Application of Cluster Nursing Among Post-Stroke Patients with
                        Dysphagia

Objective: To explore the effect of cluster nursing care among post-stroke patients. Methods: Post-stroke patients with dysphagia (n=72) were randomly divided into two groups: experimental (or intervention) (n=36) the control (n=36). Patients in the experimental group were given cluster care, including swallowing assessment, safe eating guide, swallowing rehabilitation, the establishment of cluster prevention strategy and health education to patients and caregivers. Patients in the control group were given conventional nursing care, and the score of swallowing function, the prevalence of aspiration pneumonia and nursing care satisfactory level in both groups were assessed before and after the intervention. Results: The swallowing function of patients in the two groups were improved after intervention, but patients in the experimental group showed significantly higher improvement than the control group (P<0.05). The incidence of aspiration pneumonia was significantly lower in the experimental group compared to the control group (P<0.05). Moreover, the satisfactory level of nursing management was higher in the experimental group than the control group (P<0.05). Conclusion: Cluster nursing (CN) practice has significantly improved the swallowing function of stroke patients with dysphagia, reduced the incidence of aspiration pneumonia and enhanced the satisfaction of nursing care.

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Improvement of Hand Motor Function after Radial Shock Wave Therapy in Chronic Stroke Patients

Indonesian Journal of Physical Medicine & Rehabilitation ◽

10.36803/2019.ikfr.07(1).01 ◽

2019 ◽

pp. 2-12

Author(s):

M. Kamaluddin K ◽

Erna Setiawati ◽

Tanti Ajoe Kesoema

Keyword(s):

Shock Wave ◽

Motor Function ◽

Hand Function ◽

Chronic Stroke ◽

Control Group ◽

Shock Wave Therapy ◽

Stroke Patients ◽

Before And After ◽

And Control ◽

Experimental Group

IIntroduction: The Radial Shock Wave Therapy (RSWT) expected could improve spasticity and hand function in chronic stroke patients. This study aimed to find out the improvement of hand function after RSWT as an additional therapy in chronic stroke patients. Methods: Design study was a randomized controlled trial, in December 2018. The patients were assigned randomly to the experimental group (Infrared, Stretching, and RSWT) and control group (Infrared and Stretching) for six weeks. Hand motor function was measured using Fugl-Meyer Motor Assesment (FMA) before and after intervention. Results: The median values of wrist FMA scores in the experimental and control group before and after intervention were 2 vs 5 (p=0.001) and 3 vs 4 (p<0.001) respectively. The median values of hand FMA scores in the experimental and control group before and intervention were 4 vs 6 (p=0,.001) and 4 vs 5 (p<0.001). However, the delta between before and after intervention was higher in experimental group. Conclusion: The improvement of wrist and hand FMA scores after added treatment by RSWT was tend to higher.Keywords: Spasticity, Hand Function, Stroke, Radial Shock Therapy, Fugl-Meyer Motor Assesment

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Efficacy of Myofunctional Therapy Associated with Voice Therapy in the Rehabilitation of Neurogenic Oropharyngeal Dysphagia: a pilot study

International Archives of Otorhinolaryngology ◽

10.1055/s-0037-1605597 ◽

2017 ◽

Vol 22 (03) ◽

pp. 225-230 ◽

Cited By ~ 3

Author(s):

Bruno Fraga ◽

Sheila Almeida ◽

Márcia Santana ◽

Mauriceia Cassol

Keyword(s):

