No description available.

Post-stroke fatigue is a common problem that may limit participation in everyday activities. Emerging evidence suggests that group-based training in fatigue management may be an efficient means of reducing the effects of post-stroke fatigue. This mixed methods, quasi-experimental study proposed to determine whether a group-based educational program could be successful in relieving post-stroke fatigue and improving participation in daily activities. A convenience sample of stroke survivors (n=20) from retirement communities in southeastern PA were invited to participate in the research. Participants were screened for depression, motor and cognitive recovery, and sleep quality. Fatigue was measured using the Fatigue Severity Scale (FSS) and activity participation was measured using the Physical Self-Maintenance Scale- Instrumental Activities of Daily Living (PSMS-IADL). The measures were administered in a double pre-test, double post-test format over three seven-week phases; a non-intervention period; a group-based intervention period, and a post-intervention period. Qualitative information was gathered using a self-made Intervention Satisfaction Survey. Data analysis involved measures of central tendency for the demographic information. Tabulations of the survey responses were completed to judge the effectiveness of the group-based program or its’ components from the participants’ perspectives. Results indicated a statistically significant reduction in reported fatigue post-intervention (p= .022), which continued for seven-weeks (p= .240). There was a strong effect size for the post-intervention reduction of fatigue (r= .69). There was a trend toward improved participation in daily activities. Distribution across groups for presence of social support, age, sex, and level of care was found to be equivalent after one-way chi square analysis. There was no significant influence of these variables on fatigue or participation when used as grouping variables in RM-ANOVA. Participants reported feeling most confident scheduling activity to include rest periods and least confident managing sleep problems. Limitations include small sample size, demographics not being representative of the general stroke population, use of self-report measures with possible ceiling effect of PSMS-IADL, instrumentation effect given multiple administrations, and history effects as groups occurred at different time of the year. Overall, the results indicate that participation in a group-based educational program was effective in reducing post-stroke fatigue in chronic stroke.

<p>Diss. (sammanfattning) Umeå : Umeå universitet, 2003</p> / digitalisering@umu

Background: Following a stroke the ability to walk is often impaired due to compromised motor-control, muscle weakness and spasticity, resulting in deviations during gait. Ankle-foot orthoses (AFO) can be used for people with hemiparesis to improve stability during stance phase and clearance during swing phase. There has been much discussion whether AFOs have a positive effect during early rehabilitation post stroke (in this study defined as six weeks from the initial stroke onset).Objectives: The aim was to describe the level of involvement of Danish Certified Prosthetists and Orthotists (CPO) in early rehabilitation of stroke patients in Denmark, and to describe danish orthotists view on their involvement in early rehabilitation of stroke patients.Method: A cross-sectional survey, in form of a self-administered questionnaire, was conducted during March and April 2021 in Denmark. The survey was sent to Danish CPOs who were currently members of the Danish professional organization for prosthetists/orthotists. A total of 110 members received the questionnaire by e-mail, 80 of which were registered as certified. The questionnaire consisted of 43 items (of which a minimum of 26 questions needed answering) with mainly closed ended questions. Descriptive statistics were used for data analysis, with frequencies, percentage and summarizing tables.Results: The response rate was 31.25 % (n=25). The survey demonstrated that only few participants (n=3) were involved in early gait rehabilitation, stroke patients were seen as out-patients in orthotic clinics (92%, n=23), usually 4–6-month post stoke (44%, n=11) and often with a referral from another member of the multidisciplinary team (MDT) (56%, n=14). Danish CPOs believed that orthotic assessment was an essential part of gait re-education (80% n=20), and that the orthotist should be part of the early gait rehabilitation (88%, n=22). Most of the orthotists (72%, n=18) were confident in recommending a treatment plan including lower extremity orthosis and were confident in advising the multidisciplinary team (MDT) in the use of orthosis (80%, n=20).Conclusion: It is uncommon for danish CPOs to be involved in the early rehabilitation of stroke patients and the Danish CPOs often first meet the patient late in the rehabilitation process. The CPOs believe that they should be part of early gait rehabilitation and that orthotic assessment should be part of gait re-education.

Cerebrovascular disease is a leading cause of disability and death worldwide, with about one third of stroke survivors initially suffering from communication disorders, including aphasia. Symptoms in aphasia vary from person to person, ranging from repeated failures in verbal expression to comprehension deficits that may occur in both the spoken and written modality. The current work synthesizes almost a decade of research on aphasia following left-hemispheric stroke in individuals with preserved right-hemispheric function: musical skills and formulaic expressions embedded in social interaction. Moving beyond the traditional scope of clinical linguistics, this work argues that preserved right-hemispheric function not only provides valuable resources in speech-language therapy, but also a possible foundation for psychotherapy in individuals with post-stroke aphasia and concomitant depression. An integrative summary introduces key developments in a line of research spanning from 2013 to 2021, to conclude with an outlook on forthcoming contributions and a commentary on the underlying conceptual framework. Each separate piece of research has been published previously in peer-reviewed journals. Here, the selected studies are assembled in an interdisciplinary context at the intersection of clinical neuroscience, speech-language pathology, and psychotherapy.

