Rehabilitation and Therapy Commons^™

A Young Stroke Patient With Bardet-Biedl Syndrome: A Casereport, Erh-Chun Chen, Tien-Wen Chen, Ming-Cheng Weng, Chia-Ling Lee

Rehabilitation Practice and Science

Bardet-Biedl syndrome (BBS) is a rare inherited disease. Up to date, there have been 14 known BBS-related mutation genes, resulting in ciliopathy with multiple abnormalities such as obesity, pigmentary retinopathy, polydactyly, learning disabilities, poor coordination, renal dysfunction, diabetes and hypertension. This case was a 29-year-old male, who was diagnosed as Bardet-Biedl syndrome since childhood and then was followed up for control of complications. He suffered from stroke at age of 29. Risks of young stroke were surveyed. Poorly controlled hypertension, hyperlipidemia, hyperglycemia and hyperfibrinogenemia were noted. No other examination revealed abnormality. He had received treatment of stroke in acute phase, …

The Associated Factors In Home-Based Rehabilitation Utilization Of Stroke Patients, Shu-Chuan Wu, Yu-Chia Chang, Te-Feng Yeh, Ting-Yu Chang, Wei-Chaio Lu, Chien-Tsai Huang, Chuan-Hsiung Lin, Li-Ling Huang

Rehabilitation Practice and Science

This study explores the factors correlated to the use of home-based rehabilitation services by stroke patients for whom care is provided according to the state policy pertaining to the 10-year long-term care plan.During July 2008–June 2010, data were collected from 759 stroke patients by using a long-term care management service evaluation form. These patients had initially applied for services at the long-term care centers of the Bureau of Public Health in Taichung County. Of these, 119(15.7%) eventually used home-based rehabilitation services. Using the Andersen health behavior model, we investigated how various factors influence the use of home-based rehabilitation services by …

Motor Control Of Exercise That Emphasizes Speed Post-Stroke, Vicki L. Gray

Electronic Thesis and Dissertation Repository

Purpose: To investigate whether a single session of closed kinetic chain (CKC) and open kinetic chain (OKC) exercises emphasizing speed post-stroke could evoke changes in the motor control and whether these improvements would transfer to postural tasks.

Methods: Thirty-two individuals post-stroke and 32 age- and sex- matched controls performed a single session of 50 fast squats and steps (Chapter 3). Internal perturbations (arm raise/load drop) were used to assess postural responses before exercises (Pre), immediately after exercises (Post) and 15 minutes after exercises (Retention) (Chapter 4). Eleven individuals post-stroke performed a single session of 50 fast knee and ankle OKC …

The Effectiveness Of Secondary Prevention Lifestyle Interventions Designed To Change Lifestyle Behavior Following Stroke: Summary Of A Systematic Review, Maggie Lawrence, Susan Kerr, Caroline Mcvey, John Godwin

Dr. Maggie Lawrence

Background A feature of stroke is that it recurs (25% within

five-years). Risk factors for stroke and recurrent stroke

include smoking, alcohol consumption, poor diet, and physical

inactivity.

Aim To evaluate the effectiveness of secondary prevention

lifestyle interventions designed to change lifestyle behavior

following stroke. This short paper presents a summary of the

systematic review process and findings.

Methods Ten major databases were searched using subject

headings and key words. Papers were screened using

review-specific criteria. Critical appraisal and data extraction

were conducted independently by two reviewers. Data were

pooled in statistical meta-analysis; where this was not possible

findings were …

Defining And Measuring Patient-Centred Care: An Example From A Mixed Methods Systematic Review Of The Stroke Literature., Maggie Lawrence, Sue Kinn

Dr. Maggie Lawrence

Background

Involving patients in the determination of their care is increasingly important, and healthcare professionals worldwide have recognised a need for clinical outcome measures and interventions that facilitate patient-centred care delivery in a range of settings.

Aim

A mixed-methods review was conducted, which aimed to identify stroke-specific patient-centred outcome measures, patient-centred interventions, and family-centred interventions.

