NeuroRehabilitation - Volume 54, issue 2

Authors: Vive, Sara | Zügner, Roland | Tranberg, Roy | Bunketorp-Käll, Lina

Article Type: Research Article

Abstract: BACKGROUND: Approximately 80% of stroke survivors experience motor impairment of the contralateral limb that severely affects their activities of daily living (ADL). OBJECTIVE: To evaluate whether an enriched task-specific training (ETT) program affected the performance and kinetics of sit-to-stand (STS) tasks. METHODS: The study was part of an exploratory study with a within-subject, repeated-measure-design, with assessments before and after a three-week-long baseline period, and six months after the intervention. Forty-one participants underwent assessments of strength and endurance measured by the 30-second-chair-stand test (30sCST). The STS-kinetics, including the vertical ground reaction force (GRF) during STS, were analysed …in an in-depth-subgroup of three participants, using a single-subject-experimental-design (SSED). For kinetic data, statistical significance was determined with the two-standard deviation band method (TSDB). RESULTS: After the baseline period, a small increase was seen in the 30sCST (from 5.6±4.5 to 6.1±4.9, p  = 0.042). A noticeable significant change in the 30sCST was shown after the intervention (from 6.1±4.9 to 8.2±5.4, p  < 0.001), maintained at six months. The in-depth kinetic analyses showed that one of three subjects had a significant increase in loading of the affected limb post-intervention. CONCLUSION: ETT can produce long-term gains in STS performance. Weight-bearing strategies could be one of several factors that contribute to improvements in STS performance in the chronic phase after stroke. Show more

Keywords: Enriched environment, movement analysis, recovery of function, rehabilitation, sit-to-stand, stroke

DOI: 10.3233/NRE-230204

Citation: NeuroRehabilitation, vol. 54, no. 2, pp. 297-308, 2024

Authors: Hu, Chuan | Wang, Xin | Pan, Tongliang

Article Type: Research Article

Abstract: BACKGROUND: No study has yet demonstrated the effect of lower limb gait rehabilitation robot treatment combined with acupuncture on stroke patients. OBJECTIVE: To explore the effect of acupuncture combined with lower limb gait rehabilitation robot on walking function in patients with hemiplegia after stroke. METHODS: Fifty-six patients with hemiplegia after stroke were enrolled and randomly divided into two groups. The control group received regular rehabilitation training and acupuncture therapy; the intervention group was additionally trained by AiWalker-I lower limb gait robot. Both groups received 5 sessions a week for 4 weeks. Walking function parameters were assessed …before and after the 4-week treatment. RESULTS: There was no significant difference in all parameters between the two groups in baseline (P  > 0.05). After 4 weeks of treatment, all parameters including the effectiveness of functional ambulation category (FAC), time up and go test (TUGT) time, Wisconsin gait scale (WGS) score, walking spatiotemporal parameters were all significantly improved in both groups with a significant better effect in the intervention group (P  < 0.05). CONCLUSION: Acupuncture combined with lower limb gait rehabilitation robot training has a positive effect on correction of abnormal gait and improvement of walking ability of hemiplegic patients after stroke. Show more

Keywords: Stroke, hemiplegia, acupuncture, lower limb robot training, walking function, rehabilitation

DOI: 10.3233/NRE-230258

Citation: NeuroRehabilitation, vol. 54, no. 2, pp. 309-317, 2024

Authors: Kähler, Maria | Nilsson, Hanna M. | Lexell, Jan

Article Type: Research Article

Abstract: BACKGROUND: To advance rehabilitation we need a comprehensive understanding of functioning and disability of people after stroke. OBJECTIVE: To present an overview of the methodology of the Life After Stroke In Northern Sweden Study, compare participants and non-participants regarding gender and age, and describe baseline sociodemographics, stroke characteristics and the participants’ self-rated degree of recovery. METHODS: Data were collected through a study specific questionnaire, from the participants’ medical records and with internationally established self-assessment tools focusing on sleep disturbances, depressive symptoms, fatigue, physical activity, and remaining physical and cognitive impairments, activity limitations, participation restrictions and life …satisfaction. RESULTS: Of 301 potential participants, 160 comprise the final sample (response rate 53%; 86 men and 74 women, mean age 73 years±11, mean time since stroke onset 35 months±11; 18– 61). Most participants had an ischemic stroke (87%), were retired (84%), cohabitant (63%) and walked independently (71%). The mean self-rated degree of recovery was 75 (SD±24; 0– 100). CONCLUSIONS: These baseline data together with forthcoming studies will describe stroke-related impairments, activity limitations, participation restrictions and life satisfaction more than one year after stroke, and deepen our understanding of factors of importance for a healthy and successful life after stroke. Show more