Stroke är en sjukdom som påverkar den mentala hälsan och livskvaliteten hos den drabbade. Författarna vill belysa vikten av arbetsterapeutiska interventioner och rehabilitering för patienter med stroke. Syftet med litteraturstudien var att belysa betydelsen av arbetsterapeutiska interventioner och rehabilitering för mental hälsa och livskvalitet hos patienter med stroke. Materialet till den kvantitativa litteraturstudien samlades in från databaserna CINAHL, PubMed, Psycinfo samt OT seeker. Alla artiklar kvalitetsgranskades med ett protokoll och analyserades utifrån likheter och skillnader. Studierna visade på att patientens livskvalitet påverkades negativt av depressiva symtom. De skadliga konsekvenserna av stroke reduceras om rehabilitering skedde i tidigt stadie efter insjuknandet, till exempel Post stroke depression (PSD) som var starkt associerad till låg livskvalitet. Konventionell arbetsterapeutisk behandling gav lika eller bättre effekt än teknologiska behandlingar. Arbetsterapi visade sig ha en positiv inverkan på patienternas mentala hälsa och livskvalitet. Författarna ser dock ett behov av ytterligare forskning i hur professionen kan förbättra bemötandet av den mentala hälsan hos patienter med stroke.

La fatigue post-accident vasculaire cérébral (FPAVC) est fréquente et invalidante. Pour autant, elle reste à ce jour un phénomène mal connu et reconnu. Dans ce travail de thèse, nous avons réalisé une synthèse exhaustive de la littérature scientifique sur les facteurs associés à la FPAVC. Il en ressort qu’elle est fréquemment reliée aux symptômes dépressifs et anxieux mais que ses mécanismes physiopathologiques sont encore peu compris. Nous avons conduit une étude de la FPAVC sur 153 patients de la cohorte hospitalière STROKDEM (NCT01330160) ayant été suivis 6 mois après leur AVC ischémique. Dans une première étude, nous avons montré que la FPAVC n’était pas un effet secondaire des médicaments utilisés par les patients à la sortie de l’hôpital et à 6 mois. Elle reflèterait plutôt la présence de troubles fréquemment observés après un AVC comme la dépression, l’anxiété et les troubles du sommeil. Dans une deuxième étude, nous avons mis au jour une association forte entre FPAVC et plaintes cognitives subjectives des patients qui contrastait avec l’absence d’association avec les performances cognitives objectives lors de l’évaluation neuropsychologique, quel que soit le domaine cognitif considéré. Dans une troisième étude, nous avons exploré les mécanismes neuronaux sous-jacents à la FPAVC. Avec une analyse exploratoire et sans a priori, nous n’avons pas montré de différence de connectivité fonctionnelle au repos entre les patients avec ou sans FPAVC. L’ensemble de ces données nous apporte des éléments permettant d’avancer dans la compréhension du phénomène complexe qu’est la FPAVC. / Post-stroke fatigue (PSF) is frequent and debilitating. However, PSF is up to date a poorly understood and unrecognized phenomenon. In this thesis, we have done an exhaustive synthesis of scientific literature on factors associated with PSF. It indicates that PSF is frequently related with depressive and anxious symptoms but there is a lack of understanding of its physiopathological mechanisms. We conducted a study of PSF on 153 patients from the hospital-based cohort study STROKDEM (NCT01330160), followed-up for 6 months after an ischemic stroke. In a first study, we have shown that PSF was not a side effect of drugs use. PSF more reflects presence of disturbances frequently observed after stroke such as depression, anxiety, or sleep disturbances. In a second study, we have observed a strong association between PSF and subjective cognitive complaints that contrasted with the absence of association with objective cognitive performances during the neuropsychological evaluation, regardless of the considered cognitive domain. In a third study, we explored neuronal mechanisms underlying PSF. With an exploratory analysis, without a priori, we did not demonstrate any difference in functional connectivity at rest between patients with or without PSF. As a whole, these data give us pieces to progress in the understanding of the complex phenomenon named PSF.

No description available.

