Topics in Stroke Rehabilitation最新文献

{"title":"Financial burden, non-medical drivers of health, and early caregiving role formation after stroke: a scoping review.","authors":"Munachi Okpala, Mariel Flake-Rojas, Edwin Akomaning, Shelby Woodall, Alexis Simpkins, Okechukwu Chukwuekezie, Layomi Oladunjoye, Anjail Z Sharrief","doi":"10.1080/10749357.2026.2746391","DOIUrl":"https://doi.org/10.1080/10749357.2026.2746391","url":null,"abstract":"<p><strong>Background: </strong>Family caregivers are essential to stroke recovery, yet existing assessments may not adequately capture structural factors influencing caregiving capacity. Financial toxicity, non-medical drivers of health (NMDOH), and caregiver role formation during early post-stroke recovery remain poorly characterized. This scoping review evaluated how current caregiver assessments address these domains.</p><p><strong>Methods: </strong>A scoping review using the Arksey and O'Malley and Levac frameworks was reported according to PRISMA-ScR guidelines. Four databases were searched for studies published within the past 10 years examining informal caregiving during hospitalization, inpatient rehabilitation, or early transition home after stroke. Data were extracted on caregiver assessments, financial toxicity, NMDOH, and caregiver role formation.</p><p><strong>Results: </strong>Sixteen studies were included. Assessments commonly capture caregiver burden, psychosocial distress, preparedness, social support, and caregiving tasks. Financial toxicity was absent in seven studies; most others assessed only subjective financial strain or a single objective indicator, such as income loss. Only one study assessed financial toxicity multidimensionally, incorporating income loss, direct costs, and debt. Employment and healthcare access were the most frequently assessed NMDOH domains (11 studies each), while housing and transportation were less frequently addressed; food security was absent. All studies addressed aspects of caregiver role formation, most commonly preparedness, but only one examined its relationship with financial toxicity.</p><p><strong>Conclusions: </strong>Caregiver assessments inconsistently capture financial toxicity and NMDOH. Future instruments should integrate multidimensional financial toxicity and NMDOH measures with caregiver role formation to better identify vulnerability and support equitable, sustainable stroke recovery.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-11"},"PeriodicalIF":2.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot and feasibility studies in stroke rehabilitation: reporting quality, progression to trials, and barriers: a scoping review.","authors":"Maria Tereza Mota Alvarenga, Louise Ada, Augusto Boening, Lívia Cristina Guimarães Caetano, Lucas Rodrigues Nascimento, Aline Alvim Scianni","doi":"10.1080/10749357.2026.2746388","DOIUrl":"https://doi.org/10.1080/10749357.2026.2746388","url":null,"abstract":"<p><strong>Introduction: </strong>Pilot and feasibility studies are designed to determine whether a future trial is warranted. In stroke rehabilitation, such studies have been increasingly published over the years. To clarify how well these studies support future trials, we aimed to: (1) assess the quality of reporting of pilot and feasibility studies aimed to improve mobility (ie, walking) after stroke; (2) examine whether they progress to randomized controlled trials (RCTs); and (3) explore the barriers in following up on these studies.</p><p><strong>Design: </strong>Scoping review.</p><p><strong>Participants: </strong>Adults (>18 years) after stroke.</p><p><strong>Intervention: </strong>Interventions to improve mobility (ie, walking).</p><p><strong>Results: </strong>28 papers were included. The quality of reporting of the studies was 6.1 out of 11 points. Only 3 out of 26 studies (12%) progressed to a definitive RCT. Of those authors who replied, the main reason for not proceeding to an RCT was lack of funding.</p><p><strong>Conclusion: </strong>The quality of reporting of pilot and feasibility studies still needs to improve, especially when describing the methods section. In addition, these studies should be designed a priori to provide transparency in reporting and enhance value in guiding future trials.<b>Registration:</b> 10.17605/OSF.IO/ENJ94.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-11"},"PeriodicalIF":2.