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Search Results: 1 - 10 of 4650 matches for " Stroke rehabilitation "
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A comparison between reported and ideal patient-to-therapist ratios for stroke rehabilitation  [PDF]
Gabrielle McHugh, Ian D. Swain
Health (Health) , 2013, DOI: 10.4236/health.2013.56A2016
Abstract:

Objective: Major improvement has been made in the medical management of stroke in the UK between 2008 and 2010 based on the indicators measured in the National Sentinel Audit. However based on the same audit, no corresponding improvement has been effected to patient functional impairment levels on hospital discharge in the corresponding time frame. This study derived patient-to-therapist ratios as a means of exploring the amount of rehabilitation time for stroke patients while in hospital care. Method: A purpose specific survey was developed for completion by stroke teams. From a contact list compiled primarily in collaboration with the 28 National Stroke Improvement Networks, the Nth name technique was used to target stroke teams in each geographical area covered by the 28 networks. Results: A total of 53 surveys were returned representing 20 of the 28 network areas providing 71% national coverage. Analysis conducted on 19 of the 37 inpatient hospital care units that were discrete units, had no missing data for staff numbers, unit bed numbers, number of stroke patients treated per annum, average unit length-of-stay, and unit occupancy rates. Staffing levels for some therapies were below the Department of Health staffing assumptions suggesting that stroke units are challenged to provide the recommended therapy time. Conclusions: Most stroke units surveyed are operating below the DH staffing assumption levels and are therefore challenged in providing the amount of therapy and patient time recommended in the National Institute of Clinical Excellence guidelines to facilitate optimal functional recovery for stroke patients.

Botulinum toxin type-A (BoNTA) and dynamic wrist-hand orthoses versus orthoses alone for the treatment of spastic-paretic upper extremity in chronic stroke patients  [PDF]
Sepideh Pooyania, Brenda Semenko
Open Journal of Therapy and Rehabilitation (OJTR) , 2014, DOI: 10.4236/ojtr.2014.21003
Abstract: Purpose: The purpose of this study was to investigate the potential functional improvement of the spastic-paretic upper extremity of individuals with chronic hemiparesis when using a dynamic wrist-hand orthosis with and without concurrent botulinum toxin type-A (BoNTA) injections into the spastic upper extremity muscles. Methods: A three-year retrospective chart review was conducted on all stroke patients referred to out-patient occupational therapy for an upper extremity rehabilitation program, which included use of a dynamic wrist-hand orthosis (DWHO). Three charts documented concurrent treatment with a DWHO + BoNTA. Eleven charts documented DWHO use without concurrent BoNTA treatment. Pre- and post-intervention outcome measure scores were compared between the two groups. Pre- and post-interven- tion scores were also analyzed irrespective of treatment group. Results: Although improvement approached significance on three of the documented outcome measures when comparing the DWHO + BoNTA and DWHO groups, no statistically significant changes were found. A significant difference (p < 0.05) however, was found between the pre- and post-intervention scores irrespective of treatment group in 13 of 14 of the outcome measures documented. Conclusions: Further research with a larger sample size is suggested to assess the combined effect of using a dynamic wrist-hand orthosis and BoNTA injections into the spastic upper extremity muscles of individuals with chronic hemiparesis post stroke.
