Archive for August, 2020

[Abstract] Electroacupuncture with rehabilitation training for limb spasticity reduction in post-stroke patients: A systematic review and meta-analysis – Review

ABSTRACT

Objective

To assess the effectiveness of electroacupuncture (EA) with rehabilitation training in reducing limb spasticity in post-stroke patients.

Methods

A systematic review was performed by electronically searching six databases (Medline/Pubmed, Embase, Cochrane Library, China National Knowledge Infrastructure, Database for Chinese Technical Periodicals, and Wanfang Data) for randomized controlled trials (RCTs) on EA with rehabilitation training for limb spasticity reduction in post-stroke patients from 1 January 2009 to 1 January 2019. A meta-analysis was performed using SAS 9.3 and RevMan 5.3 software after bibliography screening, data extraction, and risk of bias assessment using the Cochrane handbook. The primary outcome was spasticity.

Results

A total of 31 RCTs (including 2488 participants) were included. Except for Cai et al.’s study, the quality of other RCTs was not high. All studies performed a descriptive analysis, and 29 RCTs conducted a meta-analysis. The odds ratio (OR) for marked efficiency was 2.35 (95% confidence interval [CI] 1.68–3.27, Z = 5.03, P < .00001). The OR for Modified Ashworth Scale (MAS) classification was 2.42 (95% CI 1.89–3.10, Z = 7.03; P < .00001). The weighted mean difference (WMD) for MAS score was −0.68 (95% CI −0.79 – −0.56, Z = 11.24, P < .00001). The WMD for clinical spasticity index score was −1.50 (95% CI −2.28 – −0.72, Z = 3.79, P = .0002).

Conclusion

EA with rehabilitation training could be a good strategy for reducing limb spasticity after stroke and is better than EA alone or rehabilitation training alone. However, its effectiveness remains to be further verified by large-sample and high-quality RCTs

Source: https://www.tandfonline.com/doi/full/10.1080/10749357.2020.1812938?af=R&utm_source=researcher_app&utm_medium=referral&utm_campaign=RESR_MRKT_Researcher_inbound

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[Abstract + References] Mirror therapy simultaneously combined with electrical stimulation for upper limb motor function recovery after stroke: a systematic review and meta-analysis of randomized controlled trials

Abstract

Objective:

To evaluate the current evidence on the effectiveness of simultaneous combination of mirror therapy and electrical stimulation in the recovery of upper limb motor function after stroke, compared with conventional therapy, mirror therapy or electrical stimulation isolated.

Data sources:

Articles published in PubMed, Web of Science, Scopus, Physiotherapy Evidence Database (PEDro), Cochrane Central register of controlled trials and ScienceDirect up to July 2020.

Review methods:

The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Methodological quality was assessed using the PEDro tool. The RevMan 5.4 statistical software was used to obtain the meta-analysis, through the standardized mean difference and 95% confidence intervals (CI), and to evaluate the risk of bias. The GRADE approach was employed to assess the certainty of evidence.

Results:

Eight articles were included in this systematic review, seven were included in the meta-analysis. A total of 314 participants were analyzed. The overall quality of the articles included in this review was good. There was no overall significant mean difference on upper limb motor function after stroke using the Upper-Extremity Fugl-Meyer Assessment by 1.56 (95% CI = –2.08, 5.20; P = 0.40; moderate-certainty evidence) and the Box and Block Test results by 1.39 (95% CI = –2.14, 4.92; P = 0.44; high-certainty evidence). There was overall significant difference in the Action Research Arm Test by 3.54 (95% CI = 0.18, 6.90; P = 0.04; high-certainty evidence).

Conclusion:

Direct scientific evidence about the effectiveness of the combined therapy of mirror therapy and electrical stimulation simultaneously for the improvement of the upper limb motor function after stroke is lacking. Further high-quality and well-designed research is needed.

References

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Source: Mirror therapy simultaneously combined with electrical stimulation for upper limb motor function recovery after stroke: a systematic review and meta-analysis of randomized controlled trials – Alberto Saavedra-García, Jose A Moral-Munoz, David Lucena-Anton, 2020

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[ARTICLE] Virtual reality art-making for stroke rehabilitation: Field study and technology probe – Full Text

Highlights

In a three-week field study of traditional art-making by 14 stroke survivors with disabilities, we found that these artists utilized the physical and temporally unfolding properties of the materials to create beauty without excessive fine motor precision, used a social, situated and reflective process of tool selection, and created work that blended inspirations and accomplishments from their previous and current identity.

