Topics in Stroke Rehabilitation最新文献

{"title":"The effect of motor imagery and action observation on autonomic functions in patients with chronic stroke.","authors":"Humeyra Kiloatar, Aylin Aydogdu Delibay, Hasan Huseyin Gokpinar","doi":"10.1080/10749357.2024.2322884","DOIUrl":"10.1080/10749357.2024.2322884","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the effects of motor imagery (MI), action observation (AO), and action execution (AE) interventions on the autonomic nervous system (ANS) in individuals with chronic stroke.</p><p><strong>Methods: </strong>This was a single-center, randomized, case-control study. Thirty-six patients were randomly assigned to MI (<i>n</i> = 10), AO (<i>n</i> = 15), and the AE group (<i>n</i> = 11). Heart rate (HR)-based measurements (HR, heart rate variability (HRV)) and blood pressure were evaluated before the practice of each group. In the MI group, participants were instructed to imagine themselves walking at their own comfortable pace for 5 minutes. Meanwhile, in the AO group, participants were shown a video of a person walking for 5 minutes. Finally, in the AE group, participants were instructed to actually walk for 5 minutes. Then, all measurements were taken again.</p><p><strong>Results: </strong>A statistically significant difference was found in HR and mean RR interval within the AE group (<i>p</i> < 0.05). There was a statistically significant difference in the Root Mean Square of Successive Differences Between Normal Heartbeats (RMSSD) (ms) within the AO group (<i>p</i> < 0.05). There was a significant difference in HR and mean RR intervals (ms) between groups (<i>p</i> < 0.05). According to post-hoc analyses, HR was statistically significantly higher in the AE group compared to the other groups, and the mean RR interval was statistically significantly lower (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>In conclusion, in patients with chronic stroke, AE and AO may affect ANS by increasing sympathetic activation. It is recommended for future studies to evaluate whether patients actually engage in imagery during the MI task.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"713-722"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139997489","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 exercise on post-stroke cognitive function: a systematic review and meta-analysis of randomized controlled trials.","authors":"Gen Li, Xifeng Tao, Bingkai Lei, Xiao Hou, Xiaoguang Yang, Leiyuyang Wang, Shiyan Zhang, Yuanyuan Lv, Tongling Wang, Laikang Yu","doi":"10.1080/10749357.2024.2356393","DOIUrl":"10.1080/10749357.2024.2356393","url":null,"abstract":"<p><strong>Background: </strong>A growing body of research examining the effect of exercise on cognitive function in stroke patients, while findings of available studies were conflicting.</p><p><strong>Objectives: </strong>We aimed to estimate the effect of exercise on cognitive function in stroke patients.</p><p><strong>Methods: </strong>For this systematic review and meta-analysis, we searched PubMed, Web of Science, Embase, Cochrane, and Scopus electronic databases, through 13 March 2023. The three-level restricted maximum likelihood random effects model was used to synthesize the data.</p><p><strong>Results: </strong>Twenty-five studies met the inclusion criteria. There was a significant effect of exercise on improving cognitive function in stroke patients (Cohen's <i>d</i> = 0.37, 95% CI, 0.16 to 0.58, <i>p</i> < 0.01, <i>I²</i>  = 22.12%). Subgroup analysis showed that exercise significantly improved memory. In addition, aerobic exercise, exercise conducted 12 weeks or more, 3 times or more per week, less than 60 minutes per session, less than 180 minutes per week, and up to 12 months post-stroke increased cognitive function significantly.</p><p><strong>Conclusions: </strong>Exercise improved cognitive function in stroke patients. To improve cognitive function, this meta-analysis provides clinicians with evidence to recommend that stroke patients participate in aerobic exercise at least 3 times per week for 30-60 minutes, with a goal of 180 minutes per week being achieved by increasing the frequency of exercise. Exercise initiated within 12 months post-stroke and continued for 12 weeks or more is most beneficial for improving cognitive function.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"645-666"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200692","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":"The effect of vestibular and somatosensory rehabilitation in addition to early rehabilitation on balance after stroke: a randomized controlled trial.","authors":"Elisa Calisgan, Burcu Talu","doi":"10.1080/10749357.2024.2318096","DOIUrl":"10.1080/10749357.2024.2318096","url":null,"abstract":"<p><strong>Background: </strong>The goal of post-stroke early rehabilitation is to regain ambulation, standing and balance.