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A comparison between reported therapy staffing levels and the department of health therapy staffing guidelines for stroke rehabilitation: a national survey
Conclusions: Most in-patient stroke units are operating below the DoH guidelines and are therefore challenged in providing the recommended amount of therapy and patient time to facilitate optimal functional recovery for stroke patients.
Source: BMC Health Services Research - May 14, 2014 Category: Journals (General) Authors: Gabrielle McHughIan Swain Source Type: research

Constraint-induced movement therapy for rehabilitation of arm dysfunction after stroke in adults: an evidence-based analysis.
Authors: Medical Advisory Secretariat, Health Quality Ontario Abstract OBJECTIVE: The purpose of this evidence-based analysis is to determine the effectiveness and cost of CIMT for persons with arm dysfunction after a stroke. CLINICAL NEED: CONDITION AND TARGET POPULATION A stroke is a sudden loss of brain function caused by the interruption of blood flow to the brain (ischemic stroke) or the rupture of blood vessels in the brain (hemorrhagic stroke). A stroke can affect any number of areas including the ability to move, see, remember, speak, reason, and read and write. Stroke is the leading cause of adult neur...
Source: Ontario Health Technology Assessment Series - December 20, 2015 Category: Journals (General) Tags: Ont Health Technol Assess Ser Source Type: research

Continual Long-Term Physiotherapy After Stroke: A Health Technology Assessment.
Conclusions: We did not identify studies that addressed the specific research question. Based on the clinical evidence review, we are unable to determine the benefits of continual long-term compared with short-term physiotherapy after stroke. The cost-effectiveness of continual long-term physiotherapy after stroke in Ontario is unknown. We estimate that publicly funding continual long-term physiotherapy after stroke in Ontario would result in additional costs of between $445,000 and $888,000 annually over the next 5 years. Patients and caregivers who we spoke with felt that patients who have experienced a stroke should be ...
Source: Ontario Health Technology Assessment Series - March 22, 2020 Category: General Medicine Tags: Ont Health Technol Assess Ser Source Type: research

Mental practice for treating upper extremity deficits in individuals with hemiparesis after stroke.
CONCLUSIONS: Moderate-certainty evidence shows that MP in addition to other treatment versus the other treatment appears to be beneficial in improving upper extremity activity. Moderate-certainty evidence also shows that MP in addition to other treatment versus the other treatment appears to be beneficial in improving upper extremity impairment after stroke. Low-certainty evidence suggests that ADLs may not be improved with MP in addition to other treatment versus the other treatment. Low-certainty evidence also suggests that MP versus conventional treatment may not improve upper extremity impairment. Further study is requ...
Source: Cochrane Database of Systematic Reviews - May 24, 2020 Category: General Medicine Authors: Barclay RE, Stevenson TJ, Poluha W, Semenko B, Schubert J Tags: Cochrane Database Syst Rev Source Type: research

Physical rehabilitation approaches for the recovery of function and mobility following stroke.
CONCLUSIONS: Physical rehabilitation, comprising a selection of components from different approaches, is effective for recovery of function and mobility after stroke. Evidence related to dose of physical therapy is limited by substantial heterogeneity and does not support robust conclusions. No one approach to physical rehabilitation is any more (or less) effective in promoting recovery of function and mobility after stroke. Therefore, evidence indicates that physical rehabilitation should not be limited to compartmentalised, named approaches, but rather should comprise clearly defined, well-described, evidenced-based phys...
Source: Cochrane Database of Systematic Reviews - April 22, 2014 Category: Journals (General) Authors: Pollock A, Baer G, Campbell P, Choo PL, Forster A, Morris J, Pomeroy VM, Langhorne P Tags: Cochrane Database Syst Rev Source Type: research

Difficulties in post-stroke gait improvement caused by post-stroke depression.
CONCLUSIONS: Depression limits gait recovery after stroke. The time of initiation of rehabilitation after stroke onset does not limit the motor recovery after rehabilitation program. PMID: 24890157 [PubMed - in process]
Source: Chinese Medical Journal - June 1, 2014 Category: Journals (General) Authors: Kijowski S Tags: Chin Med J (Engl) Source Type: research

Treadmill training and body weight support for walking after stroke.
CONCLUSIONS: Overall, people after stroke who receive treadmill training with or without body weight support are not more likely to improve their ability to walk independently compared with people after stroke not receiving treadmill training, but walking speed and walking endurance may improve. Specifically, stroke patients who are able to walk (but not people who are not able to walk) appear to benefit most from this type of intervention. This review found that improvements in walking endurance in people able to walk may have persisting beneficial effects. Further research should specifically investigate the effects of d...
Source: Cochrane Database of Systematic Reviews - January 23, 2014 Category: Journals (General) Authors: Mehrholz J, Pohl M, Elsner B Tags: Cochrane Database Syst Rev Source Type: research