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How does pre-stroke physical activity influence physical activity one year after minor stroke, and what role does cognitive impairment play?","authors":"Anne Meyer Knudsen, Nanna Rolving, Janne Kærgård Mortensen, Andreas Gammelgaard Damsbo","doi":"10.1080/10749357.2026.2746396","DOIUrl":"https://doi.org/10.1080/10749357.2026.2746396","url":null,"abstract":"<p><strong>Objective: </strong>To examine the association between pre-stroke physical activity and physical activity levels 12 months after stroke, and to explore whether cognitive impairment modifies this association.</p><p><strong>Methods: </strong>This study was a secondary analysis of data from a prospective cohort study of 100 patients with stroke at Aarhus University Hospital. Physical activity was assessed using the Physical Activity Scale for the Elderly, and cognitive function was measured using the Repeatable Battery for the Assessment of Neuropsychological Status. Logistic regression analyses were performed to examine associations between pre- and post-stroke physical activity, adjusting for relevant covariates.</p><p><strong>Results: </strong>Low pre-stroke physical activity had significantly higher odds of low physical activity 12-months post-stroke (OR = 5.81, 95% CI: 1.61-24.0, <i>p</i> = 0.010). The estimated odds ratio for effect modification by cognitive impairment was 7.44 (95% CI: 0.81-89.9, <i>p</i> = 0.092), although the wide confidence interval indicates substantial uncertainty.</p><p><strong>Conclusions: </strong>Pre-stroke PA was associated with PA levels 12 months post-stroke in individuals with mild stroke. Assessing pre-stroke PA may help identify patients at risk of persistent inactivity and guide personalized rehabilitation. The modifying role of cognitive impairment remains inconclusive and warrants further investigation.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-12"},"PeriodicalIF":2.3,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between hospital-level factors and early rehabilitation initiation in patients with acute ischemic stroke: a multilevel analysis using a Japanese administrative database from a rural prefecture.","authors":"Daichi Homma, Masayasu Murakami, Takaaki Ikeda","doi":"10.1080/10749357.2026.2745004","DOIUrl":"https://doi.org/10.1080/10749357.2026.2745004","url":null,"abstract":"<p><strong>Background: </strong>Early rehabilitation after acute ischemic stroke improves functional outcomes and is recommended by clinical guidelines. However, initiation of early rehabilitation varies substantially across hospitals, and the contribution of hospital-level factors remains unclear.</p><p><strong>Objective: </strong>To examine the association between hospital-level factors and early rehabilitation initiation, adjusting for patient-level characteristics.</p><p><strong>Methods: </strong>We conducted a multicenter cross-sectional study using the Japanese Diagnosis Procedure Combination database from 43 hospitals in Yamagata Prefecture between 2017 and 2022. Patients admitted within 3 days of ischemic stroke onset who received inpatient rehabilitation were included. Early rehabilitation was defined as initiation of physical, occupational, or speech-language-hearing therapy within 2 days of admission. Multilevel Poisson regression models were constructed with patients nested within hospitals. Median rate ratio (MRR) was calculated to quantify hospital-level variation.</p><p><strong>Results: </strong>A total of 17,194 patients from 19 hospitals were analyzed; 9,533 patients (55.4%) received early rehabilitation. At the hospital-level factors, provision of weekend rehabilitation services was significantly associated with early initiation (incidence rate ratio, 1.65; 95% credible interval, 1.21-2.25). Therapist staffing levels, annual stroke volume, and availability of thrombolytic therapy were not associated with early rehabilitation. The hospital-level MRR decreased from 1.47 in the null model to 1.35 after inclusion of weekend rehabilitation services.</p><p><strong>Conclusions: </strong>The provision of weekend rehabilitation was associated with the initiation of early rehabilitation for ischemic stroke patients. Our findings suggest that variations in the initiation of early rehabilitation for acute ischemic stroke are largely driven by organizational systems rather than patient characteristics.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-10"},"PeriodicalIF":2.