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Aphasia disrupts usual care: the stroke team's perceptions of delivering healthcare to patients with aphasia.
Conclusions: Aphasia disrupts usual care. Health professionals want to help but are working in a non-optimal environment where communication and patient-centred care are not adequately resourced.IMPLICATIONS FOR REHABILITATIONCurrent hospital systems and ward culture make it difficult to offer patient-centred care to patients with aphasia.Health professionals want to help patients with aphasia but are working in an environment where patient-provider communication is not adequately resourced.As a result, health professionals dread, limit or avoid talking with patients with aphasia.Health professionals need support which may...
Source: Disability and Rehabilitation - February 10, 2020 Category: Rehabilitation Authors: Carragher M, Steel G, O'Halloran R, Torabi T, Johnson H, Taylor NF, Rose M Tags: Disabil Rehabil Source Type: research

Disrupted biographies: making sense of minor stroke after hospital discharge.
Conclusions: Although participants had different experiences of minor stroke, there were common elements. The first weeks post-hospital discharge were a time of questioning and reconciling the stroke for many participants. Adjusting to post-stroke impairments and the impact of these on social participation was also prominent. There is a critical need for education about what to expect prior to discharge from hospital with minor stroke and a designated discharge pathway to avoid the development of secondary post-stroke issues in the community.IMPLICATIONS FOR REHABILITATIONPeople with minor stroke may experience ongoing pos...
Source: Disability and Rehabilitation - January 6, 2020 Category: Rehabilitation Authors: Finch E, Foster M, Fleming J Tags: Disabil Rehabil Source Type: research

Impaired force control contributes to car steering dysfunction in chronic stroke.
Conclusion: Stroke impairs the steering ability of the paretic hand. Although grip strength and force control of the paretic hand are diminished after stroke, only grip force control predicts steering accuracy. Deficits in grip force control after stroke contribute to functional limitations in performing skilled tasks with the paretic hand.Implications for rehabilitationDriving is an important goal for independent mobility after stroke that requires motor capability to manipulate hand and foot controls.Two prominent stroke-related motor impairments that may impact precise car steering are reduced grip strength and grip for...
Source: Disability and Rehabilitation - November 5, 2019 Category: Rehabilitation Authors: Patel P, Alam T, Tracy BL, Lodha N Tags: Disabil Rehabil Source Type: research

Key informants' perspectives on implementing caregiver programs in an organized system of stroke care.
Conclusions: This study provides initial insight into the potential barriers and facilitators needed to develop and implement stroke caregiver programs. Further exploration of these topics can inform caregiver program development and their implementation into stroke systems of care. IMPLICATIONS FOR REHABILITATION Rehabilitation research needs to demonstrate that caregivers are a unique group in need of support from the health care system. Rehabilitation research needs to contribute to the evidence that caregiver programs can improve patient, caregiver, and health system outcomes. Researchers can enhance caregiver program ...
Source: Disability and Rehabilitation - August 18, 2019 Category: Rehabilitation Authors: Tseung V, Jaglal SB, Salbach NM, Yoshida K, Cameron JI Tags: Disabil Rehabil Source Type: research

Health system challenges affecting rehabilitation services in South Africa.
This article presents challenges and solutions to ensure that South Africa can meet WHO 2030 Rehabilitation Goals for equitable provision of effective public rehabilitation services using the WHO's health system building block framework. IMPLICATIONS FOR REHABILITATION To meet the challenge of providing rehabilitation for those in need requires country-specific, strategic, evidence-informed, and planned decisions in terms of best investment for highest return. Whilst there is sound international evidence for best-practice rehabilitation care, country-specific strategies are required to identify and address local barriers t...
Source: Disability and Rehabilitation - August 2, 2019 Category: Rehabilitation Authors: Morris LD, Grimmer KA, Twizeyemariya A, Coetzee M, Leibbrandt DC, Louw QA Tags: Disabil Rehabil Source Type: research

