scholarly journals Efficacy of a Training on Executive Functions in Potentiating Rehabilitation Effects in Stroke Patients

2021 ◽  
Vol 11 (8) ◽  
pp. 1002
Author(s):  
Vincenza Tarantino ◽  
Francesca Burgio ◽  
Roberta Toffano ◽  
Elena Rigon ◽  
Francesca Meneghello ◽  
...  
Keyword(s):  
Executive Functions ◽  
Functional Independence Measure ◽  
Training Group ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Functional Improvement ◽  
Control Group ◽  
Stroke Patients ◽  
Treatment As Usual ◽  
Wide Range

Cognitive impairment after a stroke has a direct impact on patients’ disability. In particular, impairment of Executive Functions (EFs) interferes with re-adaptation to daily life. The aim of this study was to explore whether adding a computer-based training on EFs to an ordinary rehabilitation program, regardless of the specific brain damage and clinical impairment (motor, language, or cognitive), could improve rehabilitation outcomes in patients with stroke. An EF training was designed to have minimal motor and expressive language demands and to be applied to a wide range of clinical conditions. A total of 37 stroke patients were randomly assigned to two groups: a training group, which performed the EF training in addition to the ordinary rehabilitation program (treatment as usual), and a control group, which performed the ordinary rehabilitation exclusively. Both groups were assessed before and after the rehabilitation program on neuropsychological tests covering multiple cognitive domains, and on functional scales (Barthel index, Functional Independence Measure). The results showed that only patients who received the training improved their scores on the Attentional Matrices and Phonemic Fluency tests after the rehabilitation program. Moreover, they showed a greater functional improvement in the Barthel scale as well. These results suggest that combining an EF training with an ordinary rehabilitation program potentiates beneficial effects of the latter, especially in promoting independence in activities of daily living.

The Current State of Stroke Rehabilitation in Japan

1999 ◽  
Vol 13 (4) ◽  
pp. 219-223
Author(s):  
Yoshihisa Masakado ◽  
Naoichi Chino
Keyword(s):  
Regression Analysis ◽  
Chronic Conditions ◽  
Stroke Rehabilitation ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Stroke Outcome ◽  
Stroke Patients ◽  
Current State ◽  
Rehabilitation System

This paper presents the current state of stroke rehabilitation in Japan. The Japanese rehabilitation system is much different from those in other countries, mainly because of the Japanese insurance system, which covers from acute to chronic conditions. In this situation, a Japanese inpatient stroke rehabilitation program treats patients until they reach a plateau in impairment and disability. Thus we can evaluate the true func tional prognosis because of longer periods of observation for assessing the recovery pat tern of impairment and disability. As a result, we can predict stroke outcome much more precisely. We recently developed a new evaluation methods for stroke patients called the Stroke Impairment Assessment Set (SIAS) based on work from the Sym posium on Methodologic Issues in Stroke Outcome Research in 1989. Using the SIAS and the Functional Independence Measure, we have successfully predicted stroke out come using regression analysis.

scholarly journals The Association Between Sarcopenia and Functional Improvement in Older and Younger Patients Who Completed Inpatient Rehabilitation: A Prospective Cohort Study

2021 ◽  
Vol 2 ◽  
Author(s):  
Irina Churilov ◽  
Leonid Churilov ◽  
Kim Brock ◽  
David Murphy ◽  
Richard J. MacIsaac ◽  
...  
Keyword(s):  
Cohort Study ◽  
Goal Attainment ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Functional Improvement ◽  
Goal Attainment Scaling ◽  
Standard Error Estimation ◽  
Measure Change

Objective: To investigate the association between sarcopenia and functional improvement in patients older and younger than 65 years upon completion of an inpatient rehabilitation program.Design: Prospective cohort study.Participants: Adult consecutive patients who completed the inpatient rehabilitation program at a metropolitan tertiary referral hospital general inpatient rehabilitation unit.Methods: Sarcopenia status was determined using the European Working Group on Sarcopenia in Older People 2 algorithm, using muscle mass measured by BioImpedance Analysis and grip strength. Progress in rehabilitation was measured using change in the Functional Independence Measure and Goal Attainment Scaling score. To investigate the age group by sarcopenia status interaction we used quantile regression models with bootstrapped standard error estimation for functional improvement and linear regression model with robust standard error estimation for GAS score.Results: 257 participants [128 (50%) male, median age 63 years (IQR: 52–72)], 33(13%) with sarcopenia, completed inpatient rehabilitation [median length of stay 16 days (IQR: 11–27.5)]. Participants' median Functional Independence Measure change was 24 (IQR 15–33.5) and mean total Goal Attainment Scaling score was 57.6 (SD 10.2). Adjusting for admission Functional Independence Measure score, the median difference in Functional Independence Measure change between participants with and without sarcopenia was: −4.3 (95% CI: −10.6, 1.9); p = 0.17 in participants 65 years and younger, and 4.6 (95% CI: 1.0, 8.2); p = 0.01 in participants older than 65; age-by-sarcopenia interaction p = 0.02.Conclusions: Unlike younger people, older people with sarcopenia have greater functional improvement in inpatient rehabilitation than those without sarcopenia.