</p><p><strong>Objective: </strong>The purpose of this study was to investigate the effects of vestibular and somatosensory rehabilitation in addition to early rehabilitation on balance in patients with early subacute stroke.</p><p><strong>Design and setting: </strong>A randomized controlled trial was conducted at a university hospital.</p><p><strong>Methods: </strong>The study was included 52 hemiplegic hospitalized early suacute stroke patients. The experimental group (n: 30), was applied with vestibular and somatosensorial rehabilitation together with early rehabilitation. Vestibular exercises, included Cawthorne-Cooksey exercises, stimulate the vestibulo-ocular and vestibulo-spinal reflex. Somatosensory exercises, which included Frenkel exercises, stimulate the sensory proprioception and somatosensory systems. The control group (n: 22) patients with early subacute stroke were treated with the early rehabilitation program only. The balance parameters of the patients were evaluated with the Korebalance System, Functional Reach Test, Postural Assessment Scale for Stroke, and Functional Ambulation Scale.</p><p><strong>Results: </strong>The mean age of the patients was 67.32 ± 9.46 years, and the mean number of days that had passed since the stroke occurred was 17.90 ± 7.26. In calculating the balance scores, statistically significant differences were observed in the experimental and control groups, with a statistically greater improvement in the rehabilitation group. Statistically significant differences were determined between the groups in respect of the balance scores.</p><p><strong>Conclusions: </strong>Based on these findings, the use of vestibular and somatosensory rehabilitation can be recommended for better functioning of the compensatory mechanism of early subacute-stroke hemiplegic patients in early ambulation, and this can lead to considerably improved standing and dynamic upper and lower body balance.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"703-712"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900485","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":"Inverted U-shaped relationship between Barthel Index Score and falls in Chinese non-bedridden patients: a cross-sectional study.","authors":"Jie Yan, Qingfang Zhang, Jing Zhou, Fubing Zha, Yan Gao, Dongxia Li, Mingchao Zhou, Jingpu Zhao, Jun Feng, Liang Ye, Yulong Wang","doi":"10.1080/10749357.2024.2318089","DOIUrl":"10.1080/10749357.2024.2318089","url":null,"abstract":"<p><strong>Background: </strong>Performing activities of daily living comprise an important risk factor for falls among non-bedridden stroke inpatients in rehabilitation departments.</p><p><strong>Objectives: </strong>To explore the correlation between Barthel Index score and the occurrence of falls in non-bedridden stroke rehabilitation inpatients.</p><p><strong>Methods: </strong>In this cross-sectional study, information of patients grouped as non-bedridden patients by the Longshi Scale was collected.</p><p><strong>Results: </strong>A total of 3097 patients were included in this study, with a fall incidence of 10.43%. After adjusting covariates, the total score of Barthel Index and falls in non-bedridden inpatients after stroke presented an inverted U-shaped curve relationship, in which inflection point was 60. The effect sizes on the left and right sides of infection point were 1.02 (95%CI 1.00-1.04) and 0.97 (95%CI 0.96-0.99), respectively.</p><p><strong>Conclusions: </strong>Non-bedridden stroke patients with moderate activities of daily living (ADL) capacity may be at particularly increased risk of falls in rehabilitation departments.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"692-702"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973569","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":"Development of the Japanese version of the stroke stigma scale: a validity and reliability assessment.","authors":"Shin Kitamura, Reiko Miyamoto, Shota Watanabe, Taiki Yoshida, Yoshikazu Ishii","doi":"10.1080/10749357.2024.2318097","DOIUrl":"10.1080/10749357.2024.2318097","url":null,"abstract":"<p><strong>Background: </strong>The stigma perceived by many post-stroke persons hinders their social lives. A scale to measure stigma is needed to identify social problems related to stigma, and to evaluate effectiveness of interventions.