Patient readiness for risk-reduction education and lifestyle change following transient ischemic attack.
Conclusion: Readiness for risk-reduction education and lifestyle change following transient ischemic attack is individual and complex. Logistical factors including the location, time, and cost of education, timing of education delivery, and patient perspectives should be considered in the development and delivery of secondary prevention interventions for these people. Implications for rehabilitation Risk reduction and lifestyle change following transient ischemic attack is vital to prevent recurrent stroke. Patients are ready to receive risk reduction and lifestyle advice approximately one week after their transient ischem...
Source: Disability and Rehabilitation - July 24, 2019 Category: Rehabilitation Authors: Geldens N, Crowfoot G, Sweetapple A, Vyslysel G, Mason G, English C, Janssen H Tags: Disabil Rehabil Source Type: research

Perspectives on neurorehabilitation of unilateral impairments through cross-education.
Conclusion: Cross-education may serve as a viable option for those patients presenting severe unilateral weakness who are not able to fully exercise their weaker side directly. However, it should not be recommended straightaway if the training goal is to improve outcomes other than strength. As such, contralateral training may prove as a primer to establish a minimum level of strength that may suffice to sustain direct training, which has been proved to prompt more meaningful functional changes. Implications for rehabilitation Cross-education consists of training the stronger limb to increase strength in the untrained weak...
Source: Disability and Rehabilitation - June 27, 2019 Category: Rehabilitation Authors: Manca A, Deriu F Tags: Disabil Rehabil Source Type: research

Predictors of return to work after stroke: a prospective, observational cohort study with 6  months follow-up.
Conclusions: Less than 50% of stroke survivors returned to work six months after stroke. Among predictors, only the level of dependence in daily activities is a modifiable factor. Interventions aimed at reducing disability after stroke might increase rates of return to work. Implications for rehabilitation In Brazil, less than 50% of stroke survivors returned to work six months after stroke. Clinicians may collect information regarding household income, type of work and dependence in daily activities to estimate chances of returning to work, in developing countries. Being independent at 3 months was the strongest predictor...
Source: Disability and Rehabilitation - June 25, 2019 Category: Rehabilitation Authors: Nascimento LR, Scianni AA, Ada L, Fantauzzi MO, Hirochi TL, Teixeira-Salmela LF Tags: Disabil Rehabil Source Type: research

Understandings stroke in rural Malaysia: ethnographic insights.
Conclusion: Lack of knowledge about stroke and its symptoms was evident in participants' account. Findings emphasize the importance of knowledge based health interventions, especially in health education strategies for stroke survivors to reduce delays to diagnosis and potentially improve health outcomes post-stroke. Implications for rehabilitation Stroke survivors often form explanatory models of stroke that draw from both biomedical and traditional explanations of stroke. Understanding how people derive lay understandings of stroke can contribute towards developing the goals and activities that facilitate recovery and re...
Source: Disability and Rehabilitation - June 5, 2019 Category: Rehabilitation Authors: Yap KH, Warren N, Allotey P, Reidpath DD Tags: Disabil Rehabil Source Type: research

Trajectories of memory, language, and visuoperceptual problems in people with stroke during the first year and controls in Colombia.
Conclusion: These findings suggest profound disparities in post-stroke cognitive functioning in Colombia compared to other more developed global region and underscore the importance of comprehensive cognitive rehabilitation services for individuals with stroke in Colombia and other similar global regions. Implications for rehabilitation Because this study found only negligible cognitive improvements beyond practice effects over the first year after stroke in Colombia among individuals without access to acute rehabilitation, it is imperative that comprehensive cognitive rehabilitation services be implemented immediately dur...
Source: Disability and Rehabilitation - June 4, 2019 Category: Rehabilitation Authors: Olabarrieta-Landa L, Pugh M, Calderón Chagualá A, Perrin PB, Arango-Lasprilla JC Tags: Disabil Rehabil Source Type: research

