Brain Impairment最新文献

{"title":"Identifying Trends of Dysautonomia Signs and Symptoms Associated with Protracted Concussion Recovery during the Buffalo Concussion Treadmill Test: A Retrospective Study","authors":"Lauren Ziaks, Jenna Tucker, T. Koc, Alexa Schaefer, Kristin R. Hanson","doi":"10.1017/brimp.2022.5","DOIUrl":"https://doi.org/10.1017/brimp.2022.5","url":null,"abstract":"\u0000 \u0000 \u0000 To identify trends of provoked dysautonomia signs and symptoms during the Buffalo Concussion Treadmill Test (BCTT).\u0000 \u0000 \u0000 \u0000 This is a retrospective cohort study of 101 patient charts post-concussion who were screened for suspected dysautonomia.\u0000 \u0000 \u0000 \u0000 Patients with suspected dysautonomia were assessed for exercise intolerance using a BCTT. Symptoms and rate of perceived exertion were recorded on a standardized form. Digital pulse oximetry was used to collect heart rate (HR) and oxygen saturation. Descriptive analyses were conducted on BCTT results.\u0000 \u0000 \u0000 \u0000 Of 101 patient charts, 57 were excluded from analysis, including four patients who completed the BCTT by asymptomatically reaching the target HR zone for their estimated HR max. The remaining 44 patients demonstrated: 35 (79.5%) poor HR stabilization defined as a drop or plateau in HR during exercise, 28 (63.8%) exacerbated concussion symptoms, 13 (29.5%) autonomic nervous system response such as hot flushed sensation, 12 (27.3%) rebound symptoms during recovery phases, and 8 (18.2%) desaturation of 90% or below. The mean delta (80% expected HR max – 80% achieved HR max) on the initial test was 80.66 (± 23.08) beats per minute.\u0000 \u0000 \u0000 \u0000 This study is the first to identify trends of signs and symptoms during the BCTT in an expanded population with suspected dysautonomia after concussion. Future studies are indicated to validate these findings and contribute to development of modified termination criteria for the BCTT in individuals with suspected dysautonomia associated with protracted concussion recovery.\u0000","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"48 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79763996","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":"Lower limb muscle performance during a closed chain single leg squat and a squat jump in people with leg weakness after stroke: A comparative study","authors":"Genevieve Tolé, Gavin Williams, A. Holland, R. Clark","doi":"10.1017/brimp.2022.4","DOIUrl":"https://doi.org/10.1017/brimp.2022.4","url":null,"abstract":"\u0000 \u0000 \u0000 To determine if the intention to perform an exercise at speed leads to beneficial alterations in kinematic and kinetic components of the movement in people with post-stroke hemiplegia.\u0000 \u0000 \u0000 \u0000 Comparative study.\u0000 \u0000 \u0000 \u0000 Subacute metropolitan rehabilitation hospital.\u0000 \u0000 \u0000 \u0000 Convenience sample of patients admitted as an inpatient or outpatient with a diagnosis of stroke with lower limb weakness, functional ambulation category score ≥3, and ability to walk ≥14metres.\u0000 \u0000 \u0000 \u0000 Participants performed a single leg squat exercise on their paretic and nonparetic legs on a leg sled under three conditions: 1) self-selected speed (SS), 2) fast speed (FS), 3) jump squat (JS). Measures of displacement, flight time, peak concentric velocity, and muscle excitation (via electromyography) were compared between legs and conditions.\u0000 \u0000 \u0000 \u0000 Eleven participants (age: 56 ± 17 years; median time since stroke onset: 3.3 [IQR 3,41] months) were tested. All participants achieved a jump during the JS, as measured by displacement and flight time respectively, on both their paretic (0.25 ± 0.16 m and 0.42 ± 0.18 s) and nonparetic (0.49 ± 0.36 m and 0.73 ± 0.28 s) legs; however it was significantly lower on the non-paretic leg (p < 0.05). Peak concentric velocity increased concordantly with intended movement speed (JS-FS paretic: 0.96 m/s, non-paretic: 0.54 m/s; FS-SS paretic 0.69 m/s, nonparetic 0.38 m/s; JS-SS paretic 1.66 m/s, non-paretic 0.92 m/s). Similarly, muscle excitation increased significantly (p < 0.05) with faster speed for the paretic and nonparetic vastus lateralis. For gastrocnemius, the only significant difference was an increase during nonparetic JS vs. SS and FS.\u0000 \u0000 \u0000 \u0000 Speed affects the kinematic and kinetic components of the movement. Performing exercises ballistically may improve training outcomes for people post-stroke.