Acute stroke unit improves stroke management-four years on from INASC.
Abstract The Irish Heart Foundation carried out the Irish National Audit of Stroke Care (INASC) in 2008. Management practices were significantly poorer than those in the UK Sentinel audits. Since then an acute stroke unit has been established in University Hospital Limerick. A stroke database was established. 12 key indicators of stroke management audited by INASC were identified. Results were compared to those in INASC. 89 stroke patients were admitted. 8 of the 12 key indicators scored significantly better than in INASC. 92.5% had a brain scan within 24hrs (INASC-40%, p = < 0.001). 100% of ischaemic strokes r...
Source: Ir Med J - February 1, 2015 Category: Journals (General) Authors: Shanahan E, Keenan R, Cunningham N, O'Malley G, O'Connor M, Lyons D, Peters C Tags: Ir Med J Source Type: research

Provision of inpatient rehabilitation and challenges experienced with participation post discharge: quantitative and qualitative inquiry of African stroke patients
Conclusion: Stroke patients admitted to hospitals in certain African countries could receive limited in-patient therapeutic interventions. With the exception of barriers in the physical environment, stroke patients in developing countries where resources are limited experience the same participation restrictions as their counterparts in developed countries where resources are more freely available. Rehabilitation interventions in these developing countries should therefore be community-based focussing on intervening in the physical environment.
Source: BMC Health Services Research - September 28, 2015 Category: Journals (General) Authors: Anthea RhodaNatalie CunninghamSimon AzariaGerard Urimubenshi Source Type: research

Treadmill training and body weight support for walking after stroke.
CONCLUSIONS: Overall, people after stroke who receive treadmill training, with or without body weight support, are not more likely to improve their ability to walk independently compared with people after stroke not receiving treadmill training, but walking speed and walking endurance may improve slightly in the short term. Specifically, people with stroke who are able to walk (but not people who are dependent in walking at start of treatment) appear to benefit most from this type of intervention with regard to walking speed and walking endurance. This review did not find, however, that improvements in walking speed and en...
Source: Cochrane Database of Systematic Reviews - August 17, 2017 Category: General Medicine Authors: Mehrholz J, Thomas S, Elsner B Tags: Cochrane Database Syst Rev Source Type: research

Low-frequency rTMS in patients with subacute ischemic stroke: clinical evaluation of short and long-term outcomes and neurophysiological assessment of cortical excitability.
This study is the first to measure the dynamics of cortical excitability by TMS mapping before and after treatment with low-frequency (LF) rTMS in the contralesional hemisphere at three different timepoints. Furthermore, the patients were clinically evaluated during the same visit as the mapping to establish both short and long-term outcomes after rTMS treatment. METHODS AND RESULTS: A total of 16 participants with acute ischemic stroke were assessed 10 days post-stroke by TMS mapping. The patients were randomized into two equal groups: a real rTMS group and a sham group. The rTMS group received LF-rTMS to the contrale...
Source: Journal of Medicine and Life - November 18, 2015 Category: Journals (General) Tags: J Med Life Source Type: research

Depression and dynamic balance recovery among stroke survivors: A preliminary investigation
Conclusions There is a high prevalence of post-stroke depression among stroke survivors and they have poor dynamic balance. However, owing to small sample of participants in the present study, its premature to draw conclusion on the relationship between depression and dynamic balance recovery among stroke survivors from the result of this study.
Source: Polish Annals of Medicine - September 10, 2016 Category: Journals (General) Source Type: research

Electromechanical-assisted training for walking after stroke.
CONCLUSIONS: People who receive electromechanical-assisted gait training in combination with physiotherapy after stroke are more likely to achieve independent walking than people who receive gait training without these devices. We concluded that eight patients need to be treated to prevent one dependency in walking. Specifically, people in the first three months after stroke and those who are not able to walk seem to benefit most from this type of intervention. The role of the type of device is still not clear. Further research should consist of large definitive pragmatic phase 3 trials undertaken to address specific quest...
Source: Cochrane Database of Systematic Reviews - October 22, 2020 Category: General Medicine Authors: Mehrholz J, Thomas S, Kugler J, Pohl M, Elsner B Tags: Cochrane Database Syst Rev Source Type: research

Weekly variation in health-care quality by day and time of admission: a nationwide, registry-based, prospective cohort study of acute stroke care
Publication date: Available online 10 May 2016 Source:The Lancet Author(s): Benjamin D Bray, Geoffrey C Cloud, Martin A James, Harry Hemingway, Lizz Paley, Kevin Stewart, Pippa J Tyrrell, Charles D A Wolfe, Anthony G Rudd Background Studies in many health systems have shown evidence of poorer quality health care for patients admitted on weekends or overnight than for those admitted during the week (the so-called weekend effect). We postulated that variation in quality was dependent on not only day, but also time, of admission, and aimed to describe the pattern and magnitude of variation in the quality of acute s...
Source: The Lancet - May 11, 2016 Category: Journals (General) Source Type: research

Repetitive peripheral magnetic stimulation for impairment and disability in people after stroke.
CONCLUSIONS: Available trials provided insufficient evidence to permit any conclusions about routine use of rPMS for people after stroke. Additional trials with large sample sizes are needed to provide robust evidence for rPMS after stroke. PMID: 31784991 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - November 29, 2019 Category: General Medicine Authors: Sakai K, Yasufuku Y, Kamo T, Ota E, Momosaki R Tags: Cochrane Database Syst Rev Source Type: research

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