Medicine and Health Sciences Commons^™

What Is Task-Oriented Training? A Scoping Review, Erin Halford, Samantha Jakubiszak, Kassidy Krug, Amanda Umphress

Student Journal of Occupational Therapy

Task-Oriented Training (TOT) is an proven stroke rehabilitation intervention with significant evidence-based research that supports its effectiveness. The absence of a clear definition has led to variability in research reporting and subsequent confusion with practical implementation. A consistent definition seeks to remedy this ambiguity to facilitate knowledge translation. The objective of this study was to determine a comprehensive definition of TOT that encapsulates previous definitions and descriptions in the literature. In order to derive this definition, a two stage scoping review process was conducted across four databases searching for articles on the use of TOT in adult stroke rehabilitation therapy. …

Examining The Delivery Mode Of Mental Practice In Reducing Hemiparesis: A Randomized Controlled Trial, Teresa M. Green, Nicole M. Fromm, Farida Sita Gayle, Jinna Lee, Wanyi Wang, Asha K. Vas

The Open Journal of Occupational Therapy

Background: Mental Practice (MP) is an effective intervention to address upper extremity (UE) hemiparesis post-stroke. However, parameters for the delivery mode of MP have not been defined. Therefore, this study's purpose was to define delivery mode parameters by comparing the effectiveness of audio-guided and video-guided MP.

Method: Eighteen participants, < 1-month post-stroke, with UE hemiparesis were randomized to a MP, repetitive task practice (RTP) or control group. The MP groups performed audio-guided or video-guided MP, 5x/week. The RTP group physically performed the functional tasks. The control group received traditional stroke rehabilitation. The Fugl-Meyer Assessment (FMA-UE) and Wolf Motor Function Test (WMFT) were used to assess change in UE hemiparesis.

Results: Wilcoxon signed-rank test demonstrated audio MP increased FMA-UE scores from pretest (Mdn = 34.0, Mean = 34.0, SD =9.56) to posttest (Mdn = 49.0, Mean = 49.6, SD =7.5), p = .042, r = .64. Similar improvement in FMA-UE scores was found with traditional therapy. Audio MP decreased WMFT …

Effects Of A Multi-Modal Gait Training Program In An Individual With Chronic Stroke: A Case Study, Anne Boddy, Lindsay A. Perry, Chitralakshmi K. Balasubramanian

Internet Journal of Allied Health Sciences and Practice

Purpose: Multi-modal gait training (MMGT) may improve impairments and functional limitations in individuals’ post-stroke. The purpose of this case study was to investigate effects of MMGT on gait and balance outcomes immediately post-intervention, 30-day short term (ST) and 1-year long term follow-up periods. Method: A 63-year-old patient, eight years post-stroke, participated in a MMGT program that included evidence-based gait interventions: unilateral treadmill training, inclined treadmill training at 8%, and over-ground fast walking. The eight sessions lasted 45-minutes each and consisted of the three interventions lasting 10-minutes each with rest breaks. Results: Self-selected (SS) and fastest comfortable gait speed revealed meaningful …

The Level Of Functionality Of The Affected Upper Limb In Stroke Patients Depends On The Type Of Therapy Used And The Lateralization Of The Subjects' Body - A Randomized Observational Study., Anna Olczak, Marcin Dornowski

Baltic Journal of Health and Physical Activity

Introduction: Impairment of the functions of the upper limb and hand is a major problem in stroke patients. The aim of the study was to evaluate various therapies in terms of their influence on changes in the activity of the affected, dominant, and non-dominant upper limb in patients after ischemic stroke. Material/Methods: This is a randomized, double-blinded study. The research was carried out in a rehabilitation clinic on a group of 60 stroke patients who were randomly assigned to groups differing in the rehabilitation program. The study group had physiotherapy based on the NDT Bobath concept and the control group …

Regaining Quality Of Life Painting Pet Portraits, Jennifer K. Fortuna

The Open Journal of Occupational Therapy

Tina Primer, an artist based in Illinois, provided the cover art for the Spring 2023 issue of The Open Journal of Occupational Therapy (OJOT). “Wriggly” is an 11” x 14” painting made from acrylic on stretched canvas. After a debilitating stroke, Tina began using art as therapy. When the strength in her dominant hand did not return, painting pet portraits provided the motivation to do things differently. Tina’s playful use of color and attention to detail capture each pet’s unique personality. Discovering a new way to paint improved Tina’s quality of life.