We contrasted themes derived from the field study and experiential virtual reality interviews using state of the art 3D tools as a technology probe. We found that the affordances of VR as a medium shifted making away from meditative, physicallysupported fine motor activity to free form mid-air gesture. The experience was immersive, physical and out of control and creations were at times abstract, intentional or emergent.

Implications for the design of VR art-making identified from two types of research inquiry. The contrast of the social, reflective and unhurried nature for traditional artmaking and the unfolding of traditional materials, with the speed, proximity and finality of 3D paint lead us to recommend social, situated, reflective, physical and meaningmaking considerations for VR art interaction.

Abstract

How can we better understand the process of therapeutic art-making for stroke rehabilitation, and what are design opportunities for virtual reality art-making for people with stroke-related impairments? We investigated this question in a two-part study with 14 amateur artists with disabilities resulting from stroke: a three-week field study and a technology probe consisting of experiential virtual reality interviews. We uncovered what participants made, the aesthetics of the materials and the process of making. The field study revealed inspirations around identity, situatedness of choices for tools in the social and physical environment, and a breadth of application techniques (e.g., dripping paint or use of tape) that varied in need for fine motor control. The experiential virtual reality interviews highlighted the need for control, the affordances of the medium, and the challenges in viewing and reflecting on work. Emergent art reflected qualities of the 3D paint and free-form gesture. Virtual reality and traditional art-making contrasted in the speed and finality of application, opportunities for iteration and reflection, and in the need for dexterity. We discuss strengths, weaknesses and implications for design of virtual reality art-making for those with stroke-related impairments.

1. Introduction

Art is immersive and virtual reality art may be especially so. Virtual reality (VR) provides a sense of presence fostered by a head-mounted display that situates the user in an immersive environment. VR has been lauded as a promising form of rehabilitation because of its ability to provide rich visual experiences and transferable skills Wilson et al. (1997), control over dynamic environments and measurements of responses Schultheis and Rizzo (2001), and the ability to present greater risks than would be possible in real life Standen and Brown (2005). While VR is heralded as a way to transcend social and physical boundaries, accessibility barriers continue to exist as basic assistive features such as auto-reading are absent Tefilo et al. (2016). Our work focuses on artists with disabilities from stroke as power users Kara et al. (1997) and lead users Von Hippel (1986) for VR art-making.

A stroke occurs when the blood supply to the brain is disrupted, resulting in brain damage and loss of ability. Stroke is the most common cause of adult disability worldwide What is stroke? (2017). Recovering from stroke requires sustained adherence to physical therapy that consists of dozens of repetitions of basic movements and tasks of daily life, such as reach and grasp, and which are perceived as tedious Bassett (2003). Lack of motivation for and adherence to therapy worsens therapeutic outcomes Maclean et al. (2000). Rehabilitation in VR meets some of these challenges because patients can perform their physical exercise while the immersion draws attention away from discomfort and pain Lohse et al. (2014)Thomson et al. (2014). VR can also be done at home and gesture activity and progress can be tracked. To be fully successful, a rehabilitation program for stroke must not only be effective and draw attention away from pain, but also be engaging and draw patients out of a state of grief Hackett et al. (2005). Immersive gaming is a burgeoning area which can engage patients in cognitive flow and continuous physical movement exploration Burke et al. (2010). VR game-based stroke interventions tend to focus on improving physical function or cognitive aspects. Depression and anxiety are common psychological disorders post-stroke, but these are neglected in current treatments Ali et al. (2014). We aim to begin to address this gap by better understanding current practices for therapeutic art-making and investigating design opportunities for VR art-based stroke rehabilitation.

Art therapy is an effective treatment for stroke Kongkasuwan et al. (2016). Art-therapists work with clients in art-making directed by therapeutic goals. Art therapy supports physical, cognitive and emotional healing through the creation of art including painting, drawing, sculpting, mixed media or other methods. The malleability and interaction possibilities of the materials are critical. Art-therapists’ expertise in materiality enables them to work with clients through the art-making process to transcend disabilities. Art-therapists overcome communication impairments by using “making” as expression  Lazar et al. (2018). Art-therapists also offer unobtrusive physical assistance to empower clients Lazar et al. (2016). To understand current therapeutic art-making practices and design opportunities for virtual art-making for stroke rehabilitation, we study the context of post-stroke art-making. We used VR art as a technology probe Hutchinson et al. (2003) within the context of an institution that offers art classes, open studio time and art therapy. Our work makes three contributions:1.

Empirical results from a field study of traditional art-making by 14 stroke survivors with disabilities. We found that these artists i) utilized the physical and temporally unfolding properties of the materials to create beauty without excessive fine motor precision, ii) used a social, situated and reflective process of tool selection, and iii) created work that blended inspirations and accomplishments from their previous and current identity.2.

