Service evaluation of lifestyle integrated functional exercise program for falls prevention in early supported discharge stroke patients

Physiotherapy ◽  
2021 ◽  
Vol 113 ◽  
pp. e74
Author(s):  
V. Butler ◽  
J. Dinsdale ◽  
L. Butler ◽  
K. French ◽  
R. De Cruz ◽  
...  
2016 ◽  
Vol 24 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Lesley Day ◽  
Margaret J. Trotter ◽  
Alex Donaldson ◽  
Keith D. Hill ◽  
Caroline F. Finch

The study aim was to evaluate the implementation of group- and home-based exercise falls prevention programs delivered through community health agencies to community-dwelling older people. Interviews with program staff were guided by the Diffusion of Innovations theory. Highly consistent themes emerged for the two types of programs. Both had high overall compatibility, high relative advantage, good observability and high inherent trialability—all factors known to strengthen implementation. The level of complexity and low financial compatibility emerged as the strongest potential inhibitors to program implementation in the context examined. The two main factors contributing to complexity were the need to challenge balance safely across a broad range of capability, and practical considerations associated with program delivery.A range of strategies to provide more technical support for exercise program leaders to tailor balance challenge for exercise program leaders may enhance implementation of falls prevention exercise programs.


Author(s):  
◽  
Anna Lee ◽  
Courtney Beyer ◽  
Jessica lim ◽  
Sienna Anderson

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lena Rafsten ◽  
Anna Danielsson ◽  
Asa Nordin ◽  
Ann Björkdahl ◽  
Asa Lundgren-Nilsson ◽  
...  

Abstract Background and purpose Early supported discharge (ESD) has been shown to be efficient and safe as part of the stroke care pathway. The best results have been seen with a multidisciplinary team and after mild to moderate stroke. However, how very early supported discharge (VESD) works has not been studied. The aim of this study was to investigate whether VESD for stroke patients in need of ongoing individualized rehabilitation affects the level of anxiety and overall disability for the patient compared with ordinary discharge routine. Methods A randomized controlled trial was performed with intention to treat analyses comparing VESD and ordinary discharge from hospital. All patients admitted at the stroke care unit at Sahlgrenska University Hospital of Gothenburg between August 2011 and April 2016 were screened. Inclusion occurred on day 4 using a block randomization of 20 and with a blinded assessor. Assessments were made 5 days post-stroke and 3 and 12 months post-stroke. Patients in the VESD group underwent continued rehabilitation in their homes with a multidisciplinary team from the stroke care unit for a maximum of 1 month. The patients in the control group had support as usual after discharge when needed such as home care service and outpatient rehabilitation. The primary outcome was anxiety as assessed by the Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A). The secondary outcome was the patients’ degree of overall disability, measured by the modified Rankin Scale (mRS). Results No significant differences were found between the groups regarding anxiety at three or 12 months post-stroke (p = 0.811). The overall disability was significantly lower in the VESD group 3 months post-stroke (p = 0.004), compared to the control group. However, there was no significant difference between the groups 1 year post-stroke. Conclusions The VESD does not affects the level of anxiety compared to ordinary rehabilitation. The VESD leads to a faster improvement of overall disability compared to ordinary rehabilitation. We suggest considering coordinated VESD for patients with mild to moderate stroke in addition to ordinary rehabilitation as part of the service from a stroke unit. Trial registration Clinical Trials.gov: NCT01622205. Registered 19 June 2012 (retrospectively registered).


2019 ◽  
Vol 02 (02) ◽  
pp. 121-122 ◽  
Author(s):  
Jiménez Rubio S. ◽  
Valera Garrido F. ◽  
Minaya Muñoz F. ◽  
Navandar A.

Abstract Background and Aims Percutaneous needle electrolysis has shown to be effective for the treatment of chronic tendinopathies, however, the scientific evidence available regarding acute muscle lesions is scarce. Lesions to the hamstrings caused by indirect mechanisms represent the most common muscle lesion in football (its incidence increases each year) with a high rate of recurrence. The aim was to evaluate whether the application of percutaneous needle electrolysis and a program of functional exercise decreases the times for return to competition after an injury to the hamstrings in athletes, and to compare performance data of subjects during competition before and after the injury. Methods A case series. Two professional football players, belonging to a first league team in Spain with a grade 2 lesion in the semitendinosus muscle on the proximal level. The affected muscle structure was assessed using ultrasound (Logiq GE E9, probe ML6–12) and functionality was evaluated based on data of the Global Positioning System (GPS), comparing the data obtained during the process of re-adaptation with data prior to the lesion. Percutaneous needle electrolysis was performed under ultrasound guidance at 48 hours after the injury following the protocol defined by Valera & Minaya (2:3:5). The indoor recovery of players began 24 hours after the percutaneous needle electrolysis. Initially, the exercise program included activities of mobility and controlled loading. Thereafter, the players completed their readaptation program in the training field with exercises of progressive complexity and intensity (biomechanical patterns and neuromuscular control of the central zone and the lower limbs, sprint). Results Player A returned to competition in 16 days, player B returned in 14 days. No adverse effects were identified during or after the percutaneous needle electrolysis technique. The players only missed one competition game and the process of readaptation allowed them to return to play registering parameters which were similar to the values prior to the lesion, and maintaining the performance during the four matches following the intervention protocol. The players were followed up to eight months after the injury and neither player suffered a relapse during this period, which indicates the complete recovery of the injured muscle both on a structural and functional level. Conclusions The combined treatment using percutaneous needle electrolysis and a functional exercise program reduces the time for return to competition after a grade 2 muscle lesion in the hamstrings, with a level of performance that is similar to prior to the lesion, without relapses, in an 8 month follow up period. The criteria we use to determine when a player can return to train with the team and compete after an acute muscle injury are: the time that has passed since the lesion, structural changes and the ability to perform tasks.


2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
H. J. R. van Duijnhoven ◽  
D. De Kam ◽  
W. Hellebrand ◽  
E. Smulders ◽  
A. C. H. Geurts ◽  
...  

Falls are a common complication after stroke, with balance and gait deficits being the most important risk factors. Taking into account the specific needs and capacities of people with stroke, we developed the FALLS program (FALL prevention after Stroke), based on the “Nijmegen falls prevention program” (a proven-effective 5-week exercise program designed for community-dwelling elderly people). The program was tested in twelve community-dwelling persons with stroke, and a process evaluation was conducted with patients, trainers, health care professionals, and managers. The FALLS program was considered suitable and feasible by people with stroke in the study and relevant health care professionals, and recommendations for implementation in clinical practice have been suggested.


2016 ◽  
Vol 64 (1) ◽  
pp. 55-64 ◽  
Author(s):  
Annika Toots ◽  
Håkan Littbrand ◽  
Nina Lindelöf ◽  
Robert Wiklund ◽  
Henrik Holmberg ◽  
...  

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