Experiences And Perspectives Of Filipino Patients With Stroke On Physical Therapy Telerehabilitation: A Phenomenological Study Protocol, Christopher G. Cruz, Donald S. Lipardo, Nicole Trizia S. Esplana, Beatrice Ann Q. Loa, Micah L. Dismaya, Janelle Meara Y. Lau, Mirzi Chelsea R. Quizzagan, Arianne B. Cardenas, Adellene Therese S. Celso, Hanz Lauren A. Taguinod, Kristian Joseph C. Martin, Leonardo S. Uy Iii

Philippine Journal of Physical Therapy

Introduction: Stroke is the third leading cause of death in the Philippines, so these patients must continuously undergo rehabilitation for faster recovery. With the rise of COVID-19, physical therapy (PT) telerehabilitation (TR) has emerged, where services are provided outside the usual rehabilitation setting for patients with stroke to continue their treatment while reducing the risk of acquiring COVID-19. However, it is a relatively new service in the country; hence, further research is needed to identify the factors and needs of these patients during TR, which may help improve PT TR services.

Objective: This study aims to explore the experiences …

Diagnosis And Treatment Of Stroke-Related Sarcopenia: A Narrative Reviewarticle, Szu-Han Chen, Tieh-Cheng Fu

Rehabilitation Practice and Science

Stroke patients have a high prevalence of sarcopenia due to the presence of several risk factors, including immobilization, impaired feeding, sympathetic activation, inflammation, and denervation. The occurrence of sarcopenia further exacerbates the disability caused by the stroke. Thus, appropriate diagnosis and intervention for sarcopenia is an important health issue for the stroke population. The article discusses the dilemma in diagnostic tests and potential treatment for stroke-related sarcopenia based on the currently available literature evidence.

Effect Of Playstation® Vr Sessions On Health-Related Quality Of Life And Motor Function In Stroke Patients Undergoing Inpatient Rehabilitation, Chien-Min Chen, Yi-Ching Huang, Kuan-Yu Kung, Yun-Chien Li, I-Lin Yen, Shih-Che Lin, Chu-Hsu Lin, Chia-Hung Lin

Rehabilitation Practice and Science

Background: Virtual Reality (VR) systems have been introduced for rehabilitation of stroke patients. Existing evidence regarding the effects of fully-immersive commercial games on health-related quality of life (HRQOL) and motor function in stroke patients is limited. Objective: To evaluate the efficacy of seven supplemental PlayStation® VR sessions on the HRQOL and motor function of stroke patients undergoing inpatient rehabilitation during a 16-day study period within the first year after stroke. Methods: A randomized, single-blind clinical trial with parallel groups (VR plus conventional therapy vs. conventional therapy) was carried out. For the assessment of outcome measures, the Stroke Impact Scale (SIS) …

Effectiveness And Predictors Of Home-Based Postacute Stroke Care, Yuan-Ting Lo, Wen-Chih Lin, Lin-Fu Lee, Willy Chou

Rehabilitation Practice and Science

Introduction: Stroke is the leading cause of disability in adults. In 2014, Taiwan's National Health Insurance Administration started to provide inpatient postacute care, and the results indicated that this model improves the overall functional status of patients with stroke. In 2017, home-based postacute stroke care was initiated; however, no study has evaluated its effectiveness. Therefore, we explored the functional recovery of patients with stroke after 6 weeks of postacute care at home and the factors that influenced their functional improvement. Method: We recruited patients with stroke who received a score of 3 or 4 on the modified Rankin Scale between …

