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Serrada I, Williams L, Hordacre B, Hillier S. Key constructs of body awareness impairments post-stroke: a scoping review of assessment tools and interventions. Disabil Rehabil 2023; 45:3177-3198. [PMID: 36189909 DOI: 10.1080/09638288.2022.2123053] [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: 07/28/2021] [Revised: 08/24/2022] [Accepted: 08/29/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To summarise body awareness assessment tools and interventions relevant for stroke rehabilitation using a framework that categorises key body awareness constructs, disorders and impairments. MATERIALS AND METHODS Online electronic databases and trial registries were searched from inception until July 2021, in addition to hand searching reference lists of included studies and reviews. Study selection included any study design where the investigation involved assessing and/or intervening in body awareness following stroke. Data were extracted based on predefined criteria by two independent reviewers and mapped to the emergent framework. RESULTS The final analysis included 144 papers that reported 43 assessment tools and 8 types of interventions for body awareness. Consensus was reached on a synthesised body awareness framework. This comprised specific impairments and disorders, constructs, sub-categories and main categories leading to the overarching term of body awareness. Clinical and psychometric properties of the assessment tools were not reported or poorly evaluated, and the interventions lacked robust study designs and rigorous methods. CONCLUSIONS The framework produced will enable future research and clinical practice to be based on consistent concepts and definitions. Clinicians can also use this information to cautiously select assessment tools and/or interventions but are reminded of the limitations identified in this review.Implications for rehabilitationThere is limited understanding, compounded by inconsistent terminology and definitions regarding body awareness after stroke.A synthesized framework to define key constructs and definitions of body awareness is proposed.Assessment tools and interventions reported in the literature are mapped to the proposed framework.Psychometric properties of available tools are reported.Significant work remains to refine concepts of body awareness, develop and evaluate assessment tools and interventions.
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Affiliation(s)
- Ines Serrada
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation (IIMPACT) in Health, University of South Australia, City East Campus, Adelaide, SA, Australia
| | - Lindy Williams
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation (IIMPACT) in Health, University of South Australia, City East Campus, Adelaide, SA, Australia
| | - Brenton Hordacre
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation (IIMPACT) in Health, University of South Australia, City East Campus, Adelaide, SA, Australia
| | - Susan Hillier
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation (IIMPACT) in Health, University of South Australia, City East Campus, Adelaide, SA, Australia
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Serrada I, Fryer C, Hordacre B, Hillier S. Can body awareness training improve recovery following stroke: A study to assess feasibility and preliminary efficacy. Clin Rehabil 2022; 36:650-659. [PMID: 35243909 DOI: 10.1177/02692155221083492] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Impairments in body awareness are common after stroke and are associated with decreased participation and performance in everyday activities. OBJECTIVES To explore the feasibility and safety of a body awareness program after stroke, and identify the preliminary efficacy of class-based lessons compared to home-based lessons on sensation, body awareness, motor impairment and quality of life. METHODS A two-armed pilot randomized controlled trial with a nested qualitative descriptive study was conducted. Individuals with a diagnosis of stroke (at least three months post injury) were randomized to either class-based face-to-face body awareness lessons or home-based individually performed body awareness lessons. Outcome measures were safety, feasibility, sensation, body awareness, motor impairment, self-efficacy and quality of life. Semi-structured interviews were used to allow greater exploration and understanding of participants' experience of the program. RESULTS Twenty participants were randomized, 16 participants completed the program. Feasibility was greater in the class-based group. No adverse events were detected. The class-based group led to improvement in body awareness (p = 0.002), quality of life (p = 0.002), and the arm (p = 0.025) and leg (p = 0.005) motor impairment scores. Qualitative data similarly indicated that the class-based group experienced a stronger sense of awareness, achievement and connection than the home-based group. CONCLUSIONS Body awareness training was safe, feasible and acceptable in people with stroke. Individuals in the class-based group showed greater benefit compared to those receiving home-based therapy.
