MD, USA
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5
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Effects of a Music-Based Rhythmic Auditory Stimulation on Gait and Balance in Subacute Stroke. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042032. [PMID: 33669715 PMCID: PMC7923168 DOI: 10.3390/ijerph18042032] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 12/19/2022]
Abstract
Gait and balance impairments are common after stroke. This study aimed to evaluate the effect of a music-based rhythmic auditory stimulation (RAS) in combination with conventional physiotherapy on gait parameters and walking ability in subacute stroke. This single-blind, historical controlled trial, included 55 patients who had suffered a stroke within the three weeks prior to enrolment. Patients from 2018 (n = 27) were assigned as the historical control group whereas 2019 patients (n = 28) received music-based RAS three times a week. Both groups received 11 h of conventional physiotherapy per week during hospitalization. Primary outcomes were gait and balance parameters (Tinetti test and Timed Up&Go test) and walking ability (Functional Ambulation Category scale). Secondary outcomes were trunk control, assistive devices, functional independence (Functional Independence Measure, Barthel index), and stroke severity and disability (modified Rankin scale, National Institutes of Health Stroke Scale). Results: No between-group differences were identified for gait and balance parameters nor for secondary outcomes. Significant between-group differences were observed in the Functional Ambulation Category: the intervention group (Δmean ± SD; 3.43 ± 1.17) showed greater improvement (p = 0.002) than the control group (Δmean ± SD; 2.48 ± 1.09). Compared with conventional physiotherapy alone, our results suggest that the walking ability of subacute stroke patients might be improved with music-based RAS combined with conventional physiotherapy, but this treatment is not more effective than conventional physiotherapy in obtaining gait and balance gains.
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Last N, Packham TL, Gewurtz RE, Letts LJ, Harris JE. Exploring patient perspectives of barriers and facilitators to participating in hospital-based stroke rehabilitation. Disabil Rehabil 2021; 44:4201-4210. [PMID: 33569980 DOI: 10.1080/09638288.2021.1881830] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Patient participation is recognized as an important element of rehabilitation. However, few studies have used a qualitative lens to specifically examine factors influencing patient participation in stroke rehabilitation. AIM The purpose of this study was to investigate patient perspectives of barriers and facilitators to participating in hospital-based stroke rehabilitation. METHODS Semi-structured interviews were conducted with 11 patients, with confirmed diagnoses of stroke, recruited from three separate rehabilitation settings. Analysis of the interviews was guided by a process of interpretive description to identify key barriers and facilitators to participation in stroke rehabilitation. RESULTS Four main themes and corresponding sub-themes were constructed concerning participation in rehabilitation: (i) Environmental Factors, (ii) Components of Therapy, (iii) Physical and Emotional Well-Being, and (iv) Personal Motivators. An exploratory model of personalized rehabilitation emerged, integrating the themes emerging from the data. DISCUSSION Personalized rehabilitation can be considered in comparison to person-centred care principles. The barriers and enablers experienced by patients in this study contribute to the existing knowledge of the patient experience of stroke rehabilitation and may be used to inform clinical practices and future research.Implications for RehabilitationThe surrounding environments can facilitate participation in rehabilitation using strategies to reduce noise and disruption and also by encouraging social interactions among patients.Increasing the frequency and consistency of communication with patients about rehabilitation goals and progress could enhance participation.Designing interventions to include activities that are meaningful and focused on the resumption of valued life roles is key to participation.Therapy intensity, time spent sedentary, and the emotional impact of stroke are aspects of rehabilitation patient's feel are neglected.
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Affiliation(s)
- Nicole Last
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Tara L Packham
- School of Rehabilitation Science, McMaster University, Hamilton, Canada.,Regional Rehabilitation Program, Hamilton Health Sciences, Hamilton, Canada
| | - Rebecca E Gewurtz
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Lori J Letts
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Jocelyn E Harris
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
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7
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Borisova V, Isakova E, Kotov S. Cognitive rehabilitation after stroke using non-pharmacological approaches. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:26-32. [DOI: 10.17116/jnevro202112112226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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8
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Kotov SV, Isakova EV, Zaitseva EV, Egorova YV. [Multimodal stimulation in the neurorehabilitation of patients with poststroke cognitive impairment]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:125-130. [PMID: 32621478 DOI: 10.17116/jnevro2020120051125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Loss of functional activity after a stroke is a leading cause of disability in adults worldwide. Particular attention is currently being paid to post-stroke cognitive impairment. Approaches based on multimodal exposure are increasingly being used when planning rehabilitation programs, which makes it possible to comprehensively cover the entire spectrum of existing neurological disorders in patients and enables to achieve a more effective recovery of functional activity after a stroke.