The Influence Of Upper Limb Motor Function On The Activity Of Life And Quality Of Life In Stroke Patients, Wan-Ling Hsu, Chi-Tzu Feng, I-Shiang Tzeng

Rehabilitation Practice and Science

Objective: This study attempted to investigate the influence of upper limb motor function on activities of daily living(ADLs) and quality of life(QoL) in stroke patients. We also wanted to reveal whether a disparity exists in ADLs and QoL for patients with different upper limbs impairment. Methods: A total of 57 stroke patients (mean age=55.55±13.11 years old, onset time= 1.57±1.87 years) were analyzed in the study. Methods used to evaluate outcomes included Fugl-Meyer assessment (FMA) for assessing the motor function of upper limbs; functional independence measure (FIM) for assessing the independent of ADLs, and stoke impact scale (SIS) for evaluating the …

Efektivitas Balance Dan Core Exercise Untuk Meningkatkankeseimbangan Statis Pada Kasus Stroke Hemiparese Sinistra, Aditya Denny Pratama, Fatimah Fatimah, Mita Noviana, Riza Pahlawi

Jurnal Fisioterapi Terapan Indonesia or Indonesian Journal of Applied Physiotherapy

Stroke is a rapidly developing loss of brain function due to interruption of the blood supply to the brain. This can be caused by a blockage or bleeding in the blood vessels in the brain. The purpose of this study is to find out and understand how the effectiveness of balance and core exercise is to improve static balance in cases of left hemiparese stroke at Karmel Stroke Services. Of the various physiotherapy methods that can be done to overcome problems that can arise such as muscle weakness, balance disorders, posture disorders, and Activity Daily Living (ADL) disturbances in cases …

Studi Kasus Penatalaksanaan Terapi Okupasi Bersumberdayamasyarakat Dalam Aktivitas Memasak Pada Penderita Strokedi Desa Setisari, Hermito Gidion, Muhammad Luthfi, Dini Fajariani, Aditya Denny Pratama

Jurnal Fisioterapi Terapan Indonesia or Indonesian Journal of Applied Physiotherapy

Stroke is a health problem that affects a person's independence. Occupational therapists can carry out community-based occupational therapy (TOBM) in intervening in stroke patients. The aim of this intervention is to improve the patient's ability to cook from an occupational therapy perspective. In community service through TOBM, stroke patients in Siteari village were given an intervention for 1 month to assess an increase in independence in cooking. There are results that TOBM can increase patient independence in cooking.

Using Creative Making To Redesign Life After Stroke, Jennifer K. Fortuna

The Open Journal of Occupational Therapy

Kate Davies, a knitwear designer and author based in Scotland, provided the cover art for the Winter 2022 edition of the Open Journal of Occupational Therapy. “Balance for Better” is a blanket made from wool and mohair. The blanket consists of 30 individual squares designed and knitted by KDD & Co. employees. The colors and pattern of each square reflect the work, achievements, and legacy of the inspirational women celebrated in the blanket. At age 36, Kate suffered a near-fatal stroke that left her paralyzed on the left side of her body. Forced to give up her career as …

Therapeutic Efficacy Of Dynamic Hand Splints In Spastic Hemiparetic Hands: A Randomized Controlled Single-Blind Trial, Yi-Ching Huang, Shih-Che Lin, Kai-Hua Chen, Chien-Min Chen, Chia-Hao Chang, Chu-Hsu Lin

Rehabilitation Practice and Science

Background: It is usually challenging to treat patients following stroke or brain injury with spastic hemiparetic upper limbs. Dynamic hand splints have been used to manage this issue for years, but evidence of their efficacy is still lacking. Objective: To investigate the treatment efficacy of dynamic hand splinting in spastic hemiparetic patients. Methods: In this randomized controlled single-blind clinical trial, patients with spastic hemiparesis lasting more than half a year after a stroke or brain injury were enrolled. They were randomly divided into a splint group and a control group, and received 1 month of task-oriented training with or without …

