Medicine and Health Sciences Commons^™

Comprehensive Quality Assessment For Aphasia Rehabilitation After Stroke: Protocol For A Multicentre, Mixed-Methods Study, Sam Harvey, Marissa Stone, Sally Zingelman, David A. Copland, Monique F. Kilkenny, Erin Godecke, Dominique A. Cadilhac, Joosup Kim, Muideen T. Olaiya, Miranda L. Rose, Caterina Breitenstein, Kirstine Shrubsole, Robyn O'Halloran, Annie J. Hill, Deborah Hersh, Kathryn Mainstone, Penelope Mainstone, Carolyn A. Unsworth, Emily Brogan, Kylie J. Short, Clare L. Burns, Caroline Baker, Sarah J. Wallace

Research outputs 2022 to 2026

INTRODUCTION: People with aphasia following stroke experience disproportionally poor outcomes, yet there is no comprehensive approach to measuring the quality of aphasia services. The Meaningful Evaluation of Aphasia SeRvicES (MEASuRES) minimum dataset was developed in partnership with people with lived experience of aphasia, clinicians and researchers to address this gap. It comprises sociodemographic characteristics, quality indicators, treatment descriptors and outcome measurement instruments. We present a protocol to pilot the MEASuRES minimum dataset in clinical practice, describe the factors that hinder or support implementation and determine meaningful thresholds of clinical change for core outcome measurement instruments. METHODS AND ANALYSIS: This research …

Remnant Cholesterol Traits And Risk Of Stroke: A Multivariable Mendelian Randomization Study, Zhiyuan Wu, Yue Jiang, Zheng Guo, Pingan Li, Yulu Zheng, Yutao Wang, Haiping Zhang, Lois Balmer, Xingang Li, Lixin Tao, Qi Zhang, Bo Gao, Xiuhua Guo

Research outputs 2022 to 2026

Observational epidemiological studies have reported a relationship between remnant cholesterol and stroke. However, the results are inconclusive, and causality remains unclear due to confounding or reverse causality. Our objective in this study was to investigate the causal relevance of remnant cholesterol and the risk of stroke and its subtypes using the Mendelian randomization (MR) approach. Genome-wide association studies (GWASs) including 115,082 European individuals (UK Biobank) were used to identify instruments for remnant cholesterol, including intermediate-density lipoprotein (IDL) cholesterol and very-low-density lipoprotein (VLDL) cholesterol. Summary-level data for total stroke, intracerebral hemorrhage, subarachnoid hemorrhage, ischemic stroke (IS), and IS subtypes were obtained …

Criteria And Indicators For Centers Of Clinical Excellence In Stroke Recovery And Rehabilitation: A Global Consensus Facilitated By Isrra, Rachel C. Stockley, Marion F. Walker, Margit A. Murphy, Noor A. A. Aziz, Philemon Amooba, Leonid Churliov, Amanda Farrin, Natalie A. Fini, Emma Ghaziani, Erin Godecke, Tania Gutierrez-Panchana, Jie Jia, Thoshenthri Kandasamy, Patrice Lindsay, John Solomon, Vincent Thijs, Tierney Tindall, Donna C. Tippett, Caroline Watkins, Elizabeth Lynch

Research outputs 2022 to 2026

Background: The aim of the International Stroke Recovery and Rehabilitation Alliance is to create a world where worldwide collaboration brings major breakthroughs for the millions of people living with stroke. A key pillar of this work is to define globally relevant criteria for centers that aspire to deliver excellent clinical rehabilitation and generate exceptional outcomes for patients. Objectives: This paper presents consensus work conducted with an international group of expert stroke recovery and rehabilitation researchers, clinicians, and people living with stroke to identify and define criteria and measurable indicators for Centers of Clinical Excellence (CoCE) in stroke recovery and rehabilitation. …

Electric Field Navigated 1-Hz Rtms For Poststroke Motor Recovery: The E-Fit Randomized Controlled Trial, Dylan J. Edwards, Charles Liu, Kari Dunning, Felipe Fregni, Jarmo Laine, Benjamin E. Leiby, Lynn M. Rogers, Richard L. Harvey

