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Do clinical guidelines guide clinical practice in stroke rehabilitation? An international survey of health professionals
CONCLUSION: While many health professionals were aware of clinical guidelines, they identified multiple barriers to their implementation. Efforts should be made to raise awareness of local guidelines in low- and middle-income countries. More attention should be paid to addressing local contextual factors to improve guideline use internationally, going beyond traditional strategies focused on individual health professionals.IMPLICATIONS FOR REHABILITATIONSystems are required so people and organisations are held accountable to deliver evidence-based care in stroke rehabilitation.Locally developed stroke rehabilitation guidel...
Source: Disability and Rehabilitation - March 2, 2021 Category: Rehabilitation Authors: Elizabeth A Lynch Louise A Connell Lilian B Carvalho Marie-Louise Bird Source Type: research

How do healthcare professionals experience communication with people with aphasia and what content should communication partner training entail?
CONCLUSIONS: According to HCP, communication difficulties challenge the provision of healthcare activities and lead to negative feelings in HCP. HCP suggest that communication can be improved by providing more time in the healthcare pathway of people with aphasia, adapting healthcare information to the needs of people with aphasia, commitment of physicians and managers, changing the roles of SLTs and improving knowledge and skills of HCP. Implications for rehabilitation Communication between healthcare professionals (HCP) and people with aphasia can be improved by training HCP to use supportive conversation techniques and ...
Source: Disability and Rehabilitation - February 2, 2021 Category: Rehabilitation Authors: van Rijssen MN, Veldkamp M, Bryon E, Remijn L, Visser-Meily JMA, Gerrits E, van Ewijk L Tags: Disabil Rehabil Source Type: research

Inclusion of stroke patients in expanded cardiac rehabilitation services: a cross-national qualitative study with cardiac and stroke rehabilitation professionals.
CONCLUSIONS: Hybrid cardiac rehabilitation programmes could be tailored to deliver stroke-specific education, exercises and multidisciplinary expertise. Post-stroke cognitive impairment was identified as a key barrier to participation in cardiac rehabilitation. A cognitive rehabilitation intervention could potentially be delivered as part of cardiac rehabilitation, to address the cognitive needs of stroke and cardiac patients. Implications for rehabilitation The cardiac rehabilitation model has the potential to be expanded to include mild stroke patients given the commonality of secondary prevention needs. Up to half of st...
Source: Disability and Rehabilitation - February 2, 2021 Category: Rehabilitation Authors: Jeffares I, Merriman NA, Doyle F, Horgan F, Hickey A Tags: Disabil Rehabil Source Type: research

The role of theory to develop and evaluate a toolkit to increase clinical measurement and interpretation of walking speed and distance in adults post-stroke.
CONCLUSIONS: The approach may help to inform toolkit development to advance other rehabilitation practices of similar complexity. Implications for Rehabilitation Toolkits are an emerging knowledge translation intervention used to support widespread implementation of clinical practice guideline recommendations. Although experts recommend using theory to inform the development of knowledge translation interventions, there is little guidance on a suitable approach. This study describes an approach to using theories, models and frameworks to design a toolkit and implementation strategy, and a process evaluation of toolkit impl...
Source: Disability and Rehabilitation - January 16, 2021 Category: Rehabilitation Authors: Salbach NM, MacKay-Lyons M, Solomon P, Howe JA, McDonald A, Bayley MT, Veitch S, Sivarajah L, Cacoilo J, Mihailidis A Tags: Disabil Rehabil Source Type: research

"Factors influencing sedentary time and physical activity early after stroke: a qualitative study".
CONCLUSION: Stroke survivors and their carers need a clearer understanding of the role of physical activity and risks of sedentary time during stroke recovery. Physical activity enablers included consistent communication, building confidence and skills to self-manage activity before discharge. Implications for Rehabilitation Inpatient rehabilitation and early after discharge may be an important time-point to support stroke survivors to establish long term physical activity behaviours before contact with healthcare professionals reduces. To reduce sedentary behaviour, people need to understand the health benefits of breakin...
Source: Disability and Rehabilitation - January 5, 2021 Category: Rehabilitation Authors: Simpson DB, Jose K, English C, Gall SL, Breslin M, Callisaya ML Tags: Disabil Rehabil Source Type: research