Physiotherapists’ and occupational therapists’ perceptions of the assessment of stroke patients for musculoskeletal rehabilitation in the UK national health service  [PDF]
Christopher Golby, Gillian Lewando Hundt, Vinesh Raja
Health (Health) , 2013, DOI: 10.4236/health.2013.59201
Abstract:

Background and Purpose: This exploratory study focused on the assessment of stroke patients for musculoskeletal rehabilitation in the United Kingdom National Health Service. It was the first phase of research on developing telerehabilitation for the assessment of patients who have had a stroke. The assessment of stroke patients for musculoskeletal rehabilitation is currently performed at the therapist’s discretion using different outcome measures. When looking at the Department of Health’s “National Clinical Guidelines for Stroke”, it is stated that there are a variety of outcome measures, yet no particular one is recommended. It is specified that each rehabilitation sector should select its own methodologies. Aim: The aim of this exploratory study was to understand physiotherapists’ and occupational therapists’ perspectives of the strengths and weaknesses of current rehabilitative assessment of stroke patients in the UK National Health Service. Methods: This study had 2 parts, non-participant observation with 2 therapists and 3 patients, and 10 semi-structured interviews with 5 physiotherapists and 5 occupational therapists to identify current practice, problem areas, and what types of improvements could be made. Interviews were transcribed and analyzed using thematic coding. Results: Seven emergent themes were identified portraying how outcome measures are currently not being used in a standardized way within National Health Service hospitals. This means that the feedback provided to patients, therapists and healthcare commissioners is limited. Therapists are currently performing more informal assessments each time a patient begins therapy and concerns are shown with these methods of assessment, including subjec

Building up Systematic Client-Centred Data as a Base for Clinical Outcome within Outpatient Neurorehabilitation  [PDF]
Jessica Vollertsen, Kersti Samuelsson
Open Journal of Therapy and Rehabilitation (OJTR) , 2016, DOI: 10.4236/ojtr.2016.41002
Abstract: Objective: This study describes the development and use of a specific database supporting personnel within outpatient neurological rehabilitation to reflect on existing interventions and improve future rehabilitation. Methods: Five outpatient rehabilitation centres in one county council in Sweden were involved in developing and implementing a systematic data collection template within the existing digital medical record system. Data were collected to get more information on the effects of outpatient stroke rehabilitation in patients who received rehabilitation the first year after a stroke (ICD-I64) and patients who received further rehabilitation 1 year or more after a stroke (ICD-I69). Data analysis included evaluation of balance, movement, activity/participation, health-related quality of life, and self-rated health. Results: The ICD-I64 group had positive results after treatment (p < 0.05) for all variables and the ICD-I69 group had positive results for balance and activity/participation. Conclusions: The use of systematic data collection provided a platform for employees and managers to discuss and use clinical results to improve the type and quality of rehabilitation interventions.
Supported Rehabilitation for Individuals Who Have Experienced a Stroke: A Pilot Control Trial  [PDF]
Charlotte Gaynor, Laura Devaux, Morley Stephanie, Kate Petropoulou, Brendon Stubbs, Andrew Soundy
Open Journal of Therapy and Rehabilitation (OJTR) , 2016, DOI: 10.4236/ojtr.2016.42008
Abstract: The purpose of this study was to pilot an innovative and supported intervention for individuals with a stroke. A pilot control trial with qualitative interviews was undertaken within a university- community setting. Thirteen individuals who had experienced a stroke for periods of least 6 months (6 male, average 71 years) were assigned to the intervention group and 7 individuals (2 male, average age 67.9 years) assigned to the control group. Eight individuals from the intervention group completed a single interview. The procedures that related to recruitment and retention and data collection methods were considered. Outcome measures including; self-efficacy, falls self-efficacy and group membership, for both groups were taken at baseline, 11 weeks, 22 weeks. There was an additional assessment at 52 weeks for the intervention group. The structured interview was designed to focus on experiences of the intervention. Self-efficacy remained stable across time for both groups. An improvement in falls self-efficacy was noted in the intervention group at 11 weeks. Consistent improvement (from baseline) was observed in the identity scale across the 52 weeks. Qualitative data provided additional findings related to identity and confidence. Details considering recruitment and retention are also provided. This pilot study provided data that can be used for a further full-scale trial to be considered.
Effect of Kinesio Taping on Hand Function in Hemiparetic Patients  [PDF]
Jonathan Galv?o Tenório x Cavalcante, Maria do Desterro Costae Silva, Jessiane Tenório da Fonseca Silva, Clarissa Cotrim dos Anjos, Renata Sampaio Rodrigues Soutinho
World Journal of Neuroscience (WJNS) , 2018, DOI: 10.4236/wjns.2018.82023
Abstract: Introduction: Cerebrovascular accident (CVA) is the second most frequent cause of death in the world. Nevertheless, most victims do survive and need treatment, and hand function is one that has to be dealt with in the rehabilitation process. Kinesio®?Taping (KT) is a bandaging method that can be applied along the muscle fibers to provide stimulation. Studies have shown its efficacy in providing afferent stimuli to weakened muscles, thus eliciting contraction with greater recruiting of motor units and inducing neuroplasticity. Benefits to the paresthesia hand have not been reported. Objective: Investigate the effects of KT on hand function in hemiparetic patients. Material and Methods: An evaluator-blinded, randomized clinical trial involving stroke victims was carried out in a physical therapy outpatient clinic. One group underwent KT intervention and the other was a control group. The Modified Ashworth Scale (MAS) and the Box and Block Test (BBT) were used as assessment tools. A data entry form was used in the Epi-info 7 software and descriptive statistics was thus calculated. The software BioStat 5.0 was employed when doing statistical tests. Associations were regarded as statistically significant when p < 0.05. Results: Eight individuals were randomly assigned to two groups. All those who had received treatment with KT had spasticity improved by one point, but there was no significant improvement in BBT. Conclusion: KT was effective when it came to improving spasticity and it may be an option in rehab, but it had no effect on gross manual dexterity. Nevertheless, it can be of help as part of a functional training program.
