The Effect of Rehabilitation Motivation and Medical Staff Support on Self-care Activities in Stroke Patients with Rehabilitation Therapy

2021 ◽  
Vol 24 (1) ◽  
pp. 25-33
Author(s):  
Haet Nim Jeong ◽  
Yu Mi Lee
Keyword(s):  
Medical Staff ◽  
Self Care ◽  
Stroke Patients ◽  
Staff Support ◽  
Rehabilitation Therapy

scholarly journals Automatic Grading of Stroke Symptoms for Rapid Assessment Using Optimized Machine Learning and 4-Limb Kinematics: Clinical Validation Study (Preprint)

2020 ◽  
Author(s):  
Eunjeong Park ◽  
Kijeong Lee ◽  
Taehwa Han ◽  
Hyo Suk Nam
Keyword(s):  
Machine Learning ◽  
Medical Staff ◽  
Machine Learning Algorithms ◽  
Training Data ◽  
Support Vector ◽  
Grading System ◽  
Operating Characteristics ◽  
Stroke Patients ◽  
Motor Weakness ◽  
Automatic Grading

BACKGROUND Subtle abnormal motor signs are indications of serious neurological diseases. Although neurological deficits require fast initiation of treatment in a restricted time, it is difficult for nonspecialists to detect and objectively assess the symptoms. In the clinical environment, diagnoses and decisions are based on clinical grading methods, including the National Institutes of Health Stroke Scale (NIHSS) score or the Medical Research Council (MRC) score, which have been used to measure motor weakness. Objective grading in various environments is necessitated for consistent agreement among patients, caregivers, paramedics, and medical staff to facilitate rapid diagnoses and dispatches to appropriate medical centers. OBJECTIVE In this study, we aimed to develop an autonomous grading system for stroke patients. We investigated the feasibility of our new system to assess motor weakness and grade NIHSS and MRC scores of 4 limbs, similar to the clinical examinations performed by medical staff. METHODS We implemented an automatic grading system composed of a measuring unit with wearable sensors and a grading unit with optimized machine learning. Inertial sensors were attached to measure subtle weaknesses caused by paralysis of upper and lower limbs. We collected 60 instances of data with kinematic features of motor disorders from neurological examination and demographic information of stroke patients with NIHSS 0 or 1 and MRC 7, 8, or 9 grades in a stroke unit. Training data with 240 instances were generated using a synthetic minority oversampling technique to complement the imbalanced number of data between classes and low number of training data. We trained 2 representative machine learning algorithms, an ensemble and a support vector machine (SVM), to implement auto-NIHSS and auto-MRC grading. The optimized algorithms performed a 5-fold cross-validation and were searched by Bayes optimization in 30 trials. The trained model was tested with the 60 original hold-out instances for performance evaluation in accuracy, sensitivity, specificity, and area under the receiver operating characteristics curve (AUC). RESULTS The proposed system can grade NIHSS scores with an accuracy of 83.3% and an AUC of 0.912 using an optimized ensemble algorithm, and it can grade with an accuracy of 80.0% and an AUC of 0.860 using an optimized SVM algorithm. The auto-MRC grading achieved an accuracy of 76.7% and a mean AUC of 0.870 in SVM classification and an accuracy of 78.3% and a mean AUC of 0.877 in ensemble classification. CONCLUSIONS The automatic grading system quantifies proximal weakness in real time and assesses symptoms through automatic grading. The pilot outcomes demonstrated the feasibility of remote monitoring of motor weakness caused by stroke. The system can facilitate consistent grading with instant assessment and expedite dispatches to appropriate hospitals and treatment initiation by sharing auto-MRC and auto-NIHSS scores between prehospital and hospital responses as an objective observation.

Abstract 2303: Therapeutic Intensity and Functional Gains of Stroke Patients during Inpatient Rehabilitation.

