scholarly journals A decision making algorithm for rehabilitation after stroke: A guide to choose an appropriate and safe treadmill training

2021 ◽  
pp. 1-11
Author(s):  
Fabio Vanoglio ◽  
Adriana Olivares ◽  
Gian Pietro Bonometti ◽  
Silvia Damiani ◽  
Marta Gaiani ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Judgment ◽  
Clinical Characteristics ◽  
Rating Scale ◽  
Strong Association ◽  
Functional Independence ◽  
Treadmill Training ◽  
Walking Ability ◽  
Stroke Patients ◽  
Post Stroke

BACKGROUND: Walking independently after a stroke can be difficult or impossible, and walking reeducation is vital. But the approach used is often arbitrary, relying on the devices available and subjective evaluations by the doctor/physiotherapist. Objective decision making tools could be useful. OBJECTIVES: To develop a decision making algorithm able to select for post-stroke patients, based on their motor skills, an appropriate mode of treadmill training (TT), including type of physiotherapist support/supervision required and safety conditions necessary. METHODS: We retrospectively analyzed data from 97 post-stroke inpatients admitted to a NeuroRehabilitation unit. Patients attended TT with body weight support (BWSTT group) or without support (FreeTT group), depending on clinical judgment. Patients’ sociodemographic and clinical characteristics, including the Cumulative Illness Rating Scale (CIRS) plus measures of walking ability (Functional Ambulation Classification [FAC], total Functional Independence Measure [FIM] and Tinetti Performance-Oriented Mobility Assessment [Tinetti]) and fall risk profile (Morse and Stratify) were retrieved from institutional database. RESULTS: No significant differences emerged between the two groups regarding sociodemographic and clinical characteristics. Regarding walking ability, FAC, total FIM and its Motor component and the Tinetti scale differed significantly between groups (for all, p <  0.001). FAC and Tinetti scores were used to elaborate a decision making algorithm classifying patients into 4 risk/safety (RS) classes. As expected, a strong association (Pearson chi-squared, p <  0.0001) was found between RS classes and the initial BWSTT/FreeTT classification. CONCLUSION: This decision making algorithm provides an objective tool to direct post-stroke patients, on admission to the rehabilitation facility, to the most appropriate form of TT.

scholarly journals Postural Assessment Scale for Stroke Patients in Acute, Subacute and Chronic Stage: A Construct Validity Study

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 365
Author(s):  
Cecilia Estrada-Barranco ◽  
Roberto Cano-de-la-Cuerda ◽  
Vanesa Abuín-Porras ◽  
Francisco Molina-Rueda
Keyword(s):  
Construct Validity ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Assessment Scale ◽  
Validity Study ◽  
Stroke Patients ◽  
Chronic Stage ◽  
Post Stroke ◽  
Valid Instrument ◽  
Postural Assessment

(1) Background: Observational scales are the most common methodology used to assess postural control and balance in people with stroke. The aim of this paper was to analyse the construct validity of the Postural Assessment Scale for Stroke Patients (PASS) scale in post-stroke patients in the acute, subacute, and chronic stroke phases. (2) Methods: Sixty-one post-stroke participants were enrolled. To analyze the construct validity of the PASS, the following scales were used: the Functional Ambulatory Category (FAC), the Wisconsin Gait Scale (WGS), the Barthel Index (BI) and the Functional Independence Measure (FIM). (3) Results: The construct validity of the PASS scale in patients with stroke at acute phase was moderate with the FAC (r = −0.791), WGS (r = −0.646) and FIM (r = −0.678) and excellent with the BI (r = 0.801). At subacute stage, the construct validity of the PASS scale was excellent with the FAC (r = 0.897), WGS (r = −0.847), FIM (r = −0.810) and BI (r = −0.888). At 6 and 12 months, the construct validity of the PASS with the FAC, WGS, FIM and BI was also excellent. (4) Conclusions: The PASS scale is a valid instrument to assess balance in post-stroke individuals especially, in the subacute and chronic phases (at 6 and 12 months).