Research outputs 2022 to 2026

BACKGROUND: To determine if low-frequency repetitive transcranial magnetic stimulation targeting the primary motor cortex contralateral (M1CL) to the affected corticospinal tract in patients with hemiparetic stroke augments intensive training-related clinical improvement; an extension of the NICHE trial (Navigated Inhibitory rTMS to Contralesional Hemisphere Trial) using an alternative sham coil. METHODS: The present E-FIT trial (Electric Field Navigated 1Hz rTMS for Post-stroke Motor Recovery Trial) included 5 of 12 NICHE trial outpatient US rehabilitation centers. The stimulation protocol remained identical (1 Hz repetitive transcranial magnetic stimulation, M1CL, preceding 60-minute therapy, 18 sessions/6 wks; parallel arm randomized clinical trial). The sham coil …

Calcium Supplements And Risk Of Cvd: A Meta-Analysis Of Randomized Trials, Xiqian Huo, Robert Clarke, Jim Halsey, Rebecca Jackson, Amy Lehman, Richard Prince, Joshua Lewis, John A. Baron, Heikki Kroger, Reijo Sund, Jane Armitage

Research outputs 2022 to 2026

Background: Vitamin D supplements may only be beneficial for the prevention of osteoporotic fractures when administered with calcium and in individuals with low blood levels of 25(OH)D, but possible hazards of calcium supplements on CVD cannot be excluded. Objectives: We conducted a meta-analysis of all placebo-controlled randomized trials assessing the effects of calcium supplements alone or with vitamin D on CHD, stroke, and all-cause mortality. Methods: A meta-analysis of 11 trials included 7 comparisons of calcium alone compared with control (n = 8634) and 6 comparisons of calcium plus vitamin D compared with control (n = 46,804). Aggregated study-level data …

Treatment Integrity And Differentiation In The Very Early Rehabilitation In Speech (Verse) Trial, Emily Brogan, Natalie Ciccone, Erin Godecke

Research outputs 2014 to 2021

Background:

Key elements of treatment fidelity include treatment integrity (adherence to the treatment protocol) and treatment differentiation (the difference in treatment ingredients in the control and intervention groups). The Very Early Rehabilitation in SpEech (VERSE) trial established treatment fidelity at the macro level for key components of therapy.

Aims:

To complete a detailed analysis of treatment integrity and differentiation at the utterance level of a therapeutic interaction.

Methods:

This was an observational study of therapy videos collected as part of the VERSE trial. Participants were people with aphasia in the very early phase of recovery post stroke (n = 44) …

The Effects Of Cognitive-Linguistic Interventions To Treat Aphasia In The First 90 Days Post-Stroke: A Systematic Review, Emily Eley, Maayken Van Den Berg, Miranda L. Rose, John E. Pierce, Abby Foster, Edwina Lamborn, Sarah D’Souza, Erin Godecke, Lucette Lanyon, Ciara Shiggins, Ian Kneebone, Caroline Baker

Research outputs 2022 to 2026

Background: Cognitive-linguistic interventions for aphasia are behavioural-based approaches to therapy that aim to treat language impairment skills post-acquired brain injury. The purpose of cognitive-linguistic intervention is to restore and rehabilitate language impairment skills through targeting phonologic, semantic and syntactic systems, which may support goals to improve everyday communication. Aims: The aim of this systematic review was to investigate the effects of cognitive-linguistic interventions on language processing for aphasia in the first 90 days post-stroke. Secondary aims include the investigation of the effects of these interventions on functional communication and quality of life. Methods: A systematic search was conducted across six …

An Updated Systematic Review Of Stroke Clinical Practice Guidelines To Inform Aphasia Management, Bridget Burton, Megan Isaacs, Emily Brogan, Kirstine Shrubsole, Monique F. Kilkenny, Emma Power, Erin Godecke, Dominique A. Cadilhac, David Copland, Sarah J. Wallace

Research outputs 2022 to 2026

Background: Aphasia is a common consequence of stroke, and people who live with this condition experience poor outcomes. Adherence to clinical practice guidelines can promote high-quality service delivery and optimize patient outcomes. However, there are currently no high-quality guidelines specific to post-stroke aphasia management. Aims: To identify and evaluate recommendations from high-quality stroke guidelines that can inform aphasia management. Summary of review: We conducted an updated systematic review in accordance with PRISMA guidelines to identify high-quality clinical guidelines published between January 2015 and October 2022. Primary searches were performed using electronic databases: PubMed, EMBASE, CINAHL, and Web of Science. Gray …

