Usefulness of Goal Attainment Scaling in Intensive Stroke Rehabilitation During the Subacute Stage

Objective To investigate the usefulness of goal attainment scaling (GAS) in intensive stroke rehabilitation during the subacute stage.Methods Medical records of subacute post-stroke patients who had undergone intensive rehabilitation under hospitalization, before and after the application of GAS, were collected. GAS was conducted at the initial evaluation of each patient. Specific goals were suggested by physical and occupational therapists and were determined by the responsible physiatrist. A 5-point scale was used for the GAS score after 4 weeks of rehabilitation according to the preset criteria of each goal. To evaluate the influence of GAS in rehabilitation practice, functional improvements were compared between two patient groups before (n=121) and after (n=141) GAS. To assess progress in GAS practice, the standard GAS score was calculated, and the changes were observed over a 3-year period. The standard GAS score converged to 50 points when the goal was achieved. The therapists who used GAS also completed a survey regarding its usefulness.Results There were no statistical differences in the motor and cognitive outcomes of the patient groups before and after applying GAS scoring. Successive yearly changes in the standard GAS scores showed progressive convergence to 50 points, signaling that the patient’s goal-setting abilities improved. According to the survey, most therapists felt that GAS enhanced the quality of therapies (84.6%).Conclusion GAS improved goal-setting for the rehabilitation of subacute post-stroke patients and might have a positive effect on rehabilitation.

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Goal Setting and Goal Attainment Scaling in Child Neuropsychological Rehabilitation

Neuropsychological Rehabilitation of Childhood Brain Injury ◽

10.1057/9781137388223.0016 ◽

2015 ◽

Author(s):

Peter Tucker

Keyword(s):

Goal Setting ◽

Goal Attainment ◽

Goal Attainment Scaling ◽

Neuropsychological Rehabilitation

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Three Wheel Bike as Physical Therapy Equipment for Post-Stroke Patient

Applied Mechanics and Materials ◽

10.4028/www.scientific.net/amm.776.337 ◽

2015 ◽

Vol 776 ◽

pp. 337-342 ◽

Cited By ~ 1

Author(s):

I. Made Londen Batan ◽

Rodika ◽

Muhamad Riva'i

Keyword(s):

Body Mass Index ◽

Energy Consumption ◽

Physical Therapy ◽

Body Mass ◽

Stroke Patient ◽

Stroke Patients ◽

Post Stroke ◽

A Value ◽

Risk Of Injury ◽

Before And After

Three wheel bike as a physical therapy equipment for post-stroke patients was designed with length of 1937 mm, 1010 mm in width and height of 905 mm. The bike is designd ergonomic and can be driven by rider foot or hand simultaneously. By using CATIA software the strength of material bike frame was analyst to support 100 kg of load. The design is realized into a prototype. The performance of bike prototype is tested, and the result sows that the function of bike mechanisme is fulfilled. By 10 respondents, who have a standard body mass index, the pedal test was conducted, and the result indicates that, the higher the speed of the pedal, the higher the energy consumption to pedaling. Leg tension muscles is measured by leg-dynamometer before and after pedaling, and the result shows the tension muscle is proportional to the increase of pedal speed. In order to evaluate the ergonomic aspect of bike design, the risk angle of extrem position of body during cycling are measured by goneo-set. By RULA method the risk of injury value of rider body is calculated while pedaling, and the result showed that 70% of respondents have a value of risk injury 2, while 30% had a value of 3. It means that, the bike design is ergonomic and comfortable to ride. In oder to evaluate the benefits of disigned bike, the pedal test is conducted by 4 post-stroke patients for 30 days periodical once every 3 days. The result shows that during 1 month exercise, the average number of cycling to pedal increase up to 100%. This means that the ability of post-stroke patients to pedal the bike increase significantly. That result showed that the bike design is useful as a tool for physical therapy post-stroke patients.

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Role of d-serine in the beneficial effects of repetitive transcranial magnetic stimulation in post-stroke patients

Acta Neuropsychiatrica ◽

10.1017/neu.2020.4 ◽

2020 ◽

Vol 32 (3) ◽

pp. 128-134 ◽

Cited By ~ 1

Author(s):

Masachika Niimi ◽

Yuko Fujita ◽

Tamaki Ishima ◽

Kenji Hashimoto ◽

Nobuyuki Sasaki ◽

...

