Predictors of accommodative status at discharge from a stroke rehabilitation unit using objective measurement scales

Introduction: Having a therapist observe patients engaged in Robotic Upper Limb Therapy (RULT) is considered inefficient use of a therapist’s time and skill. We therefore assessed the feasibility of (RULT) administered by a trained volunteer. Methods: The Volunteer had two 30-minute training sessions by an Occupational Therapist (OT) rehearsing the MIT-Manus Planar Upper Limb Robotic software applications, proper positioning of the patient, and device shut-off and safety considerations. Initial patient sessions were supervised by the patient’s OT until the Volunteer demonstrated satisfactory performance. Inpatients on a Stroke Rehabilitation Unit were referred by their OT for RULT if they could initiate horizontal gravity-eliminated movement of the forearm and could follow one step commands. They were enrolled in 25 minute (RULT) sessions based upon the Volunteer’s availability from one to three half-days per week. Functional Independence Measures and Fugl-Meyer Scores were recorded at the time of Stroke Unit Admission by the OT unaware of (RULT) score results. Statistical analyses were performed using SPSS version 11.5 and significance was attributed if p<0.05 using 2-tailed analyses. Results: A total of 28 patients were enrolled in (RULT) but 2 were unable to participate due to pain in the affected upper limb. Participants had a mean of 3 ± 1.5 SD treatments each. Both the patients and volunteer considered their involvement in the program as worthwhile and meaningful. Admission MIT-Manus Adaptive-3 treatment software data showed that the Normalized Jerk+Line+Target (Norm JLT) Score [defined as (Jerk Score/237)+(Deviation from a Straight Line/13)+(Target Distance Error/14)] demonstrated a significant Spearman-rho Correlation with admission Functional Independence Measure (FIM) upper dressing r = -0.56 p=.003; and FIM grooming subscores r = -0.415, p=.035. The Norm JLT score also predicted change in Fugl-Meyer Upper Limb scores from admission to discharge r = - .788, p = 0.000. Conclusions: Robotic Upper Limb Therapy by a trained Volunteer on an inpatient Stroke Rehabilitation Unit is easily administered, is viewed by the patients and volunteer as rewarding, and provides objective measures useful for assessing upper limb function and outcome.

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Therapy timetabling, an evaluation of outcomes following implementation at the Oxfordshire stroke rehabilitation unit

Physiotherapy ◽

10.1016/j.physio.2020.03.200 ◽

2020 ◽

Vol 107 ◽

pp. e137-e138

Author(s):

E. Garratt ◽

S. King

Keyword(s):

Stroke Rehabilitation ◽

Rehabilitation Unit

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SPARC rekindles the community stroke rehabilitation unit

British Journal of Neuroscience Nursing ◽

10.12968/bjnn.2018.14.sup5.s8 ◽

2018 ◽

Vol 14 (Sup5) ◽

pp. S8-S12

Author(s):

Amanda Jones ◽

Bev Bennett

Keyword(s):

Stroke Rehabilitation ◽

Rehabilitation Unit

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Stroke Patients’ Experiences in an Adaptive Healing Room in a Stroke Rehabilitation Unit

HERD Health Environments Research & Design Journal ◽

10.1177/1937586719879060 ◽

2019 ◽

Vol 13 (2) ◽

pp. 170-185

Author(s):

Ifah Arbel ◽

Bing Ye ◽

Alex Mihailidis

Keyword(s):

Stroke Rehabilitation ◽

Well Being ◽

Stroke Recovery ◽

Structured Interviews ◽

Stroke Patients ◽

Rehabilitation Unit ◽

Healing Environment ◽

Healthcare Settings ◽

Patient Feedback ◽

Healing Environments

Objectives: This study evaluated the user experiences (UX) of stroke patients residing in the adaptive healing room (AHR) and compared them to the UX of patients residing in standard private rooms (SPRs). Background: Healing environments in healthcare settings can promote patients’ healing processes, outcomes, and psychological well-being. The AHR was designed as a healing environment for stroke patients and has been previously evaluated in laboratory settings. This study was the first to evaluate it in its intended context—a stroke rehabilitation unit. Methods: The UX of 10 patients residing in the AHR and 15 patients residing in SPRs were collected via structured interviews with a set of open-ended questions and analyzed using quantitative and qualitative methods. Results: The AHR design features (orientation screen, skylight, and nature view) were rated positively by most patients. The skylight emerged as the least favorable. Responses to open-ended questions revealed that UX may be further improved if patients have more control over some of the settings (e.g., light intensity and nature views), and if the system allowed for more stimulation for patients at later stages of their recovery. Additionally, the results suggest that patients in the AHR have better UX than patients in the SPRs. Conclusion: The AHR has the potential to improve UX in the stroke rehabilitation unit. Patient feedback can be used to refine the AHR before carrying out clinical trials to assess the effect of the AHR on patient outcomes (e.g., sleep, mood, and length of stay) and stroke recovery.