Efficacy of Multi Unani regimen in functional independence recovery of post stroke patients and #8211; A black-box design

Spatula DD ◽  
2016 ◽  
Vol 6 (1) ◽  
pp. 41
Author(s):  
Mohd Shahid ◽  
Iram Naaz ◽  
Noor Ahmed ◽  
Sabiha Fatima ◽  
Mansoor Siddiqui
Keyword(s):  
Functional Independence ◽  
Black Box ◽  
Stroke Patients ◽  
Post Stroke

scholarly journals Treadmill training and kinesiotherapy versus conventional physiotherapy in Parkinson’s disease: a pragmatic study

2019 ◽  
Vol 32 ◽  
Author(s):  
Thiago da Silva Rocha Paz ◽  
Fernando Guimarães ◽  
Vera Lúcia Santos de Britto ◽  
Clynton Lourenço Correa
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Statistical Tests ◽  
Clinical Status ◽  
Functional Independence ◽  
Treadmill Training ◽  
Clinical Aspects ◽  
Group 12 ◽  
Conventional Physiotherapy

Abstract Introduction: Physiotherapy has been identified in the literature as an important treatment for individuals with Parkinson’s disease (PD) to improve functional capacity. Little is discussed about the physiotherapy practice environment for this population. Objective: To assess pragmatically the effects of two physiotherapy protocols: Conventional Physiotherapy (CP) and Treadmill Training and Kinesiotherapy (TTK) in PD patients. Method: Twenty-four PD patients classified from 1 to 3 on the Hoehn and Yahr scale were randomly distributed into two groups. In CP group (12 patients), exercises aimed to improve range of motion, bradykinesia, postural adjustments and gait. In TTK group (12 patients), exercises aimed to improve physical fitness, mobility and functional independence. The treatments were performed for 50 minutes, twice a week for 14 weeks. The following evaluations were performed before and after the interventions: Unified Parkinson’s Disease Rating Scale (UPDRS); gait speed (GS); up stairs (US) and down stairs (DS) tests; timed get-up-and-go test (TUG) and 6-Minute Walk Distance Test (6-MWDT). Sociodemographic and clinical data were presented as descriptive analysis. Variables with normal and non-normal distributions were analyzed by specific statistical tests. Results: Intragroup analysis showed significant results for the TTK group (TUG, US, DS, GS, UPDRS total and UPDRS II) and for the CP group only UPDRS total. Intergroup analysis was favorable for the TTK group (TUG, US, DS, 6-MWDT). Conclusion: CP group improved the patients’ general clinical status, while treadmill and kinesiotherapy improved the physical-functional and clinical aspects.

scholarly journals Effect of hydrokinesitherapy on balance and walking ability in post-stroke patients

Medicine ◽  
2018 ◽  
Vol 97 (51) ◽  
pp. e13763 ◽  
Author(s):  
Xin Wang ◽  
Taipin Guo ◽  
Tao Wang ◽  
Bo Jiang ◽  
Yan Su ◽  
...  
Keyword(s):  
Walking Ability ◽  
Stroke Patients ◽  
Post Stroke

scholarly journals Sarcopenic Obesity and Activities of Daily Living in Stroke Rehabilitation Patients: A Cross-Sectional Study

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 255
Author(s):  
Tatsuya Matsushita ◽  
Shinta Nishioka ◽  
Shiori Taguchi ◽  
Anna Yamanouchi ◽  
Ryusei Nakashima ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Older Patients ◽  
Functional Independence ◽  
The Body ◽  
Sarcopenic Obesity ◽  
Fat Percentage ◽  
Stroke Patients ◽  
Post Stroke ◽  
Simple Obesity