The relevance of stroke care for living well with post-stroke aphasia: a qualitative interview study with working-aged adults.
CONCLUSIONS: The results highlight a need for equitable, transparent, responsive access to services, information and stroke liaison support. The findings extend knowledge of the importance of stroke care for supporting working-aged adults and their families to live well in the context of aphasia. Implications for rehabilitation There is a need for equitable, transparent access to a responsive integrated pathway of stroke care to support living well with aphasia. People with aphasia post-stroke and their families need access to person-centred stroke care and information responsive to their changing needs at all stages of re...
Source: Disability and Rehabilitation - December 28, 2020 Category: Rehabilitation Authors: Manning M, MacFarlane A, Hickey A, Galvin R, Franklin S Tags: Disabil Rehabil Source Type: research

Understanding activity participation 3-months after stroke: a mixed methodology study.
CONCLUSION: Qualitative interviews extend our understanding of the process of returning to participation in life activities and occupations following stroke to reveal that it involves the stroke survivor in a dynamic adaptation process of synchronizing personal, environmental and temporal dimensions in their daily lives. IMPLICATIONS FOR REHABILITATION Rehabilitation professionals need to recognize the unique knowledge and ability stroke survivors have to manage their capacities, activities, occupations and environments. Client-centered practice involving true collaborative partnerships are needed to ensure stroke survivor...
Source: Disability and Rehabilitation - December 22, 2020 Category: Rehabilitation Authors: Tse T, Lentin P, Douglas J, Carey LM Tags: Disabil Rehabil Source Type: research

Perspectives, satisfaction, self-efficacy, and barriers to aerobic exercise reported by individuals with chronic stroke in a developing country.
CONCLUSIONS: Individuals with stroke in a developing country considered aerobic exercise important. However, they perceived barriers related to safety, individual ability, social support, and aerobic exercise. It is necessary to improve education of these individuals, family members, and health care professionals regarding aerobic exercises. IMPLICATIONS FOR REHABILITATION Individuals after stroke in developing countries consider aerobic exercise important and recognized that it improves stroke recovery and health, although they perceived barriers related to safety, individual ability, social support, and aerobic exercise ...
Source: Disability and Rehabilitation - December 16, 2020 Category: Rehabilitation Authors: Aguiar LT, Nadeau S, Teixeira-Salmela LF, Reis MTF, Peniche PDC, Faria CDCM Tags: Disabil Rehabil Source Type: research

Exploring self-management within hospital-based stroke care: current and future opportunities.
CONCLUSIONS: A consistent conceptualisation and approach to stroke self-management in the hospital setting is required. Interprofessional education and shared intentional language can enhance understanding and practice. IMPLICATIONS FOR REHABILITATION Understanding and application of stroke self-management varies among members of hospital-based stroke teams. Health professionals working in hospital-based stroke care should use the term self-management with their patients. Education of healthcare teams is necessary to develop knowledge about self-management and develop consistent practices across the continuum of care. ...
Source: Disability and Rehabilitation - October 14, 2020 Category: Rehabilitation Authors: Greenway A, Gustafsson L, Bower K, Walder K Tags: Disabil Rehabil Source Type: research