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Hua Wang ◽  
Michelle Camicia ◽  
Joseph Terdiman ◽  
Murali K Mannava ◽  
M E Sandel
Keyword(s):  
Functional Outcomes ◽  
Inpatient Rehabilitation ◽  
Functional Improvement ◽  
Stroke Patients ◽  
Rehabilitation Therapy ◽  
The Mean ◽  
Total Therapy ◽  
Therapeutic Intensity ◽  
Functional Gain ◽  
Functional Gains

Objectives: To study the effects of therapeutic intensity on functional gains of stroke patients in inpatient rehabilitation. Design: A retrospective cohort study. Setting: An inpatient rehabilitation hospital (IRH) in northern California. Participants: Three hundred and sixty stroke patients discharged from the IRH in 2007. Interventions: Average number of minutes of rehabilitation therapy per day, including physical therapy (PT), occupation therapy (OT), speech language therapy (SLT), and total treatment. Main Outcome Measures: Functional gain measured by the Functional Independence Measure (FIM TM ), including activities of daily living (ADL), mobility, cognition, and total FIM TM scores. Results: The study sample had a mean age of 64.8 years (SD=13.8), and was 57.4% male, and 61.4% White. About three quarter of the patients had an ischemic stroke; 61.4% had one or more significant comorbid conditions. Median IRH length-of-stay (LOS) was 20 days. The mean total therapy time was 190.3 minutes per day (PT 114.0, OT 42.8, and SLT 33.8). The mean total functional gain was 26.0 (ADL 9.1, mobility 11.4, and cognition 6.2). A longer therapeutic duration per day was significantly associated with functional improvement (r=0.20, p<.001). However, patients who received total therapy time of less than 3 hours per day showed significantly lower total functional gain than those treated 3 hours or longer. There was no significant difference in total functional gain between patients treated 3-3.5 hours and over 3.5 hours per day. Intensity of PT, OT, and SLT in hours per day of treatment time was also significantly associated with corresponding sub-scale functional improvements. Figure 1 presents age and gender adjusted therapeutic intensity and FIM TM Gain. Multiple linear regression analyses showed that young age, hemorrhagic stroke, earlier admission to IRH, and longer IRH stay were independent predictors of functional improvement. Conclusions: The study demonstrated a significant relationship between therapeutic intensity and functional gain during IRH stay and provides evidence of treatment intensity thresholds for optimal functional outcomes for stroke patients in inpatient rehabilitation. Key Words: Stroke, rehabilitation therapy, intensity, functional outcomes.

Study on Nursing Effect of Individualized Health Education Combined with Cognitive Training in Elderly Stroke Patients

2021 ◽  
Vol 7 (5) ◽  
pp. 3168-3173
Author(s):  
NING Min ◽  
ZENG Hui
Keyword(s):  
Job Satisfaction ◽  
Health Education ◽  
Cognitive Training ◽  
Daily Life ◽  
Self Care ◽  
Control Group ◽  
Stroke Patients ◽  
Routine Treatment ◽  
Experimental Group

Objective To study the nursing effect of individualized health education combined with cognitive training in elderly stroke patients. Methods 112 elderly stroke patients treated in the Department of Neurology of our hospital from January to June 2017 were randomly divided into experimental group and control group. In the control group, routine treatment, nursing and rehabilitation exercises were carried out, and regular health education was carried out. The experimental group, on the basis of routine treatment, nursing and rehabilitation exercise, carried out individualized health education and cognitive training combining the content of individualized health education. The effect of intervention was evaluated by Montreal Cognitive Assessment Scale (MoCA), health education questionnaire, daily life self-care scale (ADL) and nurse job satisfaction questionnaire before intervention, at the end of intervention for 4 weeks and at the end of intervention for 12 weeks. Results At the end of 4th and 12th week after intervention, the scores o MoCA, the awareness rate of health education, ADL and job satisfaction of nurses were higher than those before intervention, and the observation group was higher than that of the control group (P<0.05), with statistical difference (P<0.05). Conclusion Individualized health education combined with cognitive training can effectively improve the patients’ cognitive function, improve the patients’ awareness of stroke disease and the compliance of health education, improve the patients’ self-care ability in daily life and the satisfaction of nursing work, so as to improve the patients’ quality of life and quality of living.

