Exploring the experience of post-stroke fatigue in community dwelling stroke survivors: a prospective qualitative study

2012 ◽  
Vol 34 (16) ◽  
pp. 1376-1384 ◽  
Author(s):  
Jennifer Helen White ◽  
Kimberley R. Gray ◽  
Parker Magin ◽  
John Attia ◽  
Jonathan Sturm ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Community Dwelling ◽  
Stroke Survivors ◽  
Post Stroke

Personal and social factors that influence physical activity levels in community-dwelling stroke survivors: A systematic review of qualitative literature

2021 ◽  
pp. 026921552199369
Author(s):  
Karl R Espernberger ◽  
Natalie A Fini ◽  
Casey L Peiris
Keyword(s):  
Physical Activity ◽  
Social Factors ◽  
Self Efficacy ◽  
Data Extraction ◽  
Community Dwelling ◽  
Stroke Survivors ◽  
Activity Levels ◽  
Post Stroke ◽  
Physical Activity Levels ◽  
Mobile Community

Objectives: To determine the personal and social factors perceived to influence physical activity levels in stroke survivors. Data sources: Four electronic databases (MEDLINE, CINAHL, PubMed and Embase) were searched from inception to November 2020, including reference and citation list searches. Study selection: The initial search yielded 1499 papers, with 14 included in the review. Included articles were peer-reviewed, qualitative studies, reporting on the perceived factors influencing physical activity levels of independently mobile community-dwelling adults, greater than 3 months post stroke. Data extraction: Data extracted included location, study aim, design, participant and recruitment information and how data were collected and analysed. Data synthesis: Thematic analysis was undertaken to identify meanings and patterns, generate codes and develop themes. Five main themes were identified: (i) Social networks are important influencers of physical activity; (ii) Participation in meaningful activities rather than ‘exercise’ is important; (iii) Self-efficacy promotes physical activity and physical activity enhances self-efficacy; (iv) Pre-stroke identity related to physical activity influences post-stroke physical activity; and (v) Formal programmes are important for those with low self-efficacy or a sedentary pre-stroke identity. Conclusions: Physical activity levels in stroke survivors are influenced by social activities and support, pre-stroke identity, self-efficacy levels and completion of activities that are meaningful to stroke survivors.

Experience of family caregivers of community-dwelling stroke survivors and risk of elder abuse: a qualitative study

2014 ◽  
Vol 16 (5) ◽  
pp. 276-293 ◽  
Author(s):  
Celia Chow ◽  
Agnes Tiwari
Keyword(s):  
Qualitative Study ◽  
Family Caregivers ◽  
Local Community ◽  
Service Providers ◽  
Elder Abuse ◽  
Community Dwelling ◽  
Stroke Survivors ◽  
Content Type ◽  
The Disabled ◽  
Personal Resilience

Purpose – The purpose of this paper is to explore the following questions. First, what are the experiences of family caregivers in caring for community-dwelling stroke survivors? Second, what services help or do not help the caregivers in managing their caregiving role? Design/methodology/approach – A qualitative study was conducted with a total of six focus group interviews with 29 stroke caregivers selected using convenience sampling in a local community centre. All interviews were recorded and transcribed for content analysis. Findings – The results pointed to three main themes working together to facilitate desirable outcomes in caregiving and prevent elder abuse: factors contributing to caregiver stress and factors that have a buffering effect on caregiver stress and unmet needs identified from caregivers’ experiences. Research limitations/implications – The authors found that there were a number of factors contributing to caregiver stress. The findings matched with the concept that caregiver stress should not be considered as the primary cause of elder abuse. Findings provided information for further research to investigate positive coping and adjustment for stroke survivors, caregivers and their families. Practical implications – Policy makers and service providers may consider specific policies and tailor-made services to enhance the effectiveness of current practice. The themes emerging from the study could be further reviewed in a longitudinal way to explore the cost-effectiveness, the outcomes and trajectory of interventional programmes. Social implications – Education would be essential to let the public understand caregivers’ difficulties and needs. Prevention of elder abuse may be approached with a range of risk factors for both perpetrating and being elder abuse victim. Originality/value – From the findings of the study, the authors found that there were service gaps within policy and interventions. Concrete suggestions for improving the public's attitude and public facilities/transport for the disabled were captured in the study. In addition to personal resilience, caregivers had a strong wish for a supportive environment and services that would facilitate a better caregiving outcome.