\u0000","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"4 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87761445","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":"Lower limb muscle performance during a closed chain single leg squat and a squat jump in people with leg weakness after stroke: A comparative study.","authors":"Genevieve Tolé, Gavin Williams, Anne E Holland, Ross A Clark","doi":"10.1071/IB22031","DOIUrl":"https://doi.org/10.1071/IB22031","url":null,"abstract":"<p><strong>Objective: </strong>To determine if the intention to perform an exercise at speed leads to beneficial alterations in kinematic and kinetic components of the movement in people with post-stroke hemiplegia.</p><p><strong>Design: </strong>Comparative study.</p><p><strong>Setting: </strong>Subacute metropolitan rehabilitation hospital.</p><p><strong>Participants: </strong>Convenience sample of patients admitted as an inpatient or outpatient with a diagnosis of stroke with lower limb weakness, functional ambulation category score ≥3, and ability to walk ≥14metres.</p><p><strong>Methods: </strong>Participants performed a single leg squat exercise on their paretic and nonparetic legs on a leg sled under three conditions: 1) self-selected speed (SS), 2) fast speed (FS), 3) jump squat (JS). Measures of displacement, flight time, peak concentric velocity, and muscle excitation (via electromyography) were compared between legs and conditions.</p><p><strong>Results: </strong>Eleven participants (age: 56 ± 17 years; median time since stroke onset: 3.3 [IQR 3,41] months) were tested. All participants achieved a jump during the JS, as measured by displacement and flight time respectively, on both their paretic (0.25 ± 0.16 m and 0.42 ± 0.18 s) and nonparetic (0.49 ± 0.36 m and 0.73 ± 0.28 s) legs; however it was significantly lower on the non-paretic leg (p p Conclusions: Speed affects the kinematic and kinetic components of the movement. Performing exercises ballistically may improve training outcomes for people post-stroke.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"25 ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473071","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":"Identifying Trends of Dysautonomia Signs and Symptoms Associated with Protracted Concussion Recovery during the Buffalo Concussion Treadmill Test: A Retrospective Study.","authors":"Lauren Ziaks, Jenna Tucker, Thomas Koc, Alexa Schaefer, Kristina Hanson","doi":"10.1071/IB22030","DOIUrl":"https://doi.org/10.1071/IB22030","url":null,"abstract":"<p><strong>Objective: </strong>To identify trends of provoked dysautonomia signs and symptoms during the Buffalo Concussion Treadmill Test (BCTT).</p><p><strong>Subjects: </strong>This is a retrospective cohort study of 101 patient charts post-concussion who were screened for suspected dysautonomia.</p><p><strong>Methods: </strong>Patients with suspected dysautonomia were assessed for exercise intolerance using a BCTT. Symptoms and rate of perceived exertion were recorded on a standardized form. Digital pulse oximetry was used to collect heart rate (HR) and oxygen saturation. Descriptive analyses were conducted on BCTT results.</p><p><strong>Results: </strong>Of 101 patient charts, 57 were excluded from analysis, including four patients who completed the BCTT by asymptomatically reaching the target HR zone for their estimated HR max. The remaining 44 patients demonstrated: 35 (79.5%) poor HR stabilization defined as a drop or plateau in HR during exercise, 28 (63.8%) exacerbated concussion symptoms, 13 (29.5%) autonomic nervous system response such as hot flushed sensation, 12 (27.3%) rebound symptoms during recovery phases, and 8 (18.2%) desaturation of 90% or below. The mean delta (80% expected HR max â€\" 80% achieved HR max) on the initial test was 80.66 (± 23.08) beats per minute.</p><p><strong>Conclusions: </strong>This study is the first to identify trends of signs and symptoms during the BCTT in an expanded population with suspected dysautonomia after concussion. Future studies are indicated to validate these findings and contribute to development of modified termination criteria for the BCTT in individuals with suspected dysautonomia associated with protracted concussion recovery.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"25 ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473070","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":"Humanising health and social care: What do family members of people with a severe acquired brain injury value most in service provision","authors":"M. Holloway, C. Ellis-Hill","doi":"10.1017/BrImp.2021.36","DOIUrl":"https://doi.org/10.1017/BrImp.2021.36","url":null,"abstract":"Abstract Introduction: Family members living with relatives with severe acquired brain injury (ABI) face many challenges. Although this is recognised, service provision in the UK is poor and needs development. Method: In order to support innovative service delivery for family members, we reflect on the research carried out by the first author using a new perspective – a lifeworld humanising approach in order to consider (a) the dehumanising existential challenges facing