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of thoracic kinesiological taping on pulmonary functions, respiratory muscle strength, and functional independence in patients with hemiplegia: a randomized controlled clinical trial.","authors":"Natali Bitmani, Çiçek Günday, Yunus Emre Tütüneken, Roya Soltanalizadeh","doi":"10.1080/10749357.2026.2746392","DOIUrl":"https://doi.org/10.1080/10749357.2026.2746392","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of thoracic kinesiology taping (KT) on pulmonary function, respiratory muscle strength, and functional independence in individuals with chronic post-stroke hemiplegia.</p><p><strong>Methods: </strong>30 patients were randomly assigned to a thoracic KT or sham taping group. Both groups received conventional rehabilitation 5 days/week for 4 weeks. The KT group received thoracic taping with 50-75% tension, whereas the sham group received an identical application without tension. Outcomes were assessed at baseline and post-intervention, and included forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and Functional Independence Measure (FIM).</p><p><strong>Results: </strong>Both groups showed significant within-group improvements in FVC, FEV1, PEF, and MIP (all <i>p</i> = 0.001), with greater changes in the KT group. FIM improved significantly only in the KT group (<i>p</i> = 0.015). MEP did not change in the KT group (<i>p</i> = 0.674) but showed a small increase in the sham group (<i>p</i> = 0.010). Between-group comparisons demonstrated significant advantages in favor of KT for FVC (<i>p</i> < 0.001), FEV1 (<i>p</i> < 0.001), PEF (<i>p</i> < 0.001), and MIP (<i>p</i> < 0.001) and FIM (<i>p</i> = 0.029), while a small but significant advantage in MEP was observed in favor of the sham group (<i>p</i> = 0.030).</p><p><strong>Conclusion: </strong>Thoracic KT, when combined with conventional rehabilitation, significantly improves pulmonary function and inspiratory muscle strength in individuals with chronic stroke. Its effects appear to be primarily related to optimization of ventilatory mechanics rather than direct muscle strengthening. Thoracic KT may serve as a practical adjunct in respiratory neurorehabilitation.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-10"},"PeriodicalIF":2.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mirror therapy versus functional electrical stimulation cycling in post-stroke lower limb rehabilitation: a randomized controlled trial.","authors":"Muhammed Sefa Çınar, Engin Koyuncu, Tuğba Atan, Eda Gürçay","doi":"10.1080/10749357.2026.2742170","DOIUrl":"https://doi.org/10.1080/10749357.2026.2742170","url":null,"abstract":"<p><strong>Background: </strong>Stroke commonly leads to lower extremity motor impairment and reduced quality of life. Adjunctive rehabilitation approaches are often required to enhance recovery during the subacute phase.</p><p><strong>Objectives: </strong>To compare the effects of mirror therapy (MT) and functional electrical stimulation-assisted cycling (FES-C) as adjuncts to conventional rehabilitation in patients with subacute stroke.</p><p><strong>Methods: </strong>Forty-five patients were randomly assigned to a control, MT, or FES-C group (<i>n</i> = 15 each). All participants received conventional rehabilitation, with 30 minutes replaced by MT or FES-C in the groups, 5 days per week for six weeks. Outcomes were assessed before and after treatment using the Fugl-Meyer Assessment-Lower Extremity (FMA-LE), Brunnstrom stage, Functional Independence Measure-Motor, Berg Balance Scale, Functional Ambulation Classification, and Stroke-Specific Quality of Life Scale (SS-QOL).</p><p><strong>Results: </strong>All groups showed significant within-group improvements (<i>p</i> < 0.05). Compared with control, both the MT (mean difference [MD] -2.60, 95% CI - 5.83 to -0.63, <i>p</i> = 0.004) and FES-C groups (MD - 3.00, 95% CI - 6.23 to -0.23, <i>p</i> = 0.008) demonstrated greater improvements in ΔFMA-LE scores. Only the FES-C group showed significantly greater gains in ΔBrunnstrom stage (MD - 0.80, 95% CI - 1.49 to -0.10, <i>p</i> = 0.007) and ΔSS-QOL (MD - 19.40, 95% CI - 35.70 to -3.09, <i>p</i> = 0.015). No significant differences were observed between MT and FES-C (<i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>Despite the more advanced technological features of FES-C, MT also achieved improvements in lower extremity motor function, supporting its use as a simple and accessible adjunct intervention for post-stroke lower extremity rehabilitation.</p><p><strong>Clinicaltrials.gov: </strong>NCT06558721.</p><p><strong>Clinical trial registration number: </strong>The study was registered at the US National Institutes of Health (ClinicalTrials.gov) (NCT06558721) and available a https://clinicaltrials.gov/study/NCT06558721?term=sefa%20c%C4%B1nar&rank=1.