Keyword(s):

Amino Acids ◽

Transcranial Magnetic Stimulation ◽

Magnetic Stimulation ◽

Repetitive Transcranial Magnetic Stimulation ◽

Stroke Patients ◽

Post Stroke ◽

Beneficial Effects ◽

Depressed Patients ◽

Before And After ◽

The Impact

AbstractObjective:Abnormalities in neurotransmission via N-methyl-d-aspartic acid receptor (NMDAR) play a role in the pathophysiology of neuropsychiatric disorders. The impact of repetitive transcranial magnetic stimulation (rTMS) on NMDAR-related amino acids remains unknown. We aim to investigate the effects of rTMS on NMDAR-related amino acids in serum of post-stroke patients.Methods:Ninety-five consecutive post-stroke patients with upper limb hemiparesis were recruited. In 27 patients, the Beck Depression Inventory (BDI) score was 10 or higher. Twelve depressed patients underwent rehabilitation in combination with rTMS and 15 non-depressed patients underwent rehabilitation only without rTMS for 14 days. 1 Hz rTMS was applied to the primary motor area in the non-lesional hemisphere. BDI was conducted before and after treatment. Serum glutamine, glutamate, glycine, l-serine, and d-serine levels were measured before and after treatment.Results:There were no differences between depressed patients and non-depressed patients in clinical characteristics, levels of the five amino acids in serum, and the ratio of amino acids. However, in 27 depressed patients, there was a significant correlation between levels of glutamate in serum and BDI (ρ = 0.428, p = 0.026). BDI decreased significantly in depressed patients after treatment with or without rTMS. d-serine decreased in the rehabilitation with rTMS group, but increased in the rehabilitation without rTMS group. l-serine increased in the rehabilitation with rTMS group, but decreased in the rehabilitation without rTMS group.Conclusion:The results suggest that rTMS can modulate NMDAR-related amino acids in blood, producing beneficial effects.

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Strengthening the Planning Process of Motivational Interviewing Using Goal Attainment Scaling

Journal of Mental Health Counseling ◽

10.17744/mehc.39.3.02 ◽

2017 ◽

Vol 39 (3) ◽

pp. 195-210 ◽

Cited By ~ 3

Author(s):

Todd F. Lewis ◽

Mary F. Larson ◽

James S. Korcuska

Keyword(s):

Mental Health ◽

Motivational Interviewing ◽

Goal Setting ◽

Goal Attainment ◽

Planning Process ◽

Goal Attainment Scaling ◽

Clinical Tool ◽

Health Counseling ◽

Mental Health Settings

Client-centered, outcomes-based mental health counseling is driving the behavioral health field toward identifying mechanisms to facilitate specific, measurable goal setting and tracking with clients. Motivational interviewing (MI) is an evidence-based, collaborative, goal-oriented style of counseling; however, the fourth process of MI, planning, is not as well defined as the other MI processes, especially related to goal setting. Goal attainment scaling (GAS) is a method for setting measurable goals and assessing clinical progress. The combination of MI and GAS has potential to be a valuable clinical tool to establish client-centered goals, monitor goal attainment, and provide feedback within clinical mental health settings. Therefore, we propose that the MI planning process can be enhanced by incorporating GAS. However, research is needed to substantiate the feasibility of the proposed integration. A brief case study is provided to illustrate key concepts.

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Goal setting, using goal attainment scaling, as a method to identify patient selected items for measuring arm function

Physiotherapy ◽

10.1016/j.physio.2014.04.001 ◽

2015 ◽

Vol 101 (1) ◽

pp. 88-94 ◽

Cited By ~ 7

Author(s):

Stephen Ashford ◽

Diana Jackson ◽

Lynne Turner-Stokes

Keyword(s):

Goal Setting ◽

Goal Attainment ◽

Goal Attainment Scaling ◽

Arm Function

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The Effectiveness of Botulinum Toxin Type A (BoNT-A) Treatment in Brazilian Patients with Chronic Post-Stroke Spasticity: Results from the Observational, Multicenter, Prospective BCause Study

Toxins ◽

10.3390/toxins12120770 ◽

2020 ◽

Vol 12 (12) ◽

pp. 770

Author(s):

Patricia Khan ◽

Marcelo Riberto ◽

João Amaury Frances ◽

Regina Chueire ◽

Ana Cristina Ferreira Garcia Amorim ◽

...