family members of people living with severe ABI and (b) what family members most value in service delivery presented in humanising terms. Findings: Following ABI, family members may enter a parallel lifeworld (feeling separate from ‘usual’ life as it flows by) and face fundamental existential challenges of isolation, loss of agency, dislocation, loss of meaning and loss of personal journey. Family members have reported that service providers who are highly valued are those who act as ‘expert companions’. This role involves supporting families in some, if not all of the following (a) reaching across into the lifeworld of the family member and appreciating and validating what they are facing, (b) helping them make sense of their situation in terms which are meaningful to them and which they can explain to others, (c) through ABI expertise, supporting their relative through knowing their interests and needs and adapting the environment to suit these to help their relative to ‘settle’ and flourish, (d) supporting family members to share their life experiences – developing safe and trusting relationships, (e) having a humane, positive, creative and for some, a humorous approach, (f) being responsive to changing situations, (g) being available to call during times of worry or crisis and (h) help link with others and helpful networks. Discussion: It is suggested that the role and approach of companion may help family members regain some sense of their own life and their well-being.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"50 1","pages":"134 - 142"},"PeriodicalIF":0.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79312278","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":"Knowing-in-action that centres humanising relationships on stroke units: an appreciative action research study","authors":"Clare Gordon, C. Ellis-Hill, B. Dewar, C. Watkins","doi":"10.1017/BrImp.2021.34","DOIUrl":"https://doi.org/10.1017/BrImp.2021.34","url":null,"abstract":"Abstract Background: Equal, collaborative and therapeutic relationships centred on the person affected by stroke are important for supporting recovery and adjustment. However, realising these relationships in hospital practice is challenging when there is increasing focus on biomedical needs and organisational pressures. Despite a body of evidence advocating for quality relationships, there remains limited research describing how to achieve this in clinical practice. This appreciative action research (AAR) study aimed to describe the processes involved in co-creating meaningful relationships on stroke units. Design and methods: An AAR approach was used to develop humanising relationship-centred care (RCC) within two hospital stroke units. Participants were staff (n = 65), patients (n = 17) and relatives (n = 7). Data generation comprised of interviews, observations and discussion groups. Data were analysed collaboratively with participants using sense-making as part of the AAR cyclical process. Further in-depth analysis using immersion crystallisation confirmed and broadened the original themes. Findings: All participants valued similar relational experiences around human connections to support existential well-being. The AAR process supported changes in self, and the culture on the stroke units, towards increased value being placed on human relationships. The processes supporting human connections in practice were: (i) sensitising to humanising relational knowing; (ii) valuing, reflecting and sharing relational experiences with others that co-created a relational discourse; and (iii) having the freedom to act, enabling human connections. The outcomes from this study build on existing lifeworld-led care theories through developing orientations for practice that support relational knowing and propose the development of RCC to include humanising values.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"29 1","pages":"60 - 75"},"PeriodicalIF":0.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84671667","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":"We are human – an invisible and fundamental aspect of rehabilitation in acquired brain injury","authors":"C. Ellis-Hill, N. Kayes, J. Douglas","doi":"10.1017/brimp.2022.1","DOIUrl":"https://doi.org/10.1017/brimp.2022.1","url":null,"abstract":"The fact that acquired brain injury (ABI) rehabilitation services are made up of human beings supporting other human beings is not often considered in research or practice. In this special issue of Brain Impairment we are delighted to be able to share the work of academics who are engaging with this aspect of ABI rehabilitation. As editors, when we met in 2018 at the 41st annual conference of the Australasian Society for the Study of Brain Iimpairment (ASSBI), we were struck by how several presentations, although using slightly different