Accessible goal setting in stroke rehabilitation for stroke survivors with aphasia: A narrative review

Over seven million stroke survivors live in the US today. Despite the publication of the first post-stroke rehabilitation clinical practice guideline in 1995, many healthcare providers are unaware not only of stroke survivors’ potential for functional recovery, but also common secondary complications of stroke. This article summarises the best available evidence-based recommendations for the interdisciplinary management of stroke survivors and caregivers from five sources: two in the US, one in Canada, and two in the UK. Unique characteristics of each guideline are described, followed by a list of common clinical recommendations found in most, if not all, of the guidelines. Despite the advances in stroke rehabilitation over the past 16 years, much research still needs to be done to improve the level of evidence in stroke rehabilitation.

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Interprofessional Stroke Rehabilitation for Stroke Survivors Using Home Care

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100011537 ◽

2011 ◽

Vol 38 (2) ◽

pp. 317-334 ◽

Cited By ~ 36

Author(s):

Maureen Markle-Reid ◽

Camille Orridge ◽

Robin Weir ◽

Gina Browne ◽

Amiram Gafni ◽

...

Keyword(s):

Home Care ◽

Stroke Rehabilitation ◽

Intervention Group ◽

Home Care Services ◽

Stroke Survivors ◽

Interprofessional Team ◽

Care Services ◽

Sf 36

Objective:To compare a specialized interprofessional team approach to community-based stroke rehabilitation with usual home care for stroke survivors using home care services.Methods:Randomized controlled trial of 101 community-living stroke survivors (<18 months post-stroke) using home care services. Subjects were randomized to intervention (n=52) or control (n=49) groups. The intervention was a 12-month specialized, evidence-based rehabilitation strategy involving an interprofessional team. The primary outcome was change in health-related quality of life and functioning (SF-36) from baseline to 12 months. Secondary outcomes were number of strokes during the 12-month follow-up, and changes in community reintegration (RNLI), perceived social support (PRQ85-Part 2), anxiety and depressive symptoms (Kessler-10), cognitive function (SPMSQ), and costs of use of health services from baseline to 12 months.Results:A total of 82 subjects completed the 12-month follow-up. Compared with the usual care group, stroke survivors in the intervention group showed clinically important (although not statistically significant) greater improvements from baseline in mean SF-36 physical functioning score (5.87, 95% CI -3.98 to 15.7; p=0.24) and social functioning score (9.03, CI-7.50 to 25.6; p=0.28). The groups did not differ for any of the secondary effectiveness outcomes. There was a higher total per-person costs of use of health services in the intervention group compared to usual home care although the difference was not statistically significant (p = 0.76).Conclusions:A 12-month specialized, interprofessional team is a feasible and acceptable approach to community-based stroke rehabilitation that produced greater improvements in quality of life compared to usual home care. Clinicaltrials.gov identifier: NCT00463229

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Abstract WP185: How to Design Woke Stroke Tech: The STORIES Project

Stroke ◽

10.1161/str.51.suppl_1.wp185 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

McKenzie Eakin ◽

Amanda Gian ◽

Francesca Kim ◽

Julie Muccini ◽

Maarten Lansberg ◽

...

Keyword(s):

Technology Use ◽

Stroke Rehabilitation ◽

Financial Risk ◽

Bachelor's Degree ◽

Ease Of Use ◽

Human Interaction ◽

Stroke Survivors ◽

Risk Minimization ◽

Structured Interviews ◽

Rehabilitation Technology

Introduction: There is little foundational evidence describing needs, wants, and concerns of stroke survivors and their carers regarding stroke rehabilitation technology. The aim of the STORIES Project (Stroke Tech- Overviews in Rehabilitation, Insights, and Experiences of Survivors & carers) was to identify, characterize, and prioritize these needs and concerns, as well as differences in characterizations across subgroups, to inform socially inclusive design. Methods: Mixed-method, semi-structured interviews were conducted with 29 stroke survivors and 16 carers, including 12 matched patient-carer dyads. Participants used a 1-5 scale to rate confidence and interest in using technologies for stroke rehabilitation and to rate the importance of 41 aspects of rehabilitation technology use. Differences between subgroups were compared via student t-tests. Qualitative data was coded to add depth of understanding to quantitative results. Results: Across all participants, aspects rated most important were clear instructions, ability to return a product from home, ease of use, ability to see progress over time, and that technology use did not replace time with a therapist. Human interaction in rehabilitation was deeply important for motivation, effectiveness, and mental health. Compared to carers, patients found the following less important: training carers in rehabilitation technology use ( p =.006), ability to share progress ( p =.001), and ability to do exercises with therapists rather than carers ( p =.001). Non-whites more strongly valued including music in the rehabilitation technology experience ( p =.001). Medicaid beneficiaries cared more about time & financial risk-minimization strategies ( p <.000), but not direct cost ( p =.72). People without a Bachelor’s degree had less technology familiarity and interest ( p =.003). Finally, patients and carers of patients less than 12 months post-stroke were less interested in stroke rehabilitation technologies ( p <.000). Conclusion: To increase adoption of stroke rehabilitation technologies, development should focus on improving multiple parts of the product experience, including clear instructions, ease of use, progress tracking, music inclusion, free trials, and free returns from home.