Reports investigating the relationship between sarcopenic obesity and activities of daily living in older patients with stroke were limited. This study aimed to examine the prevalence of sarcopenic obesity and its association with activities of daily living in older post-stroke patients in convalescent rehabilitation wards. This study was performed in older post-stroke patients admitted to convalescent rehabilitation wards between January 2017 and March 2019. Sarcopenia was diagnosed based on the skeletal muscle mass index and hand grip strength according to the criteria of the 2019 Asian Working Group for Sarcopenia. Obesity was diagnosed according to the body fat percentage; ≥27% in men, ≥38% in women. The primary outcome was the Functional Independence Measure (FIM) score upon admission, which was analyzed using multiple linear regression. In total, 376 participants (women 44%; mean age 77.5 years) were analyzed and classified as normal (22%), simple obesity (17%), sarcopenia without obesity (32%), and sarcopenic obesity (28%). The presence of sarcopenic obesity was independently associated with the FIM score (95% CI, −16.157 to −5.353), whereas simple obesity and sarcopenia without obesity were not. In conclusion, sarcopenic obesity was independently associated with lower activities of daily living capability in older patients with stroke.

scholarly journals Importance of retardation and fatigue/interest domains for the diagnosis of major depressive episode after stroke: a four months prospective study

2009 ◽  
Vol 31 (3) ◽  
pp. 202-207 ◽  
Author(s):  
Luisa de Marillac Niro Terroni ◽  
Renério Fráguas ◽  
Mara de Lucia ◽  
Gisela Tinone ◽  
Patricia Mattos ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Depressive Episode ◽  
Major Depressive Episode ◽  
Rating Scale ◽  
University Hospital ◽  
Regression Equations ◽  
Stroke Patients ◽  
Major Depressive ◽  
Post Stroke ◽  
Neurology Clinic

OBJECTIVE: Post-stroke major depressive episode is very frequent, but underdiagnosed. Researchers have investigated major depressive episode symptomatology, which may increase its detection. This study was developed to identify the depressive symptoms that better differentiate post-stroke patients with major depressive episode from those without major depressive episode. METHOD: We screened 260 consecutive ischemic stroke patients admitted to the neurology clinic of a university hospital. Seventy-three patients were eligible and prospectively evaluated. We assessed the diagnosis of major depressive episode using the Structured Clinical Interview for DSM-IV and the profile of depressive symptoms using the 31-item version of the Hamilton Depression Rating Scale. For data analysis we used cluster analyses and logistic regression equations. RESULTS: Twenty-one (28.8%) patients had a major depressive episode. The odds ratio of being diagnosed with major depressive episode was 3.86; (95% CI, 1.23-12.04) for an increase of one unit in the cluster composed by the domains of fatigue/interest and retardation, and 2.39 (95% CI, 1.21-4.71) for an increase of one unit in the cluster composed by the domains of cognitive, accessory and anxiety symptoms. The domains of eating/weight and insomnia did not contribute for the major depressive episode diagnosis. CONCLUSION: The domains of retardation and interest/fatigue are the most relevant for the diagnosis of major depressive episode after stroke.

scholarly journals Magnitude and determinants of depression in acute stroke patients admitted in a rural tertiary care hospital

2015 ◽  
Vol 6 (02) ◽  
pp. 202-207 ◽  
Author(s):  
Amrish Saxena ◽  
Ajitabh Suman
Keyword(s):  
Acute Stroke ◽  
Rating Scale ◽  
Tertiary Care Hospital ◽  
Economic Status ◽  
Tertiary Care ◽  
Care Hospital ◽  
Stroke Patients ◽  
Post Stroke ◽  
Socio Economic Status ◽  
Post Stroke Depression