Pilot Study ◽

Oropharyngeal Dysphagia ◽

Oral Intake ◽

Control Group ◽

Stroke Patients ◽

Swallowing Rehabilitation ◽

Significant Difference ◽

Vocal Exercises ◽

Experimental Group ◽

Post Therapy

Introduction Dysphagia causes changes in the laryngeal and stomatognathic structures; however, the use of vocal exercises is poorly described. Objective To verify whether the therapy consisting of myofunctional exercises associated with vocal exercises is more effective in rehabilitating deglutition in stroke patients. Methods This is a pilot study made up of two distinct groups: a control group, which performed only myofunctional exercises, and an experimental group, which performed myofunctional and vocal exercises. The assessment used for oral intake was the functional oral intake scale (FOIS). Results The FOIS levels reveal that the pre-therapy median of the experimental group was 4, and increased to 7 after therapy, while in the control group the values were 5 and 6 respectively. Thus, the experimental group had a statistically significant difference between the pre- and post-therapy assessments (p = 0.039), which indicates that the combination of myofunctional and vocal exercises was more effective in improving the oral intake levels than the myofunctional exercises alone (p = 0.059). On the other hand, the control group also improved, albeit at a lower rate compared with the experimental group; hence, there was no statistically significant difference between the groups post-therapy (p = 0.126). Conclusion This pilot study showed indications that using vocal exercises in swallowing rehabilitation in stroke patients was able to yield a greater increase in the oral intake levels. Nevertheless, further controlled blind clinical trials with larger samples are required to confirm such evidence, as this study points to the feasibility of conducting this type of research.

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Improvement of Hand Motor Function after Radial Shock Wave Therapy in Chronic Stroke Patients

Indonesian Journal of Physical Medicine & Rehabilitation ◽

10.36803/ijpmr.v7i01.115 ◽

2018 ◽

Vol 7 (01) ◽

pp. 2

Author(s):

M. Kamaluddin K ◽

Erna Setiawati ◽

Tanti Ajoe Kesoema

Keyword(s):

Shock Wave ◽

Motor Function ◽

Hand Function ◽

Chronic Stroke ◽

Control Group ◽

Shock Wave Therapy ◽

Stroke Patients ◽

Before And After ◽

And Control ◽

Experimental Group

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Learning of a postural control task by elderly post-stroke patients

Motricidade ◽

10.6063/motricidade.7004 ◽

2016 ◽

Vol 12 (1) ◽

pp. 141

Author(s):

Giordano Marcio Gatinho Bonuzzi ◽

Tatiana Beline Freitas ◽

Umberto Cesar Corrêa ◽

Andrea Michele Freudenheim ◽

José Eduardo Pompeu ◽

...

Keyword(s):

Motor Learning ◽

Postural Control ◽

Learning Process ◽

Healthy Subjects ◽

Task Complexity ◽

Control Group ◽

Control Task ◽

Stroke Patients ◽

Post Stroke ◽

Experimental Group

<p class="ResumoAbstract">The aim of this study was to compare the learning process of a postural control task between post-stroke patients and healthy subjects. The sample was composed of 20 post-stroke individuals (Experimental Group) and 20 aged matched healthy individuals (Control Group). Participants practiced a postural control task in a virtual environment with increasing of complexity. The study design involved four phases: pre-test (five trials), acquisition phase (four blocks of thirty minutes), post-test (five trials), and retention test (five trials after a week without practice). The statistical analysis was run by a 2 x 3 ANOVA (groups x learning tests). Results: There was no difference in motor learning between Experimental Group and Control Group (F= 41.22; p=0.88). In addition, it was founded that the Control Group could learn the task in a higher-level complexity than Experimental Group (F = 4.77; p = 0.01), and both groups increased the error during the trials of practice (F = 0.53; p = 0.00) because of task complexity. Conclusion: Therefore has been found that post-stroke individuals have the ability to learn a postural control task similar to healthy subjects, and the task complexity seems to be a key-factor in order to differentiate stroke from healthy subject's motor learning process.</p>

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Effects of Neuromuscular Electrical Stimulation (NMES) Plus Upper Cervical Spine Mobilization on Forward Head Posture and Swallowing Function in Stroke Patients with Dysphagia

Brain Sciences ◽

10.3390/brainsci10080478 ◽

2020 ◽

Vol 10 (8) ◽

pp. 478

Author(s):

Yung Hyun Jeon ◽

Kyun Hee Cho ◽

Shin Jun Park

Keyword(s):

