Topics in Stroke Rehabilitation最新文献

{"title":"Cortical activation and functional connectivity during thumb-to-finger opposition in patients with stroke with varying functional levels: insights from fNIRS.","authors":"Yu-Ping Huang, Xiao-Xuan Zhan, Qian-Qian Fan, Jing-Jing Pan, Hui-Zi Zeng, Bin-Bin Li, Yan-Fang Sui, Zhen-Hua Song","doi":"10.1080/10749357.2026.2692531","DOIUrl":"https://doi.org/10.1080/10749357.2026.2692531","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare cortical activation and functional connectivity (FC) during a thumb-to-finger opposition task in stroke patients stratified by hand function level, and to explore the modulatory role of hand dominance.</p><p><strong>Methods: </strong>Fifty-two right-handed stroke patients were divided into low-function (LFG, <i>n</i> = 28) and high-function (HFG, <i>n</i> = 24) groups based on task performance. Using 49-channel functional near-infrared spectroscopy (fNIRS), activation and FC were assessed in bilateral premotor/supplementary motor area (PMC&SMA), sensorimotor cortex (SMC), primary motor cortex (M1), and dorsolateral prefrontal cortex (DLPFC). Activation was analyzed via paired t-tests, FC matrices using Pearson's correlation, and the effects of task and hand dominance via linear mixed models.</p><p><strong>Results: </strong>Only the LFG showed a significant task-related increase in right DLPFC activation (q = 0.009), with a significant between-group difference (q = 0.019). FC analysis revealed stronger and more extensive connections in the HFG, particularly between M1 and PMC&SMA. In the LFG, FC significantly increased during the task (<i>p</i> = 0.006), and a significant task-by-hand dominance interaction was observed (<i>p</i> = 0.037), indicating that FC modulation depended on whether the affected hand was dominant. No such effects were found in the HFG.</p><p><strong>Conclusions: </strong>Post-stroke functional level distinctly influences cortical activation and FC during fine motor tasks. Lower-function patients rely more on cognitive resources (DLPFC) and exhibit FC modulated by task demands and hand dominance, whereas higher-function patients demonstrate efficient integration within core motor networks. These findings support function-level-dependent neural reorganization and highlight the need for stratified, individualized rehabilitation strategies that consider both functional capacity and hand dominance.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-19"},"PeriodicalIF":2.3,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333235","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":"Cognitive strategies for improving activity-level outcomes post stroke: an integrative review.","authors":"Faye Tabone, Ibe Couwels, Rachel C Stockley, Nele Demeyere","doi":"10.1080/10749357.2026.2684949","DOIUrl":"10.1080/10749357.2026.2684949","url":null,"abstract":"<p><strong>Purpose: </strong>This integrative review aimed to identify cognitive strategy interventions supporting rehabilitation engagement and activity-level outcomes for individuals with post-stroke cognitive impairments.</p><p><strong>Materials and methods: </strong>Following Joanna Briggs Institute (JBI) methodology and PRISMA-ScR checklist, comprehensive searches were conducted in Embase, CINAHL, Scopus, MEDLINE, and PsycINFO. Two reviewers independently performed study selection and data extraction, using the TIDieR checklist and QuADS for quality assessment.</p><p><strong>Results: </strong>From 35,250 articles screened, 40 studies met the inclusion criteria, half (<i>n</i> = 20) were randomised controlled trials. Interventions were delivered between 6 days and 9.5 years post-stroke. Cognitive strategies included 20 domain-specific, 12 mental practice, and 8 global approaches. Global approaches were most consistent, though applicability across cognitive impairment type remains unclear. Domain-specific strategies target impairment directly and aim for transfer to functional outcomes, while mental practice approaches may only be suitable for mildly impaired cognition. Across studies, 47 different primary outcome measures were reported, with the Functional Independence Measure and Barthel Index used the most, across 10 studies each.</p><p><strong>Conclusions: </strong>Three cognitive strategy categories were identified. Outcome measures lacked consistency and there was a notable lack of stakeholder involvement. Future research should standardise interventions and outcome measures to enable systematic evidence synthesis and inform clinical guidelines.