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-11"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a dynamic wrist-hand orthosis combined with modified constraint-induced movement therapy on upper limb and hand function in acute and sub-acute stroke patients: a randomized controlled trial.","authors":"Songhua Huang, Tianhao Gao, Junqi Ling, Jing Tian, Chan Chen, Rongrong Lu, Yulong Bai","doi":"10.1080/10749357.2026.2648215","DOIUrl":"10.1080/10749357.2026.2648215","url":null,"abstract":"<p><strong>Background: </strong>Constraint-Induced Movement Therapy (CIMT) is a \"rehabilitation strategy\" supported by numerous basic studies. However, its clinical implementation is often limited by the poor ability of the affected limb.</p><p><strong>Objectives: </strong>To combine mCIMT plus a SaeboGlove for persons who would not normally qualify for mCIMT training.</p><p><strong>Methods: </strong>Part A: mCIMT+Saebo group (<i>n</i> = 18) and mCIMT group (<i>n</i> = 19). Part B: mCIMT+Saebo group (<i>n</i> = 10) and control group (<i>n</i> = 9). Both parts were assessor-blinded, two-arm, parallel-group randomized controlled trials. In addition to conventional rehabilitation therapy, all groups, except the control group, underwent mCIMT. The mCIMT group wore a mitt for approximately 4 hours per day, 5 days a week, for 3 consecutive weeks. The mCIMT+Saebo group wore both the SaeboGlove and a mitt for the same duration.</p><p><strong>Results: </strong>Part A: Wolf Motor Function Test (WMFT) showed that mCIMT+Saebo group scored 7.23 points higher (95% CI 1.93 to 12.53) than mCIMT group (P < 0.05). Hand grip strength (item 14 of WMFT) scored 3.29 points higher (95% CI 1.35 to 5.24) than in the mCIMT group (P < 0.01). Part B: The WMFT showed that mCIMT+Saebo group scored 5.45 points higher (95% CI 1.92 to 8.98) than the control group (P < 0.01). Hand grip strength was 2.66 points higher (95% CI 1.33 to 3.99) (P < 0.001), and ARAT was 10.75 points higher (95% CI 0.93 to 20.57) than in the control group (P < 0.05).</p><p><strong>Conclusions: </strong>The SaeboGlove may enhance the therapeutic advantages of mCIMT and expand the inclusion criteria for CIMT.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"789-799"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Center-of-pressure responses to optokinetic stimulation in patients with stroke and age-matched healthy adults: identifying sensitive measures-an exploratory study.","authors":"Shota Hayashi, Tomohiko Kamo, Shingo Hirano, Naoya Takahashi, Kazusa Saisu, Takechiyo Honma, Hironobu Kakima, Yuta Tani, Kazutaka Kobayashi, Hirofumi Ogihara, Tatsuya Igarashi, Akira Kimura","doi":"10.1080/10749357.2026.2628552","DOIUrl":"10.1080/10749357.2026.2628552","url":null,"abstract":"<p><strong>Background: </strong>Visual dependence and optokinetic stimulation (OKS) modulate sensory weighting for postural control and may be altered after stroke. However, the center-of-pressure (COP) measures that most sensitively index OKS-related changes during quiet standing, compared with age-matched older adults, have not been clearly defined.</p><p><strong>Objectives: </strong>To explore which COP measures are most responsive to OKS during quiet standing in patients with stroke versus older adults, and to interpret these responses using visual dependence and frequency-domain COP measures.</p><p><strong>Methods: </strong>This was a retrospective secondary analysis of a cross-sectional dataset. Thirty patients with subacute stroke and 30 age-matched healthy adults underwent stabilometry under eyes-open and rotating-visual conditions induced through OKS. COP measures were derived; frequency-domain features indexed sensory weighting. Visual dependence was defined as dynamic minus static Subjective Visual Vertical. Two-way mixed analysis of variance evaluated group and condition effects.</p><p><strong>Results: </strong>Significant group × condition interactions were observed for sway path, mediolateral amplitude, and mediolateral sway velocity (<i>p</i> < 0.01, partial η² ≈0.08-0.09). In the stroke group, these indices were higher under both rotating-visual conditions than in the eyes-open condition (<i>p</i> < 0.01, Hedges' <math><mrow><msub><mi>g</mi><mrow><mi>av</mi></mrow></msub></mrow></math> ≈0.76-1.33). Visual dependence was greater in patients with stroke than in healthy controls (20.1 ± 10.0° vs. 15.1 ± 8.0°, <i>p</i> < 0.05, <i>r</i> = 0.29).</p><p><strong>Conclusions: </strong>Under OKS, group-by-condition interactions appeared mainly in mediolateral-direction COP measures, and visual dependence was higher in patients with stroke than in healthy controls, suggesting greater susceptibility to visually induced imbalance.