Medicine and Health Sciences Commons^™

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 …

Effectiveness Of 3d-Printed Upper Extremity Device For Chronic Neurological Impairment, Joe Kardine, Mba, Ms, Otr/L, Cbis, Mikael Avery, Ms, Otr/L, Alessandro Naopli, Phd, Namrata Grampurohit, Phd, Otr/L, Maryjane Mulcahey, Phd, Otr/L, Mijail Serruya, Md, Phd

Farber Institute for Neuroscience Staff Papers and Presentations

Report on the results of the five adults with UE mobility impairment due to stroke experiences with a lightweight, customized, powered hand orthosis. Study measures utilized were Canadian Occupational Performance Measure, Box and Blocks, and Action Research Arm Test.

Unobtrusive Assessment Of Upper-Limb Motor Impairment Using Wearable Inertial Sensors, Brandon R. Oubre

Doctoral Dissertations

Many neurological diseases cause motor impairments that limit autonomy and reduce health-related quality of life. Upper-limb motor impairments, in particular, significantly hamper the performance of essential activities of daily living, such as eating, bathing, and changing clothing. Assessment of impairment is necessary for tracking disease progression, measuring the efficacy of interventions, and informing clinical decision making. Impairment is currently assessed by trained clinicians using semi-quantitative rating scales that are limited by their reliance on subjective, visual assessments. Furthermore, existing scales are often burdensome to administer and do not capture patients' motor performance in home and community settings, resulting in a …

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.

Effectiveness Of Support Groups For Stroke Patients, Wendy H. Rosario

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Effect Of Behavioural Practice Targeted At The Motor Action Selection Network After Stroke, Jill C. Stewart Pt,Phd, Jessica F. Baird, Allison F. Lewis, Stacy L. Fritz, Julius Fridriksson

Faculty Publications

Motor action selection engages a network of frontal and parietal brain regions. After stroke, individuals activate a similar network, however, activation is higher, especially in the contralesional hemisphere. The current study examined the effect of practice on action selection performance and brain activation after stroke. Sixteen individuals with chronic stroke (Upper Extremity Fugl–Meyer motor score range: 18–61) moved a joystick with the more-impaired hand in two conditions: Select (externally cued choice; move right or left based on an abstract rule) and Execute (simple response; move same direction every trial). On Day 1, reaction time (RT) was longer in Select compared …

Effect Of Behavioural Practice Targeted At The Motor Action Selection Network After Stroke, Jill C. Stewart, Jessica F. Baird, Stacy L. Fritz, Julius Fridriksson Ph.D.

Faculty Publications

Motor action selection engages a network of frontal and parietal brain regions. After stroke, individuals activate a similar network, however, activation is higher, especially in the contralesional hemisphere. The current study examined the effect of practice on action selection performance and brain activation after stroke. Sixteen individuals with chronic stroke (Upper Extremity Fugl–Meyer motor score range: 18–61) moved a joystick with the more-impaired hand in two conditions: Select (externally cued choice; move right or left based on an abstract rule) and Execute (simple response; move same direction every trial). On Day 1, reaction time (RT) was longer in Select compared …

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.

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 …

Bilateral Upper Extremity Motor Priming (Bump) Plus Task-Specific Training For Severe, Chronic Upper Limb Hemiparesis: Study Protocol For A Randomized Clinical Trial, Mary Ellen Stoykov, Olivia M Biller, Alexandra Wax, Erin King, Jacob M Schauer, Louis F Fogg, Daniel M Corcos

Department of Occupational Therapy Faculty Papers

BACKGROUND: Various priming techniques to enhance neuroplasticity have been examined in stroke rehabilitation research. Most priming techniques are costly and approved only for research. Here, we describe a priming technique that is cost-effective and has potential to significantly change clinical practice. Bilateral motor priming uses the Exsurgo priming device (Exsurgo Rehabilitation, Auckland, NZ) so that the less affected limb drives the more affected limb in bilateral symmetrical wrist flexion and extension. The aim of this study is to determine the effects of a 5-week protocol of bilateral motor priming in combination with task-specific training on motor impairment of the affected …

Barriers To Exercise And Physical Activity - Insight From The Rural Practitioner, Erin G. Tillery

Honors College Theses

Sedentary lifestyles are a growing public health concern. Furthermore, many rural Americans lack adequate access to healthcare resources. When healthcare is sought, the patient-practitioner interactions may serve to influence the patient’s lifestyle choices. The practitioners' exercise and physical activity habits may shape the effectiveness of the patient-practitioners interaction. Here, we explored the potential barriers to exercise and physical activity (PA) in licensed physical and occupational therapists. In addition, we aimed to describe barriers to exercise and PA in individuals with a history of stroke from the perspective of the practitioner. Lastly, how current exercise and physical activity habits influence their …

Quantifying Intra- And Interlimb Use During Unimanual And Bimanual Tasks In Persons With Hemiparesis Post-Stroke, Susan V. Duff, Aaron Miller, Lori Quinn, Gregory Youdan Jr., Lauri Bishop, Heather Ruthrauff, Eric Wade

Physical Therapy Faculty Articles and Research

Background

Individuals with hemiparesis post-stroke often have difficulty with tasks requiring upper extremity (UE) intra- and interlimb use, yet methods to quantify both are limited.

Objective

To develop a quantitative yet sensitive method to identify distinct features of UE intra- and interlimb use during task performance.