</p><p><strong>Objectives: </strong>This study aimed to develop a Japanese version of the Stroke Stigma Scale (SSS-J), and confirm its utility by examining reliability and validity.</p><p><strong>Methods: </strong>Eighty community-dwelling post-stroke individuals were enrolled at six sites. After translating the scale into Japanese using back translation methods, psychometric properties of the rating scale, internal scale validity, and reliability were examined to fit the Rasch model. Criterion-related validity, construct validity, and test-retest reliability were examined using total scores transformed to logit. For test-retest reliability, 30 participants completed the SSS-J twice, one week apart.</p><p><strong>Results: </strong>Rasch analysis showed that the SSS-J had the best fit with 15 items on a 3-category rating scale. Item difficulty logits were -2.01 to 2.21, person ability logits were -4.69 to 0.62 (mean, -1.41), person reliability coefficient was 0.71 (separation index, 1.58), and item reliability coefficient was 0.96 (separation index, 5.04). For criterion validity, Spearman's rank correlation coefficient with the Center for Epidemiologic Studies Depression Scale was 0.51 (<i>p</i> < 0.001). For construct validity, Spearman's rank correlation coefficients with each subscale of the Stroke Impact Scale ranged from -0.36 to -0.16 (<i>p</i> = 0.002-0.126). For test-retest reliability, the intra-class correlation coefficient was 0.64 (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>The SSS-J adapted to the Rasch model was reliable and valid. This scale can be used to quantitatively measure stigma among community-dwelling post-stroke persons in Japan.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"745-754"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900483","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":"Repetitive peripheral sensory stimulation for motor recovery after stroke: a scoping review.","authors":"Gabrielly Fernanda Silva, Lorrane Freitas Campos, Jéssica Mariana de Aquino Miranda, Flávia Guirro Zuliani, Bruno Henrique de Souza Fonseca, Amaro Eduardo Tavares de Araújo, Priscilla Flávia de Melo, Luiz Gustavo Suzuki, Luiz Paulo Aniceto, Rodrigo Bazan, Luciane Aparecida Pascucci Sande de Souza, Gustavo José Luvizutto","doi":"10.1080/10749357.2024.2322890","DOIUrl":"10.1080/10749357.2024.2322890","url":null,"abstract":"<p><strong>Background and purpose: </strong>Enhancing afferent information from the paretic limb can improve post-stroke motor recovery. However, uncertainties exist regarding varied sensory peripheral neuromodulation protocols and their specific impacts. This study outlines the use of repetitive peripheral sensory stimulation (RPSS) and repetitive magnetic stimulation (rPMS) in individuals with stroke.</p><p><strong>Methods: </strong>This scoping review was conducted according to the JBI Evidence Synthesis guidelines. We searched studies published until June 2023 on several databases using a three-step analysis and categorization of the studies: pre-analysis, exploration of the material, and data processing.</p><p><strong>Results: </strong>We identified 916 studies, 52 of which were included (<i>N</i> = 1,125 participants). Approximately 53.84% of the participants were in the chronic phase, displaying moderate-to-severe functional impairment. Thirty-two studies used RPSS often combining it with task-oriented training, while 20 used rPMS as a standalone intervention. The RPSS primarily targeted the median and ulnar nerves, stimulating for an average of 92.78 min at an intensity that induced paresthesia. RPMS targeted the upper and lower limb paretic muscles, employing a 20 Hz frequency in most studies. The mean stimulation time was 12.74 min, with an intensity of 70% of the maximal stimulator output. Among the 114 variables analyzed in the 52 studies, 88 (77.20%) were in the \"s,b\" domain, with 26 (22.8%) falling under the \"d\" domain of the ICF.</p><p><strong>Discussion and conclusion: </strong>Sensory peripheral neuromodulation protocols hold the potential for enhancing post-stroke motor recovery, yet optimal outcomes were obtained when integrated with intensive or task-oriented motor training.