Poststroke Swallowing Rehabilitation And Recent Development, Shu-Fen Sun, Ping-Hsin Chang, Chien-Wei Hsu, I-Hsiu Liou

Rehabilitation Practice and Science

Dysphagia is a common poststroke complication. It is associated with aspiration, malnutrition, dehydration, and disability, and it may increase the risk of pneumonia, and even death. Early diagnosis and treatment of patients with dysphagia reduces not only the aforementioned risks, but also the length of hospitalization and overall healthcare expenditures. Patients with poststroke oropharyngeal dysphagia exhibit highly variable patterns of swallowing abnormalities, and the related symptoms remain challenging to identify clinically. Patients who have experienced stroke should be screened for dysphagia as early as possible on admission and prior to any form of oral intake. Those who fail dysphagia screening …

The Effectiveness Of Occupation-Based Virtual Reality Intervention On Upper Extremity Functional Improvement In Post-Stroke Individuals: A Systematic Review, Darcy Bowman, Tiffani Suhm, Ann Marie Brown, Aubrey Barrett, Hannah Reilley

Student Journal of Occupational Therapy

Purpose: Virtual reality (VR)-based therapy is an emerging practice in the clinical setting and still requires research documenting its efficacy. This review analyzed the effectiveness of VR-based therapy on upper extremity (UE) motor recovery in individuals with chronic stroke by analyzing multiple randomized controlled trials.

Methods: Search limits for this review consisted of articles published between January 2010 and January 2020 and available in English. Search keywords were based on language in individual databases (e.g. stroke or cerebrovascular accident, upper extremity, occupational therapy). Articles were limited to include only randomized control trials consisting of adult patients (18+) with …

A Qualitative Study Investigating Stroke Survivors’ Perceptions Of Their Psychosocial Needs Being Met During Rehabilitation, Robin A. Wenzel, Emily A. Zgoda, Mia C. St. Clair, Lisa J. Knecht-Sabres

The Open Journal of Occupational Therapy

Background: Depression and anxiety can negatively impact one’s recovery, outcomes, and quality of life. Even though therapists consider the mental health needs of their clients to be a priority, they are dissatisfied with their ability to completely address these needs. The purpose of this study was to examine the client’s perspective regarding the extent to which health care professionals addressed their psychosocial needs after a stroke.

Method: A phenomenological research design was used to collect data from six participants. Interviews and focus group were audiotaped, transcribed verbatim, and thematically analyzed. Member checks, peer-review, multiple coders, triangulation, and expert …

A Systematic Reviewarticle On Discharge Destinations For Patients With Stroke, Lin-Fu Lee, Wen-Chih Lin, Willy Chou

Rehabilitation Practice and Science

Introduction: Complex and diverse factors affect the placement of patients with stroke after they are discharged from hospitals. In this study, a systematic reviewarticle of relevant literature was performed to compile related research data and explore the importance of individuals factors and the overall predictive power of multiple variables. Methods: Electronic resources from PubMed and the Cochrane Library were used along with keywords such as ＂stroke＂ and ＂discharge destination＂ to search for relevant articles published between 2005 and 2018. Only original research articles written in English were selected. Results: A total of 19 articles were selected to compile 10 factors, …

Effects Of An Anterior Ankle-Foot Orthosis On Static Standing Balance Control In Patients With Chronic Stroke Wearing The Orthosis For A Long Time, Min-Yuan Yu, Yu-Hsuan Tseng, Po-Chih Chen, Jen-Wen Hung

Rehabilitation Practice and Science

Aims: To investigate the effects of anterior ankle-foot orthosis (A-AFO) on static standing postural control in patients with chronic stroke wearing the A-AFO for a long time. Methods: We recruited patients with chronic stroke wearing an A-AFO for at least 5 months. Static standing balance control was evaluated using the Tetrax Balance System in eight positions: (1) eyes open on a solid surface [NO];(2) eyes closed on a solid surface [NC];(3) eyes open on a foam surface [PO];(4) eyes closed on a foam surface [PC];and head turned at 30° to (5) right [HR], (6) left [HL], (7) up [HB], and …