scholarly journals Facilitating Exercise Engagement among Community Dwelling Stroke Survivors: Is a once Per Week Group Session Sufficient?

2019 ◽  
Vol 16 (23) ◽  
pp. 4746
Author(s):  
Nor Azlin Mohd Nordin ◽  
Nor Asma Husna Yusoff ◽  
Devinder Kaur Ajit Singh
Keyword(s):  
Physical Performance ◽  
Low Frequency ◽  
Community Dwelling ◽  
Exercise Session ◽  
Stroke Recurrence ◽  
Stroke Survivors ◽  
Group Exercise ◽  
Post Stroke ◽  
Sit To Stand ◽  
Balance Ability

Although exercise is proven as an effective strategy to combat post-stroke complications and the risk of stroke recurrence, many stroke survivors fail to engage in this activity following rehabilitation. In this study, we assessed the feasibility and usefulness of a low-frequency group exercise to determine its suitability as an approach to facilitate exercise engagement among stroke survivors. Forty-one stroke survivors, mean (SD) age 59.34 (10.02) years, mean time post-stroke 17.13 (17.58) months, completed a 90 minute, once per week, group exercise supervised by therapists for 12 weeks. The exercise outcomes were measured using standardized clinical tests. We observed improvement in the group’s physical performance; balance score by 3 units (Z = −3.88, p < 0.001), speed of repetitive sit to stand by 3.4 s (Z = −4.69, p < 0.001), and walking speed by 8.22 m/min (Z = −3.25, p < 0.001). Scores of seven out of 14 Berg’s balance scale items increased significantly, indicating better balance ability among the survivors. In conclusion, a 12-week, once per week group exercise session seems feasible and sufficient to improve the physical performance of community dwelling stroke survivors. This exercise arrangement may be offered to stroke survivors to facilitate exercise practice following rehabilitation.

Abstract P428: Effects of Tai Chi on Physical Function and Quality of Life in Chronic Stroke

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Ruth E Taylor-Piliae ◽  
Tiffany M Hoke ◽  
Joseph T Hepworth ◽  
L. Daniel Latt ◽  
Bijan Najafi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Physical Function ◽  
Tai Chi ◽  
Community Dwelling ◽  
Stroke Survivors ◽  
Post Stroke ◽  
Sf 36 ◽  
Fall Rates