Stroke survivors' perceptions of their sedentary behaviours three months after stroke.
Conclusions: This information will inform evidence-based sedentary behaviour interventions after stroke.Implications for rehabilitationHigher levels of sedentary behaviours are associated with poor health and stroke survivors are highly sedentary.Stroke survivors have complex reasons for spending time in sedentary behaviours including fatigue, pain, fear of falling and environmental barriers.Future interventions should educate stroke survivors on the health consequences of sedentary behaviours and encourage an increased awareness of time spent sedentary.Supporting stroke survivors to identify enjoyable and achievable activ...
Source: Disability and Rehabilitation - June 25, 2020 Category: Rehabilitation Authors: Fitzsimons CF, Nicholson SL, Morris J, Mead GE, Chastin S, Niven A Tags: Disabil Rehabil Source Type: research

How is carer strain related to the recovery of stroke survivors with right hemisphere dysfunction? Implications for practice.
Conclusion: Carer strain worsens with increases in significant concerns about the rehabilitation process and poor survivor functioning skills, which potentially increase risk of depression in carers. Consequently, improving right-hemisphere stroke survivors' recovery and nurturing the carer-survivor relationship are likely to enhance overall outcomes and caring experiences.IMPLICATIONS FOR REHABILITATIONIn the context of right hemisphere stroke: Carer assessment should be comprehensive and include a measure of perceived ability to care.Less strained carers tend to report fewer caring concerns and have lower depression leve...
Source: Disability and Rehabilitation - June 15, 2020 Category: Rehabilitation Authors: Stein MS, Reynolds FA Tags: Disabil Rehabil Source Type: research

Increasing time spent engaging in moderate-to-vigorous physical activity by community-dwelling adults following a transient ischemic attack or non-disabling stroke: a systematic review.
Conclusion: Despite recommendations to participate in regular physical activity at moderate-to-vigorous intensity for secondary stroke prevention, there is very little evidence for effective interventions for this patient population. There is need for clinically feasible interventions that result in long-term participation in physical activity in line with clinical guidelines. Trial registration: Protocol registration: PROSPERO CRD42018092840Implications for rehabilitationThere is limited evidence of the effectiveness of interventions that aim to increase time spent engaging in moderate-to-vigorous physical activity (MVPA)...
Source: Disability and Rehabilitation - May 31, 2020 Category: Rehabilitation Authors: Sammut M, Fini N, Haracz K, Nilsson M, English C, Janssen H Tags: Disabil Rehabil Source Type: research

The long-term unmet needs of informal carers of stroke survivors at home: a systematic review of qualitative and quantitative studies.
Conclusions: Evidence from this review suggests that carers are experiencing a range of long-term unmet needs, particularly in education and training, coping and managing their own emotions, and accessing much-needed services. Recommendations to support carers at home include continuing engagement, assessment, and support from health care providers and services to meet the needs of carers throughout the stroke recovery process.IMPLICATIONS FOR REHABILITATIONCarers of stroke survivors experience complex long-term unmet needs around managing the recovery process of the stroke survivor when they have been discharged from hosp...
Source: Disability and Rehabilitation - May 11, 2020 Category: Rehabilitation Authors: Denham AMJ, Wynne O, Baker AL, Spratt NJ, Loh M, Turner A, Magin P, Bonevski B Tags: Disabil Rehabil Source Type: research

Experienced consequences of spasticity and effects of botulinum toxin injections: a qualitative study amongst patients with disabling spasticity after stroke.
Conclusion: Incorporating patient-relevant outcomes into the current assessment of spasticity and monitoring these outcomes may improve spasticity management, particularly regarding the timing of botulinum toxin injections.Implications for rehabilitationBecause chronic spasticity after stroke impacts on almost all domains of everyday life, professionals should identify and target the most relevant problems in each individual patient.Monitoring patient-reported outcomes may help patients and professionals to get insight in the fluctuations of spasticity-related symptoms and may help to evaluate the effects of botulinum toxi...
Source: Disability and Rehabilitation - April 6, 2020 Category: Rehabilitation Authors: Kerstens HCJW, Satink T, Nijkrake MJ, De Swart BJM, Nijhuis-van der Sanden MWG, Van der Wees PJ, Geurts ACH Tags: Disabil Rehabil Source Type: research

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