Cervical Spine ◽

Neuromuscular Electrical Stimulation ◽

Control Group ◽

Upper Cervical Spine ◽

Stroke Patients ◽

Swallowing Function ◽

Forward Head Posture ◽

Head Posture ◽

Upper Cervical ◽

Experimental Group

After a stroke, forward head posture occurs, resulting in swallowing dysfunction. Neuromuscular electrical stimulation (NMES) combined with upper cervical spine mobilization has demonstrated enhanced recovery of the swallowing function in stroke patients. This study investigated the therapeutic effects of NMES in conjunction with upper cervical mobilization in stroke patients with dysphagia. Thirty-four stroke patients were recruited (in a randomized controlled clinical trial) and divided into an experimental group (n = 17; NMES plus upper cervical spine mobilization) and a control group (n = 17; NMES plus sham mobilization). Forward head posture was measured by craniocervical flexion test (CCFT) and craniovertebral angle (CVA). Swallowing function was measured by variations in video fluoroscopic dysphagia scale (VDS) and penetration–aspiration scale (PAS) scores using the video fluoroscopic swallowing study (VFSS). All measurements were done at baseline and after four weeks of NMES plus mobilization. A significant increase was observed in CCFT, CVA, VDS (total VDS score, oral stage score, pharyngeal stage score), and PAS score in all variations in the experimental group. The CCFT, CVA, pharyngeal stage score, total VDS, and PAS score were significantly higher in the experimental group when compared to the control group. NMES plus upper cervical spine mobilization can be regarded as a promising method to improve swallowing function and forward head posture changes in stroke patients with dysphagia.

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PENGARUH ZIKIR TERHADAP PENURUNAN TEKANAN DARAH PADA PASIEN STROKE AKUT DI RSUP DR.M. DJAMIL PADANG

Jurnal Sehat Mandiri ◽

10.33761/jsm.v16i1.383 ◽

2021 ◽

Vol 16 (1) ◽

pp. 151-161

Author(s):

Hendri Budi ◽

Herwati Herwati

Keyword(s):

Blood Pressure ◽

Acute Stroke ◽

Diastolic Blood Pressure ◽

Intervention Group ◽

Control Group ◽

Stroke Patients ◽

Before And After ◽

Quasi Experimental ◽

Experimental Group ◽

Therapy Intervention

70-94% of acute stroke patients have an increase in blood pressure. Relaxation can be done to treat hypertension. Relaxation in Islam uses zikr (remembering Allah SWT). The purpose of this study was to determine the effect of zikr on reducing blood pressure in acute stroke patients. The research design was quasi-experimental, with two group pretest-posttest design with a control group. The experimental group was given the zikr therapy intervention. The sample of the study was acute stroke patients in the Nervous Room of RSUP Dr. M. Djamil Padang. There were 40 samples, 20 people in the experimental group and 20 people in the control group obtained by purposive sampling. Data collection is September to November 2020 by measuring the patient's blood pressure before and after the intervention. The data is processed manually. Analysis of data with non-parametric Mann Whitney test. The results showed that there was no difference between systolic blood pressure before treatment in the intervention group and the control group (p = 0.976), but there was a difference after treatment (p = 0.000). There was no difference between diastolic blood pressure before treatment in the intervention group and the control group, (p = 0.294), but there was a difference after treatment (p = 0.000). The study concludes that zikr therapy can reduce systolic and diastolic blood pressure in acute stroke patient. It is recommended to the head of the Nerve room to apply zikr therapy in acute stroke patients.