Search strategy

Databases searched included MEDLINE and PsycINFO; search strings were based on MeSH terms and keywords associated with the terms ‘stroke’ and ‘patient-centred’.

Data extraction and analysis

Descriptive statistics were used to report quantitative data; papers included in the review were also underwent thematic …

Pirandello’S Analogy: A Source For A Better Understanding Of The Social Impact Of Stroke, M.A.C. Van Haaren, Maggie Lawrence, P.H. Goossens, B. Van Den Bossche, M.J.H. Wermer, A.A. Kaptein

Dr. Maggie Lawrence

Background: Suffering a stroke has major implications for the patient. To understand human suffering, one should understand society. Pirandello described society as a higher entity than the individual, thereby justifying human adaptability to society. We explore a qualitative finding that suggests that social trends may influence how stroke patients prioritize aspects of their rehabilitation. Methods: We compare a contemporary patient’s experience of stroke recovery with that of a fictional character from the works of Luigi Pirandello. Both patients had two main residual symptoms: hemiparesis and aphasia. Results: The rehabilitation priorities of the two patients differed, and appeared to reflect the …

Determining The Needs, Priorities, And Desired Rehabilitation Outcomes Of Young Adults Who Have Had A Stroke, Maggie Lawrence, Sue Kinn

Dr. Maggie Lawrence

Background: Guidelines state that young adults’ rehabilitation needs and priorities following stroke are different from older adults’. However, there is a lack of evidence regarding young adults’ perspectives of their needs and priorities.

Aims: To gain an understanding of young adults’ experience of stroke and associated rehabilitation needs, priorities and desired outcomes.

Methods: Longitudinal data were gathered using unstructured interviews and analysed using phenomenological reduction.

Results: Ten young adults took part in up to four interviews over two years. An overarching theme, Embodied Disorientation, and three sub-themes: Mortal Body, Situated Body, and Embodied Perception of Difference, described the young adults’ …

Aphasia Incidence And Intervention In The Acute Hospital Setting, Dominique Lidia Ferreira

Theses : Honours

Background: Current research highlights the significance of providing early and intensive aphasia therapy to maximise neural plasticity and enhance communication gains. Acute speech pathology service delivery in Australia does not consistently meet best practice standards recommended by the National Stroke Foundation. Aims: This study aimed to: i) investigate the incidence of post-stroke aphasia in the acute setting; ii) determine the referral rate to speech pathology for patients with aphasia; iii) investigate the amount of language therapy provided to people with aphasia and iv) explore the relative proportion of aphasia service delivery within the overall caseload management of speech pathologists. Method …

Constraint Induced Aphasia Therapy In The Very Early Phase Of Recovery Following Stroke, Sarah D'Souza

Theses : Honours

Background and purpose: Research suggests communication outcomes following stroke may be greater when treatment is administered in the acute phase of recovery. In addition, treatment outcomes are improved when therapy is provided at a greater intensity. Constraint Induced Aphasia Therapy (CIAT) has addressed the issue of treatment intensity by delivering therapy for three hours per weekday for two weeks, but its effectiveness has largely been investigated in the chronic phase of recovery. Treatment outcomes have typically been assessed on standardised tests and few studies have used connected speech and discourse measures to assess change. This research investigated daily intervention in …

Effects Of Taping On Motor Function Of Upper Extremity In Chronic Stroke Patients, Rong-Bin Hong, Yi-Ru Chen, Da-Fang Chan, Willy Chou, Jeng-Feng Yang

Rehabilitation Practice and Science

The purpose of this study was to evaluate the effects of taping on motor recovery of paretic upper limb in chronic stroke patients. Ten chronic stroke patients with upper limb paresis were recruited. They all received regular rehabilitation programs before this study. Taping was applied to the upper trunk and paretic shoulder of those patients in addition to regular 3-week rehabilitation. Succeedingly, they received only regular rehabilitation for another 3 weeks. Three tests were conducted before and after taping and at 3 weeks follow-up. For each test, we measured the movement amplitudes of active shoulder flexion and abduction, Fugl-Meyer Motor …