Themes derived from experiential VR interviews using a state of the art 3D tool as a technology probe. We found that the affordances of VR as a medium shifted making away from meditative, physically-supported fine motor activity to free-form mid-air gesture. The experience was immersive, physical and sometimes out of control. Creations were abstract, intentional or emergent.3.

Implications for the design of VR art-making which have been identified from two types of research inquiry. The contrasts of the social, reflective and unhurried nature of traditional art-making and the unfolding of traditional materials, with the speed, proximity and finality of 3D paint lead us to recommend social, situated, reflective, physical and meaning-making considerations for VR art interaction.[…]

Continue —> Virtual reality art-making for stroke rehabilitation: Field study and technology probe – ScienceDirect

Fig. 3
Fig. 3. Participants’ artworks. From first row left: 3a. Example of mixing inspirations: a painting with overlayed poetry; 3b. Example of alternative methods: a painting from a dripping and rotating method. Second row: 3c. Example of alternative tools: texture from sponges; 3d. Example of social inspiration: a painting of a peer. Third row: 3e. Example of a personal artistic style, abstract in this case, carried on in VR art; 3f. Second example of a personal artistic style, exploration of color and shape in this case, carried on in VR art.

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[Ebook] Epilepsy Complementary And Alternative Treatments – PDF


Ebook Title : Epilepsy Complementary And Alternative Treatments

Read Epilepsy Complementary And Alternative Treatments PDF on your Android, iPhone, iPad or PC directly.

The following PDF file is submitted in 19 Jan 2020

Ebook ID PDF-12ECAAT11.

Download full version PDF for Epilepsy Complementary And Alternative Treatments using the link below:

Download: EPILEPSY COMPLEMENTARY AND ALTERNATIVE
TREATMENTS PDF

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[Abstract] Potential for recovery between 4 and 8 years after a severe traumatic brain injury. Data from the PariS-TBI longitudinal study

Highlights

• Most patients with severe traumatic brain injury showed late improvement (4 to 8 years post-injury).

Abstract

Background

Severe traumatic brain injury (TBI) is a leading cause of complex and persistent disability. Yet, long-term change in global functioning and determinants of this change remain unclear.

Objectives

This study aimed to assess change in global functioning in the long-term after severe TBI and factors associated with the change.

Methods

This was a prospective observational study of an inception cohort of adults with severe TBI in the Paris area (PariS-TBI). Outcome was assessed at 1, 4 and 8 years post-injury. For the included participants (n = 257), change in global outcome between 4 and 8 years was evaluated with the Glasgow Outcome Scale Extended (GOSE) score, and its association with pre-injury, injury-related and post-injury variables was tested with univariate and multivariable analyses.

Results

More than half of the 73 participants evaluated at both 4 and 8 years showed global improvement (of at least one point) in GOSE score and an improvement in mood, executive function, and subjective complaints. On univariate analysis, none of the pre-injury, injury or post-injury variables were associated with GOSE score change between 4 and 8 years, except for GOSE score at 4 years (rho = −0.24, P = 0.04). On multivariable analysis, probability of increased GOSE score was associated with more years of education (odds ratio 1.18 [95% confidence interval 1.02–1.37], P = 0.03). The change in GOSE score was significantly correlated with change in Hospital Anxiety Depression Scale score between 4 and 8 years (rho = −0.42, P < 0.001).

Conclusions

Most participants with severe TBI in the present sample showed a late improvement (4 to 8 years post-injury) in global functioning. Of the socio-demographic and injury-related factors, only more years of education was associated with improvement in global functioning. Decreased anxiety and depression symptoms were associated with improved global functioning. Targeting interventions to enhance resilience may be the most effective in the long-term after severe TBI.

Source: https://www.sciencedirect.com/science/article/abs/pii/S1877065720301500?dgcid=rss_sd_all&utm_campaign=RESR_MRKT_Researcher_inbound&utm_medium=referral&utm_source=researcher_app

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[WEB PAGE] The Truth about the Plateau in Stroke Recovery

As a stroke survivor, you may have heard someone say, “You’ve reached a plateau,” or “You’re plateauing.” A plateau is high flat land, so what does it have to do with your stroke recovery?

Immediately after you have a stroke is when everything is at the very worst. You may be paralyzed, confused, and unable to speak. Each day you get better as your brain heals, recovering from the shock of the stroke. The progress in the first few weeks or months is often rapid— a steadily upward line on the recovery chart.