Treatment Fidelity Monitoring, Reporting And Findings In A Complex Aphasia Intervention Trial: A Substudy Of The Very Early Rehabilitation In Speech (Verse) Trial, Erin Godecke, Emily Brogan, Natalie Ciccone, Miranda L. Rose, Elizabeth Armstrong, Anne Whitworth, Fiona Ellery, Audrey Holland, Sandy Middleton, Tapan Rai, Graeme J. Hankey, Dominique Cadilhac, Julie Bernhardt

Research outputs 2022 to 2026

Background: Treatment fidelity is inconsistently reported in aphasia research, contributing to uncertainty about the effectiveness of types of aphasia therapy following stroke. We outline the processes and outcomes of treatment fidelity monitoring in a pre-specified secondary analysis of the VERSE trial. Methods: VERSE was a 3-arm, single-blinded RCT with a 12-week primary endpoint comparing Usual Care (UC) to two higher intensity treatments: Usual Care-Plus (UC-Plus) and VERSE, a prescribed intervention. Primary outcome results were previously reported. This secondary analysis focused on treatment fidelity. Video-recorded treatment sessions in the higher intensity study arms were evaluated for treatment adherence and treatment differentiation. …

A Tailored Occupational Therapist-Led Vocational Intervention For People With Stroke: Protocol For A Pilot Randomized Controlled Trial, Sophie O'Keefe, Kathryn Radford, Amanda Farrin, Jodi Oakman, Serena Alves-Stein, Geoffrey Cloud, Jacinta Douglas, Mandy Stanley, Natasha A. Lannin

Research outputs 2022 to 2026

Background: Resuming work after stroke is a common goal of working-age adults, yet there are few vocational rehabilitation programs designed to address the unique challenges faced following stroke. The Work intervention was developed to address these gaps. Objective: This paper presents a protocol that outlines the steps that will be undertaken to pilot both the intervention and trial processes for the Work trial. Methods: The Work trial is a 2-arm, prospective, randomized, blinded-assessor study with intention-to-treat analysis. A total of 54 adults of working age who have experienced a stroke <4 months prior will be randomized 1:1 to either (1) an experimental group who will receive a 12-week early vocational intervention (Work intervention) plus usual clinical rehabilitation or (2) a control group who will receive only their usual clinical rehabilitation. Results: Outcomes include study and intervention feasibility and intervention benefit. In addition to evaluating the feasibility of delivering vocational intervention early after stroke, benefit will be assessed by measuring rates of vocational participation and quality-of-life improvements at the 3- and 6-month follow-ups. Process evaluation using data collected during the study, as well as postintervention individual interviews with participants and surveys with trial therapists, will complement quantitative data. Conclusions: The results of the trial will provide details on the feasibility of delivering the Work intervention embedded within the clinical rehabilitation context and inform future trial processes. Pilot data will enable a future definitive trial to determine the clinical effectiveness of vocational rehabilitation when delivered in the early subacute phase of stroke recovery.

Living Clinical Guidelines For Stroke: Updates, Challenges And Opportunities, Coralie English, Kelvin Hill, Dominique A. Cadilhac, Maree L. Hackett, Natasha A. Lannin, Sandy Middleton, Annemarei Ranta, Nigel P. Stocks, Julie Davey, Steven G. Faux, Erin Godecke, Bruce C. V. Campbell

Research outputs 2022 to 2026

Continued growth in the number of published clinical studies has necessitated changes to the way evidence-based resources such as clinical guidelines are developed and updated. The Australian and New Zealand Clinical Guidelines for Stroke Management (https://informme.org.au/guidelines/clinical-guidelines-for-stroke-management) are based on continual evidence surveillance and timely updates to recommendations as new research is published. In this article, we outline the main updates to recommendations since the guidelines moved into a living mode in 2018, and discuss key challenges and benefits of living guidelines.