ABSTRACT Objectives: Depression is one of the most frequent neuropsychiatric disturbances after a cerebrovascular stroke. The frequency of depression in stroke patients has varied widely in different populations. Post stroke depression is an important factor limiting recovery and rehabilitation in acute stroke patients. Settings and Design: A cross-sectional hospital-based study was performed in acute stroke patients admitted in the department of Medicine of a rural teaching tertiary care hospital in central India. Materials and Methods: In all consecutive acute stroke inpatients, the intensity of depression was assessed by a trained person through a questionnaire, Montgomery-Asberg Depression Rating Scale (MADRS), who is blind of the diagnosis and investigations of the patient. Another study person collected the data including demographics, co-morbid diseases or risk factors. Radiological imaging data was noted from the CT/MRI head reports of stroke patients. Results: Of the total 107 stroke patients, 60 (56%) were males and 47 (44%) were females. Sixty-one (57%) of the 107 stroke patients had depression. Of the 107 stroke patients, 35 (33%) had mild depression, 22 (20%) had moderate depression and 4 (4%) had severe depression. The age, gender, education status and co-morbidities of the stroke patient were not associated with depression. The association of socio-economic status and left-sided lesions with depression was found to be statistically significant (P < 0.05). Type and location of the lesion were not associated with depression. Conclusion: Post-stroke depression was present in more than half of the stroke patients and was related to socio-economic status and left-sided hemisphere lesions.

The Post-Stroke depression rating scale: A test specifically devised to investigate affective disorders of stroke patients

1997 ◽  
Vol 19 (3) ◽  
pp. 340-356 ◽  
Author(s):  
Guido Gainotti ◽  
Antonella Azzoni ◽  
Carmelina Razzano ◽  
Monica Lanzillotta ◽  
Camillo Marra ◽  
...  
Keyword(s):  
Affective Disorders ◽  
Rating Scale ◽  
Stroke Patients ◽  
Post Stroke ◽  
Post Stroke Depression

scholarly journals Factors Affecting Post-Stroke Depression in Acute Ischemic Stroke Patients after 3 Months

2021 ◽  
Vol 11 (11) ◽  
pp. 1178
Author(s):  
Chan-Hyuk Lee ◽  
Su Hong Jeon ◽  
Min Ju Kim ◽  
Gyu Dam Ra ◽  
Yong-Hyun Lee ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Prognostic Factors ◽  
Environmental Factors ◽  
Acute Ischemic Stroke ◽  
Study Design ◽  
Rating Scale ◽  
Stroke Patients ◽  
Post Stroke ◽  
Hospitalization Period ◽  
Post Stroke Depression

Post-stroke depression (PSD) affects approximately one-third of stroke patients. PSD not only impairs recovery and lowers quality of life, but has also serious neurological consequences, high mortality, and stroke recurrence risks. Studies on PSD-related prognostic factors are still lacking, especially environmental factors. Moreover, relieving factors after PSD in stroke patients has not been reported. This study aimed to investigate (study design 1) risk factors for PSD diagnosis after three months, and (study design 2) related factors for the relieving of early PSD after three months. This retrospective study included 227 patients hospitalized for acute ischemic stroke within three days at Jeonbuk National University Hospital from January to December 2019. The depressive status was assessed using the Hamilton Depression Rating Scale (HDRS) at admission and after three months. Clinical and laboratory data were analyzed for relevant prognostic factors. (Study design 1) HDRS score at admission (adjusted odds ratio (aOR) 1.22, 95% confidence interval (CI) 1.14–1.31; p < 0.001) and hospitalization period (aOR 1.11, 95% CI 1.02–1.20; p = 0.013) were confirmed as prognostic factors of PSD after three months. (Study design 2) The National Institute of Health Stroke Scale (NIHSS) score at discharge (aOR 0.80, 95% CI 0.68–0.94; p = 0.006) and HDRS score at admission (aOR 0.80, 95% CI 0.71–0.89; p < 0.001) were confirmed as prognostic factors of depression improvement after three months. In conclusion, environmental factors such as hospitalization period could be important in managing PSD. Factors related to PSD improvement are expected to be helpful in establishing a strategy for PSD recovery.

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