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Soto-Vidal C, Calvo-Fuente V, Hidalgo-Galante E, Cerezo-Téllez E, Pérez-Martín Y, Pacheco-da-Costa S. Effectiveness of Physiotherapy for Improving Functionality, Participation, and Quality of Life after a Stroke: Study Protocol for a Randomized Controlled Clinical Trial. J Pers Med 2024; 14:891. [PMID: 39202082 PMCID: PMC11355197 DOI: 10.3390/jpm14080891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 08/16/2024] [Accepted: 08/19/2024] [Indexed: 09/03/2024] Open
Abstract
BACKGROUND Stroke survivors experience significant alterations in their daily functionality that has a negative impact on their functionality, participation, and quality of life. Person-centered approaches in Physical Therapy interventions that are focused on functional and meaningful goals help to minimize the impact of the alterations. Therefore, the aim of this study is to assess the effectiveness of a Physical Therapy intervention based on a goal-oriented approach with task-specific training for improving functionality, participation, and quality of life for people with Stroke. METHODS A single-blinded randomized controlled clinical trial will be developed. Adults over 50 years old diagnosed with Stroke over 6 months will be included in this study. Participants (n = 62) will be randomly allocated into two groups: The experimental group (n = 31) will receive 30 sessions, three per week during 10 weeks, of Physical Therapy sessions of goal-directed and task-specific training. The control group (n = 31) will follow the same intervention intensity of their usual Physical Therapy treatment. The primary outcome variables quality of life (NewsQol), participation (Ox-PAQ), and gait functionality (FAC) and the secondary outcome variables functional disability (BI), postural control (PASS), dynamic trunk balance (TIS), and functional goals (GAS) will be measured at baseline, after group interventions (10 weeks), and 6 months after the baseline. Statistical analyses will include repeated-measures ANOVA, Student's t-test, or the Mann-Whitney U-test, with a 95% confidence interval and significance level of p < 0.05. CONCLUSION Person-centered approaches in Physical Therapy interventions may yield better outcomes in functionality, participation, and quality of life for Stroke patients compared to standardized interventions. TRIAL REGISTRATION ClinicalTrials.gov: NCT06165666 (December 2023).
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Affiliation(s)
- Concepción Soto-Vidal
- Neuromusculoskeletal Physical Therapy in Stages of Life Research Group (FINEMEV), Department of Nursing and Physical Therapy, Faculty of Medicine and Health Sciences, Universidad de Alcalá, Autovía A2, km 33.200, Alcalá de Henares, 28805 Madrid, Spain; (C.S.-V.); (E.C.-T.); (S.P.-d.-C.)
| | - Victoria Calvo-Fuente
- Neuromusculoskeletal Physical Therapy in Stages of Life Research Group (FINEMEV), Department of Nursing and Physical Therapy, Faculty of Medicine and Health Sciences, Universidad de Alcalá, Autovía A2, km 33.200, Alcalá de Henares, 28805 Madrid, Spain; (C.S.-V.); (E.C.-T.); (S.P.-d.-C.)
| | - Ezequiel Hidalgo-Galante
- Physical Medicine and Rehabilitation Service, Ramón y Cajal University Hospital, Ctra. Colmenar Viejo km 9.100, 28034 Madrid, Spain;
| | - Ester Cerezo-Téllez
- Neuromusculoskeletal Physical Therapy in Stages of Life Research Group (FINEMEV), Department of Nursing and Physical Therapy, Faculty of Medicine and Health Sciences, Universidad de Alcalá, Autovía A2, km 33.200, Alcalá de Henares, 28805 Madrid, Spain; (C.S.-V.); (E.C.-T.); (S.P.-d.-C.)
| | - Yolanda Pérez-Martín
- Humanization in the Intervention of Physiotherapy for the Integral Attention to the People (HIPATIA), Department of Nursing and Physical Therapy, Faculty of Medicine and Health Sciences, Universidad de Alcalá, Autovía A2, km 33.200, Alcalá de Henares, 28805 Madrid, Spain;
| | - Soraya Pacheco-da-Costa
- Neuromusculoskeletal Physical Therapy in Stages of Life Research Group (FINEMEV), Department of Nursing and Physical Therapy, Faculty of Medicine and Health Sciences, Universidad de Alcalá, Autovía A2, km 33.200, Alcalá de Henares, 28805 Madrid, Spain; (C.S.-V.); (E.C.-T.); (S.P.-d.-C.)