Results Of The Compare Trial Of Constraint-Induced Or Multimodality Aphasia Therapy Compared With Usual Care In Chronic Post-Stroke Aphasia, Miranda L. Rose, Lyndsey Nickels, David Copland, Leanne Togher, Erin Godecke, Marcus Meinzer, Tapan Rai, Dominique A. Cadilhac, Joosup Kim, Melanie Hurley, Abby Foster, Marcella Carragher, Cassie Wilcox, John E. Pierce, Gillian Steel

Research outputs 2022 to 2026

Background:

While meta-analyses confirm treatment for chronic post-stroke aphasia is effective, a lack of comparative evidence for different interventions limits prescription accuracy. We investigated whether Constraint-Induced Aphasia Therapy Plus (CIAT-plus) and/or Multimodality Aphasia Therapy (M-MAT) provided greater therapeutic benefit compared with usual community care and were differentially effective according to baseline aphasia severity.

Methods:

We conducted a three-arm, multicentre, parallel group, open-label, blinded endpoint, phase III, randomised-controlled trial. We stratified eligible participants by baseline aphasia on the Western Aphasia Battery-Revised Aphasia Quotient (WAB-R-AQ). Groups of three participants were randomly assigned (1:1:1) to 30 hours of CIAT-Plus or M-MAT or to …

Differential Effects Of Speech And Language Therapy And Rtms In Chronic Versus Subacute Post-Stroke Aphasia: Results Of The Northstar-Ca Trial, Anna Zumbansen, Heike Kneifel, Latifa Lazzouni, Anja Ophey, Sandra E. Black, Joyce L. Chen, Dylan Edwards, Thomas Funck, Alexander Erich Hartmann, Wolf Dieter Heiss, Franziska Hildesheim, Sylvain Lanthier, Paul Lespérance, George Mochizuki, Caroline Paquette, Elizabet Rochon, Ilona Rubi-Fessen, Jennie Valles, Susan Wortman-Jutt, Alexander Thiel

Research outputs 2022 to 2026

Background & objective: Contralesional 1-Hz repetitive transcranial magnetic stimulation (rTMS) over the right pars triangularis combined with speech-language therapy (SLT) has shown positive results on the recovery of naming in subacute (5–45 days) post-stroke aphasia. NORTHSTAR-CA is an extension of the previously reported NORTHSTAR trial to chronic aphasia (>6 months post-stroke) designed to compare the effectiveness of the same rTMS protocol in both phases. Methods: Sixty-seven patients with left middle cerebral artery infarcts (28 chronic, 39 subacute) were recruited (01-2014 to 07-2019) and randomized to receive rTMS (N = 34) or sham stimulation (N = 33) with SLT for …

Utilising A Systematic Review-Based Approach To Create A Database Of Individual Participant Data For Meta- And Network Meta-Analyses: The Release Database Of Aphasia After Stroke, Louise R. Williams, Myzoon Ali, Kathryn Vandenberg, Linda J. Williams, Masahiro Abo, Frank Becker, Audrey Bowen, Caitlin Brandenburg, Caterina Breitenstein, Stefanie Bruehl, David A. Copland, Tamara B. Cranfill, Marie Di Pietro-Bachmann, Pamela Enderby, Joanne Fillingham, Federica Lucia Galli, Marialuisa Gandolfi, Bertrand Glize, Erin Godecke, Neil Hawkins, Katerina Hilari, Jacqueline Hinckley, Simon Horton, David Howard, Petra Jaecks, Elizabeth Jefferies, Luis M T Jesus, Maria Kambanaros, Eun K. Kang, Eman M. Khedr, Anthony P H Kong, Tarja Kukkonen, Marina Laganaro, Matthew A. Lambon Ralph, Ann C. Laska, Béatrice Leemann, Alexander P. Leff, Roxele R. Lima, Antje Lorenz, Brian Macwhinney, Rebecca S. Marshall, Flavia Mattioli, İlknur Maviş, Marcus Meinzer, Reza Nilipour, Enrique Noé, Nam-Jong Paik, Rebecca Palmer, Ilias Papathanasiou, Brigida F. Patricio, Isabel P. Martins, Cathy Price, Tatjana P. Jakovac, Elizabeth Rochon, Miranda L. Rose, Charlotte Rosso, Ilona Rubi-Fessen, Marina B. Ruiter, Claerwen Snell, Benjamin Stahl, Jerzy P. Szaflarski, Shirley A. Thomas, Mieke Van De Sandt-Koenderman, Ineke Van Der Meulen, Evy Visch-Brink, Linda Worrall, Heather H. Wright, Marian C. Brady, The Release Collaborators