Kienböck's Disease In A Patient With Hemiparetic Stroke: A Casereport, Pao-Sheng Wu, Yen-Ting Cho

Rehabilitation Practice and Science

Kienböck's disease of the wrist is a multifactorial, progressive osteonecrosis of the lunate bone. Patients with this disease often complain of dorsal wrist pain and other wrist dysfunctions. Image studies are usually required for definite diagnosis; however, careful history taking and physical examination are also necessary. Treatment varies according to the stage of the disease; although surgery is needed in most of the cases, rehabilitation after the surgery seems helpful as well. Kienböck's disease is rarely seen in our daily practice, and even though we do recognize the disease, diagnosing it correctly in patients with comorbidities such as stroke is …

Assessing Unmet Needs Of Caregivers After Stroke: Occupational Therapist Practices And Perspectives, Deborah R. Clymer, Hadley A. Fields, Kathy Kniepmann

The Open Journal of Occupational Therapy

Background: Family caregivers of stroke survivors often feel unprepared and overwhelmed post discharge with numerous unmet needs. Occupational therapists can play an integral role in addressing family caregivers’ needs. Limited research exists on assessment practices of occupational therapists in identifying caregivers’ needs poststroke. This study explores the practices and perspectives of occupational therapists in assessing unmet caregivers’ needs.

Method: A cross-sectional, mixed methods research design was used to electronically survey 15 occupational therapists. Part 1 of the survey explored participant methods for identifying caregivers’ needs and their views on using formal caregiver assessment tools. Part 2 gathered participant perspectives on …

An Exploration Of Quality Of Life Contributors For Stroke Survivors: Potential Implications For Service Delivery Within The Community Rehabilitation Context, Gaylea Fritsch, Sarah Patterson, Anita Blight, Renaye Daniells

Internet Journal of Allied Health Sciences and Practice

Purpose: Community rehabilitation services typically assist stroke survivors with function, participation, and quality of life. Many factors have been found to influence the overall quality of life including self-identity, control, social supports, personality, and participation in valued activities. This review explored the possible contributing quality of life factors for stroke survivors within a community rehabilitation context to assist with further development of service delivery within this clinical area. Method: A purposive sample of clients with stroke (n=20) was selected based on their overall quality of life change during their rehabilitation program as measured on the World Health Organisation Quality of …

Determinants Of Stroke Inpatient Charge In Chronic Rehabilitation Wards Of A Community Hospital In Taiwan, Allen C.L. Hsu, Miao-Ming Chen, Chih-Kuang Chen

Rehabilitation Practice and Science

Stroke is a disease with severe consequences which impose a considerable socio-economic burden on patients and society. In developed countries, stroke patients alone generate about 3-4% of the direct costs within the healthcare system. The costs of rehabilitation and long-term care of disabled stroke survivors are expected to rise even further because of the increasing number of the aging population and declining stroke case-fatality rates. The aims of the paper are to evaluate the factors that may influence costs of stroke patients in chronic rehabilitation wards for better management of medical resources. This study was conducted at a local general …

Is Vertical Orientation Ability And Visual Feedback Training Strategy Useful For Pusher Syndrome After Stroke: A System Reviewarticle, Chien-Hsun Lee

Rehabilitation Practice and Science

Stroke patients with pusher syndrome (PS) have a longer recovery time than those without this disorder. This special syndrome causes difficulty in maintaining balance when sitting or standing, with sufferers ＂pushing and leaning＂ automatically to hemi-side. PS patients may also have cognition impairment, hemi-neglect, or aphasia. Alleviating all these factors requires extensive training for therapists, however, few undergo such training. Wang et. al. published a reviewarticle article in Taiwan Journal of Physical Medicine and Rehabilitation in 2005, and the conclusions drawn were: 1) PS patients have abnormal subjective posture and vertical orientation ability; 2) training strategies that use visual feedback …