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52A Quality Improvement Initiative in the Stroke Rehabilitation Unit

Age and Ageing ◽

10.1093/ageing/afy140.39 ◽

2018 ◽

Vol 47 (suppl_5) ◽

pp. v13-v60

Author(s):

Fiona Craven ◽

Suzanne Noel ◽

Rachael Doyle ◽

Laura Bourke ◽

Kate McCaffrey ◽

...

Keyword(s):

Quality Improvement ◽

Stroke Rehabilitation ◽

Quality Improvement Initiative ◽

Rehabilitation Unit

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Technology-assisted toilets: Improving independence and hygiene in stroke rehabilitation

Journal of Rehabilitation and Assistive Technologies Engineering ◽

10.1177/2055668317725686 ◽

2017 ◽

Vol 4 ◽

pp. 205566831772568 ◽

Cited By ~ 1

Author(s):

David Yachnin ◽

Georges Gharib ◽

Jeffrey Jutai ◽

Hillel Finestone

Keyword(s):

Quality Of Life ◽

Pilot Study ◽

Stroke Rehabilitation ◽

Bowel Movement ◽

Assistive Devices ◽

Stroke Patients ◽

Rehabilitation Unit ◽

Full Protocol ◽

Perineal Region

Background and Purpose Dependence on assistance for toileting is a widespread problem for persons receiving healthcare. Technology-assisted toilets, which hygienically wash and dry the perineal region, are devices that could improve toileting independence in a variety of patients. The objective was to investigate whether technology-assisted toilets improve toileting independence, quality of life, and whether technology-assisted toilets can provide sufficient toileting hygiene in stroke rehabilitation. Methods This pilot study was carried out in a stroke rehabilitation unit. Thirty participants were recruited. Participants had a bowel movement and cleaned themselves using the technology-assisted toilet on one to three occasions. Participants rated their toileting before using the technology-assisted toilet and after each technology-assisted toilet use with the Psychosocial Impact of Assistive Devices Scale (PIADS). After each session, participants were rated for cleanliness. Results PIADS scores were analyzed from eight individual participants, five of whom completed the full protocol. PIADS scores were significantly higher with the technology-assisted toilet than with the participants’ regular toileting routine (p < 0.05). Technology-assisted toilets cleaned effectively in 73% of cases (16/22, p < 0.05). Conclusion Technology-assisted toilets improved stroke patients’ psychosocial outcomes compared to standard toileting and completely cleaned participants in the majority of cases. A larger study should confirm technology-assisted toilet’s benefit in stroke rehabilitation through improved independence and hygiene.

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Mood Disorder Following Cerebrovascular Accident

The British Journal of Psychiatry ◽

10.1192/bjp.154.2.195 ◽

1989 ◽

Vol 154 (2) ◽

pp. 195-200 ◽

Cited By ~ 165

Author(s):

M. R. Eastwood ◽

S. L. Rifat ◽

H. Nobbs ◽

J. Ruderman

Keyword(s):

Risk Factors ◽

Psychiatric Disorder ◽

Depressed Mood ◽

Cerebrovascular Accident ◽

Patient Population ◽

Stroke Rehabilitation ◽

Brain Lesion ◽

Hemispheric Differences ◽

Rehabilitation Unit ◽

History Of

Depression appears to be common after stroke, and therefore may have a bearing upon rehabilitation. To examine whether the depression is due to a specific brain lesion, or is reactive to the consequent disability, this study looked at the frequency and associations of depressed mood in a stroke rehabilitation unit in-patient population, unselected for site of lesion. Depression affected 50% of the patients; history of previous psychiatric disorder and cerebrovascular accident appeared to be important risk factors. There were hemispheric differences in the relationships between measures, with both the site-of-lesion and reactive viewpoints being upheld.

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