The impact of aphasia on Internet and technology use.
CONCLUSIONS: It is clear that aphasia often negatively affects Internet use and proficiency. However, this research clearly demonstrates that it is important to consider the influence of factors such as age, proxy use, education, and previous technology use and experience. Implications for rehabilitation Post-stroke aphasia contributes negatively to Internet use, particularly in the use of online communication tools such as email and messaging services. Sub-groups of people with aphasia are likely to be more vulnerable to exclusion from the benefits of the Internet; specifically, older people and those with lower levels of...
Source: Disability and Rehabilitation - April 12, 2019 Category: Rehabilitation Authors: Menger F, Morris J, Salis C Tags: Disabil Rehabil Source Type: research

"I'm just not a Sudoku person": analysis of stroke survivor, carer, and healthcare professional perspectives for the design of a cognitive rehabilitation intervention.
CONCLUSIONS: Qualitative work with stroke survivors, carers and healthcare professionals provided vital information for the intervention design. Issues identified by participants as being key to intervention development included: (i) implications of post-stroke cognitive impairment survivors' confidence; (ii) their individual capacity in terms of fatigue and metacognition; and (iii) practical issues such as intervention location. The inclusion of psychoeducation regarding consequences of stroke was recommended. Implications for rehabilitation Stroke survivors, carers, and rehabilitation professionals who provide stroke car...
Source: Disability and Rehabilitation - April 10, 2019 Category: Rehabilitation Authors: Merriman NA, Bruen C, Gorman A, Horgan F, Williams DJ, Pender N, Byrne E, Hickey A Tags: Disabil Rehabil Source Type: research

Stroke survivor attitudes toward, and motivations for, considering experimental stem cell treatments.
CONCLUSIONS: Stroke survivors may consider undergoing experimental stem cell treatments despite uncertainty regarding the risks/benefits. Clinicians should be mindful of the factors that may increase the likelihood of patients considering these treatments and intervene, where appropriate, to clarify any misconceptions regarding the medical/financial risks. IMPLICATION FOR REHABILITATION Stem cell treatments offer a new focus for reducing stroke-related disability, although their safety and effectiveness have yet to be established. Despite uncertainty regarding the medical risks and benefits associated with stem cell inject...
Source: Disability and Rehabilitation - February 1, 2019 Category: Rehabilitation Authors: Unsworth DJ, Mathias JL, Dorstyn DS, Koblar SA Tags: Disabil Rehabil Source Type: research

Exploring perceptions of stroke survivors and caregivers about secondary prevention: a longitudinal qualitative study.
CONCLUSION: Despite experiencing some barriers, stroke survivors adopted lifestyle changes transitioning through different stages of change. Stroke prevention education and interventions from experts would be helpful later in the rehabilitation phase (once at home) and adopting a patient-family centered approach may assist stroke survivors and their caregivers in the uptake of secondary stroke prevention activities. Implications for rehabilitation Stroke is perceived as a soul searching experience by stroke survivors and their caregivers motivating them to enquire its causes and adopting lifestyle changes to prevent a futu...
Source: Disability and Rehabilitation - January 22, 2019 Category: Rehabilitation Authors: Parappilly BP, Mortenson WB, Field TS, Eng JJ Tags: Disabil Rehabil Source Type: research

Experiences of people with stroke and multiple sclerosis and caregivers of a community exercise programme involving a healthcare-recreation partnership.
CONCLUSIONS: Group, task-oriented community-based exercise programmes incorporating a healthcare-recreation partnership may yield health benefits for exercise participants and caregivers. Results can guide programme evaluation, the nature and timing of education about such programmes, and efforts to address cost and transportation issues. Implications of rehabilitation Stroke and multiple sclerosis commonly cause balance and mobility limitations that can result in physical inactivity and further deterioration in health. Group, task-oriented community-based exercise programmes in which rehabilitation professionals train and...
Source: Disability and Rehabilitation - January 22, 2019 Category: Rehabilitation Authors: Merali S, Cameron JI, Barclay R, Salbach NM Tags: Disabil Rehabil Source Type: research

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