Effectiveness of community rehabilitation for chronic stroke patients—effect factors of outpatient rehabilitation class

Physiotherapy ◽  
2015 ◽  
Vol 101 ◽  
pp. e1069-e1070
Author(s):  
E. Nakamata ◽  
Y. Yuri ◽  
K. Nagino ◽  
K. Okamoto ◽  
M. Nishii ◽  
...  
Keyword(s):  
Chronic Stroke ◽  
Outpatient Rehabilitation ◽  
Stroke Patients ◽  
Effect Factors ◽  
Community Rehabilitation

scholarly journals Changes in motor paralysis involving upper extremities of outpatient chronic stroke patients from temporary rehabilitation interruption due to spread of COVID-19 infection: An observational study on pre- and post-survey data without a control group

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260743
Author(s):  
Daigo Sakamoto ◽  
Toyohiro Hamaguchi ◽  
Yasuhide Nakayama ◽  
Takuya Hada ◽  
Masahiro Abo
Keyword(s):  
Observational Study ◽  
Statistical Significance ◽  
Joint Stiffness ◽  
Chronic Stroke ◽  
Muscle Stiffness ◽  
Model Fit ◽  
Outpatient Rehabilitation ◽  
Control Group ◽  
Stroke Patients ◽  
Survey Period

Background Outpatient rehabilitation was temporarily suspended because of coronavirus disease (COVID-19), and there was a risk that patients’ activities of daily living (ADLs) would decrease and physical functions unmaintained. Therefore, we investigated the ADLs and motor functions of chronic stroke patients whose outpatient rehabilitation was temporarily interrupted. Methods In this observational study, the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE), Action Research Arm Test (ARAT), and Barthel Index (BI) scores of 49 stroke hemiplegic patients at 6 and 3 months before rehabilitation interruptions were retrospectively determined and were prospectively investigated on resumption of outpatient rehabilitation. Presence or absence of symptoms and difficulties caused by the interruption period (IP) was investigated using a binomial method. Deltas were analyzed using a generalized linear model (GLM) according to the survey period. Age, sex, severity of FMA-UE immediately post-resumption and post-onset period were used as covariates. For survey items showing significant model fit, the 95% confidence interval of minimum detectable change (MDC95) was calculated, and the amount of change was compared. Questionnaire responses were tested via proportion ratio. Statistical significance was set at 5%. Results The FMA-UE part A and total scores were significantly model fit depending on periods. The estimated FMA-UE total score decreased by 1.64 (z = −2.38, p = 0.02) during the 3-month IP. No fits were observed by GLM in other parts of the FMA-UE, ARAT, or BI. The calculated MDC95 was 3.58 for FMA-UE part A and 4.50 for FMA-UE overall. Answers to questions regarding sleep disturbance and physical pain were significantly biased toward “no” in the psychosomatic function items (p<0.05). There was no bias in the distribution of answers to questions regarding joint stiffness, muscle weakness, muscle stiffness, and difficulty in moving arms and hands. All 16 questions regarding activities and participation items were significantly biased toward answers “no” (p<0.05). Conclusions The FMA-UE part A and total scores were affected. Patients complained of subjective symptoms related to upper limb paralysis after the IP. Since ADLs of patients were maintained, the therapist can recommend that patients not receiving outpatient treatments be evaluated in relation to the shoulder, elbow, and forearm and instructed on self-training to maintain motor function.

Abstract WP195: Patients Beginning Community Based Outpatient Stroke Rehabilitation Program More Than 6 Months Post Stroke Achieve Equally Excellent Outcomes as Sub-Acute Patients

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Joan Breen ◽  
Jeanne Andrusin ◽  
Tom Ferlito
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Rehabilitation Program ◽  
Chronic Stroke ◽  
Outpatient Rehabilitation ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Community Based ◽  
Post Stroke ◽  
Rehabilitation Programs