language, were all touching on the same aspect of rehabilitation - human connection. Despite consensus and anecdotal evidence that human connection is a critical component of rehabilitation, there is remarkably little written in the literature to help us unpack, reflect on and harness human connection. Human connection is therefore not only ‘ invisible ’ in itself but also in developments in rehabilitation research and practice. As a first step, we would like to encourage service managers, researchers and clinicians to consider the value of human connection within service provision, to explore new ways of researching which allows human connection to come to the fore, and to celebrate the experience and power of human connection in our therapeutic relationships. In this special issue we invite you, the reader into the world of the invisible and immeasurable - human connection. We have a diverse range of authors and topics ranging from those reflecting individual lived experience, through therapeutic relationship, to wider social discourses. Although the focus for each author is discrete we feel that each contribution adds to this continuum as each part cannot exist without each other; the individual experience is always relational and social in an ever changing and powerful sea of meaning. The first author in our issue, Rixon sets the scene and in a way ‘ says it all ’ . Through sharing his own experience of","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"21 1","pages":"1 - 3"},"PeriodicalIF":0.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86825181","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":"Connection: stories not statistics","authors":"C. Rixon","doi":"10.1017/BrImp.2021.37","DOIUrl":"https://doi.org/10.1017/BrImp.2021.37","url":null,"abstract":"When health professionals and systems reduce people who survive brain injury to their symptoms and “survivor narratives” they create The Isolation Industry an industry that perpetuates a feeling of difference and deficit that caps the potential of those who they seek to help. So, how might stories disrupt this? I think the sharing of survival stories should be sexy. Not to be confused with sexual I’m talking about making lived experiences of brain injury palatable, relatable and investible. Narratives that evoke empathy, understanding and excitement eliminate stigma and end isolation. This paper holds familiar themes drawn from values consistent with research found in Brain Impairment; the importance of listening to the stories of people with lived experience of brain injury. Within the journal, I have read the work of many researchers on this topic; fancy-pants people with lots of degrees, who know a lot about brain injury. I am not a researcher; I am not an academic. I am a stroke survivor, a storyteller and a community mobiliser with firsthand experience of empowerment built through story-sharing. Sharing (and listening to) stories is important, but the challenge for health professionals is to use these stories to improve their practice and the experiences for survivors. Through their research, Tevendale and Armstrong (2015) found that when survivors shared their stories with health professionals, it improved the health professionals’ understanding of issues affecting people with lived experience and helped to refocus their beliefs of what mattered most in assisting people living with brain injury. Stories invite an emotional response and offer a narrative that likely differs from the patient history engaged by some health professionals. This work is an attempt to use my early stories to cast a spotlight on the disconnection that can occur in the rehabilitation process. By sharing these, I hope to start a conversation about the isolation that occurs for people with living experience of brain injury and how health professionals, policymakers and the system contribute to this. I want to create a dialogue loud enough to inspire you to pause and reflect on the part you could play in building a more connected rehab journey. Let us create a stronger connection; one built through stories, not statistics. The rhetoric we use and the paternalistic approach we engage reduces survivors to their disability; disempowering engagement leads to more isolation and increases mental health problems. We can change these outcomes by creating safe spaces for peers to connect and build capacity, using supportive and empowering language, recognising the wisdom people with lived experience hold, and by making collaboration, not compliance, an industry standard. I know this because I live it and it has been my journey for the past 13 years. Some of the most oppressive interactions that halted my recovery journey involved members of my healthcare team, particularly thos","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"66 