Keyword(s):

Botulinum Toxin ◽

Lower Limb ◽

Goal Attainment ◽

Botulinum Toxin Type A ◽

Type A ◽

Botulinum Toxin Type ◽

Goal Attainment Scaling ◽

Post Stroke ◽

Baseline Visit ◽

Post Marketing

Botulinum toxin type A (BoNT-A) is an effective treatment for post-stroke spasticity; however, some patients cannot access treatment until ≥1 year post-stroke. This Brazilian post-marketing study (NCT02390206) assessed the achievement of person-centered goals in patients with chronic post-stroke spasticity after a BoNT-A injection. Patients had a last documented stroke ≥1 year before study entry and post-stroke upper limb (UL) spasticity, with or without lower limb (LL) spasticity. Patients received BoNT-A injections at baseline (visit 1) and visit 2 (3–6 months). Primary endpoint was responder rate (achievement of primary goal from Goal Attainment Scaling (GAS)) at visit 2. Overall, 204 patients underwent GAS evaluation at visit 2, mean (SD) age was 56.4 (13.2) years and 90.7% had LL spasticity. Median (range) time between first stroke and onset of spasticity was 3.6 (0−349) months, onset of spasticity and first injection was 22.7 (0−350) months and waiting time for a rehabilitation appointment was 9.0 (1−96) months. At visit 2, 61.3% (95% CI: 54.4, 67.7) of patients were responders, which was similar for UL and LL primary goals (57.8% [95% CI: 49.9, 65.3] vs. 64.1% [95% CI: 48.4, 77.3]). This study provides evidence to support the effectiveness of BoNT-A treatment for chronic post-stroke spasticity.

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A Positive Relationship between Cognitive Reserve and Cognitive Function after Stroke: Dynamic Proxies Correlate Better than Static Proxies

Journal of the International Neuropsychological Society ◽

10.1017/s1355617719000638 ◽

2019 ◽

Vol 25 (09) ◽

pp. 910-921 ◽

Cited By ~ 2

Author(s):

Macarena Gil-Pagés ◽

Rocío Sánchez-Carrión ◽

Jose M. Tormos ◽

Antonia Enseñat-Cantallops ◽

Alberto García-Molina

Keyword(s):

Cognitive Performance ◽

Brain Damage ◽

Cognitive Reserve ◽

Daily Life ◽

Stroke Patients ◽

Self Assessment ◽

Chronic Stage ◽

Post Stroke ◽

Before And After ◽

Mean Differences

AbstractObjectives: How brain damage after stroke is related to specific clinical manifestation and recovery is incompletely understood. We studied cognitive reserve (CR) in stroke patients by two types of measurements: (i) objectively verifiable static proxies (i.e., education, occupational attainment), and (ii) subjective, dynamic proxies based on patient testimony in response to a questionnaire. We hypothesized that one or both of these types of CR measurements might correlate positively with patient cognitive performance during the post-acute and chronic phases of recovery. Method: Thirty-four stroke patients underwent neuropsychological assessment at 2, 6 and 24 months after stroke onset. In chronic stage at 24+ months, self-rating assessments of cognitive performance in daily life and social integration were obtained. CR before and after stroke was estimated using static proxies and dynamic proxies were obtained using the Cognitive Reserve Scale (CRS-Pre-stroke, CRS-Post-stroke). Results: CRS-Pre-stroke and CRS-Post-stroke showed significant mean differences. Dynamic proxies showed positive correlation with self-assessment of attention, metacognition, and functional ability in chronic stage. In contrast, significant correlations between static proxies and cognitive recovery were not found. Conclusions: Dynamic proxies of CR were positively correlated with patients’ perception of their functional abilities in daily life. To best guide cognitive prognosis and treatment, we propose that dynamic proxies of CR should be included in neuropsychological assessments of patients with brain damage.

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