Secondary Prevention Of Stroke And Transient Ischaemic Attack, Maggie Lawrence, Hazel Fraser, Charlotte Woods, Jon Mccall

Dr. Maggie Lawrence

Transient Ischaemic Attack (TIA) and stroke are clinical syndromes characterised by acute neurological deficits with vascular causes. People experiencing TIA or first stroke are at significant risk of subsequent stroke. Risk factors, which are associated with 90% of risk of all stroke, have been identified, and include factors associated with lifestyle i.e. tobacco use, diet, obesity, alcohol consumption, physical activity and stress. Targeted therapeutic interventions have the potential to substantially reduce the burden of stroke. The aim of this article is to provide an overview of the current evidence base relating to these lifestyle risk factors. Health promotion theories and …

Mechanisms Of The Contextual Interference Effect In Individuals Poststroke, Nicolas Schweughofer, Jeong-Yoon Lee, Hui-Ting Goh, Youggeun Choi, Sung Shin Kim, Jill Campbell Stewart Pt,Phd, Rebecca Lewthwaite, Carolee J. Winstein

Faculty Publications

Although intermixing different motor learning tasks via random schedules enhances long-term retention compared with “blocked” schedules, the mechanism underlying this contextual interference effect has been unclear. Furthermore, previous studies have reported inconclusive results in individuals poststroke. We instructed participants to learn to produce three grip force patterns in either random or blocked schedules and measured the contextual interference effect by long-term forgetting: the change in performance between immediate and 24-h posttests. Nondisabled participants exhibited the contextual interference effect: no forgetting in the random condition but forgetting in the blocked condition. Participants at least 3 mo poststroke exhibited no forgetting in …

The Lisbeth Hockey Community Nursing Research Training Fellowship 2008. Final Report, Maggie Lawrence, Susan Kerr, Caroline Mcvey, Dorothy Ferguson

Dr. Maggie Lawrence

Background Stroke is the most common cause of adult disability in the UK; the incidence is particularly high in Scotland, with more than 12,000 new cases per year. Stroke recurs in approximately 25% of patients and may result in death or an increased risk of disability or institutionalisation. Stroke is associated with a disadvantaged socio-economic profile and lifestyle behaviours which include smoking, unhealthy diet, excessive alcohol consumption and lack of exercise. Crucially, these factors are amenable to change by means of pharmacotherapy and/or the delivery of lifestyle interventions. While the provision of lifestyle interventions has the potential to improve health …

Is Gait Training With The Elliptically Based Robotic Gait Trainer (Ebrgt) Feasible In Ambulatory Patients After Stroke?, J. Cortney Bradford

Theses and Dissertations

In response to the potential benefits of task specific training in rehabilitation of gait after stroke and the need for affordable, simple ways to implement it, our group designed the elliptically based robotic gait trainer (EBRGT). A design review of the EBRGT, covering the design goals, an overview of the mechanical and electrical design, and a discussion of the novelty of the device and why it may be beneficial for individuals with hemiparesis secondary to stroke is discussed (Chapter 2). To characterize the new device, a study was performed to determine if the EBRGT produced a gait pattern that mimicked …

Effects Of Distributed Constraint-Induced Therapy On Trunk Control, Daily Function, And Quality Of Life In Patients With Chronic Stroke, Yi-An Chen, Keh-Chung Lin, Ching-Yi Wu, Yin-Chou Lin, Ngok-Kiu Chu, Jyh-Yuh Ke, Pei-Hsuan Wu

Rehabilitation Practice and Science

Objective: Patients commonly have impaired arm trunk coordination following a stroke. The trunk compensation often used by stroke patients may hinder recovery of the affected arm. Given that the extent to which constraint-induced therapy (CIT) affects arm-trunk coordination has not been investigated previously, this study examines how distributed CIT (dCIT) affects arm trunk coordination and trunk compensation strategy, as well as functional performance and quality of life.Materials and Methods: Sixteen participants (at least 6 months post-onset) after stroke were randomly assigned to either the dCIT group which received training 2 hours daily for 3 weeks, with the unaffected arm restrained …