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"723-737"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140060588","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":"Non-pharmacological interventions to treat mood disturbances post-stroke: a systematic review.","authors":"Vibha Balram,Rhianna Ingleton,Dave Parsons,Stacey George,Maayken Van Den Berg","doi":"10.1080/10749357.2024.2384325","DOIUrl":"https://doi.org/10.1080/10749357.2024.2384325","url":null,"abstract":"BACKGROUNDStroke survivors face high rates of depression, anxiety, and pseudobulbar affect. Clinicians report lack of clarity on effective non-pharmacological interventions due to uncertainty about treatment options as barriers to evidence-based treatment. No systematic review has investigated the effectiveness of non-pharmacological interventions on the conditions of depression, anxiety, and pseudo-bulbar affect.OBJECTIVESThe aim of this study was to evaluate the effectiveness of non-pharmacological interventions on the outcomes of depression, anxiety, and pseudobulbar affect in post-stroke individuals.METHODSFollowing the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched databases Medline, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO for randomized controlled trials in English, within 2012-2023, evaluating the effect of a non-pharmacological intervention on depression, anxiety, and/or pseudobulbar affect. Two researchers screened titles, abstracts, and full texts. One researcher extracted data and assessed risk of bias. Data were synthesized narratively.RESULTSForty-two studies were included. Intervention types included education (n = 9), psychological therapy (n = 8), and physical exercise (n = 8). Intervention types reporting positive outcomes for depression were psychological therapy (n = 6), physical exercise (n = 3) and robot-assisted therapy (n = 3). Intervention types effective in improving anxiety were physical exercise (n = 2), psychological therapy (n = 3) and multi-modal therapy approaches (n = 2). No studies explored the impact on pseudobulbar affect.CONCLUSIONNon-pharmacological interventions may be effective in improving mood in stroke survivors. Robot-assisted therapy and physical exercise were seen to improve multiple outcome measures. Patient education should be delivered alongside rehabilitation and directed to both stroke-survivor and caregiver.","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":"197 1","pages":"1-20"},"PeriodicalIF":2.2,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142265858","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":"Predictive utility of self-efficacy in early stroke rehabilitation.","authors":"Rachel M Vaughn,Rachana Gangwani,Jasper I Mark,Kelly Fletcher,John M Baratta,Jessica M Cassidy","doi":"10.1080/10749357.2024.2403806","DOIUrl":"https://doi.org/10.1080/10749357.2024.2403806","url":null,"abstract":"INTRODUCTIONA biopsychosocial approach entailing person-centered factors provides valuable insight to post-stroke rehabilitation potential. The consideration of an individual's belief in their capabilities, known as self-efficacy, may prove especially informative in the inpatient rehabilitation setting where motor learning often occurs.OBJECTIVETo assess the predictive utility of self-efficacy in functional independence status change during inpatient rehabilitation.METHODSIndividuals with stroke admitted to an inpatient rehabilitation facility (IRF) completed an assessment battery near IRF admission and discharge involving motor assessments, participant-reported self-efficacy (Stroke Self-Efficacy Questionnaire), and functional independence status evaluation (sum of self-care and mobility Quality Indicators (QI) from the IRF-Patient Assessment Instrument). Linear regression was performed to determine the predictive performance of self-efficacy on QI change during IRF stay while accounting for age, time post-stroke, and IRF length of stay. Regression procedures were repeated for separate subgroups based on initial motor impairment level.RESULTSThirty individuals with stroke (14 females, age = 67.0 ± 9.80 years, 10.4 ± 3.46 days post-stroke) were enrolled. Self-efficacy at IRF admission explained a significant percentage of variance in QI Change for the cohort (R2 = 30.7%, p = .001) and for the moderate to severe motor impairment subgroup (n = 12; R2 = 49.9%, p = .010). After accounting for confounders, self-efficacy remained a significant predictor for the cohort (n = 30) model.DISCUSSIONFindings generated from this work support the predictive utility of self-efficacy in early post-stroke motor recovery. The inclusion of self-efficacy in a multi-faceted evaluation framework may therefore optimize rehabilitation outcomes by providing therapists with additional knowledge to better tailor an individual's care.","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":"99 1","pages":"1-9"},"PeriodicalIF":2.2,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142265857","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":"A systematic review of upper extremity outcome measures