1","pages":"4 - 8"},"PeriodicalIF":0.8,"publicationDate":"2022-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73491208","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":"Comparing participation in sports discussion and art therapy groups in ABI","authors":"Bronwyn Moorhouse, Erica R. Mainprize, J. Douglas, C. Fisher","doi":"10.1017/BrImp.2021.32","DOIUrl":"https://doi.org/10.1017/BrImp.2021.32","url":null,"abstract":"Abstract Background: Social connection is often impacted by acquired brain injury (ABI), contributing to isolation and compromised mental health. Group therapy is thought useful in this context. For those experiencing cognitive communication challenges, finding alternative ways to engage is also valuable. Art therapy may offer pro-social support through shared activity, self-expression, organic subject matter and enduring visual prompts. Method: A multiple A-B-A single case experimental design compared participation in sports discussion and art therapy groups on a long-stay secure unit. Nine individuals with ABI and complex combinations of communication, cognitive and mental health needs were studied. It was hypothesised that for some individuals, participation would be greater in art therapy than sports discussion groups. Results: Results from six individuals with at least five measurement points per phase are reported. Tau statistics revealed significant interphase differences for three individuals. Significantly less participation was recorded for two individuals in art than sports discussion, however they still appeared invested in the art groups. The remaining participant, with the most severe communication difficulties, avoided all baseline sports discussion groups, but participated in almost all art groups, with significant increase between initial sports discussion and art phases. Conclusion: Further research is warranted regarding the potential art therapy offers for group engagement, particularly where complex challenges render traditional talking-style groups less appropriate. Furthermore, disparate and complex needs in severe ABI require diverse, well-designed groups offering different opportunities and responding to individual strengths and motivations. More research into such approaches may increase group participation in this challenging cohort.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"37 1","pages":"76 - 90"},"PeriodicalIF":0.8,"publicationDate":"2022-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86328405","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":"Developing connections for engagement in stroke rehabilitation","authors":"N. Kayes, C. Cummins, K. McPherson, Linda Worrall, F. Bright","doi":"10.1017/BrImp.2021.27","DOIUrl":"https://doi.org/10.1017/BrImp.2021.27","url":null,"abstract":"Abstract Background and Aims: Engagement is increasingly recognised as important for maximising rehabilitation outcome following stroke. However, engagement can be challenging when neurological impairment impacts a persons’ ability to activate the regulatory processes necessary for engagement and in the context of a changed self. We explored engagement in stroke rehabilitation from the perspective of people with stroke with a primary focus on identifying key processes that appeared important to engagement in stroke rehabilitation. Design and Methods: This study drew on Interpretive Description methodology. Maximum variation and theoretical sampling were used to capture diversity in the sample and access a depth and breadth of perspectives. Data collection included semi-structured interviews with people with stroke (n = 19). Data were analysed through a collaborative and iterative process drawing on range of analytical tools including coding, memoing, diagramming and group discussions. Findings: Our findings highlight that engagement is a complex, nuanced, responsive, flexible and inherently two-way process. Developing connections appeared central to engagement with connections taking various forms. The most fundamental was the therapeutic connection between the person with stroke and their practitioner as it provided the foundation on which to build other connections. Connection was made possible through five collaborative processes: Knowing, Entrusting, Adapting, Investing and Reciprocating. Conclusions: Engagement is a social and relational process enabled through an inherently person-centred approach and active and ongoing reflexivity – highlighting the importance of a humanising approach to care where aspects of self, care and emotion are evident, for both the person with stroke and their practitioner.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"1 1","pages":"42 - 59"},"PeriodicalIF":0.8,"publicationDate":"2021-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83211293","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}