Research outputs 2014 to 2021

Background: Collation of aphasia research data across settings, countries and study designs using big data principles will support analyses across different language modalities, levels of impairment, and therapy interventions in this heterogeneous population. Big data approaches in aphasia research may support vital analyses, which are unachievable within individual trial datasets. However, we lack insight into the requirements for a systematically created database, the feasibility and challenges and potential utility of the type of data collated. Aim: To report the development, preparation and establishment of an internationally agreed aphasia after stroke research database of individual participant data (IPD) to facilitate planned …

Development And Diagnostic Validation Of The Brisbane Evidence-Based Language Test, Alexia Rohde, Suhail A. Doi, Linda Worrall, Erin Godecke, Anna Farrell, Robyn O'Halloran, Molly Mccracken, Nadin Lawson, Rebecca Cremer, Andrew Wong

Research outputs 2014 to 2021

Purpose:

To describe the development and determine the diagnostic accuracy of the Brisbane Evidence-Based Language Test in detecting aphasia. Methods: Consecutive acute stroke admissions (n = 100; mean = 66.49y) participated in a single (assessor) blinded cross-sectional study. Index assessment was the ∼ 45 min Brisbane Evidence-Based Language Test. The Brisbane Evidence-Based Language Test is further divided into four 15–25 min Short Tests: two Foundation Tests (severe impairment), Standard (moderate) and High Level Test (mild). Independent reference standard included the Language Screening Test, Aphasia Screening Test, Comprehensive Aphasia Test and/or Measure for Cognitive-Linguistic Abilities, treating team diagnosis and aphasia referral …

Identifying Key Elements To Assess Patient’S Acceptability Of Neurorehabilitation In Stroke Survivors–A Delphi Method, Manonita Ghosh, Kaoru Nosaka, Lisa Whitehead, Kazunori Nosaka

Research outputs 2014 to 2021

Purpose:

Assessing patient acceptability of treatment is a clinical concern. No guidance exists to determine the best way to measure acceptability in stroke neurorehabilitation. This study identifies key elements to measure patient’s acceptance of stroke neurorehabilitation by establishing expert consensus.

Materials and methods:

A four-phase Delphi method with a three-round electronic-based survey was conducted. Experts were considered as stroke survivors or their caregivers and professionals in stroke neurorehabilitation. A twenty-five-item list was sourced from a literature review and discussion with a consumer panel (n = 22). In Round-1 (n = 118) and Round-2 (n = 80), experts …

Patients’ Experiences Of A Communication Enhanced Environment Model On An Acute/Slow Stream Rehabilitation And A Rehabilitation Ward Following Stroke: A Qualitative Description Approach, Sarah D'Souza, Deborah J. Hersh, Erin Godecke, Natalie Ciccone, Heidi Janssen, Elizabeth Armstrong

Research outputs 2014 to 2021

Background

Patients in hospital following stroke express a desire to continue therapy tasks outside of treatment activities. However, they commonly describe experiences of boredom and inactivity. An enriched environment aims to provide opportunities for physical, cognitive and social activity and informed the development of a Communication Enhanced Environment (CEE) model to promote patient engagement in language activities.

Purpose

Explore patient perceptions of a CEE model, and barriers and facilitators to engagement in the model.

Methods

A qualitative description study from a larger project that implemented a CEE model into acute and rehabilitation private hospital wards in Western Australia. Semi-structured interviews …

Inter-Rater Reliability, Intra-Rater Reliability And Internal Consistency Of The Brisbane Evidence-Based Language Test, Alexia Rohde, Molly Mccracken, Linda Worrall, Anna Farrell, Robyn O'Halloran, Erin Godecke, Michael David, Suhail A. Doi

Research outputs 2014 to 2021

Purpose: To examine the inter-rater reliability, intra-rater reliability, internal consistency and practice effects associated with a new test, the Brisbane Evidence-Based Language Test. Methods: Reliability estimates were obtained in a repeated-measures design through analysis of clinician video ratings of stroke participants completing the Brisbane Evidence-Based Language Test. Inter-rater reliability was determined by comparing 15 independent clinicians’ scores of 15 randomly selected videos. Intra-rater reliability was determined by comparing two clinicians’ scores of 35 videos when re-scored after a two-week interval. Results: Intraclass correlation coefficient (ICC) analysis demonstrated almost perfect inter-rater reliability (0.995; 95% confidence interval: 0.990–0.998), intra-rater reliability (0.994; 95% …