scholarly journals Early home-supported discharge for patients with stroke in Portugal: a randomised controlled trial

2016 ◽  
Vol 31 (2) ◽  
pp. 197-206 ◽  
Author(s):  
Silvina Santana ◽  
José Rente ◽  
Conceição Neves ◽  
Patrícia Redondo ◽  
Nina Szczygiel ◽  
...  
Keyword(s):  
Stroke Unit ◽  
Controlled Trial ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Primary Outcome Measure ◽  
Control Group ◽  
Stroke Patients ◽  
Control Groups ◽  
Open Label

Objective: To evaluate an early home-supported discharge service for stroke patients. Design: We carried out a prospective, randomised, open-label, blinded-endpoint trial (allocation ratio of 1:1) with patients assigned to either an early home-supported discharge service or usual care. Setting: The study was undertaken in Aveiro, Portugal, between April 2009 and April 2013. Subjects: We included stroke patients aged 25–85 years admitted to the stroke unit with an initial Functional Independence Measure of up to 100, who gave informed consent. Interventions: Patients in the early home-supported discharge group began their rehabilitation intervention in the stroke unit and the early home-supported discharge team worked with them at home for a maximum of one month. Patients in the control group received usual services. Main measures: The primary outcome measure was the Functional Independence Measure at six months after stroke. Results: We randomised 190 patients of whom 34 were lost to follow-up. There were no significant differences (p > 0.5) in the average scores of Functional Independence Measure between the early home-supported discharge (69 ±22; mean ±SD) and the control groups (71 ±17) measured at baseline; and between the early home-supported discharge (107 ±20) and the control groups (107 ±25) measured at six months. The number of individuals with a low Functional Independence Measure score (<60) in the early home-supported discharge group compared with the control group was higher at admission (34/95 vs. 26/95) and lower at follow-up (2/74 vs. 5/78). Conclusions: It was feasible to implement early home-supported discharge procedures in a Southern European setting, but we have not shown convincing differences in disability at six months.

scholarly journals Evaluation of sensorimotor reactions during early rehabilitation for patients after cerebral stroke

Medicina ◽  
2007 ◽  
Vol 43 (12) ◽  
pp. 942
Author(s):  
Daiva Petruševičienė ◽  
Raimondas Savickas ◽  
Aleksandras Kriščiūnas
Keyword(s):  
Early Stage ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Early Rehabilitation ◽  
Point Of View ◽  
Functional Improvement ◽  
Cerebral Stroke ◽  
Stroke Patients ◽  
Functional Changes

Early inpatient rehabilitation is extremely important in functional improvement of patients suffering from cerebral stroke. From our point of view, in rehabilitation of patients after cerebral stroke, the estimation of sensorimotor reactions that enables the evaluation of sensorimotor functional changes is highly relevant. The article describes the comparison of sensorimotor reactions in two subgroups – stroke patients and healthy individuals – by applying Sensoneck system. The evaluation was performed before early stage of rehabilitation and thereafter (following early rehabilitation). In order to estimate the correlation between changes in functional independence and sensorimotor reactions, Functional Independence Measure was used. The study revealed that stroke patients had sensorimotor dysfunctions. During early rehabilitation, the quality of motion performance improved slightly, and sensorimotor reactions improved statistically significantly (P<0.05). The relationship between Functional Independence Measure and Sensoneck scores was not significant (P>0.05).

scholarly journals Action Observation Therapy for Upper Limb Recovery in Patients with Stroke: A Randomized Controlled Pilot Study

2021 ◽  
Vol 11 (3) ◽  
pp. 290
Author(s):  
Mauro Mancuso ◽  
Serena Di Tondo ◽  
Enza Costantini ◽  
Alessio Damora ◽  
Patrizio Sale ◽  
...  
Keyword(s):  
Upper Limb ◽  
Action Observation ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Motor Recovery ◽  
Control Group ◽  
Stroke Patients ◽  
Rehabilitative Treatment ◽  
Subacute Stroke ◽  
The Moment