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Hernández-Martínez A, Fernandez-Escabias M, Amaya-Pascasio L, Carrilho-Candeias S, Ramos-Teodoro M, Gil-Rodríguez M, Orellana-Jaen A, Martínez-Rosales E, Ruiz-González D, Esteban-Simón A, Castro-Ropero B, del-Olmo-Iruela L, López-López MI, Ramos-Herrera AI, Fajardo-Rodríguez MF, Gómez-García S, Rodríguez-Camacho M, Conde-Negri E, Rodríguez-Pérez M, Marcos-Pardo PJ, Ruiz JR, Villegas-Rodríguez I, Amaro-Gahete FJ, Martínez-Sánchez P, Soriano-Maldonado A. Evaluation of the effects of a gamified, fully immersive and stroke-specific virtual reality intervention for improving disability and quality of life in patients with stroke in the subacute phase: study protocol of the RESET randomised trial. BMJ Open Sport Exerc Med 2024; 10:e002123. [PMID: 39161559 PMCID: PMC11331906 DOI: 10.1136/bmjsem-2024-002123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2024] [Indexed: 08/21/2024] Open
Abstract
Stroke is the leading cause of disability and the second cause of death worldwide. The increasing burden of stroke underscores the importance of optimising rehabilitation protocols. Virtual reality (VR) can improve poststroke prognosis. A VR software combining gamification, full immersion and stroke specificity (ie, the Development and validation of a novel viRtual rEality software for improving diSability and quality of lifE in patients with sTroke (RESET) software) might substantially improve disability and quality of life (QoL). However, this technology is still very scarce. The RESET trial aims to assess the effects of an early 10-week gamified, fully immersive and stroke-specific VR intervention (ie, starting at week 3 poststroke) on disability and QoL in people with stroke in the subacute phase. People with ischaemic or haemorrhagic stroke (n=94) aged ≥ 18 years will be randomised to receive (1) usual care (UC), (2) commercial VR or (3) gamified, fully immersive and stroke-specific VR (RESET). The three groups will receive UC (ie, three sessions/week of 90 min of standard rehabilitation). The VR groups will additionally receive three VR sessions of 20 min per week. The outcome measures will be assessed at baseline (week 2 from stroke occurrence), week 13 (approximately 90 days from the event) and week 26 (approximately 6 months from the event). The primary outcome is disability measured with the Barthel Index. Secondary outcomes include QoL, upper-extremity and lower-extremity motor function, gross manual dexterity, handgrip strength and cognitive function. This study will unravel the effects of a gamified, fully immersive and stroke-specific VR software on disability and QoL in patients with stroke in the early subacute phase.Trial registration number: NCT06132399.
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Affiliation(s)
- Alba Hernández-Martínez
- SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social), University of Almería, Almería, Spain
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
| | | | | | - Sofia Carrilho-Candeias
- Department of Physiology, Faculty of Medicine, University of Granada, Granada, Spain
- Fundación para la Investigación Biosanitaria de Andalucía Oriental (FIBAO), Granada, Spain
| | - Máriam Ramos-Teodoro
- SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social), University of Almería, Almería, Spain
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
| | - Mercedes Gil-Rodríguez
- Fundación para la Investigación Biosanitaria de Andalucía Oriental (FIBAO), Almería, Spain
| | - Andrea Orellana-Jaen
- Department of Physiology, Faculty of Medicine, University of Granada, Granada, Spain
| | - Elena Martínez-Rosales
- SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social), University of Almería, Almería, Spain
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
| | - David Ruiz-González
- SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social), University of Almería, Almería, Spain
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
| | - Alba Esteban-Simón
- SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social), University of Almería, Almería, Spain
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
| | - Belén Castro-Ropero
- Servicio de Medicina Física y Rehabilitación del Hospital Universitario Clínico San Cecilio, Granada, Spain
| | - Laura del-Olmo-Iruela
- Servicio de Medicina Física y Rehabilitación del Hospital Universitario Clínico San Cecilio, Granada, Spain
| | | | | | | | - Silvia Gómez-García
- Servicio de Medicina Física y Rehabilitación, Hospital Universitario Torrecárdenas, Almería, España, Almería, Spain
| | | | - Elena Conde-Negri
- Servicio de Medicina Física y Rehabilitación, Hospital Universitario Torrecárdenas, Almería, España, Almería, Spain
| | - Mónica Rodríguez-Pérez
- Servicio de Medicina Física y Rehabilitación, Hospital Universitario Torrecárdenas, Almería, España, Almería, Spain
| | - Pablo Jorge Marcos-Pardo
- SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social), University of Almería, Almería, Spain
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
| | - Jonatan R Ruiz
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, ibs.Granada, Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Francisco J Amaro-Gahete
- Department of Physiology, Faculty of Medicine, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, ibs.Granada, Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Patricia Martínez-Sánchez
- Servicio de Neurología, Hospital Universitario Torrecárdenas, Almería, Spain
- Facultad de Ciencias de la Salud, Centro de Investigación en Salud (CEINSA), Universidad de Almería, Almería, Spain
| | - Alberto Soriano-Maldonado
- SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social), University of Almería, Almería, Spain
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