But then the slope of that line may start to grow more horizontal. The change doesn’t come as fast or as spontaneously. As that line flattens out, you’ll start to hear about a plateau in your progress. After you’ve reached it, it may feel like you’re stuck—unable to climb any higher. Therapists may start to suggest your therapy will end. Doctors might say this is the best you’ll ever be. And you know what? They might be right— if you believe them.

The Myth of the Plateau in Stroke Recovery

Lots of stroke survivors keep improving, years after their stroke. They say the plateau doesn’t exist – it’s a myth! But doctors are saying it’s real – that recovery slows or stops. So is the plateau in stroke recovery true, or is it a myth?

It’s both. While it’s true that spontaneous recovery in the brain does slow down after a period of time post-stroke, the key word there is spontaneous. That means it happens without you even trying. If you’re riding the wave of recovery, thinking each day is going to be better than the last, there will come a point when that stops being true. When you see that you’re not getting better, you may start to feel sad and hopeless. And then things really stop getting better. In fact, they may start to get worse because you’re depressed.

Related Article: The Under-Recognized Connection between Aphasia and Depression

The myth part of the plateau concept is that there’s nothing you can do about it. The brain can and will continue to change and improve if you work at it. Progress is absolutely possible years after stroke with focused exercises toward specific goals. It’s just not as easy as it was early on. You have to set a target, break it down into steps, and work on it repetitively. You may need to work on just one goal at a time. But you can make progress. You have to maintain your hope and motivation, and you’ll start to see change again.

Plateau in stroke recovery means something different than you might think. Focused effortful progress comes after rapid spontaneous recovery.

Ups and Downs in Stroke Recovery

There are always ups and downs in stroke recovery. Some days your skills may take a dip, or even a dive. If you’re tired, sick, overwhelmed, or stressed, your speech or mobility may suffer. These downturns may last a few hours, a few days, or even a few weeks. But over time, they’ll get better. If they don’t, it’s a good signal to go talk to your doctor or therapist to see if something else may be causing the decline. Usually, you’ll return to your best abilities once you’re rested or relaxed.

Plateau means flat. Recovery is always up and down, but generally up.

There are also exciting upturns, like when a full sentence comes out perfectly, or your finger moves in a way it never has before. This spark of recovery may only last a moment, but it’s good news. It often means your brain is ready for the next step.

With all the daily ups and downs, the important thing to focus on is the overall trend of recovery. What can you do today that you couldn’t do a month ago? How much better do you sound now than six months ago? Keeping a journal, a video diary, or weekly recordings of yourself can really help you to see the progress over time that you may not notice day-to-day.

Tactus Therapy apps make it easy to track your progress. You can send detailed reports after each session, then compare when you’re ready. Try our aphasia apps for free to see how you can keep your stroke recovery going. Not sure where to start? Our App Finder can help!

What to Do When You Reach a Plateau in Stroke Recovery

Since we know that progress can stall out, it’s important to understand how to jump-start recovery again. Here are some things you can try to get things moving again:

Set a new functional goal

Learn to set SMART goals: specific, measurable, achievable, relevant, and time-bound. When you’re working systematically toward something that matters to you, your motivation will stay high.

Use a new evidence-based technique

Research tells us what works and for whom. Ask your therapist about techniques that are proven, or start with our How To guides for evidence-based speech therapy treatments and our Language Therapy app that has been proven to help people make progress, years after stroke.

Sign up for a research study

Get the latest cutting-edge treatments by being part of the research studies that will inform therapists. It may not always work, or you may be part of a control/placebo group, but it feels good to help others and you may just luck out with a great new treatment.

Try a new therapist

It may not be you who’s stuck— it may be your therapist. Starting therapy with a new clinician can bring fresh eyes and a different bag of tricks to help you solve your problems.

Join a stroke or aphasia group

Support groups can help in so many ways: friendship, inspiration, and exercises. It helps to know you’re not alone in stroke recovery. If there are none in your area, try an online group, like #2 on this list.

Learn a new hobby or skill

Using your mental and physical abilities in fun activities can reap benefits in other areas of your life. Take up the piano and you may see improvement in buttoning your shirt. Join a bridge group to strengthen your math and attention skills you need to manage your finances.

Volunteer

Get out and help others to add purpose to your life. Babysitting, dog walking, or visiting lonely elders can give you more chances to speak without feeling judged. Community gardens and food banks offer a chance to get out of the house and help.

Take a break

Sometimes taking a break from therapy can let your brain recharge and refocus, while giving you time to do things you enjoy. Having fun is therapeutic too, and it can inspire new functional goals.

Don’t get discouraged

Everyone recovers at different rates. Don’t compare your recovery to others. Hope is the most powerful drug there is, so do everything you can to hold onto it.