assessed in randomized controlled trials of post stroke upper extremity rehabilitation over time.","authors":"Robert Teasell,Sarvenaz Mehrabi,Marcus Saikaley,Catherine George,Sean P Dukelow,Amber Harnett,Jamie L Fleet","doi":"10.1080/10749357.2024.2395723","DOIUrl":"https://doi.org/10.1080/10749357.2024.2395723","url":null,"abstract":"BACKGROUNDThe heterogeneity in outcome measures of post stroke rehabilitation trials suggests the need for consensus approach in stroke recovery measurement. To reach this aim, it is important to understand the past and current use of outcome measures in randomized control trials (RCTs) of stroke rehabilitation.OBJECTIVETo systematically review RCTs of post stroke UE rehabilitation interventions to understand the use of UE outcome measures in research and their changes over time.METHODSCINAHL, Embase, PubMed, Scopus and Web of Science were searched from 1960 to 1 April 2021. Studies were eligible for inclusion if they (1) were RCTs or crossovers published in English (2) ≥50% of participants were affected by stroke, 3) included adults ≥ 18 years old, and (4) applied an intervention to the hemiparetic UE as the primary objective of the study.RESULTS1,276 RCTs met inclusion criteria, and 112 different outcome measures were identified. Outcome measures were classified according to the International Classification of Functioning, Disability and Health (ICF) framework. Outcome measures most frequently assessed body function and structure (n = 1,692), followed by activities (n = 1,572) and participation (n = 162). The most used outcome measures were the Fugl-Meyer Assessment (n = 619), the modified Ashworth Scale (n = 255), Action Research Arm Test (n = 211), Wolf Motor Function Test (n = 184), and Box and Block Test (n = 178).CONCLUSIONSUnderstanding the breadth of outcome measures that have been used over time emphasizes the need for proposed standardization of outcome measures but also the need to adjust and expand consensus recommendations based on past and ongoing research trends.","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":"4 1","pages":"1-16"},"PeriodicalIF":2.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142200911","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":"Articulated ankle-foot orthoses associated with home-based task-specific training improve functional mobility in patients with stroke: a randomized clinical trial.","authors":"Gabriela Vieira de Paula,Gustavo José Luvizutto,Luana Aparecida Miranda,Taís Regina da Silva,Lucas Tadeu Carvalho Silva,Fernanda Cristina Winckler,Gabriel Pinheiro Modolo,Cristiane Lara Mendes Chiloff,Silméia Garcia Zanati Bazan,Rafael Dalle Molle da Costa,Luis Cuadrado Martin,Rodrigo Bazan","doi":"10.1080/10749357.2024.2399467","DOIUrl":"https://doi.org/10.1080/10749357.2024.2399467","url":null,"abstract":"INTRODUCTIONWe compared fixed and articulated ankle-foot orthoses (AFOs) in home-based mobility tasks to assess short-term mobility, dynamic balance, quality of life, anxiety/depression, disability level, stroke severity, autonomy, human functioning, and patient satisfaction.METHODSThis was a two-arm, parallel-group, randomized controlled trial with concealed allocation, assessor blinding, and a complete case analysis involving patients with chronic stroke. The participants were randomized into two groups: fixed (n = 24) and articulated (n = 23) AFOs. The AFOs were custom-fabricated, and both groups performed four-week home-based mobility tasks five days weekly. Primary outcome measures included changes in balance and mobility assessed using the Tinetti Performance-Oriented Mobility Assessment (POMA), Timed Up and Go (TUG) test, and Functional Ambulation Category (FAC). Secondary outcomes included quality of life, anxiety/depression, disability, stroke severity, autonomy, human functioning, and patient satisfaction.RESULTSIn a between-group comparison, after adjusting for age, sex, stroke severity, and thrombolysis, the articulated AFO group showed better performance in the TUG test (p = 0.020; d = 0.93), POMA-Gait (p = 0.001; d = 0.53), POMA-Total (p = 0.048; d = 0.98), and FAC (p = 0.003; d = 1.03) than the fixed AFO group. Moreover, significant difference was noted in human functioning (moving around using equipment)between the groups (p = 0.047; d = 92).CONCLUSIONA program involving home-based mobility tasks and articulated AFOs improved functional mobility after stroke.","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":"6 1","pages":"1-14"},"PeriodicalIF":2.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142200885","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}