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Affiliation(s)
- Ines Serrada
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation (IIMPACT) in Health, 1067University of South Australia, City East Campus, Adelaide SA 5000, Australia
| | - Caroline Fryer
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation (IIMPACT) in Health, 1067University of South Australia, City East Campus, Adelaide SA 5000, Australia
| | - Brenton Hordacre
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation (IIMPACT) in Health, 1067University of South Australia, City East Campus, Adelaide SA 5000, Australia
| | - Susan Hillier
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation (IIMPACT) in Health, 1067University of South Australia, City East Campus, Adelaide SA 5000, Australia
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Serrada I, Hordacre B, Hillier S. Recovery of Body Awareness After Stroke: An Observational Study. Front Neurol 2021; 12:745964. [PMID: 34912283 PMCID: PMC8666978 DOI: 10.3389/fneur.2021.745964] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/19/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Body awareness (BA) is a process that involves sensory awareness originating from the body's physiological states, processes and actions, and is shaped by one's attitudes, perceptions, beliefs and experience of social and cultural context. Impairments in body awareness after stroke are believed to be common and may be an important influence on recovery outcomes. However, recovery of body awareness is poorly understood and receives little consideration in rehabilitation. Aims: To investigate if body awareness changes over time following stroke; and identify if body awareness after stroke is associated with sensation, motor impairment, self-efficacy and quality of life. Methods: An exploratory longitudinal observational study was performed. Participants with a stroke diagnosis and associated motor impairment were recruited from an acute stroke unit. An assessment battery consisting of sensory and motor impairment and function, body awareness, self-efficacy and quality of life measures were used at baseline, 1, 3 and 6 months. Results: A total of 105 people with stroke were recruited. Most recovery in sensation and body awareness occurred within the first month after stroke (all p < 0.01). Sensation and body awareness were correlated with other clinical outcomes (motor impairment, self-efficacy and quality of life), demographics, and stroke specific clinical characteristics (all p < 0.01). Conclusions: This is the first study to track recovery of body awareness after stroke and investigate the relationship it may have in recovery of sensation, motor impairment and function, self-efficacy and quality of life. Further research is now warranted to continue investigation of body awareness and to develop effective stroke-specific assessment and intervention strategies.
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Affiliation(s)
- Ines Serrada
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation in Health, University of South Australia, Adelaide, SA, Australia
| | - Brenton Hordacre
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation in Health, University of South Australia, Adelaide, SA, Australia
| | - Susan Hillier
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation in Health, University of South Australia, Adelaide, SA, Australia
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Umeonwuka C, Roos R, Ntsiea V. Current trends in the treatment of patients with post-stroke unilateral spatial neglect: a scoping review. Disabil Rehabil 2020; 44:2158-2185. [DOI: 10.1080/09638288.2020.1824026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Chuka Umeonwuka
- Department of Physiotherapy, Faculty of Health Science, University of Witwatersrand, Johannesburg, South Africa
| | - Ronel Roos
- Department of Physiotherapy, Faculty of Health Science, University of Witwatersrand, Johannesburg, South Africa
- Department of Physiotherapy, The Wits-JBI Centre for Evidenced-Based Practice: A Joanna Briggs Institute Affiliated Group, Johannesburg, South Africa
| | - Veronica Ntsiea
- Department of Physiotherapy, Faculty of Health Science, University of Witwatersrand, Johannesburg, South Africa
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Alamer A, Getie K, Melese H, Mazea H. Effectiveness of Body Awareness Therapy in Stroke Survivors: A Systematic Review of Randomized Controlled Trials . OPEN ACCESS JOURNAL OF CLINICAL TRIALS 2020. [DOI: 10.2147/oajct.s260476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Park SE, Oh DS, Moon SH. Effects of oculo-motor exercise, functional electrical stimulation and proprioceptive neuromuscular stimulation on visual perception of spatial neglect patients. J Phys Ther Sci 2016; 28:1111-5. [PMID: 27190436 PMCID: PMC4868196 DOI: 10.1589/jpts.28.1111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 12/18/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to identify the effects of oculo-motor exercise, functional electrical stimulation (FES), and proprioceptive neuromuscular facilitation (PNF) on the visual perception of spatial neglect patients. [Subjects and Methods] The subjects were randomly allocated to 3 groups: an oculo-motor exercise (OME) group, a FES with oculo-motor exercise (FOME) group, and a PNF with oculo-motor exercise (POME) group. The line bisection test (LBT), motor free visual test (MVPT), and Catherine Bergego Scale (CBS) were used to measure visual perception. These were performed 5 times per week for 6 weeks. [Results] The OME group and POME group showed significant improvements according to the LBT and MVPT results, but the FOME group showed no significant improvement. According to the CBS, all 3 groups showed significant improvements. The OME and POME groups showed improvement over the FOME group in the LBT and MVPT. However, there was no significant difference among the three groups according to the CBS. [Conclusion] These results indicate that oculo-motor exercise and PNF with oculo-motor exercise had more positive effects than FES with oculo-motor exercise on the visual perception of spatial neglect patients.