Σκοπός είναι να ερευνηθεί αν οι μετρήσεις του Πάχος του Ενδοθηλίου των Κοινών Καρωτίδων (ΠΕΚΚΑ) σε ασθενείς με Αγγειακό Εγκεφαλικό Επεισόδιο (ΑΕΕ) σχετίζονται με την άμεση ή μακροπρόθεση έκβαση του ΑΕΕ, με την μελλοντική εμφάνιση νοητικής έκπτωσης ή κατάθλιψης και με την υποτροπή του ΑΕΕ. ΜΕΘΟΔΟΙ: 284 ασθενείς με πρώτο ισχαιμικό ΑΕΕ που υποβλήθηκαν σε υπερηχογραφική μέτρηση του ΠΕΚΚΑ στην οξεία φάση, παρακολουθήθηκαν για ένα χρόνο. Η άμεση έκβαση εκτιμήθηκε κατά την έξοδο, ενώ η μακροπρόθεσμη έκβαση, η νοητική και συναισθηματική κατάσταση εκτιμήθηκαν μετά από 12 μήνες. Επίσης καταγράφηκαν οι υποτροπές στη διάρκεια του πρώτου χρόνου. ΑΠΟΤΕΛΕΣΜΑΤΑ: το ΠΕΚΚΑ δε συσχετιζόταν με την άμεση ή μακροπρόθεσμη έκβαση του ΑΕΕ ούτε με την ύπαρξη κατάθλιψης ένα χρόνο αργότερα. Αντίθετα, αυξημένες τιμές ΠΕΚΚΑ σχετίζονταν σημαντικά και ανεξάρτητα τόσο με την ύπαρξη νοητικής έκπτωσης 12 μήνες αργότερα όσο και με τoν κίνδυνο υποτροπής του ΑΕΕ κατά τη διάρκεια του πρώτου χρόνου. ΣΥΜΠΕΡΑΣΜΑ: οι μετρήσεις του ΠΕΚΚΑ αμέσως μετά από ισχαιμικό ΑΕΕ μπορεί να χρησιμεύουν στην αναγνώριση ασθενών με αυξημένο κίνδυνο για μελλοντική νοητική έκπτωση ή υποτροπή του ΑΕΕ. / Thesis objective is to investigate whether the measurements of Common Carotid Artery Intima Media Thickness (CCA-imt) in patients with acute stroke are associated with the stroke outcome, either short term or long term, with the future development of post stroke cognitive impairment and post stroke depression and with stroke recurrences within the first year after the stroke. METHODS: 284 consequent patients with first ever ischaemic stroke that underwent carotid ultrasonographic measurement of CCA-imt in the acute phase, were followed-up for one year. The short-term outcome was assessed at discharge. The long-term outcome and the presence of cognitive impairment and depressive symptoms were assessed 12 months later. The number of recurrences within the first year was also recorded. RESULTS: CCA-imt values were not associated with the short- or long-term stroke outcome or the presence of depression one year after the ictus. On the contrary, increased CCA-imt values were significantly and independently associated with cognitive impairment and with the risk of recurrence during the first year. CONCLUSION: measurements of CCA-imt right in the acute phase after an ischaemic stroke can help with the identification of patients in higher risk for future cognitive impairment and stroke recurrence.

In Folge eines Schlaganfalls leiden 90% aller Patienten an einer Handparese, die sich in 30-40% als chronisch manifestiert. Derzeit wächst seitens der Neurologie und Technologie das Forschungsinteresse an der Effektivität robotergestützter Therapieansätze, welche für schwer betroffene Patienten als besonders vielversprechend eingestuft werden. Die hierfür verwendeten Therapieroboter setzen sich aus einem mechanischen Teil und einer softwaregestützten virtuellen Umgebung zusammen, welche neben dem graphischen Interface, audio-visuelles Feedback sowie Musik beinhaltet. Bisher wurden Effekte der klanglichen Anteile dieses Szenarios noch nicht hinsichtlich möglicher Einflüsse auf Motivation, Bewegungsdurchführung, motorisches Lernen und den gesamten Rehabilitationsprozess untersucht. Die vorliegende Arbeit untersucht die Rolle von Sound in robotergestütztem Handfunktionstraining. Die Hauptziele im Rahmen dessen sind es, 1) Potentiale von Sound/ Musik für den Kontext robotergestützten Handfunktionstrainings zu explorieren, 2) spezifizierte klangliche Umgebungen zu entwickeln, 3) zu untersuchen, ob Schlaganfallpatienten von diesen spezifizierten Soundanwendungen profitieren, 4) ein besseres Verständnis über Wirkmechanismen von Sound und Musik mit Potential für robotergestützte Therapie darzulegen, und 5) Folgetechnologien über eine effektive Applikation von Sound/ Musik in robotergestützter Therapie zu informieren. / 90% of all stroke survivors suffer from a hand paresis which remains chronic in 30-40% of all cases. Currently, there is an increasing research interest in neurology and technology on the effectiveness of robot-assisted therapies. Robotic training is considered as especially promising for patients suffering from severe limitations. Commonly, rehabilitation robots consist of a mechanical part and a virtual training environment with a graphical user interface, audio-visual feedback, sound, and music. So far, the effects of sound and music that are embedded within these scenarios have never been evaluated in particular while taking into account that it might influence motivation, motor execution, motor learning and the whole recovery process. This thesis investigates the role of sound in robot-assisted hand function training post-stroke. The main goals of this work are 1) to explore potentials of sound/ music for robotic hand function training post-stroke, 2) to develop specified sound-/ music-applications for this context, 3) to examine whether stroke patients benefit from these specified sound/ music-application, 4) to gain a better understanding of sound-/ music-induced mechanisms with therapeutic potentials for robotic therapy, and 5) to inform further arising treatment approaches about effective applications of sound or music in robotic post-stroke motor training.