The Effects Of Rehabilitation Exercises In Community-Dwelling Elderly With Osteoarthritis And Stroke: A Pilot Study, Jia-Ching Chen, Chun-Hsiang Lin, Li-Chun Chen, Yu-Chun Wei, Jung Hsiao, Nan-Yueh Lin, Chung-Chao Liang

Rehabilitation Practice and Science

The prevalence of chronic disease in community-dwelling elderly has increased with the increase in the elderly population in Taiwan. This study investigated the effects of regular rehabilitation exercises provided by rehabilitation professionals in community-dwelling elderly people with osteoarthritis and stroke. A single group with pretest-posttest design was used in this pilot study. A total of 32 elderly people in the community were recruited and classified into two groups, one with osteoarthritis (n=21) and the other with chronic stroke (n=11). The intervention of one consisted of one 3-hour rehabilitation exercise session each week provided by a physical therapist and consultation with …

Novel Orthoses For Male Hemiplegic Patients To Perform Clean Intermittent Catheterization: A Casereport, Yu-Lin Tsai, Mao-Hsiung Huang, Chia-Hsin Chen

Rehabilitation Practice and Science

A 37-year-old male suffered from hemorrhagic stroke with left side hemiplegia and neurogenic bladder. On admission, due to post-renal acute renal failure with hydronephrosis, he received indwelling catheterization but felt very uncomfortable. However, he was physically unable to perform clean intermittent catheterization (CIC) due to his hemiplegia. Two novel devices were designed to help him perform CIC using one side of his body. As in our experience with this case, hemiplegic patients may now be able to perform CIC by themselves to achieve adequate bladder drainage using one-sided limbs under the assistance of the novel orthoses.

Do People With Aphasia Want Written Information? A Verbal Survey Exploring Preferences For When And How To Provide Stroke And Aphasia Information, Tanya Rose, Linda Worrall, Louise Hickson, Tammy Hoffmann

Tammy Hoffmann

Purpose: Written health information can be better comprehended by people with aphasia if it is provided in an aphasiafriendly format. However, before pursuing research in the area of text-formatting for people with aphasia, it must be determined whether people with aphasia consider it helpful to receive health information in the written media. This study, therefore, aimed to determine the following: whether people with aphasia consider it important to receive written stroke and aphasia information; when people with aphasia prefer to receive this information; and what their preferences are for health information media.

Method: Surveys were administered in a face-to-face interview …

The Hemineglect And Hemianopia In Right Hemispheric Stroke Patients, Yung-Nan Hsu, Liu-Ing Bih, Chang-Zern Hong

Rehabilitation Practice and Science

This study investigated whether a stroke patient with left hemianopsia, which was confirmed by the perimetric test, may also have hemineglect. The relationship between hemineglect and hemianopia in patients with right hemispheric stroke was evaluated. Eleven subjects with left unilateral neglect underwent three testing sessions separated in time. The three test sessions, including cancellation and static perimetric tests, were performed at approximately 3 months, 4 months, and 7 months post the onset of the stroke. For the cancellation test, patients were asked to circle 60 marks on the test paper, and the number of marks correctly circled was scored. For …

The Impact Of Left Hemisphere Stroke On Force Control With Familiar And Novel Objects: Neuroanatomic Substrates And Relationship To Apraxia, Amanda M. Dawson, Laura J. Buxbaum, Susan V. Duff

Physical Therapy Faculty Articles and Research

Fingertip force scaling for lifting objects frequently occurs in anticipation of finger contact. An ongoing question concerns the types of memories that are used to inform predictive control. Object-specific information such as weight may be stored and retrieved when previously encountered objects are lifted again. Alternatively, visual size and shape cues may provide estimates of object density each time objects are encountered. We reasoned that differences in performance with familiar versus novel objects would provide support for the former possibility. Anticipatory force production with both familiar and novel objects was assessed in six left hemisphere stroke patients, two of whom …

Observation Of Amounts Of Movement Practice Provided During Stroke Rehabilitation, Catherine E. Lang, Jillian R. Macdonald, Darcy S. Reisman, Lara Boyd, Teresa Jacobson Kimberley, Sheila M. Schindler-Ivens, T. George Hornby, Sandy A. Ross, Patricia L. Scheets

Physical Therapy Faculty Research and Publications

Objective

To investigate how much movement practice occurred during stroke rehabilitation, and what factors might influence doses of practice provided.