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Effects of Self-Management Intervention Programs Based on the Health Belief Model and Planned Behavior Theory on Self-Management Behavior and Quality of Life in Middle-Aged Stroke Patients. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:8911143. [PMID: 34707678 PMCID: PMC8545554 DOI: 10.1155/2021/8911143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 09/29/2021] [Indexed: 12/12/2022]
Abstract
Objectives To study the effect of self-management intervention programs based on the health belief model and planned behavior theory on self-management behavior and quality of life in middle-aged stroke patients. Most of the intervention studies on the self-management of middle-aged stroke patients focus on traditional Chinese medicine nursing and continuous nursing, lacking theoretical support. In particular, there is a lack of interventions based on the integration of two or more theories. Method The middle-aged stroke patients were divided into the control group and the intervention group according to the disease area. A total of 70 patients were included, and 35 patients were included in the control group and the intervention group, respectively. The control group received routine neurological treatment and health education during hospitalization and continued to receive routine health education for 3 months after discharge. On this basis, the intervention group received an intervention program based on an integrated model of health beliefs and planned behavior theory, including 3 health education sessions during hospitalization and 3 months of postdischarge health education. A self-administered stroke general information questionnaire was used to collect basic information on patients' age, gender, and comorbidities. The Stroke Self-Management Behavior Rating Scale and Stroke-Specific Quality-of-Life Scale (SS-QOL) were used to evaluate the management behavior and quality of life of the patients in both groups before and after the intervention. Results Before the intervention, there was no statistically significant difference between the two groups in terms of self-management score, quality of life total score, and scores of each dimension (P > 0.05). At different periods after the intervention, the total score of self-management, total score of quality of life, and scores of each dimension were significantly higher in both groups than before the intervention (P < 0.05). In particular, the self-management and quality of life scores of the intervention group were higher than those of the control group at 1 and 3 months after the intervention (P < 0.05). Conclusion The self-management intervention scheme based on the integrated model of health belief and planned behavior theory is beneficial to improve the self-management ability and quality of life of stroke patients. It provides basis for clinical nurses to further improve the self-management ability and quality of life of stroke patients. Our findings may also serve as a reference for caregivers in other countries to improve the self-management and quality of life of stroke patients.
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Soto-Vidal C, Calvo-Fuente V, Muriel-García A, Gallego-Izquierdo T, González-Alted C, Pacheco-da-Costa S. Responsiveness of the Spanish Version of Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10034. [PMID: 34639337 PMCID: PMC8507955 DOI: 10.3390/ijerph181910034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/08/2021] [Accepted: 09/16/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the responsiveness of the Spanish version of the Newcastle Stroke-specific Quality of Life measure (NEWSQOL) to assess quality of life in Spanish people after suffering a stroke. DESIGN A prospective observational study was conducted to assess the responsiveness of the Spanish version of NEWSQOL. The sample contained 128 patients who filled in the questionnaires before and after a physical therapy intervention. The responsiveness was assessed with p-values using the effect size (ES) and the standardized response means (SRMs) of the change. Besides, two other external criteria were used to distinguish patients who improved with the treatment from those who remained stable. This classification was based on one functional independence measure (the Barthel Index) and one disability measure (the modified Rankin Scale). RESULTS There was a statistically significant correlation (Spearman's coefficient = p < 0.01) between the domains of the Spanish version of NEWSQOL in relation to the Barthel Index and the modified Rankin Scale. All domains showed between marked-to-mild change responsiveness except sleep and relationships; mobility (ES 0.66 and SRM 0.92) and activities of daily living (ES 0.75 and SRM 0.87) were markedly responsive; communication (ES 0.38 and SRM 0.61) was moderately responsive; and pain, vision, cognition, feelings, emotions and fatigue were mildly responsive (ES 0.21-0.41 and SRM 0.23-0.44). CONCLUSION The Spanish version of NEWSQOL shows between marked and mild responsiveness to measure the perception of QoL in post-stroke patients. Therefore, its use can be suitable for evaluation studies, clinical trials and clinical practice.
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Affiliation(s)
- Concepción Soto-Vidal
- Department of Nursing and Physiotherapy, Universidad de Alcalá, 28871 Madrid, Spain; (C.S.-V.); (A.M.-G.); (T.G.-I.); (S.P.-d.-C.)
| | - Victoria Calvo-Fuente
- Department of Nursing and Physiotherapy, Universidad de Alcalá, 28871 Madrid, Spain; (C.S.-V.); (A.M.-G.); (T.G.-I.); (S.P.-d.-C.)
| | - Alfonso Muriel-García
- Department of Nursing and Physiotherapy, Universidad de Alcalá, 28871 Madrid, Spain; (C.S.-V.); (A.M.-G.); (T.G.-I.); (S.P.-d.-C.)
| | - Tomás Gallego-Izquierdo
- Department of Nursing and Physiotherapy, Universidad de Alcalá, 28871 Madrid, Spain; (C.S.-V.); (A.M.-G.); (T.G.-I.); (S.P.-d.-C.)
| | | | - Soraya Pacheco-da-Costa
- Department of Nursing and Physiotherapy, Universidad de Alcalá, 28871 Madrid, Spain; (C.S.-V.); (A.M.-G.); (T.G.-I.); (S.P.-d.-C.)
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