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Affiliation(s)
- S V Kotov
- Vladimirsky Moscow Regional Clinical Research Institute, Moscow, Russia
| | - E V Isakova
- Vladimirsky Moscow Regional Clinical Research Institute, Moscow, Russia
| | - E V Zaitseva
- Vladimirsky Moscow Regional Clinical Research Institute, Moscow, Russia
| | - Yu V Egorova
- Vladimirsky Moscow Regional Clinical Research Institute, Moscow, Russia
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9
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Vive S, Bunketorp-Käll L, Carlsson G. Experience of enriched rehabilitation in the chronic phase of stroke. Disabil Rehabil 2020; 44:412-419. [PMID: 32478573 DOI: 10.1080/09638288.2020.1768598] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: In this study, we explored the experiences of patients who participated in an enriched task-specific therapy (ETT) program in the chronic phase after stroke.Method: Focus group interviews were conducted with twenty participants with a mean time since stroke of 30 months and mean age 61 years, who completed the ETT program including task-specific training and environmental enrichment. ETT was delivered 3.5-6 h per day, 5½ days per week for 3 weeks in a climate suitable for both indoor and outdoor activities. The training consisted of repetitive mass practice of gradually increasing difficulty. Directly after the intervention, qualitative interviews were conducted in six focus groups. The interviews were analysed with qualitative content analysis.Results: Three main categories describing the informants' experiences of the ETT program were identified. These categories were; 1. The program-different and hard - highlighting the participants view of the ETT as strenuous and different in nature; 2. My body and mind learn to know better - describing positive changes in participants' body function and functional ability as well as behavioural changes experienced throughout the ETT; and 3. The need and trust from others - emphasizing the perceived importance of trust in rehabilitation clinicians and the support of family and other participants. From these categories, a main theme emerged: It's hard but possible-but not alone!Conclusion: A therapy program including task-specific training and environmental enrichment may provide late-phase stroke survivors with perceived improvements in functional ability, knowledge insights, perceptions of rehabilitation needs and enriching emotional impacts.Implications for rehabilitationETT is feasible and may lead to perceived improvements in function and a change of mindset, even in the chronic phase after stroke.Trust in the competence of the rehabilitation staff is an important factor in compliance with the high-intensity training in the ETT program.Given the lack of stimulation and socialization among many individuals with chronic stroke, the social and physical environment are important components of the ETT program.
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Affiliation(s)
- Sara Vive
- Section for Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Neurocampus, Sophiahemmet Hospital, Stockholm, Sweden
| | - Lina Bunketorp-Käll
- Section for Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Centre for Advanced Reconstruction of Extremities (C.A.R.E.), Sahlgrenska University Hospital, Mölndal, Sweden
| | - Gunnel Carlsson
- Section for Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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10
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Liang Z, Munro CL, Ferreira TBD, Clochesy J, Yip H, Sena Moore K, Kip K. Feasibility and acceptability of a self-managed exercise to rhythmic music intervention for ICU survivors. Appl Nurs Res 2020; 54:151315. [PMID: 32650887 DOI: 10.1016/j.apnr.2020.151315] [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: 10/03/2019] [Accepted: 05/17/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Post-ICU rehabilitation is a challenging clinical issue for patients discharged from an Intensive Care Unit ("ICU survivors"). Our exercise to rhythmic music intervention was designed to allow ICU survivors to self-manage their exercise by following a personalized, recorded exercise playlist. AIM Our study reports the feasibility and acceptability of an innovative music intervention among ICU survivors enrolled in a randomized controlled pilot study. METHODS ICU survivors, admitted in ICU for at least 5 days and cognitively intact, were randomly assigned to an exercise to rhythmic music group (n = 10) or an active control group (n = 10). Participants in the music group were taught to self-manage exercise by listening to a recorded playlist of instructions and music-facilitated movements tailored to their musical preference and exercise ability. Participants in the control group were provided a brochure with exercise instructions. After 5 days or at hospital discharge, participants completed an 8-item acceptability questionnaire and were interviewed. Content analysis was conducted. RESULTS 18 Participants were included for final analysis. Participants were 61.8 ± 14.7 years old, predominantly male (66.7%), and Caucasian (55.6%). Results demonstrated feasibility, as the study team was able to meet the enrollment goal of 5-6 participants per month. Three themes related to general, physical, and psychosocial benefits were identified. Based on positive feedback, the exercise to rhythmic music intervention was deemed acceptable. CONCLUSION The exercise to rhythmic music intervention was feasible and acceptable, suggesting that clinical trials with larger sample sizes should investigate the effects of the intervention on outcomes among ICU survivors.