Background: Poor physical function and quality of life are ubiquitous post-stroke. Effective interventions to improve physical function and quality of life for stroke survivors are critically needed. Objective: Examine the effect of a Tai Chi (TC) intervention on physical function and quality of life. Methods: In a single-blind randomized clinical trial community-dwelling stroke survivors, aged ≥ 50 years and ≥ 3 months post-stroke, were assigned to: Yang style 24-posture TC (n=53), SilverSneakers® (SS, n=44) strength and range of movement exercise, or Usual Care (UC, n=48) for 12 weeks. TC and SS attended a 1-hour class 3 times/week, while UC had weekly phone calls. Standardized measures for Physical Function were the Short Physical Performance Battery (SPPB), Fall Rates and 2-Minute StepTest; and for Quality of Life were the Medical Outcomes Study SF-36, Center for Epidemiological Studies Depression and Pittsburgh Sleep Quality Index. Results: A total of 145 stroke survivors (47% women, mean age=70 years, time post-stroke=3 years, ischemic stroke=66%, hemiparesis=73%) enrolled. During the intervention, TC participants had 2/3 fewer falls (n=5 falls), than the SS (n=14 falls) and UC (n=15 falls) groups (χ2=5.60, p=0.06). All groups had improvements in the SPPB score (F 1,142 =85.29, p<0.01), after the 12-week intervention. Post-hoc tests following a significant interaction for the 2-Minute StepTest (F 2,142 =4.69, p<0.01) indicated TC (t 53 =2.45, p=0.02) and SS (t 44 =4.63, p<0.01) groups had significantly better aerobic endurance over time, though the UC group did not (t 48 =1.58, p=0.12). All groups reported better perceived physical (SF-36 PCS, F 1,142 =4.15, p=0.04) and mental health (SF-36 MCS, F 1,142 =15.60, p<0.01), after the intervention. There were no significant within group changes in perceived physical health (p>0.05), while significant improvements in perceived mental health (p < 0.05) were observed within all groups. No significant changes in depressive symptoms or sleep quality were observed (p>0.05). Attrition was 10% (n=14), and intervention adherence rates were 85%. Conclusions: Goals of stroke rehabilitation are to prevent disability, improve physical function and quality of life. TC and SS led to improved aerobic endurance, and both are suitable community-based programs that may aid in stroke recovery and community reintegration. Our data suggest that a 12-week TC intervention may be more effective in reducing fall rates than SS or UC. Future studies examining the effectiveness of TC to reduce fall rates; and improve physical function and quality of life for community-dwelling stroke survivors are recommended.

Abstract P276: Aerobic Endurance and Leg Strength are Predictive of Gait Velocity among Community-Dwelling Stroke Survivors

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Ruth E Taylor-Piliae ◽  
L. Daniel Latt ◽  
Bruce M Coull
Keyword(s):  
Cognitive Impairment ◽  
Functional Disability ◽  
Chronic Stroke ◽  
Community Dwelling ◽  
Step Test ◽  
Gait Velocity ◽  
Stroke Survivors ◽  
Chair Stand ◽  
Post Stroke ◽  
Leg Strength

Background: Gait velocity is an objective, fundamental indicator of post-stroke walking ability. Most stroke survivors have diminished aerobic endurance and paretic leg strength, with one or both of these conditions affecting their gait velocity. Other reported underlying factors affecting gait velocity include functional disability, balance and cognitive impairment. Objective: To examine potential independent predictors of gait velocity in chronic stroke. Methods: Cross-sectional design using baseline data from the first 100 community-dwelling stroke survivors enrolled in an exercise intervention study. Eligible subjects included men and women aged ≥ 50 years and at ≥ 3 months post-stroke. Subjects completed a comprehensive, self-administered health survey prior to their baseline study visit. At the baseline visit, functional disability (Modified Rankin Scale), aerobic endurance (2-minute step-test), leg strength (timed 5-chair stand test), balance (single-leg stance) and cognitive impairment (Mini-Mental Status Exam) were assessed. Gait speed was assessed using a valid and reliable timed 4-meter walk test designed for older adults with disabilities; to calculate gait velocity (meters/second). Multiple linear regression was conducted to explore potential independent predictors of gait velocity. Results: Subjects (n=100) were on average 70±10 years old, and 39±49 months post-stroke. The majority reported an ischemic stroke (68/100) with hemiparesis (80/100); and were married (59/100), White/European-American (78/100), college-educated (79/100), men (54/100). Subjects had an average gait velocity of 0.75±0.23 meters/second, categorized as limited community walkers. Approximately 37% of the variance in gait velocity, could be explained by the optimal combination of the independent variables in the model: functional disability, aerobic endurance, leg strength, balance, and cognitive impairment (R 2 =0.37, F 5,74 =8.64, p<0.01). Only better aerobic endurance (t 1,74 =3.41, p<0.01) and leg strength (i.e. faster chair stand time) (t 1,74 =–2.23, p=0.03) contributed uniquely and significantly to faster gait velocity. Conclusion: A hallmark of gait dysfunction in chronic stroke is slow gait velocity, even among well-educated, community-dwelling survivors. Gait velocity is simple to measure requiring only a stopwatch and flat surface for walking. Our findings are similar to reports by others that diminished aerobic endurance and leg strength are major contributors to slow gait velocity in chronic stroke. Long term rehabilitation efforts are needed to improve gait velocity in chronic stroke, and may need to incorporate multifaceted strategies concurrently, focusing on aerobic endurance and leg strength, to maximize community ambulation and reintegration.

