Medicine and Health Sciences Commons^™

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. …

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 …

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.

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 …

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.

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 …

Investigation Of A Communication Enhanced Environment Model After Stroke: A Mixed Methods Before-And-After Pilot Study, Sarah D’Souza

Theses: Doctorates and Masters

Background: Aphasia is an acquired communication disorder that affects approximately 30% of first ever stroke survivors and persists one-year post-stroke in up to 61% of survivors. Aphasia impacts on all communication modalities with significant negative consequences for social participation, interpersonal relationships, autonomy, capacity to work and quality of life. It is recognised that the environment can influence neural remapping during early stroke recovery. However, patients with aphasia (PWA) following stroke have been observed to spend less than 30% of their day communicating and 44% of their day alone during their first weeks of in-patient rehabilitation. Inadequate opportunities for communication places …

General Practitioners’ Perceptions Of Their Communication With Australian Aboriginal Patients With Acquired Neurogenic Communication Disorders, Deborah Hersh, Elizabeth Armstrong, Meaghan Mcallister, Natalie Ciccone, Judith Katzenellenbogen, Juli Coffin, Sandra Thompson, Colleen Hayward, Leon Flicker, Deborah Woods

Research outputs 2014 to 2021

Objective:

Aboriginal people have high rates of stroke and traumatic brain injury (TBI), often with residual, chronic communication deficits and multiple co-morbidities. This study examined general practitioners’ (GPs’) perceptions of their communication with Aboriginal patients with acquired communication disorders (ACD) after brain injury. Effective communication underpins good care but no previous research has explored this specific context.

Methods:

A qualitative descriptive approach was employed using interviews and focus groups with 23 GPs from metropolitan Perth and five regional sites in Western Australia. Data were analysed thematically. Results: GPs reported low visibility of Aboriginal patients with ACD in their practices, minimal …

Treatment Fidelity In Aphasia Randomised Controlled Trials, Emily Brogan, Natalie Ciccone, Erin Godecke

Research outputs 2014 to 2021

Background: Treatment fidelity is at the heart of evidence-based practice and treatment fidelity processes help to determine the ‘active ingredients’ of a treatment. Hinckley and Douglas in 2013 reviewed treatment fidelity processes in published aphasia trials and found 14% of aphasia treatment studies reported treatment fidelity. This led the authors to call for journals to make treatment fidelity reporting mandatory.

Aims: To review the implementation and reporting of treatment fidelity processes in recent aphasia RCTs to update on practices since 2012.

Methods and Procedures: Aphasia RCTs published between 2012 and 2017 were sourced from online databases speechBITE, …

Treatment Fidelity In The Very Early Rehabilitation In Speech (Verse) Randomised Controlled Trial: An Exploration Of Treatment For Aphasia, Emily Louise Brogan

Theses: Doctorates and Masters

Background

Aphasia is a neurological condition that affects the expression and/or comprehension of language and can have considerable impact on a person’s quality of life. Treatment for aphasia from speech language pathologists is effective. However, more information is needed on the nature of effective intervention including consideration for what therapy is provided, when it is commenced and how it is delivered. Treatment fidelity is concerned with ensuring research treatment protocols are implemented as they were intended, which assists in uncovering the specifics of how and why treatments work. When treatment fidelity is investigated thoroughly, researchers and research consumers can be …

Factors That Influence The Decision-Making Of An Integrated Rehabilitation Team When Choosing A Post-Hospital Discharge Destination For Survivors Of Stroke, Jessie M. Johnson

Theses: Doctorates and Masters

Stroke is one of the more disabling conditions which may result in the inability for survivors to care for themselves independently. Stroke survivors benefit most when they receive early onset assessment, treatment, and rehabilitation. Increasingly, stroke care in Canadian hospitals relies on an interdisciplinary rehabilitation team approach to provide immediate rehabilitation services and to make decisions about discharge destination for stroke survivors. Currently, there is little research on how interdisciplinary rehabilitation teams decide upon rehabilitation placements for stroke survivors or how individuals on the team, stroke survivors, or their families participate in and contribute to this decision. This research studied …

Speech And Swallowing Rehabilitation In The Home: A Comparison Of Two Service Delivery Models For Stroke Survivors, Katy J. E. Stewart

Theses: Doctorates and Masters

Background and Aims

Speech and swallowing difficulties are common sequelae for people who have suffered a stroke. Recently, there has been an increase in early discharge, community rehabilitation and the use of therapy assistants to support health professionals in stroke rehabilitation. However, the impact of these factors on communication and swallowing outcomes remains under researched. This research explored Rehabilitation in the Home (RITH) Speech Pathology (SP) services for stroke survivors with dysarthria and dysphagia. More specifically, this research investigated whether traditional speech pathology interventions, supplemented with a home practice program are effective, as well as compare usual treatment to that …