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-18"},"PeriodicalIF":2.3,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319101","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 repetitive transcranial magnetic stimulation combined with soft robotic glove training for slight-to-moderate post-stroke upper limb spasticity: a randomized controlled trial.","authors":"Suhail Jamid, Xiupan Wei, Xiangshan Wei, Pei Wang, Ting Zhou, Bo Liu, Hongxing Wang","doi":"10.1080/10749357.2026.2684952","DOIUrl":"https://doi.org/10.1080/10749357.2026.2684952","url":null,"abstract":"<p><strong>Background: </strong>Post-stroke upper-limb spasticity can limit motor recovery and functional use of the affected arm. This randomized controlled trial investigated whether repetitive transcranial magnetic stimulation combined with soft robotic glove training improves wrist flexor spasticity and upper-limb motor function in patients with stroke.</p><p><strong>Methods: </strong>Fifty-four patients were randomized to the rTMS + SRG group or the sham rTMS + SRG group. Four participants withdrew for reasons unrelated to the trial or early hospital discharge, and 50 participants completed the intervention and post-intervention assessment. Both groups received 12 treatment sessions over two weeks in addition to conventional rehabilitation. The primary outcome was wrist flexor spasticity assessed using the Modified Ashworth Scale (MAS). Secondary outcomes included the Fugl-Meyer Assessment for Upper Extremity (FMA-UE) and the Hmax/Mmax ratio.</p><p><strong>Results: </strong>Wrist flexor spasticity decreased significantly in the rTMS + SRG group after treatment (<i>p</i> = 0.0051), but not in the sham rTMS+SRG group (<i>p</i> = 0.98). The between-group comparison of change scores also favored the rTMS+SRG group (<i>p</i> = 0.021). FMA-UE scores improved significantly in both groups (both <i>p</i> < 0.0001), with greater improvement in the rTMS + SRG group (<i>p</i> = 0.038). The Hmax/Mmax ratio decreased significantly in the rTMS + SRG group (<i>p</i> = 0.030), whereas the between-group difference in change scores was not statistically significant (<i>p</i> = 0.086).</p><p><strong>Conclusion: </strong>Compared with sham rTMS combined with soft robotic glove training, rTMS combined with soft robotic glove training produced greater reductions in wrist flexor spasticity and greater improvements in upper-limb motor function after stroke.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-12"},"PeriodicalIF":2.5,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259739","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":"Common coping and collaborative management of stroke survivors' spousal caregivers: a moderated mediation model of illness perception and resilience.","authors":"Linjia Xia, Xiaoxuan Wang, Zihao Ruan, Joanne Chong, Yinxia Dou, Lingling Wang, Shuiling Wang, Ling Ma, Yongxia Mei, Zhenxiang Zhang","doi":"10.1080/10749357.2026.2651794","DOIUrl":"10.1080/10749357.2026.2651794","url":null,"abstract":"<p><strong>Background: </strong>Collaborative management has been proposed as an effective strategy to enhance disease management. Common coping, positive illness perceptions, and strong resilience are crucial to enhancing collaborative management. The relationship between these variables is still unclear.</p><p><strong>Aims: </strong>This study aimed to explore the influence of common coping on collaborative management among spousal caregivers, and to examine the mediating role of illness perception and the moderating effect of resilience.</p><p><strong>Methods: </strong>This study was conducted on spousal caregivers of stroke survivors between May 2024 and September 2024 in Zhengzhou. Self-reported questionnaires were used to assess general information, illness perception, resilience, common coping, and collaborative management. Data analysis was performed using SPSS version 27.0. Pearson correlation and multiple linear regression analyses were conducted to examine relationships among the variables. Mediation and moderated mediation models were tested using PROCESS macro.</p><p><strong>Result: </strong>A total of 578 dyads completed the questionnaire. Spousal caregivers' collaborative management was at a moderate level. A significant association was found between common coping and collaborative management. Illness perception significantly mediated this relationship, while resilience moderated the path from illness perception to collaborative management. Notably, the mediating effect of illness perception was not significant among spousal caregivers with high resilience.</p><p><strong>Conclusion: </strong>Among spousal caregivers of stroke survivors, common coping directly influenced collaborative management. This relationship was partially mediated through illness perception, with resilience moderating the association between common coping and collaborative management. Interventions targeting common coping, illness perception, and resilience may enhance collaborative management among spousal caregivers.