Abstract TMP99: Farmalarm: App for Mobile Devices Improves Risk Factor Control After Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Marc Ribo ◽  
Estefania montiel ◽  
Estela Sanjuan ◽  
Mireia Sanchis ◽  
Marta Rubiera ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Medical Staff ◽  
Healthy Lifestyle ◽  
Medication Compliance ◽  
Treatment Compliance ◽  
Lifestyle Changes ◽  
Stroke Patients ◽  
Risk Factor Control ◽  
Stroke Awareness

Risk factor control and treatment compliance in the following months after stroke are often poor. We aim to validate a digital platform for smartphones designed to raise awareness in patients about the need to perform healthy lifestyle changes, improve communication with medical staff and increase treatment compliance Methods: Farmalarm is an app for smartphones designed to increase stroke awareness by: medication visual alerts and compliance control, chat communication with medical staff, sharing didactic video files, exercise monitoring... Stroke patients discharged home were screened for participation and divided in two groups: to follow the FARMALARM program during 3-4 weeks or standard of care follow-up. We determined risk factor control goals at 90 days in all patients Results: During 16 months, from the 457 patients discharged home, 126 (27.6%) were included in the study: Farmalarm n=74; age 57±12, Control n=52, age 59±10. There were no significant differences in baseline characteristics between groups. Patients in Farmalarm group followed the program for 23±6 days after discharge. In Farmalarm group, mean number alarms due to medication intake failure dropped from 68.5% in the first week to 44.6% in the third week (p=0.03). At 90 days, achievement of risk factor control was higher in the FARMALARM group (table). The rate of patients with 4/4 risk factors under control was higher in the FARMALARM group (45.3% Vs 22.5%; p=0.02) (graph) and less patients dropped all medications at 3 months in the Farmalarm group (1.5% Vs 8.16%:p=0.05). A regression model adjusted for age and gender showed that the only variable independently associated with all risk factors under control at 90 days was the use of Farmalarm (OR: 4.7; 95% CI:1.1-6.9;p=0.03). Conclusion: In stroke patients discharged home the use of mobile applications to monitor medication compliance and increase stroke awareness is feasible and seems to improve the control of vascular risk factors.

scholarly journals Effect of implementing designed educational training program for neurological nurses on clinical outcomes of stroke patients

2018 ◽  
Vol 6 (4) ◽  
pp. 121 ◽  
Author(s):  
Seham A. Abd El-Hay ◽  
Amany K. Abed Allah ◽  
El Sayed A. Tag El Din
Keyword(s):  
Activities Of Daily Living ◽  
Training Program ◽  
Clinical Outcomes ◽  
Daily Living ◽  
Self Care ◽  
Educational Training ◽  
Stroke Patients ◽  
Knowledge And Practice ◽  
Educational Training Program ◽  
Nurses Knowledge

Background: Stroke is a major cause of functional disability, it increased the need for continuous nursing care. Nurses need to pay attention not only to the physical recovery after stroke, but also to the psychological and social recovery. Therefore, it is important to provide training courses to nurses about care of stroke patients.Aim: This study was conducted to evaluate the effect of implementing designed educational training program for neurological nurses on clinical outcomes of stroke patients.Methods: Design: A quasi experimental research design was utilized. Setting: Data were collected from Neurological Intensive Care Units, Wards and Neurological outpatient clinics of Tanta Main University Hospital. Sample: All nurses (n = 35) who are providing direct care for stroke patients and a purposive sample of 30 stroke patients. Tools: Three tools were used to collect data. Tool (I): Assessment of nurses’ knowledge questionnaire sheet about stroke; Tool (II): Observational checklist to evaluate nurses’ practice regarding care of stroke patients; and Tool (III): Patient’s clinical outcomes assessment sheet.Results: The results revealed that there were significant improvements in nurses’ knowledge and practice regarding care of stroke patients post training program at p < .01. Also, significant improvements in self-care and activities of daily living among stroke patients were observed from immediately to 2 months later post application of training program.Conclusions: The study findings revealed that the implementation of designed educational training program within 2 months were successful for improving nurses’ knowledge and practice regarding care of stroke patients. Furthermore, there was improvement in activities of daily living and self-care among stroke patients.Recommendations: It is recommended to generalize implementation of designed educational training program for neurological nurses as a routine hospital care for stroke patients.