Keywords: Depression, fatigue, fatigue assessment scale (FAS), international classification of functioning, disability and health, outcome assessment, health care, exercise, sleep wake disorders, stroke, sleep

DOI: 10.3233/NRE-230278

Citation: NeuroRehabilitation, vol. 54, no. 2, pp. 319-329, 2024

Authors: Appelin, Katja | Erlandsson, Lena-Karin | Lexell, Jan | Lexell, Eva Månsson

Article Type: Research Article

Abstract: BACKGROUND: People with late effects of polio (LEoP) may need rehabilitation to manage everyday life but knowledge of the benefits of interdisciplinary rehabilitation is limited. OBJECTIVE: To evaluate changes in performance and satisfaction with performance of activities among people with LEoP following interdisciplinary rehabilitation. METHODS: A pre-post retrospective study based on data on 102 participants with LEoP from a rehabilitation clinic. Changes in performance and satisfaction with performance of daily activities before and after interdisciplinary rehabilitation were assessed with the Canadian Occupational Performance Measure (COPM). RESULTS: There were statistically significant increases in the mean …performance and mean satisfaction with performance COPM scores from admission to discharge. Twenty-three percent and 19% of the participants, respectively, had improved their performance and satisfaction with performance, 25% and 26% of the participants had no changes, and 19% and 22% of the participants, respectively, rated their performance and satisfaction lower at discharge compared to admission. CONCLUSION: Interdisciplinary rehabilitation can enhance self-rated performance and satisfaction with performance of daily activities among people with LEoP. Future studies of rehabilitation for people with LEoP should use a prospective design and capture the participants’ process of change related to their rehabilitation period. Show more

Keywords: Occupational performance, outcome, post-poliomyelitis syndrome, daily activities, rehabilitation

DOI: 10.3233/NRE-230219

Citation: NeuroRehabilitation, vol. 54, no. 2, pp. 331-342, 2024

Authors: Cordani, Claudio | Battel, Irene

Article Type: Other

Abstract: BACKGROUND: Evidence on acute stroke management is continuously growing. Stroke units are often associated with better access to high-level evidence-based practices, but even there, recommendations can be inconsistently delivered to patients with stroke. Implementation interventions are strategies designed to improve the application of evidence-based care. OBJECTIVE: To provide a commentary on the Cochrane Review by Lynch et al. on the effects of implementation interventions on adherence to evidence-based recommendations by health professionals working in acute stroke units. METHODS: A systematic search was performed in CENTRAL, MEDLINE, Embase, and other databases. The search was also performed in …grey literature databases, trial registries, systematic reviews and primary studies, as well as in the reference list of identified studies. RESULTS: The review included seven cluster-randomized trials (with 42,489 participants). Studies compared the implementation of strategies composed of different parts (multifaceted) to no intervention, or a multifaceted strategy vs another intervention. These strategies were aimed at changing and improving the delivery of care in the hospital. It included health professional participants, such as nurses, physicians and allied health professionals. The authors concluded that there was uncertainty whether implementation strategies compared with no intervention have any effect on patients receiving evidence-based care during their stroke unit admission. Implementation interventions compared to no intervention probably have little or no effect on the risk of patients dying or being disabled or dependent, and probably do not change patients’ hospital length of stay. CONCLUSION: Due to the very low certainty of evidence, there is uncertainty whether a multifaceted implementation intervention, compared to no intervention, can improve adherence to evidence-based recommendations in acute stroke settings. Show more

Keywords: Stroke, health personnel, hospital units, implementation science, systematic review

DOI: 10.3233/NRE-246002

Citation: NeuroRehabilitation, vol. 54, no. 2, pp. 343-346, 2024

Authors: Wei, Tianqi | Ge, Xiangyang | Lu, Lingfeng | Li, Jing | Xu, Panpan | Wu, Qinfeng

Article Type: Correction

DOI: 10.3233/NRE-236008

Citation: NeuroRehabilitation, vol. 54, no. 2, pp. 347-347, 2024