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-12"},"PeriodicalIF":2.3,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253132","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":"Prevalence of knee pain and factors influencing its risk in ambulatory chronic stroke survivors.","authors":"Hung Quang Ho, Thanh Dinh Ngan Pham, Yu-Tang Pan, Mu-Hua Wang, You-Yin Chen, Jiunn-Horng Kang","doi":"10.1080/10749357.2026.2684951","DOIUrl":"https://doi.org/10.1080/10749357.2026.2684951","url":null,"abstract":"<p><strong>Background: </strong>Gait alterations after stroke may lead to knee pain, limiting rehabilitation and reducing quality of life.</p><p><strong>Objectives: </strong>To estimate the prevalence of knee pain and identify associated factors in ambulatory chronic stroke survivors.</p><p><strong>Methods: </strong>We conducted a cross-sectional study in 12 outpatient rehabilitation units in Vietnam, enrolling 212 patients with stroke. We recorded demographics, morbidities, knee pain, clinical examination findings and gait parameters. Weight-bearing asymmetry was measured using a two-scale method. Minimal knee flexion during the stance phase was derived from markerless gait analysis. Factors associated with knee pain were assessed using modified Poisson regression with robust standard errors to estimate adjusted prevalence ratios (aPRs). Multinomial logistic regression was performed to identify factors associated with pain laterality.</p><p><strong>Results: </strong>The prevalence of knee pain was 19.8%. The following factors were independently associated with knee pain: age (aPR: 1.03; 95% CI: 1.01-1.06), stroke type (aPR: 2.51; 95% CI: 1.55-4.09), time since stroke onset (aPR: 1.08; 95% CI: 1.04-1.12), prior knee osteoarthritis (aPR: 2.27; 95% CI: 1.31-3.91), obesity (aPR: 1.84; 95% CI: 1.14-2.96), and quality of life (aPR: 0.02; 95% CI: 0.01-0.06). Smaller minimal knee flexion was associated with a higher risk of ipsilateral knee pain (<i>p</i> = 0.009).</p><p><strong>Conclusion: </strong>The prevalence of knee pain among ambulatory chronic stroke survivors was approximately 20%. Older age, hemorrhagic stroke, longer poststroke time, obesity, prior knee osteoarthritis, and poorer quality of life were independently associated with knee pain. Greater hyperextension during stance was associated with a higher risk of knee pain in the affected limb.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-10"},"PeriodicalIF":2.5,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219740","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":"Optimizing cervical breath sound acquisition protocol in dysphagia patients: an orthogonal experimental study.","authors":"Hairong Yu, Jingyi Huang, Tianchi Zhuang, Jiemiao Shen, Minghui Ji, Yuanyuan Zhang, Shen Chen","doi":"10.1080/10749357.2026.2675410","DOIUrl":"https://doi.org/10.1080/10749357.2026.2675410","url":null,"abstract":"<p><strong>Background: </strong>Dysphagia is a highly prevalent condition among patients with stroke. Cervical auscultation serves as a crucial screening method for dysphagia detection. The advancement of artificial intelligence has enabled acoustic analysis to emerge as a viable alternative to manual auscultation. While high-quality breath sound recordings are fundamental for reliable acoustic analysis in dysphagia screening, current clinical practice lacks standardized protocols for acquiring cervical respiratory sounds during auscultation.</p><p><strong>Objective: </strong>To investigate the optimal acquisition protocol for cervical breath sounds in dysphagia patients after stroke using orthogonal experimental design.</p><p><strong>Method: </strong>The experimental design incorporated three key factors (auscultation position, dressing material, and tape type) with three levels each, configured into an L₉(3³) orthogonal array. Cervical breath sound data were systematically acquired from 298 dysphagia patients across nine protocol variations. Acoustic signal processing quantified three parameters: signal-to-noise ratio (SNR), aggregate entropy, and average power.</p><p><strong>Results: </strong>Statistical analysis revealed that Factor A (auscultation position), Factor B (dressing material), and Factor C (tape type) demonstrated significant effects (<i>p</i> < 0.05) on signal-to-noise ratio (SNR), aggregate entropy, and average power. The optimal configuration (A1B1C3) achieved maximum SNR (37.35 dB), maximum average power (78.79 dB), and minimum aggregate entropy (1.51 bits).</p><p><strong>Conclusions: </strong>The optimal acquisition protocol involves positioning the stethoscope on the lateral trachea immediately below the cricoid cartilage, maintaining direct skin contact without interposing dressing materials, and secured with medical-grade pressure-sensitive tape. These evidence-based specifications offer technical guidance and standardized procedures for clinical implementation of cervical auscultation in the assessment of dysphagia after stroke.