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Affiliation(s)
- Si-Eun Park
- Department of Physical Therapy, Pohang College, Republic of Korea
| | - Dae-Sik Oh
- Department of Physical Therapy, Sugi Woori Hospital, Republic of Korea
| | - Sang-Hyun Moon
- Department of Physical Therapy, Dream Hospital, Republic of Korea
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Bang DH, Cho HS. Effect of body awareness training on balance and walking ability in chronic stroke patients: a randomized controlled trial. J Phys Ther Sci 2016; 28:198-201. [PMID: 26957757 PMCID: PMC4756003 DOI: 10.1589/jpts.2016.198] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 10/14/2015] [Indexed: 01/13/2023] Open
Abstract
[Purpose] To investigate the effects of body awareness training on balance and walking
ability in chronic stroke patients. [Subjects] The subjects were randomly assigned to a
body awareness training group (n=6) and a control group (n=6). [Methods] Patients in the
body awareness training group received body awareness training for 20 minutes, followed by
walking training for 30 minutes a day, 5 days a week for 4 weeks. The control group
received walking training for 30 minutes a day, 5 days a week for 4 weeks. [Results] After
the intervention, both groups showed significant improvements in the Berg Balance Scale,
Timed Up and Go Test, and 10 m walk test compared with baseline results. The body
awareness training group showed more significant improvements in the Berg Balance Scale
and Timed Up and Go Test than the control group. There was no significant difference in
the 10 m walk test between the groups. [Conclusion] The results of this study suggest that
body awareness training has a positive effect on balance in patients with chronic
stroke.
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Affiliation(s)
- Dae-Hyouk Bang
- Department of Physical Therapy, Graduate School of Daejeon University, Republic of Korea
| | - Hyuk-Shin Cho
- Department of Physical Therapy, Wonkwang Health Science University, Republic of Korea
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Oh SI, Kim JK, Park SY. The effects of prism glasses and intensive upper limb exercise on hemineglect, upper limb function, and activities of daily living in stroke patients: a case series. J Phys Ther Sci 2015; 27:3941-3. [PMID: 26834386 PMCID: PMC4713825 DOI: 10.1589/jpts.27.3941] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 09/24/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study aimed to examine the effects of visual field with prism glasses, and
intensive upper limb functional training on reduction of hemineglect and improvement in
upper limb function and activities of daily living in three stroke patients with
hemineglect. [Subjects] This study included three stroke patients hospitalized in a
sanatorium. [Methods] Intervention treatment involving prism glass use for 12 hours and 30
minutes and paretic side upper limb training was conducted 5 days a week for 15 weeks.
Three upper limb training tasks (hitting a balloon, passing through a ring, and reading a
newspaper) were performed for 10 minutes each session, for a total of 30 minutes. Line by
Section, Motor-Free Visual Perception Test-3 (MVPT-3), Manual Function Test (MFT), Box
& Block Test (BBT), and Assessment of Motor and Process Skills (AMPS) were conducted
before and after intervention. [Results] Subjects’ hemineglect decreased and upper limb
function on the paretic side improved after intervention, which enhanced activities of
daily living. [Conclusion] Prism glass use and paretic upper limb functional training
effectively ameliorated stroke patients’ hemineglect and improved upper limb function.
Future research should focus on prism glasses that provide a wide visual field for use in
patients with different conditions.
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Affiliation(s)
- Se-Il Oh
- Department of Occupational Therapy, Rehabilitation Clinic, Joy Hospital, Republic of Korea
| | - Jin-Kyung Kim
- Department of Occupational Therapy, College of Health Science, Hanseo University, Republic of Korea
| | - So-Yeon Park
- Department of Occupational Therapy, College of Health Science, Hanseo University, Republic of Korea
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Park JH, Lee JH. The effects of mental practice on unilateral neglect in patients with chronic stroke: a randomized controlled trial. J Phys Ther Sci 2015; 27:3803-5. [PMID: 26834356 PMCID: PMC4713795 DOI: 10.1589/jpts.27.3803] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 09/17/2015] [Indexed: 12/03/2022] Open
Abstract
[Purpose] This study aims to investigate the effects of mental practice on unilateral
neglect in patients with chronic stroke. [Subjects] The subjects of this study included 30
patients with chronic unilateral neglect. [Methods] The subjects were randomly divided
into either the experimental group (EG) or control group (CG). All subjects received a
standard rehabilitation program. In addition to the standard rehabilitation, the EG
subjects received mental practice (5 days a week for 4 weeks) for 10 minutes. To compare
two groups, line bisection test (LBT) and star cancellation test (SCT) were conducted.
[Results] Both groups showed significant improvement in the LBT and SCT. There were
statistically significant differences in the changes in LBT, but there were no significant
differences in the changes in the SCT between both groups. [Conclusion] This study
demonstrated that mental practice may be a valuable additional rehabilitation method in
the chronic stage of neglect.
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Affiliation(s)
- Jin-Hyuck Park
- Department of Occupational Therapy, College of Health Science, Yonsei University, Republic of Korea
| | - Joo-Hyun Lee
- Department of Occupational Therapy, College of Health Science, Yonsei University, Republic of Korea
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