Design

Observational survey of stroke therapy sessions.

Setting

Seven inpatient and outpatient rehabilitation sites.

Participants

We observed a convenience sample of 312 physical and occupational therapy sessions for people with stroke.

Interventions

Not applicable.

Main Outcome Measures

We recorded numbers of repetitions in specific movement categories and data on potential modifying factors (patient age, side affected, time since stroke, FIM item scores, years of therapist experience). Descriptive statistics were used to characterize amounts of practice. Correlation and regression analyses were …

What Education Do Stroke Patients Receive In Australian Hospitals?, Tammy Hoffmann, Tammy Cochrane

Tammy Hoffmann

Objective: This study evaluated the educational practices of staff working in acute stroke wards in Australian hospitals, including the coordination and methods of patient education provision, postdischarge education and support services available, and the education and support services that health professionals would like to provide.

Methods: Health professionals who worked in acute stroke wards in Australian hospitals were surveyed about the stroke education practices of staff in their ward. Thirty-four hospitals returned a completed questionnaire via email or fax.

Results: Verbal communication and written materials were the most frequently used methods of information provision. Twenty-three (67.6%) wards developed their own …

Stroke Research Questions: A Nursing Perspective., Anne Rowat, Maggie Lawrence, Dorothy Horsburgh, Lynne Legg, Lorraine Smith

Dr. Maggie Lawrence

No abstract provided.

Initial Blood Glucose Level In The Emergency Department As A Prognostic Factor On Functional Outcome Of Ischemic Stroke, Yi-Min Chen, Gwo-Chi Hu, Jiann-Perng Chen, Chien-Shen Chen, Cheng-Tsong Liao, Kuan-Wen Chen

Rehabilitation Practice and Science

Although many studies are available in focus on prognostic factors for acute cerebral vascular disease, there are few reports to discuss the impact of the initial glucose level on the functional outcome after stroke. The initial glucose level in the emergency department is more representative of acute glucose response after stroke and is not influenced by the treatment in the emergency department. The aim of our study is to evaluate the prognostic role of the initial glucose level on the functional outcome after stroke.We recruited individuals who sustained first-ever stroke and were admitted to an inpatient stroke rehabilitation program. Patients …

Intensive Cardiopulmonary Rehabilitation Program For Patients With Severe Heart Failure And Acute Stroke: A Report Of Two Cases, Chyi-Yann Wang, Jue-Long Wang, Ai-Lun Yang, Ko-Long Lin

Rehabilitation Practice and Science

Cardiovascular disease is a major factor restricting successful outcomes after stroke rehabilitation. While neurological recovery after stroke has been extensively investigated, cardiovascular adaptations to physical activities poststroke have received little attention. Severe heart failure patients have been well known for limitation of ambulation, but the influence over acute poststroke patients have rarely been investigated. Exercise testing has become a mainstay for the prognostic assessment of patients with heart failure. Various studies have shown that patients with impaired exercise capacity, as measured by low peak oxygen consumption (Vo2), have an unfavorable outcome, independent of other parameters. Whether parameters from submaximal test …

A Reviewarticle Of Psychometric Properties Of Five Tests Of Attention Commonly Used In Patients With Stroke, Hui-Yan Chiau, I-Ping Hsueh, Chia-Lin Koh, Hui-Chun Chen, Chin-Ling Hsieh