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-12"},"PeriodicalIF":2.5,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148101912","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 effects of advanced nursing program on the quality of life and psychological outcomes of patients with stroke: a meta-analysis.","authors":"Min Ye, Dan Ou, Hongli Zhu, Yanhong Hu","doi":"10.1080/10749357.2026.2674877","DOIUrl":"https://doi.org/10.1080/10749357.2026.2674877","url":null,"abstract":"<p><strong>Objectives: </strong>Thismeta-analysis compared the efficacy of advanced nursing program and usualnursing on the prognosis and quality of life of patients with stroke.</p><p><strong>Methods: </strong>TheCochrane Library, PubMed, Web of Science, and Scopus were systematically searchedfrom their establishment to 13 July 2025, to identify randomized controlledtrials comparing the effect of advanced nursing program with usual nursing careon perceived stroke severity, quality of life, and psychological outcomes ofpatients suffering from stroke. This meta-analysis was conducted using arandom-effects model.</p><p><strong>Results: </strong>Finally, 18 randomized controlled trials with 2845 participantswere eligible for inclusion. Compared to usual nursing care, advancednursing program significantly increased the Barthel index (SMD 0.70),suggesting an improvement in activities of daily living. Furthermore, advancednursing program significantly increased SS-QOL (SMD 4.12), EQ-5D-5 (SMD 0.73), SF-36general health (SMD 2.23), SF-36 mental health (SMD 1.49), and SF-36 physicalfunction (SMD 1.69) scores, suggesting an improvement in health-related qualityof life. Advanced nursing program markedly decreased the NIHSS score (SMD -0.82),indicating decreased disease severity. Moreover, advanced nursing program significantlydecreased SAS (SMD -4.78), HADS-anxiety (SMD -0.40), SDS (SMD -3.68), andHADS-depression (SMD -0.30) scores, suggesting great improvement in depressionand anxiety.</p><p><strong>Conclusion: </strong>The integration of advancednursing program can significantly improve the function, quality of life,anxiety, and depression in patients with stroke.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-11"},"PeriodicalIF":2.5,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148035203","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":"Integrating acupuncture and modern rehabilitation for post-stroke dysphagia: narrative review of mechanisms, clinical evidence, and future perspectives.","authors":"Junbing Liu, Rong Chen, Qimi Huang, Hui Cheng, Shenghong Ren, Yue Wang","doi":"10.1080/10749357.2026.2670718","DOIUrl":"https://doi.org/10.1080/10749357.2026.2670718","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the synergistic mechanisms and clinical efficacy of integrating acupuncture with modern rehabilitation (including functional swallowing training and neuromuscular electrical stimulation) for post-stroke dysphagia (PSD).</p><p><strong>Materials and methods: </strong>This is a narrative review with a systematic literature approach.This review synthesizes evidence from recent randomized controlled trials, meta-analyses, and mechanistic studies on combined acupuncture and rehabilitation interventions for PSD. Key outcomes assessed include swallowing function (VFSS, FOIS), aspiration pneumonia rates, and quality-of-life measures.</p><p><strong>Results: </strong>Current evidence demonstrates that combining acupuncture with conventional rehabilitation yields superior improvements in swallowing function, oral intake, and aspiration reduction compared to rehabilitation alone. Acupuncture enhances neuroplasticity, modulates central and peripheral swallowing circuits, and reduces inflammation, while rehabilitation strengthens neuromuscular coordination. Synergistic effects arise as acupuncture primes neural substrates, facilitating more efficient gains from rehabilitative exercises. However, challenges include heterogeneity in acupuncture protocols, limited mechanistic clarity, and practitioner variability.</p><p><strong>Conclusions: </strong>Integrative therapy combining acupuncture and modern rehabilitation represents a potentially promising strategy that requires further validation through ri-gorously designed studies for managing PSD. With further standardization, mechanistic research, and international collaboration, this approach could become a widely accepted, effective treatment to improve swallowing recovery and quality of life among stroke survivors.