scholarly journals Unmet care needs of community-dwelling stroke survivors: a systematic review of quantitative studies

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e045560
Author(s):  
Bei-lei Lin ◽  
Yong-xia Mei ◽  
Wen-na Wang ◽  
Shan-shan Wang ◽  
Ying-shuang Li ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Physical Function ◽  
Unmet Needs ◽  
Community Dwelling ◽  
Information Support ◽  
Stroke Survivors ◽  
Care Needs ◽  
Post Stroke ◽  
Quantitative Studies

ObjectivesUnderstanding the unmet needs of community-dwelling stroke survivors is essential for further intervention. This systematic review was performed to summarise their unmet needs from a quantitative viewpoint.DesignSystematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesA comprehensive search of six databases was conducted from inception to February 2020: PubMed, EMBASE, CINAHL, PsycINFO, SCOPUS and CBM. The methodological quality of the studies was assessed. Unmet needs were categorised, and a pooled analysis of the main outcomes was conducted.Eligibility criteria for selecting studiesWe included quantitative studies focused on the unmet needs of stroke survivors who live at homes rather than in any other institutionalised organisation.ResultsIn total, 32 of 2660 studies were included, and 1980 unmet needs were identified. The prevalence of patients with unmet needs ranged from 15.08% to 97.59%, with a median of 67.20%; the median number of unmet needs per patient ranged from 2 to 8 (0–31). The prevalence of unmet needs was high at 6 months post-stroke (62.14%) and 2 years post-stroke (81.37%). After categorisation, the main concerns among these patients were revealed to be information support, physical function and mental health; a few studies reported unmet needs related to leisure exercise, return to work and so on. Additionally, differences in the measurement tools used across studies affect what unmet needs participants report.ConclusionsSufficient, accurate, individualised and dynamic information support is a priority among community-dwelling stroke survivors. Physical function and mental health are also the most significant concerns for re-achieving social participation. It is essential to design and disseminate standard, effective and time-saving tools to assess unmet needs.Trial registration numberCRD42018112181.

scholarly journals Exercise instructor-led functional training programme for community dwelling stroke survivors: A qualitative study

2013 ◽  
Vol 20 (12) ◽  
pp. 597-605 ◽  
Author(s):  
Meriel Norris ◽  
Cherry Kilbride ◽  
Amir Mohagheghi ◽  
Christina Victor ◽  
Taryn M Jones ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Training Programme ◽  
Community Dwelling ◽  
Stroke Survivors ◽  
Functional Training

scholarly journals The meaning of loneliness to stroke survivors: A qualitative study in Northeast England

2021 ◽  
pp. 135910532110171
Author(s):  
Keming Yang ◽  
Nicole Armstrong ◽  
Clare Diamond ◽  
Alison R Lane ◽  
Stephen Dunne
Keyword(s):  
Qualitative Study ◽  
Social Relations ◽  
Healthcare Professionals ◽  
Stroke Survivor ◽  
Community Dwelling ◽  
Stroke Survivors

This study explored stroke survivors’ experiences of loneliness. Drawing on interviews with 29 community-dwelling stroke survivors living in the Northeast of England, we found several themes: loneliness as being alone, the season or time, lack of understanding from those without any experience of stroke, reduced autonomy, and deterioration of social relations. It is important that healthcare professionals pay attention to the aspects of life that may increase the chances of a stroke survivor becoming lonely after being discharged from hospital, and to measure loneliness in stroke survivors a more valid scale should include items that touch on the aspects reported here.

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