Due to the complexity of the interventions for upper limb recovery, at the moment there is a lack of evidence regarding innovative and effective rehabilitative interventions. Action Observation Training (AOT) constitutes a promising rehabilitative method to improve upper limb motor recovery in stroke patients. The aim of the present study was to evaluate the potential efficacy of AOT, both in upper limb recovery and in functional outcomes when compared to patients treated with task oriented training (TOT). Both treatments were added to traditional rehabilitative treatment. Thirty-two acute stroke patients at 15.6 days (±8.3) from onset, with moderate to severe upper limb impairment at baseline following their first-ever stroke, were enrolled and randomized into two groups: 16 in the experimental group (EG) and 16 in the control group (CG). The EG underwent 30 min sessions of AOT, and the CG underwent 30 min sessions of TOT. All participants received 20 sessions of treatment for four consecutive weeks (five days/week). The Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Box and Block Test (BBT), Functional Independence Measure (FIM) and Modified Ashworth Scale (MAS) were administered at baseline (T0) and at the end of treatment (T1). No statistical differences were found at T0 for inclusion criteria between the CG and EG, whereas both groups improved significantly at T1. After the treatment period, the rehabilitative gain was greater in the EG compared to the CG for FMA-UE and FIM (all p < 0.05). Our results suggest that AOT can contribute to increased motor recovery in subacute stroke patients with moderate to severe upper limb impairment in the early phase after stroke. The improvements presented in this article, together with the lack of adverse events, confirm that the use of AOT should be broadened out to larger pools of subacute stroke patients.

scholarly journals Effects of Tele-Rehabilitation Compared with Home-Based in-Person Rehabilitation for Older Adult’s Function after Hip Fracture

2021 ◽  
Vol 18 (10) ◽  
pp. 5493
Author(s):  
Mariana Ortiz-Piña ◽  
Pablo Molina-Garcia ◽  
Pedro Femia ◽  
Maureen C. Ashe ◽  
Lydia Martín-Martín ◽  
...  
Keyword(s):  
Older Adults ◽  
Hip Fracture ◽  
Functional Recovery ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Control Group ◽  
Control Groups ◽  
Timed Up And Go ◽  
Home Based

This study aimed to examine the effect of a multidisciplinary tele-rehabilitation program on functional recovery of older adults with hip fracture compared with home-based in-person rehabilitation. In this single-blinded, non-randomized clinical trial, we included older with hip fracture. The tele-rehabilitation group received a 12-week tele-rehabilitation program (supervised by their family caregivers). The control group received the usual postoperative rehabilitation provided by the Andalusian health system (Spain). The primary outcome was the patient-reported functional status assessed with the Functional Independence Measure. We also measured performance-based functional recovery using the Timed Up and Go Test and Short Physical Performance Battery. We performed both a per-protocol (62 participants; 28 tele-rehabilitation and 34 control groups) and an intention-to-treat analysis (71 participants; 35 tele-rehabilitation and 36 control groups). Participants who used the tele-rehabilitation program had higher Functional Independence Measure scores (high effect size: 0.98 Cohen’s d; p < 0.001) and better performance in the Timed Up and Go Test (medium effect size: 0.63 Cohen’s d; p = 0.025) compared with the control group. Differences between groups post-intervention were not statistically significant in the Short Physical Performance Battery. The tele-rehabilitation intervention proposed in this study is a valuable treatment option in the recovery process for older adults with hip fracture. ClinicalTrials.gov Identifier: NCT02968589.

scholarly journals Does botulinum toxin improve the function of the patient with spasticity after stroke?

2007 ◽  
Vol 65 (3a) ◽  
pp. 592-595 ◽  
Author(s):  
Eduardo Cardoso ◽  
Glícia Pedreira ◽  
Antônio Prazeres ◽  
Nildo Ribeiro ◽  
Ailton Melo
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin Type A ◽  
Functional Independence Measure ◽  
Botulinum Toxin Type ◽  
Functional Independence ◽  
Functional Improvement ◽  
Stroke Patients ◽  
Early Management ◽  
Post Stroke ◽  
Upper Limb Function