Background: Despite the availability of community based outpatient rehabilitation programs in the U.S., few use standardized measure sets and assessments, and outcomes studies are sparse. There is especially a knowledge gap regarding outcomes of participating chronic stroke patients (rehabilitation begins more than 6 months post stroke). Methods: Prospective observational study of stroke patients treated between 12/2011-1/2015 in an interdisciplinary outpatient rehabilitation program that addresses health literacy, risk factors, physical, psychosocial, cognitive, communicative and vocational issues. Patients were classified as chronic if admitted to the program >6 months and sub-acute if admitted <6 months post stroke. Results: Among 96 consecutive patients, 71 were sub-acute (72% ischemic, 28% hemorrhages) and 25 chronic (68% ischemic, 32% hemorrhages) who were admitted to the program an average 18.5 months post stroke (range 6-121 months). Chronic vs subacute stroke patients were 64% vs 59% male, with no difference in age (mean 66, range 27-90 years vs 65, range 18-90 years), but with greater stroke severity (chronic mean NIHSS score 8.32, range 2-15 vs subacute NIHSS of 5.2, range 0-16). On admission, chronic vs subacute patients were 44% vs 34% aphasic and 96% vs 86% needed assistance with activities of daily living (chronic with modified Rankin Scale [mRS] of 3=28% and 4=68% vs subacute mRS of 3=65% and 4=21%). The percent change in outcomes from baseline to program discharge for subacute and chronic stroke patients is presented in the Table. Conclusions: Although age, sex and stroke types were similar in both groups, chronic patients were more severely impaired than subacute patients but achieved greater improvement in activities of daily living, recovery, walking speed, balance, and risk factor knowledge. These findings demonstrate that outpatient rehabilitation programs can aid in stroke recovery independent of time since stroke onset.

scholarly journals Functional outcome of joint mobilization added to task-oriented training on hand function in chronic stroke patients

2020 ◽  
Vol 56 (1) ◽  
Author(s):  
Asmaa Sabbah ◽  
Sherine El Mously ◽  
Hanan Helmy Mohamed Elgendy ◽  
Mona Adel Abd Eltawab Farag ◽  
Abeer Abo Bakr Elwishy
Keyword(s):  
Functional Outcome ◽  
Hand Function ◽  
Chronic Stroke ◽  
Stroke Patients ◽  
Joint Mobilization ◽  
Task Oriented

scholarly journals Impact of Somatosensory Training on Neural and Functional Recovery of Lower Extremity in Patients with Chronic Stroke: A Single Blind Controlled Randomized Trial

2021 ◽  
Vol 18 (2) ◽  
pp. 583
Author(s):  
Reem M. Alwhaibi ◽  
Noha F. Mahmoud ◽  
Mye A. Basheer ◽  
Hoda M. Zakaria ◽  
Mahmoud Y. Elzanaty ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Lower Extremity ◽  
Functional Recovery ◽  
Intervention Group ◽  
Chronic Stroke ◽  
Post Treatment ◽  
Control Group ◽  
Stroke Patients ◽  
Significant Difference ◽  
Group Post

Recovery of lower extremity (LE) function in chronic stroke patients is considered a barrier to community reintegration. An adequate training program is required to improve neural and functional performance of the affected LE in chronic stroke patients. The current study aimed to evaluate the effect of somatosensory rehabilitation on neural and functional recovery of LE in stroke patients. Thirty male and female patients were recruited and randomized to equal groups: control group (GI) and intervention group (GII). All patients were matched for age, duration of stroke, and degree of motor impairment of the affected LE. Both groups received standard program of physical therapy in addition to somatosensory rehabilitation for GII. The duration of treatment for both groups was eight consecutive weeks. Outcome measures used were Functional Independent Measure (FIM) and Quantitative Electroencephalography (QEEG), obtained pre- and post-treatment. A significant improvement was found in the FIM scores of the intervention group (GII), as compared to the control group (GI) (p < 0.001). Additionally, QEEG scores improved within the intervention group post-treatment. QEEG scores did not improve within the control group post-treatment, except for “Cz-AR”, compared to pretreatment, with no significant difference between groups. Adding somatosensory training to standard physical therapy program results in better improvement of neuromuscular control of LE function in chronic stroke patients.

scholarly journals Manipulating Single-Trial Motor Performance in Chronic Stroke Patients by Closed-Loop Brain State Interaction

2021 ◽  
Vol 29 ◽  
pp. 1806-1816
Author(s):  
Andreas Meinel ◽  
Jan Sosulski ◽  
Stephan Schraivogel ◽  
Janine Reis ◽  
Michael Tangermann
Keyword(s):  
Motor Performance ◽  
Closed Loop ◽  
Chronic Stroke ◽  
State Interaction ◽  
Brain State ◽  
Single Trial ◽  
Stroke Patients
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