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16 Stroke Rehabilitation for Falls and Risk of Falls in Southeast Asia: A Scoping Review with Stakeholders’ Consultation

Age and Ageing ◽

10.1093/ageing/afz164.16 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv4-iv5

Author(s):

Husna Ahmad Ainuddin ◽

Muhammad Hibatullah Romli ◽

Mazatulfazura S F Salim ◽

Tengku Aizan Tengku Abd Hamid ◽

Lynette Mackenzie

Keyword(s):

Southeast Asia ◽

Scoping Review ◽

Stroke Rehabilitation ◽

Psychological Intervention ◽

Final Analysis ◽

Falls Prevention ◽

Stroke Survivors ◽

Contributing Factors ◽

Risk Of Falls ◽

One Year

Abstract Introduction Stroke is a serious problem in Southeast Asia. Falls are common among stroke survivors especially within one-year post-stroke and the implication is devastating. Rehabilitation for stroke survivors is important especially to prevent falls. However, literature in Southeast Asia pertaining to the topic is sparse. This study aims to systematically identify literature related to stroke and falls in Southeast Asia. Methods This scoping review followed Levac, Colquhoun and O’Brien’s framework. Systematic searching was conducted on four databases (MEDLINE, CINAHL, Scopus, ASEAN Citation Index) on August 2019. Generation of review question and keyword, and selection criteria were developed according to the Patient Intervention Comparison and Outcome (PICO) method. Consultation via several focus group discussions with stakeholders (i.e. stroke survivors, caregivers and therapists) were conducted and integrated with the synthesis of the review. Results Initial search yielded 2412 articles after removing the duplicates; however, only 19 were accepted in the final analysis. Most of the articles focused on physical rehabilitation and using conventional therapies. While the literatures may reflect the practice in Southeast Asia, stakeholders perceived that the literature is inadequate to show the true practice, lack to inform and missed several aspects such as functional, cognitive and psychological intervention in managing falls. Home hazards are considered as contributing factors but not deemed important. Discussion Individual-centric interventions dominated the review while community-based and environmental-focused studies were limited. Only several articles were mainly written by physiotherapists while others are from medical physicians and engineers but negligible from other healthcare practitioners (i.e. occupational therapists, speech therapists, psychologists) or other disciplines interested with falls. Conclusion Falls prevention among stroke survivors received lack of attention and just an indirect goal in stroke rehabilitation. More innovative research adopted from falls research with older people is needed to advance falls prevention and intervention practice with stroke survivors.

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Stroke survivors’ experiences of occupation in hospital-based stroke rehabilitation: a qualitative exploration

Disability and Rehabilitation ◽

10.1080/09638288.2018.1542460 ◽

2019 ◽

Vol 42 (13) ◽

pp. 1880-1885 ◽

Cited By ~ 2

Author(s):

Sarah Purcell ◽

Peter Scott ◽

Louise Gustafsson ◽

Matthew Molineux

Keyword(s):

Stroke Rehabilitation ◽

Stroke Survivors ◽

Qualitative Exploration

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Navigating patient-centered goal setting in inpatient stroke rehabilitation: How clinicians control the process to meet perceived professional responsibilities

Patient Education and Counseling ◽

10.1016/j.pec.2011.01.011 ◽

2011 ◽

Vol 85 (2) ◽

pp. 206-213 ◽

Cited By ~ 91

Author(s):

William M.M. Levack ◽

Sarah Gerard Dean ◽

Richard John Siegert ◽

Kath Margaret McPherson

Keyword(s):

Goal Setting ◽

Stroke Rehabilitation ◽

Patient Centered ◽

Professional Responsibilities

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Requirements Elicitation and Prototyping of a Fully Immersive Virtual Reality Gaming System for Upper Limb Stroke Rehabilitation in Saudi Arabia

Mobile Information Systems ◽

10.1155/2017/7507940 ◽

2017 ◽

Vol 2017 ◽

pp. 1-12 ◽

Cited By ~ 5

Author(s):

Maram AlMousa ◽

Hend S. Al-Khalifa ◽

Hana AlSobayel

Keyword(s):

Virtual Reality ◽

Saudi Arabia ◽

Upper Limb ◽

Stroke Rehabilitation ◽

Requirements Elicitation ◽

Stroke Survivors ◽

Immersive Virtual Reality ◽

Stroke Patients ◽

Rehabilitation System

Stroke rehabilitation plays an important role in recovering the lifestyle of stroke survivors. Although existing research proved the effectiveness and engagement of nonimmersive virtual reality- (VR-) based rehabilitation systems, limited research is available on the applicability of fully immersive VR-based rehabilitation systems. In this paper, we present the elicited requirements of a fully immersive VR-based rehabilitation system that will be designed for domestic upper limb stroke patients; we will also provide an initial conceptual prototype of the proposed system.

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