scholarly journals Association between pre-stroke physical activity and mobility and walking ability in the early subacute phase: A registry-based study

Author(s):  
Malin Reinholdsson ◽  
Anna Grimby-Ekman ◽  
Hanna C. Persson

Objective: To investigate associations between pre-stroke physical activity and mobility, walking ability, and self-perceived upper extremity function during stroke unit care. Design: A longitudinal, registry-based study with a consecutively collected cohort. Subjects/patients: A total of 1,092 adults with stroke admitted to 3 Swedish stroke units between 2017 and 2018. Methods: Logistic mixed effects regression models were performed to investigate associations (adjusted for age and sex). Pre-stroke physical activity was assessed with Saltin-Grimby Physical Activity Level Scale on admission. Mobility, walking ability, and self-perceived upper extremity function were assessed at admission and discharge from the stroke units and compared between pre-stroke physically active (45%) and inactive (55%) groups. Results: All groups of patients showed improvements in mobility (p  < 0.001), walking ability (p  < 0.001), and upper extremity function (p  < 0.001). The chang-es over time tended to differ between the physically inactive and active groups for mobility (p  < 0.062) and walking ability (p  < 0.056), but the differences were not significant. Conclusion: Pre-stroke physically active people show-ed a tendency to be more independent in physical functioning early after stroke. Regardless of pre-stroke physical activity, all patients showed improvements in mobility, walking ability, and self-perceived upper extremity function during inpatient care.

2016 ◽  
Author(s):  
Leila Sadat Rezai ◽  
Catherine Marie Burns

BACKGROUND There have been challenges in designing effective behaviour-change interventions, including those that promote physical activity. One of the key reasons is that many of those systems do not account for individuals’ characteristics and their psychological differences, which affect their approach toward adopting target behaviour. For decades, tailoring has been used as a common technique to effectively communicate health-related information to persuade people to follow a healthier living. However, its use in the design of persuasive technologies has not been adequately investigated. OBJECTIVE The objective of this research is to explore the effects of tailoring when it is grounded in Higgins’ regulatory focus theory. METHODS A combination of cross-sectional and longitudinal studies has been proposed to examine how individuals’ intention to become more physically active would be affected by receiving health messages that may or may not match their self-regulatory orientation. The research would also subjectively, as well as objectively, measures the changes in individuals’ physical activity level. RESULTS The anticipated completion date for the consequent studies is December 2016. CONCLUSIONS In this article, the importance of refining message-framing research questions and a stepwise approach to develop an efficient experimental design to examine a new tailoring strategy is discussed. A set of small studies is proposed that would inform the best approach to design the principal experiment. The findings of principal experiment will provide a deeper insight into the relationship between regulatory-focus theory, persuasive message construction, and individuals’ physical activity behaviour.


2021 ◽  
pp. 1-14
Author(s):  
Uta Roentgen ◽  
Loek van der Heide ◽  
Ingrid E.H. Kremer ◽  
Huub Creemers ◽  
Merel A. Brehm ◽  
...  

BACKGROUND: Impaired upper extremity function due to muscle paresis or paralysis has a major impact on independent living and quality of life (QoL). Assistive technology (AT) for upper extremity function (i.e. dynamic arm supports and robotic arms) can increase a client’s independence. Previous studies revealed that clients often use AT not to their full potential, due to suboptimal provision of these devices in usual care. OBJECTIVE: To optimize the process of providing AT for impaired upper extremity function and to evaluate its (cost-) effectiveness compared with care as usual. METHODS: Development of a protocol to guide the AT provision process in an optimized way according to generic Dutch guidelines; a quasi-experimental study with non-randomized, consecutive inclusion of a control group (n= 48) receiving care as usual and of an intervention group (optimized provision process) (n= 48); and a cost-effectiveness and cost-utility analysis from societal perspective will be performed. The primary outcome is clients’ satisfaction with the AT and related services, measured with the Quebec User Evaluation of Satisfaction with AT (Dutch version; D-QUEST). Secondary outcomes comprise complaints of the upper extremity, restrictions in activities, QoL, medical consumption and societal cost. Measurements are taken at baseline and at 3, 6 and 9 months follow-up.


Author(s):  
Joo Yeol Jung ◽  
Pong Sub Youn ◽  
Dong Hoon Kim

AbstractThis study was performed to evaluate the effects of Mirror therapy combined with EMG-triggered Functional Electrical Stimulation on upper extremity function in patient with Chronic Stroke. A total of 24 chronic stroke patients were divided into 3 groups. Group I (n=8) was given with traditional physical therapy (TPT), group II (n=7) was given with traditional physical therapy and mirror therapy (MT), and group III (n=9) was given with traditional physical therapy and mirror therapy in conjunction with EMG-triggered Functional Electrical Stimulation (EMGFES-MT). Each group performed one hour a day 5 times a week for 6 weeks.We obtained the following result between before and after treatments about changes of elbow flexion muscle strength (EFMS), elbow extension muscle strength (EEMS), wrist flexion muscle strength (WFMS), wrist extension muscle strength (WEMS), elbow flexion range of motion (EFROM), elbow extension range of motion (EEROM), wrist flexion range of motion (WFROM), wrist extension range of motion (WEROM), grip strength (GS) and upper extremity function.Each group showed a significant difference in EFMS, EEMS, WFMS, WEMS, EFROM, EEROM, WFROM, WEROM, GS and upper extremity function (p<0.05) EMFES-MT group revealed significant differences in EEMS, WEROM, grip strength and upper extremity function as compared to the other groups (p<0.05). No difference was found in the change of spasticity among the 3 groups.Our results showed that EMFES-MT was more effective on elbow, WFMS, WEMS, AROM, grip strength and upper extremity function in patients with chronic stroke. We suggest that this study will be able to be used as an intervention data for recovering upper extremity function in chronic stroke patients


Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Venkadesan Rajendran ◽  
Deepa Jeevanantham ◽  
Céline Larivière ◽  
Ravinder-Jeet Singh ◽  
Lisa Zeman ◽  
...  

Abstract Background Many therapeutic interventions are performed by physiotherapists to improve upper extremity function and/or activities of daily living (ADL) in stroke patients. Mirror therapy (MT) is a simple technique that can be self-administered by the patients with intact cognition following patient education by a skilled physiotherapist. However, the effectiveness of self-administered MT in post-stroke patients in upper extremity function remains unclear. Therefore, the objective of this study is to examine the effectiveness of MT in improving upper extremity function and recovery in acute stroke patients. Methods This study is a single-center, prospective, randomized, open-label, controlled trial with blinded outcome evaluation (PROBE design), in which a total of 36 eligible acute stroke patients will be randomly assigned to control (n=18) and experimental group (n=18). Participants in the control group will receive regular rehabilitation interventions whereas participants in the experimental group will receive MT education in addition to their regular interventions for 4 weeks. Study outcome The primary outcome measure will be upper extremity function that will be measured using the Fugl-Meyer Assessment scale and the Wolf Motor Function Test. The secondary outcome measure will be behaviors related to ADL as estimated using the Modified Barthel Index. Outcome measures will be assessed at baseline and at 4 weeks post-rehabilitation intervention/MT. Results A two-way repeated analysis of variance (ANOVA) with time and group effects will be used to analyze between-group differences. The level of significance will be set at P < 0.05. Conclusion The results of the study will provide critical information to include self-administered MT as an adjuvant to regular interventions and may facilitate recovery of the upper extremity function of stroke patients. Trial registration ClinicalTrials.gov NCT04542772. Registered on 9 September 2020. Protocol version: Final 1.0.


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