Statistical Analysis Plan For The Stepped-Wedge Clinical Trial Healing Right Way - Enhancing Rehabilitation Services For Aboriginal Australians After Brain Injury, Elizabeth Armstrong, Tapan Rai, Deborah Hersh, Sandra Thompson, Juli Coffin, Natalie Ciccone, Leon Flicker, Dominique Cadilhac, Erin Godecke, Deborah Woods, Colleen Hayward, Graeme J. Hankey, Meaghan Mcallister, Judith Katzenellenbogen

Research outputs 2022 to 2026

Background: Aboriginal Australians are known to suffer high levels of acquired brain injury (stroke and traumatic brain injury) yet experience significant barriers in accessing rehabilitation services. The aim of the Healing Right Way trial is to evaluate a culturally secure intervention for Aboriginal people with newly acquired brain injury to improve their rehabilitation experience and quality of life. Following publication of the trial protocol, this paper outlines the statistical analysis plan prior to locking the database. Methods: The trial involves a stepped wedge design with four steps over 3 years. Participants were 108 adult Aboriginal Australians admitted to one of …

Dosage, Intensity, And Frequency Of Language Therapy For Aphasia: A Systematic Review-Based, Individual Participant Data Network Meta-Analysis, The Rehabilitation And Recovery Of People With Aphasia After Stroke (Release) Collaborators

Research outputs 2022 to 2026

Background and Purpose: Optimizing speech and language therapy (SLT) regimens for maximal aphasia recovery is a clinical research priority. We examined associations between SLT intensity (hours/week), dosage (total hours), frequency (days/week), duration (weeks), delivery (face to face, computer supported, individual tailoring, and home practice), content, and language outcomes for people with aphasia.

Methods: Databases including MEDLINE and Embase were searched (inception to September 2015). Published, unpublished, and emerging trials including SLT and ≥ 10 individual participant data on aphasia, language outcomes, and time post-onset were selected. Patient-level data on stroke, language, SLT, and trial risk of bias were independently extracted. …

Development And Field Testing Of A Standardised Goal Setting Package For Person-Centred Discharge Care Planning In Stroke, Rebecca Barnden, Dominique A. Cadilhac, Natasha A. Lannin, Ian Kneebone, Deborah Hersh, Erin Godecke, Rene Stolwyk, Tara Purvis, Rebecca Nicks, Michelle Farquhar, Stephanie Gleeson, Carol Gore, Kelsie Herrmann, Nadine E. Andrew

Research outputs 2022 to 2026

Objective: Develop and test a person-centred goal-setting package for discharge care planning in acute and rehabilitation stroke units. Methods: A multidisciplinary, expert working group (n = 15), and consumer group (n = 4) was convened. A multistage iterative approach was used to develop and test the package. Stages included: (i) contextual understanding, (ii) package development, and (iii) clinician training and field-testing in acute and rehabilitation settings. Observational field notes were taken and clinicians' perspectives captured using semi-structured focus groups post-testing. Results: The final package included a 34-item menu aligned with a manual containing: guideline summaries; common goals; goal metrics based …

Reflecting On Experiences Of Care: An Exploratory Qualitative Descriptive Study Of The Perspectives Of Stroke Survivors, Families And Staff, Caroline Bulsara, Rosemary Saunders, Laura Emery, Christopher Etherton-Beer

Research outputs 2014 to 2021

Objective:

The aim of this study was to identify barriers and enablers from the perspectives of stroke survivors, carers and staff to understand the experiences of care.

Design:

The study used a qualitative descriptive methodology and employed semistructured interview technique.

Setting:

A metropolitan stroke rehabilitation unit in Western Australia providing rehabilitation services for inpatients and outpatients.

Participants:

Overall, 10 participants (four staff, four stroke survivors and two primary carers) were interviewed. Transcripts were analysed using thematic analysis.

Results:

Experiences of care focused on lack of time, urgency to regain mobility, postshock recovery, uncertainty about the future and the importance of …

Hospital Staff, Volunteers’ And Patients’ Perceptions Of Barriers And Facilitators To Communication Following Stroke In An Acute And A Rehabilitation Private Hospital Ward: A Qualitative Description Study, Sarah D'Souza, Erin Godecke, Natalie Ciccone, Deborah J. Hersh, Heidi Janssen, Elizabeth Armstrong

Research outputs 2014 to 2021

Objectives

To explore barriers and facilitators to patient communication in an acute and rehabilitation ward setting from the perspectives of hospital staff, volunteers and patients following stroke.