Descripción clínica, social, laboral y de la percepción funcional individual en pacientes con ataque cerebrovascular
Suárez-Escudero,Juan Camilo; Restrepo Cano,Sandra Catalina; Ramírez,Elsa Patricia; Liliana Bedoya,Claudia; Jiménez,ván;
Acta Neurológica Colombiana , 2011,
Abstract: introduction. in addition to different functional and structural deficits, cerebrovascular disease causes several types of restrictions in social participation. objective. the aim of this study was to describe the clinical, social and occupational characteristics as well as the self-perception in patients with cerebrovascular disease (stroke) attended in a neurological institution in colombia. materials and methods. 81 clinical records with stroke diagnosis and a hospital discharge time between 6 months and two years were evaluated. date regarding sings, symptoms and vascular territory were collected. additionally a 19 questions interview was applied asking about self-perception, course and current state of disability results. the distribution of patients was ischemic stroke 71,6%, hemorrhagic stroke 19.8% and lacunar infarction 8.6%. right middle cerebral artery was the most frequently affected (58%). motor deficit and dysarthria were the main complains at the admission time. 65.3% reported improvement of the motor deficit initially described. before the stroke 64.3% were occupationally active, after the stroke only 10.7% kept their previous job. conclusion. in this sample ischemic stroke was the most frequent cause of cerebrovascular disease. alterations on the speaking and motor skills are explainable by the compromise of the right middle cerebral artery. in spite of the self - perception of improvement there is considerable impact on the occupational field.
Constipa??o intestinal em pacientes admitidos em programa de reabilita??o neurológica
Engler, Tania Mara Nascimento de Miranda;Farage, Luciano;Mello, Paulo Andrade de;
Acta Paulista de Enfermagem , 2011, DOI: 10.1590/S0103-21002011000600013
Abstract: objectives: to determine the prevalence of constipation in patients admitted for rehabilitation and to verify the results of two intervention models for bowel retraining during hospitalization. methods: a longitudinal, analytical study, with 98 patients admitted to rehabilitation ward between december 2009 and may 2010. results: the prevalence of constipation was 57.1%, there was no correlation with gender, education, age, transportation assistance, language disorder, physical activity, diet and presence of constipation; the improvement in functional capacity was a predictor of progress in intestinal frequency; interventions introduced demonstrated an important role in improving bowel habits. conclusions: conduct studies may provide treatment options for constipation, improving the quality of life for these individuals.
Paciente com acidente vascular encefálico e a rede de apoio familiar
Rodrigues, Lívia de Sousa;Alencar, Ana Maria Parente G.;Rocha, Edilma Gomes;
Revista Brasileira de Enfermagem , 2009, DOI: 10.1590/S0034-71672009000200016
Abstract: the study aimed at investigating the perception of the familiar/care worker about his contribution in the rehabilitation of the patient with stroke. qualitative study, carried through in the medical clinic of a hospital located in the city of crato, ce, brazil, between march and may, 2006. results: between the home care workers predominated the feminine gender, in the age range between 27 and 66 years, with blood relation with the patient and presenting educational level between the half-illiteracy and university level. the information is deficient in all the aspects. among the delivered care, the physical ones are highlighted. conclusion: this work demonstrates that the familiar care worker is not prepared to receive and to rehabilitate people who have special necessities as it is the case of victims of stroke.
Reabilita??o em disfagia orofaríngea neurogênica: sabor azedo e temperatura fria
Cola, Paula Cristina;Gatto, Ana Rita;Silva, Roberta Gon?alves da;Schelp, Arthur Oscar;Henry, Maria Aparecida Coelho de Arruda;
Revista CEFAC , 2008, DOI: 10.1590/S1516-18462008000200009
Abstract: background: rehabilitation in neurogenic oropharyngeal dysphagia purpose: to submit an overview of the related literature about neurophisiological control of oropharingeal dysphagia and the role of temperature and sour taste on swallowing mechanisms. conclusions: as for the neurophysiologic swallowing control, there are still controversies when it comes to sour taste and cold temperature. these two standards can change the swallowing dynamics, and they may bring out benefits to the individuals with neurogenic oropharyngeal dysphagia. therefore, the findings suggest the need for further investigations with randomized studies.
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