A Focal Survey Of Medical Professionals' Conceptions Of Gastrostomy In Patients With Dysphagia After Stroke In Taiwan, Sheng-Hao Cheng, Yi-Ching Chen, Ming-Yen Hsiao, Tyng-Guey Wang

Rehabilitation Practice and Science

Background and aims: People with dysphagia may require long-term tube feeding to maintain adequate nutrition. In Taiwan, nasogastric (NG) tubes are more commonly used than gastrostomy tubes. This practice is inconsistent with international treatment guidelines. Medical professionals' attitudes toward treatment may influence patients' decisions. Therefore, we designed a questionnaire to assess whether medical professionals' conceptions of gastrostomy are consistent with current international treatment principles. Methods: We used an online questionnaire hosted on ＂Google Forms＂ to collect medical professionals' conceptions of gastrostomy. Societies related to dysphagia distributed copies of the questionnaire to their members. The professionals included specialists (physiatrists, otolaryngologists, oral …

Use Of Standardized Assessments And Online Resources In Stroke Rehabilitation, Susan H. Lin, Pamela R. Bosch, Veronica T. Rowe, Susan E. Fasoli, Jeanne Langan

The Open Journal of Occupational Therapy

Background: The extent to which movement-related standardized assessments and online resources are used in stroke rehabilitation is unclear in the United States.

Method: The researchers used a cross-sectional descriptive survey that examined (a) therapists use of movement-related standardized assessments, (b) factors influencing learning of new assessments, and (c) use of frequency of online resources by occupational therapists and physical therapists in the United States.

Results: Of 151 respondents (46.4% occupational therapists, 53.6% physical therapists), the most frequently used movement-related assessments by occupational and physical therapists were the Berg and Fugl-Meyer Assessment, respectively. More physical therapists use motor-related …

Low Income And Stroke Rehabilitation: A Tale Of Two Clients, Sarah Bernard, Katrine Sauvé-Schenk, Mary Egan

The Open Journal of Occupational Therapy

No abstract provided.

Development Of A Training Program To Increase Student Clinician Competency When Communicating With People With Aphasia, Meghan Doherty, Chevie Lay

Journal of Occupational Therapy Education

The Washington University in St. Louis Stroke Clinic is a student-run free clinic (SRSC) designed to enhance student learning and provide the community with no-cost evidence-based occupational therapy services. Aphasia is a common communication impairment after stroke that affects the ability to access services and give and get information, and impacts life participation and satisfaction. Conversation partner training is an evidence-based treatment approach to improve communication with people with aphasia (PWA). The purpose of this project was to develop and evaluate the effectiveness of student clinician training about communicating with PWA using conversation partner training in the SRSC. This study …

The Tailoring Of National Guidelines For Upper Extremity Post-Stroke Rehabilitation: A Concept In Use., Salem F. Alatawi

Internet Journal of Allied Health Sciences and Practice

Background: In Saudi Arabia, national evidence-based clinical guidelines (NCG) were created based for healthcare interventions. However, clinicians appear to be slow to incorporate the evidence into practice. As a result, there exists a time-gap between the gathering and presentation of evidence for best practice and the use of that evidence by clinicians. It becomes, therefore, imperative to investigate the gap between the research evidence and clinical practice. The knowledge to action (KTA) framework is available to facilitate the implementation of research evidence. This framework incorporates the theory of tailoring, a concept that is intended to create a fit between …

A Systematic Reviewarticle Of Turning Difficulties In Individuals With Stroke, Pei-Yi Chou, Shu-Chun Lee

Rehabilitation Practice and Science

Introduction: Making turn is a challenging task that is reported as one of the activities that most frequently leads to fall in stroke patients. Among community-dwelling older adults, hip fractures are eight times more likely to result from falls while making turns than from falls while walking straight. The stroke patients have asymmetric posture and movements due to hemiparesis, thus their turning performance may varied depending on the direction of the turn. Therefore, the purpose of this systematic reviewarticle was to summarize the characteristics of turning after stroke and discuss the possible neuromuscular mechanisms of turning difficulties. Methods: Searches of …