Methods

Twenty adults post-stroke and 20 controls wore five inertial sensors (wrists, upper arms, sternum) during 12 seated UE tasks. Three sensor modalities (acceleration, angular rate of change, orientation) were examined for three metrics (peak to peak amplitude, time, and frequency). To allow for comparison between sensor data, the resultant values were combined into …

Rehabilitation Through Reintegration: Supporting Survivors Of Stroke, Alexander T. Wiemann

Occupational Therapy Capstone Presentations

After returning home from inpatient care, survivors of stroke have several ongoing needs related to this transition that are not always fully addressed, leading to poor community reintegration and psychosocial well-being. The purpose of this capstone project was to modify a community-based occupational therapy program to improve community reintegration and psychosocial well-being among survivors of stroke. One significant modification was the implementation of a survivor support group focused on psychosocial topics. Interviews and formal assessments conducted with participants indicated several perceived benefits from the support groups as well as a decrease in depression and anxiety and an increase in community …

Effective Therapies And Nursing Approaches: Improving Cognition In Older Adult Stroke Patients, Selyna Baltazar

Nursing | Senior Theses

Background

Ischemic stroke occurs in thousands of older adults throughout the year. Due to the lack of oxygen entering the brain, many patients experience a decline in cognitive function due to ischemic stroke. Cognition is the ability to understand, learn, and remember information which is needed for completing daily tasks. Modern technology has allowed for patients to survive ischemic strokes but has yet to provide proper screening tools and methods for stroke-related cognitive impairment.

Objective

To investigate the best practices for identifying, treating, and caring for patients with a cognitive injury related to a stroke. A review of the research …

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 …

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 …

Visualization-Driven Time-Series Extraction From Wearable Systems Can Facilitate Differentiation Of Passive Adl Characteristics Among Stroke And Healthy Older Adults, Joby John, Rahul Soangra

Physical Therapy Faculty Articles and Research

Wearable technologies allow the measurement of unhindered activities of daily living (ADL) among patients who had a stroke in their natural settings. However, methods to extract meaningful information from large multi-day datasets are limited. This study investigated new visualization-driven time-series extraction methods for distinguishing activities from stroke and healthy adults. Fourteen stroke and fourteen healthy adults wore a wearable sensor at the L5/S1 position for three consecutive days and collected accelerometer data passively in the participant’s naturalistic environment. Data from visualization facilitated selecting information-rich time series, which resulted in classification accuracy of 97.3% using recurrent neural networks (RNNs). Individuals with …

Kinematic Analysis Of 360° Turning In Stroke Survivors Using Wearable Motion Sensors, Masoud Abdollahi, Pranav Madhav Kuber, Michael Shiraishi, Rahul Soangra, Ehsan Rashedi

Physical Therapy Faculty Articles and Research

Background: A stroke often bequeaths surviving patients with impaired neuromusculoskeletal systems subjecting them to increased risk of injury (e.g., due to falls) even during activities of daily living. The risk of injuries to such individuals can be related to alterations in their movement. Using inertial sensors to record the digital biomarkers during turning could reveal the relevant turning alterations. Objectives: In this study, movement alterations in stroke survivors (SS) were studied and compared to healthy individuals (HI) in the entire turning task due to its requirement of synergistic application of multiple bodily systems. Methods: The motion of 28 participants (14 …

Effects Of Quadruped Movement In An Individual With Chronic Stroke: A Case Study, Maureen Romanow Pascal, Emily Connell, Alyssa Pratti, Kristina Russell

Student Research Poster Presentations 2022

Background/Purpose: Neuromuscular dysfunction encompasses a wide variety of conditions that impact proper muscle functioning. One common condition resulting in neuromuscular dysfunction is a cerebrovascular accident (CVA) which can disrupt sensory, motor, visual and language systems. The resulting combination of impairments can cause limitations in activity performance and restrict participation across domains. In addition, muscle weakness is widely recognized as a major contributing factor to decline in function. Literature is showing that rehabilitation programs focusing on development of core strength with emphasis on repetition, intensity and novelty are critical for recovery of motor function. The purpose of this research was to …

The Experience Of Meditation, And Its Effects On Attention, For Adults With Stroke Or Attention Deficit Hyperactivity Disorder: A Three-Part Dissertation With Qualitative And Quantitative Evidence, Cheryl Carrico

Theses and Dissertations--Rehabilitation Sciences

Impairment of attention is common after stroke; is a defining characteristic of attention deficit hyperactivity disorder (ADHD); and has been shown to correlate significantly with difficulties in daily life for individuals with these conditions. More research is needed to establish effective interventions addressing impaired attention in such cases. Meditation is not a standard-of-care intervention for this purpose but may have therapeutic potential. Meditation has been broadly defined as an activity which has self-regulation of attention as its main aim. In other words, it can be considered a training of attention. To shed light on the therapeutic potential of meditation, including …

Evaluating The Microbiome To Boost Recovery From Stroke: The Embrs Study, Tyler Hammond

Theses and Dissertations--Neuroscience

Accumulating evidence suggests that gut microbes modulate brain plasticity via the bidirectional gut-brain axis and may play a role in stroke rehabilitation. A severely imbalanced microbial community has been shown to occur following stroke, causing a systemic flood of neuro- and immunomodulatory substances due to increased gut permeability and decreased gut motility. Here we measure post-stroke increased gut dysbiosis and how it correlates with gut permeability and subsequent cognitive impairment.

We recruited 12 participants with acute stroke, 12 healthy control participants, and 18 participants who had risk factors for stroke, but had not had a stroke. We measured the gut …

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 …