Design

A qualitative descriptive study as part of a larger study which aimed to develop and test a Communication Enhanced Environment model in an acute and a rehabilitation ward.

Setting

A metropolitan Australian private hospital.

Participants

Focus groups with acute and rehabilitation doctors, nurses, allied health staff and volunteers (n=51), and interviews with patients following stroke (n=7), including three with aphasia, were conducted.

Results

The key themes related to barriers and facilitators to …

Critically Appraised Paper: Non-Invasive Brain Stimulation Does Not Enhance The Effect Of Robotic-Assisted Upper Limb Training On Arm Motor Recovery After Stroke [Commentary], Dylan J. Edwards

Research outputs 2014 to 2021

In people with hemiparesis after stroke, intensive upper limb motor practice, such as robot-assisted training, can lead to clinically meaningful improvement, yet the benefit typically falls far short of full functional recovery. Supplemental therapies have the potential to enhance training effects, and non-invasive brain stimulation as a candidate add-on therapy has previously been reported; this literature was systematically reviewed by Reis and colleagues. The review found that there is no beneficial effect of non-invasive brain stimulation as a supplement to robot-assisted training. The eight reviewed trials used a variety of existing best non-invasive brain stimulation practices and available robotic technology.

Effect Of Occupational Therapy Home Visit Discharge Planning On Participation After Stroke: Protocol For The Home Rehab Trial, Natasha A. Lannin, Lindy Clemson, Avril Drummond, Mandy Stanley, Leonid Churilov, Kate Laver, Sophie O'Keefe, Ian Cameron, Maria Crotty, Tim Usherwood, Nadine E. Andrew, Laura Jolliffe, Dominique A. Cadilhac

Research outputs 2014 to 2021

Introduction: After first stroke, the transition from rehabilitation to home can be confronting and fraught with challenges. Although stroke clinical practice guidelines recommend predischarge occupational therapy home visits to ensure safe discharge and provision of appropriate equipment, there is currently limited evidence to support this recommendation. Methods and analysis: The HOME Rehab trial is a national, multicentre, phase III randomised controlled trial with concealed allocation, blinded assessment and intention-to-treat analysis being conducted in Australia. The trial aim is to determine the effect and potential cost-effectiveness of an enhanced occupational therapy discharge planning intervention that involves pre and postdischarge home visits, …

The Development Of Aboriginal Brain Injury Coordinator Positions: A Culturally Secure Rehabilitation Service Initiative As Part Of A Clinical Trial, Elizabeth Armstrong, Kathy Mccoy, Rebecca Clinch, Maureen Merritt, Renee Speedy, Meaghan Mcallister, Kym Heine, Natalie Ciccone, Melanie Robinson, Julie Coffin

Research outputs 2014 to 2021

Brain injury, resulting from stroke and traumatic brain injury, is a common occurrence in Australia, with Aboriginal people affected at a significant rate and impact felt by individuals, families and communities. Access to brain injury rehabilitation services for Aboriginal people is reported to be often limited, with very little support outside the hospital environment. Our research involving Aboriginal brain injury survivors and their families to date has revealed that people often manage ‘on their own’ following such events. Following recommendations from survivors and their families, the Healing Right Way clinical trial, currently underway in Western Australia, has created the role …

An Exploration Of Aphasia Therapy Dosage In The First Six Months Of Stroke Recovery, Emily Brogan, Natalie Ciccone, Erin Godecke

Research outputs 2014 to 2021

Aphasia research uses the length of time within rehabilitation sessions as the main measure of dosage. Few papers detail therapeutic ingredients or outline the number of times these were delivered over the treatment period. The present observational study identified therapeutic ingredients in the Very Early Rehabiltiation in SpEech (VERSE) trial and explored the dosage provided using a model of cumulative intervention intensity (CII). Therapists video recorded one therapy session per week and 53 (12%) randomly selected therapy videos were analysed. The videos were coded for number of error productions, self-corrections and type and frequency of therapist cueing. The Western Aphasia …