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"744-754"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of combined vagus nerve stimulation and exercise training for upper limb recovery in people with stroke: a systematic review and meta-analysis.","authors":"Longjun Ren, Shamay Ng, Chung Raymond Chi Keung, Jean Woo, Thomson Wong","doi":"10.1080/10749357.2026.2648211","DOIUrl":"10.1080/10749357.2026.2648211","url":null,"abstract":"<p><strong>Background: </strong>Recent emerging evidence suggests that vagus nerve stimulation combined with exercise training (VNS+training) is effective in improving upper limb recovery in people with stroke. The current study aimed (1) to conduct a meta-analysis of the effectiveness VNS+training on upper limb recovery and (2) to identify potential factors that may affect the effect size (ES)of VNS+training in people with stroke.</p><p><strong>Methods: </strong>The electronic databases CINAHL, Medline, Cochrane Library, EMBASE, PubMed, Scopus, Web of Science, CINAHL, CNKI, and WANFANG, were systematically searched from inception to July 2025. Studies investigating the effectiveness of VNS+training on upper limb recovery in people with stroke were included.</p><p><strong>Results: </strong>A total of 13 articles were included in the systematic review, and data from 10 discrete studies with 424 participants were included in the meta-analysis. The ES of VNS+training was large in motor impairment (g = 1.264, 95% CI = 0.727-1.800) and in motor function (g = 0.728, 95% CI = 0.354-1.102) and was moderate in activities of daily living (ADL) (g = 0.508, 95% CI = 0.190-0.826). Subgroup analyses revealed larger effects for participants who received VNS prior to exercise training (with transcutaneous auricular VNS and at acute/subacute phase of stroke).</p><p><strong>Conclusion: </strong>The effectiveness of VNS+training in improving upper limb impairment, function, and ADL in people with stroke were found to be significantly higher than that of control group. The larger ES suggests that prior taVNS may have a more beneficial effect than concurrent taVNS. Further well-designed, adequately powered studies are needed to confirm these findings and directly compare prior versus concurrent taVNS.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"719-733"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimal detectable change and minimal important change of the simple test for evaluating hand function in patients with subacute stroke.","authors":"Takuya Imai, Sota Kobayashi, Koya Zenyoji, Nozomi Sakakibara, Akihiro Kobayashi","doi":"10.1080/10749357.2026.2628557","DOIUrl":"10.1080/10749357.2026.2628557","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the minimal detectable change (MDC) and minimal important change (MIC) of the Simple Test for Evaluating Hand Function (STEF) in patients with subacute stroke.</p><p><strong>Design and setting: </strong>Prospective longitudinal study at a single rehabilitation hospital.</p><p><strong>Participants: </strong>Fifty-three patients with subacute stroke.</p><p><strong>Intervention: </strong>Patients received standard stroke rehabilitation, including physical, occupational, and speech therapy. Upper extremity function was assessed using the STEF at admission, the next day, and 4 weeks later.</p><p><strong>Main measures: </strong>The primary outcome was the STEF score. Additional measures were the Global Rating of Change Scale (GRCS), the Functional Independence Measure (FIM) self-care domain, and the Modified Rankin Scale (mRS). Test - retest reliability and MDC were calculated. MIC was estimated using an anchor-based receiver operating characteristic analysis and an adjusted logistic regression approach.</p><p><strong>Results: </strong>The STEF showed excellent reliability, with an intraclass correlation coefficient of 0.98 and a MDC₉₅ of 12.7 points. Anchor-based MIC values were 14.5 points for participants' GRCS, 9.0 points for therapists' GRCS, 11.5 points for the FIM self-care domain, and 16.0 points for the mRS. Adjusted predictive values were 7.9, 8.6, 9.5, and 16.6 points, respectively.</p><p><strong>Conclusions: </strong>A change greater than 12 points on the STEF likely exceeds measurement error. These thresholds support interpretation of patient changes and guide clinical decision-making in subacute stroke rehabilitation.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"767-778"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}