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-20"},"PeriodicalIF":2.5,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148035245","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":"Optimal exercise dose and modality-specific effects on lower-limb balance and functional motor performance in middle-aged and older adults with stroke: a Bayesian network meta-analysis.","authors":"Yi-Ming Li, Le Zhang","doi":"10.1080/10749357.2026.2677641","DOIUrl":"https://doi.org/10.1080/10749357.2026.2677641","url":null,"abstract":"<p><strong>Objective: </strong>To compare the effects of different exercise modalities on lower-limb balance and functional motor performance after stroke and to examine their nonlinear dose-response relationships to identify potentially optimal exercise doses using a Bayesian network meta-analysis.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, Web of Science, the Cochrane Library, and SPORTDiscus identified 54 randomized controlled trials (RCTs). A Bayesian random-effects dose-response network meta-analysis examined associations between total exercise dose, exercise modalities, and lower-limb balance and functional mobility after stroke.</p><p><strong>Results: </strong>Both lower-limb balance and functional movement outcomes showed clear nonlinear improvements with increasing total exercise doses, peaking at approximately 1,800-2,200 MET×min/week. Beyond this range, marginal benefits plateaued or declined, with greater inter-individual variability. For lower-limb balance, gains stabilized or slightly decreased past 2,200 MET×min/week. Functional movement improvements formed an early plateau at around 1,800 MET×min/week, sustained up to 2,200, then gradually diminished. Exercise modalities displayed distinct dose sensitivities: integrated aerobic training (IAT) rapidly achieved peak benefits at moderate loads, supporting early rehabilitation; motor control training (MCT) maintained stable effects over a broader range, facilitating long-term neuromuscular reinforcement; virtual reality training (VRT) showed localized peaks at low to moderate doses but exhibited increased uncertainty at higher levels.</p><p><strong>Conclusions: </strong>This study suggests that moderate weekly exercise doses may improve lower-limb balance and functional mobility after stroke, with dose-response patterns differing across exercise modalities. These findings support dose regulation and individualized exercise prescription, although further high-quality trials are needed to confirm the observed dose ranges and modality-specific effects.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-17"},"PeriodicalIF":2.5,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017476","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 and validation of a protective factor-based rehabilitation resilience nursing intervention for stroke survivors.","authors":"Lian-Huan Cai, Xiao-Fang Wang, Hui Chen, Yang-Yang Mei, Min-Fang Ding, Yan Zhuo, Li-Qun Yao","doi":"10.1080/10749357.2026.2677636","DOIUrl":"https://doi.org/10.1080/10749357.2026.2677636","url":null,"abstract":"<p><strong>Objective: </strong>To develop and content-validate a protective factor - based nursing intervention aimed at enhancing rehabilitation resilience in stroke survivors.</p><p><strong>Materials and methods: </strong>This study was guided by the Medical Research Council Framework for Developing and Evaluating Complex Interventions (the MRC framework). Focusing on the development phase (Phase I), we systematically integrated existing evidence, theoretical models, and clinical guidelines to construct a structured intervention protocol targeting rehabilitation resilience. A two-round Delphi process was conducted to evaluate content validity, with the Content Validity Index (CVI), coefficient of variation (CV), and Kendall's coefficient of concordance (W) used to assess expert consensus and reliability.</p><p><strong>Results: </strong>Sixteen experts participated in the Delphi process, demonstrating high engagement and authority (authority coefficient = 0.875). Consensus improved across rounds, with CV values decreasing (0-0.29 to 0-0.20) and Kendall's W increasing (0.276 to 0.519). All intervention items achieved excellent content validity (I-CVI = 1.00; S-CVI = 1.00). The finalized intervention protocol is structured across four rehabilitation phases: early rehabilitation, mid-stage rehabilitation, late rehabilitation, and discharge planning, with each phase targeting key protective factors to enhance resilience.Conclusion: A theoretically grounded and evidence-informed rehabilitation resilience nursing intervention was successfully developed and validated. The protocol demonstrates strong content validity, clinical relevance, and feasibility, providing a robust foundation for subsequent feasibility testing and randomized controlled trials. This work addresses a critical gap in the literature by offering a transparent and systematic description of intervention development for resilience-based stroke rehabilitation.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-12"},"PeriodicalIF":2.5,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989079","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}