Nursing And Allied Health Staff Perceptions And Experiences Of A Volunteer Stroke Peer Support Program: A Qualitative Study, Rosemary Saunders, Kien Chan, Renée M. Graham, Elena Adams, Caroline E. Bulsara, Karla Seaman, Marcella Cranny-Connolly

Research outputs 2014 to 2021

Purpose: Stroke brings about physical, cognitive, and psychosocial changes and, conse-quently, many stroke survivors feel underprepared for the transition from hospital to home. Nursing and allied health staff have a key role in stroke rehabilitation. Peer support programs have been found effective in supporting stroke survivors, alongside hospital staff caring for stroke patients, by providing experiential knowledge that staff are not able to provide. Aim: This study explored the perceptions and experiences of nursing and allied health staff of a volunteer peer support program for stroke inpatients. Methods: This study utilised a qualitative, evaluative case study design. This study was …

Behind The Therapy Door: What Is “Usual Care” Aphasia Therapy In Acute Stroke Management?, Emily Brogan, Erin Godecke, Natalie Ciccone

Research outputs 2014 to 2021

Background:

Usual care is the term used to describe everyday practice in the management of a client within a profession. The knowledge of the tasks used in therapy and key therapeutic processes used within these treatments, provides critical information about if and how the therapy works. The Very Early Rehabilitation in SpEech Randomised Controlled Trial (VERSE RCT) had three arms with therapists within the intensive Usual Care-Plus arm (UC-Plus) providing daily direct aphasia therapy at their discretion for 20 sessions.

Aims:

To describe usual care aphasia treatment provided in the Usual Care-Plus arm of VERSE RCT.

Methods and Procedures:

One …

Release: A Protocol For A Systematic Review Based, Individual Participant Data, Meta- And Network Meta-Analysis, Of Complex Speech-Language Therapy Interventions For Stroke-Related Aphasia, Marian C. Brady, Myzoon Ali, Kathryn Vandenberg, Linda J. Williams, Louise R. Williams, Masahiro Abo, Frank Becker, Audrey Bowen, Caitlin Brandenburg, Caterina Breitenstein, Stefanie Bruehl, David A. Copland, Tamara B. Cranfill, Marie Di Pietro-Bachmann, Pamela Enderby, Joanne Fillingham, Federica Lucia Galli, Marialuisa Gandolfi, Bertrand Glize, Erin Godecke, Neil Hawkins, Katerina Hilari, Jacqueline Hinckley, Simon Horton, David Howard, Petra Jaecks, Elizabeth Jefferies, Luis M. T. Jesus, Maria Kambanaros, Eun Kyoung Kang, Eman M. Khedr, Anthony Pak-Hin Kong, Tarja Kukkonen, Marina Laganaro, Matthew A. Lambon Ralph, Ann Charlotte Laska, Béatrice Leemann, Alexander P. Leff, Roxele R. Lima, Antje Lorenz, Brian Macwhinney, Rebecca Shisler Marshall, Flavia Mattioli, Ilknur Mavis, Marcus Meinzer, Reza Nilipour, Enrique Noé, Nam-Jong Paik, Rebecca Palmer, Ilias Papathanasiou, Brigida F. Patricio, Isabel Pavão Martins, Cathy Price, Tatjana Prizl Jakovac, Elizabeth Rochon, Miranda L. Rose, Charlotte Rosso, Ilona Rubi-Fessen, Marina B. Ruiter, Claerwen Snell, Benjamin Stahl, Jerzy P. Szaflarski, Shirley A. Thomas, Mieke Van De Sandt-Koenderman, Ineke Van Der Meulen, Evy Visch-Brink, Linda Worrall, Heather Harris Wright

Research outputs 2014 to 2021

Background: Speech and language therapy (SLT) benefits people with aphasia following stroke. Group level summary statistics from randomised controlled trials hinder exploration of highly complex SLT interventions and a clinically relevant heterogeneous population. Creating a database of individual participant data (IPD) for people with aphasia aims to allow exploration of individual and therapy-related predictors of recovery and prognosis. Aim: To explore the contribution that individual participant characteristics (including stroke and aphasia profiles) and SLT intervention components make to language recovery following stroke. Methods and procedures: We will identify eligible IPD datasets (including randomised controlled trials, non-randomised comparison studies, observational studies …