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Affiliation(s)
- Zhan Liang
- University of Miami, School of Nursing and Health Studies, United States of America.
| | - Cindy L Munro
- University of Miami, School of Nursing and Health Studies, United States of America
| | - Tanira B D Ferreira
- University of Miami Hospital & Clinics, Department of Medicine, Division of Pulmonary Disease and Critical Care, Miami, FL, United States of America
| | - John Clochesy
- University of Miami, School of Nursing and Health Studies, United States of America
| | - Hilary Yip
- University of Miami, Frost School of Music, United States of America
| | | | - Kevin Kip
- University of South Florida, College of Public Health, United States of America
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11
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Pohl P, Wressle E, Lundin F, Enthoven P, Dizdar N. Group-based music intervention in Parkinson's disease - findings from a mixed-methods study. Clin Rehabil 2020; 34:533-544. [PMID: 32070122 PMCID: PMC7132435 DOI: 10.1177/0269215520907669] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective: To evaluate a group-based music intervention in patients with Parkinson’s
disease. Design: Parallel group randomized controlled trial with qualitative
triangulation. Setting: Neurorehabilitation in primary care. Subjects: Forty-six patients with Parkinson’s disease were randomized into intervention
group (n = 26), which received training with the
music-based intervention, and control group (n = 20)
without training. Interventions: The intervention was delivered twice weekly for 12 weeks. Main measures: Primary outcome was Timed-Up-and-Go subtracting serial 7’s (dual-task
ability). Secondary outcomes were cognition, balance, concerns about
falling, freezing of gait, and quality of life. All outcomes were evaluated
at baseline, post-intervention, and three months post-intervention. Focus
groups and individual interviews were conducted with the intervention group
and with the delivering physiotherapists. Results: No between-group differences were observed for dual-task ability.
Between-group differences were observed for Falls Efficacy Scale (mean
difference (MD) = 6.5 points; 95% confidence interval (CI) = 3.0 to 10.0,
P = 0.001) and for Parkinson Disease Questionnaire-39
items (MD = 8.3; 95% CI = 2.7 to 13.8, P = 0.005) when
compared to the control group post-intervention, but these were not
maintained at three months post-intervention. Three themes were derived from
the interviews: Expectations versus Results, Perspectives on
Treatment Contents, and Key Factors for
Success. Conclusion: Patient-reported outcomes and interviews suggest that the group-based music
intervention adds value to mood, alertness, and quality of life in patients
with Parkinson’s disease. The study does not support the efficacy in
producing immediate or lasting gains in dual-tasking, cognition, balance, or
freezing of gait.
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Affiliation(s)
- Petra Pohl
- Department of Activity and Health, and Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
| | - Ewa Wressle
- Department of Acute Internal Medicine and Geriatrics, Department of Social and Welfare Studies, Linköping University, Linköping, Sweden
| | - Fredrik Lundin
- Department of Neurology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Paul Enthoven
- Pain and Rehabilitation Centre, and Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
| | - Nil Dizdar
- Department of Neurology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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12
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Bunketorp-Käll L, Pekna M, Pekny M, Blomstrand C, Nilsson M. Effects of horse-riding therapy and rhythm and music-based therapy on functional mobility in late phase after stroke. NeuroRehabilitation 2019; 45:483-492. [PMID: 31868694 PMCID: PMC7029334 DOI: 10.3233/nre-192905] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Persons with stroke commonly have residual neurological deficits that seriously hamper mobility. OBJECTIVE To investigate whether horse-riding therapy (H-RT) and rhythm and music-based therapy (R-MT) affect functional mobility in late phase after stroke. METHODS This study is part of a randomized controlled trial in which H-RT and R-MT was provided twice weekly for 12 weeks. Assessment included the timed 10-meter walk test (10 mWT), the six-minute walk test (6 MWT) and Modified Motor Assessment Scale (M-MAS). RESULTS 123 participants were assigned to H-RT (n = 41), R-MT (n = 41), or control (n = 41). Post-intervention, the H-RT group completed the 10 mWT faster at both self-selected (-2.22 seconds [95% CI, -3.55 to -0.88]; p = 0.001) and fast speed (-1.19 seconds [95% CI, -2.18 to -0.18]; p = 0.003), with fewer steps (-2.17 [95% CI, -3.30 to -1.04]; p = 0.002 and -1.40 [95% CI, -2.36 to -0.44]; p = 0.020, respectively), as compared to controls. The H-RT group also showed improvements in functional task performance as measured by M-MAS UAS (1.13 [95% CI, 0.74 to 1.52]; p = 0.001). The gains were partly maintained at 6 months among H-RT participants. The R-MT did not produce any immediate gains. However, 6 months post-intervention, the R-MT group performed better with respect to time; -0.75 seconds [95% CI, -1.36 to -0.14]; p = 0.035) and number of steps -0.76 [95% CI, -1.46 to -0.05]; p = 0.015) in the 10 mWT at self-selected speed. CONCLUSIONS The present study supports the efficacy of H-RT in producing immediate gains in gait and functional task performance in the late phase after stroke, whereas the effectiveness of R-MT is less clear.