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Effects of Fresnel prism glasses on balance and gait in stroke patients with hemiplegia: A randomized controlled trial pilot study

Technology and Health Care ◽

10.3233/thc-191973 ◽

2020 ◽

Vol 28 (6) ◽

pp. 625-633

Author(s):

Sun-Young Ha ◽

Yun-Hee Sung

Keyword(s):

Visual Perception ◽

Dynamic Balance ◽

Gait Training ◽

Control Group ◽

Stroke Patients ◽

Unilateral Neglect ◽

Significant Difference ◽

Functional Reach Test ◽

Before And After ◽

Experimental Group

BACKGROUND: Fresnel prism shifts the field of view and converts object position in space, but its effect on stroke patients without unilateral neglect has not been examined. OBJECTIVE: We aimed to investigate the effect of Fresnel prism glasses on balance and gait in stroke patients with hemiplegia. METHODS: This study included 17 stroke patients with hemiplegia without unilateral neglect. Balance and gait training were applied in the control group (n= 9), and Fresnel prism glasses were applied with balance and gait training in the experimental group (n= 8). In all groups, interventions were done for 30 min/day for 5 times/week for 4 weeks. Motor-free visual perception test for visual perception (MVPT), Berg Balance Scale (BBS), and functional reach test (FRT) for dynamic balance ability, and gait were performed. Measurements were done before and after interventions. RESULTS: MVPT showed no significant difference between the groups (p> 0.05). A significant increase in BBS and FRT results was found before and after interventions in the experimental group (p< 0.05). Gait variables showed significant difference in the experimental group (p< 0.05). CONCLUSION: Fresnel prism glasses may effectively improve dynamic balance and gait functions by shifting body weight to the affected side of stroke patients with hemiplegia without vision loss.

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Effect of a Planned Health Teaching on Improving Knowledge and Competence of Home Care Practice of Post Stroke Patient Among Caregivers' Achievement

International Journal of Studies in Nursing ◽

10.20849/ijsn.v5i2.761 ◽

2020 ◽

Vol 5 (2) ◽

pp. 51

Author(s):

Eman Ali Abd El Moaty Sheha ◽

Asmaa Abouda Abdelhamed Soultan ◽

Rasha Nabil Malk ◽

Eman Mohammed Mohammed Elsherbeny

Keyword(s):

Home Care ◽

Functional Ability ◽

Control Group ◽

Stroke Patients ◽

Post Intervention ◽

Post Stroke ◽

Care Practices ◽

Experimental Group ◽

Group Post ◽

Health Teaching

Background: Stroke is one of the major healthcare challenges, being one of the leading causes of death, disability, and dependency in the activity of daily living worldwide Homecare of stroke patients is having a great role in the patient recovery. Patient family caregivers and relatives can play an important role in the care of patients. But how to continue proper care of the patient at home after discharge, they don't know what to do and don't have practice as well. In this view, the researcher believes that it might be a great help for caregivers and the patients to teach theirs about stroke and home care of stroke patients. Objective: The study aims to evaluate the effectiveness of a planned health teaching on the caregiver's knowledge and competence of home care of stroke patients. Therefore, improve the patients' functional ability. Methods: The two group pre and post-test, quasi-experimental design was conducted among 50 caregivers of stroke patients, assigned to 25 caregivers as a control group and 25 caregivers as an experimental group. The study was done in the university hospital at El Fayoum city from 1st March 2019 to 31st August 2019. Four tools were used for data collection after reviewing relevant data as the following; a structured interviewing questionnaire, caregiver's knowledge questionnaire regarding stroke, caregiver's practices regarding bed position, Position Change and Transfer, and Range of Motion Exercises, and patient function ability assessment according to Barthel index. Results: revealed that there was a poor score level of knowledge and competence of home care practices before the intervention. However, there was an improvement of score level in the control and experimental group post-intervention, but the higher score was observed in the experimental group. The mean score level of patient functional ability in the experimental group improved than the control group through follow up. Highly statistical significance was found between control and experimental group post-intervention related to knowledge and practices. A positive significant correlation between caregiver's practices and patients function ability in the experimental group was found. Conclusion: planned health teaching is important after patients discharge to increase the caregiver's knowledge and competence of home care practices of post-stroke patients; resulting in improved patient functional ability.