Self-care in Preserving the Vascular Network: Old Problem, New Challenge for the Medical Staff

2018 ◽  
Vol 22 (4) ◽  
pp. 332-336
Author(s):  
Clemente N Sousa ◽  
Inês Ligeiro ◽  
Paulo Teles ◽  
Lúcia Paixão ◽  
Vanessa FF Dias ◽  
...  
Keyword(s):  
Medical Staff ◽  
Self Care ◽  
Vascular Network

Adopting Literature-based Discovery on Rehabilitation Therapy Repositioning for Stroke

2018 ◽  
Author(s):  
Guilin Meng ◽  
Yong Huang ◽  
Qi Yu ◽  
Ying Ding ◽  
David Wild ◽  
...  
Keyword(s):  
Text Mining ◽  
Upper Limb ◽  
Clinical Validation ◽  
Abc Model ◽  
Stroke Patients ◽  
Limb Function ◽  
Rehabilitation Therapy ◽  
Upper Limb Function ◽  
Literature Based Discovery ◽  
Assessment Scales

AbstractStroke is a common disabling disease severely affecting the daily life of the patients. There is evidence that rehabilitation therapy can improve the movement function. However, there are no clear guidelines that identify specific, effective rehabilitation therapy schemes, and the development of new rehabilitation techniques has been fairly slow. One informatics translational approach, called ABC model in Literature-based Discovery, was used to mine an existing rehabilitation candidate which is most likely to be repositioned for stroke. As in the classic ABC model originated from Don Swanson, we built the internal links of stroke (A), assessment scales (B), rehabilitation therapies (C) in PubMed relating to upper limb function measurements for stroke patients. In the first step, with E-utility we retrieved both stroke related assessment scales and rehabilitation therapies records, and complied two datasets called Stroke_Scales and Stroke_Therapies, respectively. In the next step, we crawled all rehabilitation therapies co-occurred with the Stroke_Theapies, named as All_Therapies. Therapies that were already included in Stroke_Therapies were deleted from All_Therapies, so that the remaining therapies were the potential rehabilitation therapies, which could be repositioned for stroke after subsequent filtration by manual check. We identified the top ranked repositioning rehabilitation therapy following by subsequent clinical validation. Hand-arm bimanual intensive training (HABIT) ranked the first in our repositioning rehabilitation therapies list, with the most interaction links with Stroke_Scales. HABIT showed a significant improvement in clinical scores on assessment scales of Fugl-Meyer Assessment and Action Research Arm Test in the clinical validation on upper limb function for acute stroke patients. Based on the ABC model and clinical validation of the results, we put forward that HABIT as a promising rehabilitation therapy for stroke, which shows that the ABC model is an effective text mining approach for rehabilitation therapy repositioning. The results seem to be promoted in clinical knowledge discovery.Author SummaryIn the present study, we proposed a text mining approach to mining terms related to disease, rehabilitation therapy, and assessment scale from literature, with a subsequent ABC inference analysis to identify relationships of these terms across publications. The clinical validation demonstrated that our approach can be used to identify potential repositioning rehabilitation therapy strategies for stroke. Specifically, we identified a promising rehabilitation method called HABIT previously used in pediatric congenital hemiplegia. A subsequent clinical trial confirmed this as a highly promising rehabilitation therapy for stroke.

scholarly journals Longitudinal Brain Functional Connectivity Changes of the Cortical Motor-Related Network in Subcortical Stroke Patients with Acupuncture Treatment

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Yongxin Li ◽  
Ya Wang ◽  
Chenxi Liao ◽  
Wenhua Huang ◽  
Ping Wu
Keyword(s):  
Functional Connectivity ◽  
Western Medicine ◽  
Primary Motor Cortex ◽  
Brain Connectivity ◽  
Effective Means ◽  
Brain Network ◽  
Stroke Patients ◽  
Rehabilitation Therapy ◽  
Cortical Motor ◽  
Before And After

In clinical practice, the effectiveness of the rehabilitation therapy such as acupuncture combining conventional Western medicine (AG) on stroke people’s motor-related brain network and their behaviors has not been systematically studied. In the present study, seventeen adult ischemic patients were collected and divided into two groups: the conventional Western medicine treatment group (CG) and the AG. The neurological deficit scores (NDS) and resting-state functional MRI data were collected before and after treatment. Compared with the CG patients, AG patients exhibited a significant enhancement of the percent changes of NDS from pre- to posttreatment intervention. All patients showed significant changes of functional connectivity (FC) between the pair of cortical motor-related regions. After treatment, both patient groups showed a recovery of brain connectivity to the nearly normal level compared with the controls in these pairs. Moreover, a significant correlation between the percent changes of NDS and the pretreatment FC values of bilateral primary motor cortex (M1) in all patients was found. In conclusion, our results showed that AG therapy can be an effective means for ischemic stroke patients to recover their motor function ability. The FC strengths between bilateral M1 of stroke patients can predict stroke patients’ treatment outcome after rehabilitation therapy.

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