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Affiliation(s)
- Lina Bunketorp-Käll
- Center for Brain Repair, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Center for Advanced Reconstruction of Extremities C.A.R.E. Institute of Clinical Sciences, Sahlgrenska University Hospital/Mölndal, Sweden
| | - Marcela Pekna
- Center for Brain Repair, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Florey Institute of Neuroscience and Mental Health, Parkville, Melbourne, Australia
| | - Milos Pekny
- Center for Brain Repair, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Florey Institute of Neuroscience and Mental Health, Parkville, Melbourne, Australia
- University of Newcastle, New South Wales, Australia
| | - Christian Blomstrand
- Center for Brain Repair, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Neuroscience, Stroke Center West, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Michael Nilsson
- Center for Brain Repair, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Florey Institute of Neuroscience and Mental Health, Parkville, Melbourne, Australia
- Centre for Rehab Innovations (CRI), University of Newcastle and Hunter Medical Research Institute (HMRI) Newcastle, Australia
- LKC School of Medicine, Nanyang Technological University, Singapore
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13
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Marín J, Blanco T, Marín JJ, Moreno A, Martitegui E, Aragüés JC. Integrating a gait analysis test in hospital rehabilitation: A service design approach. PLoS One 2019; 14:e0224409. [PMID: 31665158 PMCID: PMC6821402 DOI: 10.1371/journal.pone.0224409] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 10/11/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Gait analysis with motion capture (MoCap) during rehabilitation can provide objective information to facilitate treatment decision making. However, designing a test to be integrated into healthcare services requires considering multiple design factors. The difficulty of integrating a 'micro-service' (gait test) within a 'macro-service' (healthcare service) has received little attention in the gait analysis literature. It is a challenge that goes beyond the gait analysis case study because service design methods commonly focus on the entire service design (macro-level). OBJECTIVE This study aims to extract design considerations and generate guidelines to integrate MoCap technology for gait analysis in the hospital rehabilitation setting. Specifically, the aim is to design a gait test to assess the response of the applied treatments through pre- and post-measurement sessions. METHODS We focused on patients with spasticity who received botulinum toxin treatment. A qualitative research design was used to investigate the integration of a gait analysis system based on inertial measurement units in a rehabilitation service at a reference hospital. The methodological approach was based on contrasted methodologies from the service design field, which materialise through observation techniques (during system use), semi-structured interviews, and workshops with healthcare professionals (13 patients, 10 'proxies', and 6 doctors). RESULTS The analysis resulted in six themes: (1) patients' understanding, (2) guiding the gait tests, (3) which professionals guide the gait tests, (4) gait test reports, (5) requesting gait tests (doctors and test guide communication), and the (6) conceptual design of the service with the gait test. CONCLUSIONS The extracted design considerations and guidelines increase the applicability and usefulness of the gait analysis technology, improving the link between technologists and healthcare professionals. The proposed methodological approach can also be useful for service design teams that deal with the integration of one service into another.
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Affiliation(s)
- Javier Marín
- IDERGO (Research and Development in Ergonomics) Research Group, I3A (Aragon Institute of Engineering Research), University of Zaragoza, Zaragoza, Spain
- Department of Design and Manufacturing Engineering, University of Zaragoza, Zaragoza, Spain
| | - Teresa Blanco
- HOWLab (Human Openware Research Lab) Research Group, I3A, University of Zaragoza, Zaragoza, Spain
- GeoSpatiumLab, S.L. Zaragoza, Spain
| | - José J. Marín
- IDERGO (Research and Development in Ergonomics) Research Group, I3A (Aragon Institute of Engineering Research), University of Zaragoza, Zaragoza, Spain
- Department of Design and Manufacturing Engineering, University of Zaragoza, Zaragoza, Spain
| | - Alejandro Moreno
- IDERGO (Research and Development in Ergonomics) Research Group, I3A (Aragon Institute of Engineering Research), University of Zaragoza, Zaragoza, Spain
- Department of Health and Sports Sciences, University of Zaragoza, Zaragoza, Spain
| | - Elena Martitegui
- Rehabilitation and Physical Medicine Service, HUMS (Miguel Servet University Hospital), Zaragoza, Spain
| | - Juan C. Aragüés
- Rehabilitation and Physical Medicine Service, HUMS (Miguel Servet University Hospital), Zaragoza, Spain
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