Post-stroke spasticity is an important cause of disability in adults, due to muscle hyperactivity, which results in limb stiffness and muscle spasm. The prognosis for these patients depends on several features such as early management and adequate physical therapy to avoid muscle shortening, pain, and their consequences. Although several papers have shown that intramuscular injections of botulinum toxin type A (BT-A) decreases spasticity in post-stroke patients, few authors have demonstrated functional improvement after this therapy. In order to assess if individualized BT-A injections improves upper limb function in post-stroke spastic patients, we prospectively followed 20 consecutive patients of 18 years of age or more with spastic hemiparesis secondary to stroke. Fulg-Meyer scale modified for upper limbs, measure of functional independence (MFI), Ashworth modified scale, and goniometry were applied in the beginning of the investigation and in the 16th and 32nd weeks. BT-A was applied at baseline and in the 16th week. All subjects were submitted to rehabilitation therapy. All patients showed improvement according to Ashworth modified scale and increase in the range of motion, which were sustained until the 32nd week (p<0.05). The assessment of the first three parameters of the Fulg-Meyer scale and the evaluations of the motor part of the Functional Independence Measure showed statistically improvement until the end of the study. We conclude that proper choice of muscles and individualized doses of BT-A can improve function in selected post-stroke patients.

scholarly journals Effects of botulinum toxin type A for spastic foot in post-stroke patients enrolled in a rehabilitation program

2014 ◽  
Vol 72 (1) ◽  
pp. 28-32 ◽  
Author(s):  
Leonardo Halley Carvalho Pimentel ◽  
Francisco José Alencar ◽  
Leonardo Raphael Santos Rodrigues ◽  
Francisca Cléa Florenço de Sousa ◽  
João Batista Mendes Teles
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin Type A ◽  
Functional Independence Measure ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Gait Velocity ◽  
Stroke Patients ◽  
Hemiparetic Stroke

The objective of this study was to evaluate the effects of botulinum toxin type A (BTX-A) on spastic foot in stroke patients in a rehabilitation program. Method: Hemiparetic stroke patients (n=21) enrolled in a rehabilitation program were divided into two groups. The first group (n=11) received a total of 300UI BTX-A, and the second group (n=10) received 100 UI BTX-A. All patients were assessed at baseline and 2, 4, 8 and 12 weeks after injection for Modified Ashworth Score, time walking 10 meters, and the Functional Independence Measure (mFIM) motor score. Results: The higher-dose group exhibited a significant improvement in spasticity, and both groups showed an improvement in time walking 10 meters and mFIM, with no significant differences between them. Conclusions: Our findings suggest that gains in gait velocity and functional independence were not correlated to BTX-A dose.

scholarly journals Associated Mirror Therapy Enhances Motor Recovery of the Upper Extremity and Daily Function after Stroke: A Randomized Control Study

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Jin-Yang Zhuang ◽  
Li Ding ◽  
Bei-Bei Shu ◽  
Dan Chen ◽  
Jie Jia
Keyword(s):  
Upper Extremity ◽  
Controlled Trial ◽  
Motor Impairment ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Motor Recovery ◽  
Control Group ◽  
Mirror Therapy ◽  
Stroke Patients ◽  
Daily Function

Bimanual cooperation plays a vital role in functions of the upper extremity and daily activities. Based on the principle of bilateral movement, mirror therapy could provide bimanual cooperation training. However, conventional mirror therapy could not achieve the isolation of the mirror. A novel paradigm mirror therapy called associated mirror therapy (AMT) was proposed to achieve bimanual cooperation task-based mirror visual feedback isolating from the mirror. The study was aimed at exploring the feasibility and effectiveness of AMT on stroke patients. We conducted a single-blind, randomized controlled trial. Thirty-six eligible patients were equally assigned into the experimental group (EG) receiving AMT and the control group (CG) receiving bimanual training without mirroring for five days/week, lasting four weeks. The Fugl-Meyer Assessment Upper Limb subscale (FMA-UL) for upper extremity motor impairment was used as the primary outcome. The secondary outcomes were the Box and Block Test (BBT) and Functional Independence Measure (FIM) for motor and daily function. All patients participated in trials throughout without adverse events or side effects. The scores of FMA-UL and FIM improved significantly in both groups following the intervention. Compared to CG, the scores of FMA-UL and FIM were improved more significantly in EG after the intervention. The BBT scores were improved significantly for EG following the intervention, but no differences were found in the BBT scores of CG after the intervention. However, no differences in BBT scores were observed between the two groups. In summary, our study suggested that AMT was a feasible and practical approach to enhance the motor recovery of paretic arms and daily function in stroke patients. Furthermore, AMT may improve manual dexterity for poststroke rehabilitation.

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