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Video Game-Based Therapy on Balance and Gait of Patients with Stroke: A Systematic Review

Applied Sciences ◽

10.3390/app10186426 ◽

2020 ◽

Vol 10 (18) ◽

pp. 6426

Author(s):

Silvia Pintado-Izquierdo ◽

Roberto Cano-de-la-Cuerda ◽

Rosa María Ortiz-Gutiérrez

Keyword(s):

Systematic Review ◽

Information And Communication Technologies ◽

Video Game ◽

Outcome Measurement ◽

Control Group ◽

Stroke Patients ◽

Post Stroke ◽

Standard Quality ◽

Experimental Group

Background: Stroke patients with motor, sensory and cognitive diseases can take profits from information and communication technologies—in particular, from the latest commercial video consoles, which are based on motion capture. These technologies are positioning themselves as complementary therapeutic tools for treating gait and balance disorders. In this paper, a systematic review of the effect of video game-based therapy on balance and gait in stroke patients is shown and compared with other types of treatments. Methods: A systematic review of prospective controlled clinical trials published in the main biomedical databases in English and Spanish between 2005 and 2020 was performed. The systematic review presented in this paper has been done following the Cochrane Manual recommendations and the PRISMA Declaration by two independent reviewers. Data about participants, intervention, outcome measurements and outcome measurement results were extracted. The quality of evidence of each study was assessed using Cochrane’s standard quality assessment format, which includes a description of the risk of bias. Additionally, the Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of each paper. Results: A total of 18 papers, including 479 patients, were included in this systematic review, in which the use of video consoles (in combination with conventional rehabilitation or exclusively) was compared with conventional rehabilitation to treat balance or gait in post-stroke patients. In all studies, a tendency to improve balance was found in both intervention groups, finding, in 10 of 17 studies that analysed it, a better capacity in the experimental group that included video consoles compared to the conventional rehabilitation control group. Regarding gait, in six of seven studies that analysed it, improvements were found in both intervention groups, and these improvements were greater in the experimental group than compared to the control group in three of them. Conclusions: Commercial video game systems, in combination with conventional rehabilitation, have shown positive results on balance and gait in post-stroke patients. There were variations between the trials in terms of the video consoles used and the duration, frequency and number of sessions with commercial video games. Future studies should compare the effects of commercial video game treatments on balance and gait in stroke patients with a nonintervention group to know their real efficacy.

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Therapeutic Effect of Xingnaotongdu Acupuncture Combined with Huoxuetongluo Decoction on Patients with Post-Stroke Cognitive Dysfunction

E3S Web of Conferences ◽

10.1051/e3sconf/202018503012 ◽

2020 ◽

Vol 185 ◽

pp. 03012

Author(s):

Ruicong Ding ◽

Shenghua Zhou

Keyword(s):

Cognitive Function ◽

Heat Shock ◽

Cognitive Dysfunction ◽

Daily Living ◽

Control Group ◽

Hsp70 Level ◽

Statistical Comparison ◽

Post Stroke ◽

Before And After ◽

Experimental Group

To investigate the efficacy of Xingnao Tongdu Acupuncture Combined with Huoxue Tongluo Decoction in the treatment of post-stroke cognitive dysfunction. Eighty-eight patients with post-stroke cognitive dysfunction were enrolled in our hospital from July 2016 to July 2018. The patients were randomly assigned to a total of 44 patients. The control group was treated with conventional western medicine. The experimental group was treated with Xingnao Tongdu Acupuncture Method + Huoxue Tongluo Decoction on the basis of the control group for 1 month. Statistical comparison was performed between the two groups before and after treatment (NCSE), serum heat shock protein (HSP70), cortisol (Cor), and daily living ability (ADL). Compared with the control group, the NCSE scores of the experimental group were higher after treatment (P<0.05). Compared with the control group, the serum HSP70 level was higher and the Cor level was lower (P<0.05). The ADL score of the experimental group was higher after treatment (P<0.05). Xingnao Tongdu Acupuncture Combined with Huoxue Tongluo Decoction in the treatment of post-stroke cognitive dysfunction can regulate serum Cor and HSP70 levels, improve cognitive function and improve daily living ability.

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