Rehabilitation Practice and Science

Background and purpose: Comparison of the psychometric properties of tests of attention can provide guidelines with which clinicians and researchers can determine a useful measurement. The purpose of this study is to reviewarticle and appraise the psychometric properties of attentional tests frequently used during the last 3 years in empirical studies of stroke and to determine how well these tests can be applied on people with stroke.Methods: This study included two parts: first, a search from the MEDLINE, PsycINFO, CINAHL and Index to Chinese Periodical Literature databases for attentional tests used more than twice in empirical studies of stroke in …

The Pressure Distribution Of Hemiplegics At The Femoral Greater Trochanter And Sacrum In Different Bed Positions, Chin-Teng Chung, Wei-Feng Tang, Chorng-Song Chou, Lu-Han Liu, May-Hua Liao, Yu-Chun Yin

Rehabilitation Practice and Science

Pressure ulcers frequently develop in hemiplegic stroke patients who are immobilized and bedridden. Common sites for pressure ulcers include the sacrum, greater trochanter of the femur, lateral malleolus, and the heel. Such ulcers cause extra burdens for the whole medical team, the caregiver, and the patients themself. The ulcers also increase more medical cost at the same time. Patients with pressure ulcers also become depressed and less motivated to undergo rehabilitation. The prevention of pressure ulcer formation has thus become an important issue among stroke patients.The most important factor in pressure ulcer formation is the direct pressure of the mattress …

Correlation Between Impairment And Motor Performance During Reaching Tasks In Subjects With Spastic Hemiparesis, Charles Leonard, Kelsey A. Gardipee, Jennifer R. Koontz, John-Henry Anderson, Scott A. Wilkins

Physical Therapy and Rehabilitation Science Faculty Publications

Objective: The main purposes of this study were to examine, in subjects with chronic hemiparesis following a stroke: (i) the correlations between tests of muscle tone, stiffness, spasticity, paresis and co-contraction, and (ii) the correlations of these tests and measurements of impairment to upper extremity motor performance.

Design: Prospective, cross-sectional, correlation matrix using sample of convenience.

Subjects: Thirteen subjects with chronic hemiparesis secondary to a cerebrovascular accident (stroke) were tested.

Methods: Subjects were assessed using the Fugl-Meyer Upper Extremity Motor Assessment, modified Ashworth scale, deep tendon reflexes, and muscle characteristics that included quantification of muscle stiffness, paresis and co-contraction during …

Risk Factors Of Post-Stroke Depression In Middle-Aged Adults And The Elderly, Yuan-Yang Cheng, Chen-Liang Chou, Shun-Ping Cheng, Tcho-Jen Liu, Rai-Chi Chan, Wen-Jang Wong

Rehabilitation Practice and Science

In order to evaluate the prevalence and risk factors of post-stroke depression, this study collected the data of 102 stroke patients from the outpatient clinic of the neurology and rehabilitation departments in a medical center in Taipei. The patients' objective data, such as age, infarction area of the brain, duration from the stroke attack to the time of our study, number of stroke attacks, antidepressant use, and rehabilitation program, were obtained from the history chart. A questionnaire evaluation of the swallowing function, depression status, and functional independence measure was also done by interviewing the patients individually. The results showed that …

Thickening Of Finger Extensor Tendons In Hemiplegic Hands Of Stroke Patients, Nai-Hsin Meng, Sui-Foon Lo, Ting-I Han, Yi-Fang Hu, I-Shien Tseng, Mu-Jung Kao

Rehabilitation Practice and Science

Thickening of finger extensor tendons in hemiplegic hands of stroke patients has never been reported. We reported 11 patients with stroke who experienced gradual onset of a painless swelling at the dorsal aspect of the hemiplegic wrist. Soft tissue sonography revealed that the swellings were mainly composed of thickened finger extensor tendons. This thickening typically involved the tendons of the 4th dorsal extensor compartment between the proximal carpal and mid-metacarpal levels. The maximal thickness of these tendons could reach over three times that of the corresponding tendons of the contralateral hand. The synovial tissue surrounding the thickened tendon was also …