Stroke recovery isn’t easy, and it isn’t fast, but you can always make progress. Henry Ford famously said, “Whether you think you can, or think you can’t– you’re right.”

Source: https://tactustherapy.com/stroke-recovery-plateau-truth-myth/

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[Abstract] Implementing the exoskeleton Ekso GTTM for gait rehabilitation in a stroke unit – feasibility, functional benefits and patient experiences

Abstract

Background

Reports on the implementation of exoskeletons for gait rehabilitation in clinical settings are limited.

Objectives

How feasible is the introduction of exoskeleton gait training for patients with subacute stroke in a specialized rehabilitation hospital?

What are the functional benefits and the patient experiences with training in the Ekso GTTM exoskeleton?

Design

Explorative study.

Methods

During an 18 months inclusion period, 255 in-patients were screened for eligibility. Inclusion criteria were; walking difficulties, able to stand 10 min in a standing frame, fitting into the robot and able to cooperate. One-hour training sessions 2–3 times per week for approximately 3 weeks were applied as a part of the patients’ ordinary rehabilitation programme. Assessments: Functional Independence Measure, Motor Assessment Scale (MAS), Ekso GTTM walking data, patient satisfaction and perceived exertion of the training sessions (Borg scale).

Results

Two physiotherapists were certified at the highest level of Ekso GTTM. Twenty-six patients, median age 54 years, were included. 177 training sessions were performed. Statistical significant changes were found in MAS total score (p < 0.003) and in the gait variables walking time, up-time, and a number of steps (p < 0.001). Patients reported fairly light perceived exertion and a high level of satisfaction and usefulness with the training sessions. Few disadvantages were reported. Most patients would like to repeat this training if offered.

Conclusions

Ekso GTTM can safely be implemented as a training tool in ordinary rehabilitation under the prerequisite of a structured organization and certified personnel. The patients progressed in all outcome measures and reported a high level of satisfaction.

  • Implications for rehabilitation
  • The powered exoskeleton Ekso GTTM was found feasible as a training option for in-patients with severe gait disorders after stroke within an ordinary rehabilitation setting.
  • The Ekso GTTM must be operated by a certified physiotherapist, and sufficient assistive personnel must be available for safe implementation.
  • Patients’ perceived exertion when training in the Ekso GTTM was relatively low.
  • The patients expressed satisfaction with this training option.

Source: https://www.tandfonline.com/doi/full/10.1080/17483107.2020.1800110?scroll=top&needAccess=true

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[WEB PAGE] Epilepsy: A Neurological Disorder

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Epilepsy is a group of neurological disorders characterized by recurrent epileptic seizures. Epileptic seizures are episodes that can vary from brief and nearly undetectable periods to long periods of vigorous shaking. These episodes can result in physical injuries, including occasionally broken bones. In epilepsy, seizures have a tendency to recur and, as a rule, have no immediate underlying cause.

Isolated seizures that are provoked by a specific cause such as poisoning are not deemed to represent epilepsy. People with epilepsy may be treated differently in various areas of the world and experience varying degrees of social stigma due to their condition.

The underlying mechanism of epileptic seizures is excessive and abnormal neuronal activity in the cortex of the brain. The reason this occurs in most cases of epilepsy is unknown. Some cases occur as the result of brain injury, stroke, brain tumors, infections of the brain, or birth defects through a process known as epileptogenesis. Known genetic mutations are directly linked to a small proportion of cases. The diagnosis involves ruling out other conditions that might cause similar symptoms, such as fainting, and determining if another cause of seizures is present, such as alcohol withdrawal or electrolyte problems. This may be partly done by imaging the brain and performing blood tests. Epilepsy can often be confirmed with an electroencephalogram (EEG), but a normal test does not rule out the condition. Epilepsy that occurs as a result of other issues may be preventable.

Seizures are controllable with medication in about 70% of cases; inexpensive anti-seizure medications are often available. In those whose seizures do not respond to medication, surgery, neurostimulation or dietary changes may then be considered. Not all cases of epilepsy are lifelong, and many people improve to the point that treatment is no longer needed. As of 2015, about 39 million people have epilepsy.

Nearly 80% of cases occur in the developing world. In 2015, it resulted in 125,000 deaths, an increase from 112,000 in 1990. Epilepsy is more common in older people. In the developed world, onset of new cases occurs most frequently in babies and the elderly. In the developing world, onset is more common in older children and young adults due to differences in the frequency of the underlying causes. About 5–10% of people will have an unprovoked seizure by the age of 80, and the chance of experiencing a second seizure is between 40 and 50%. In many areas of the world, those with epilepsy either have restrictions placed on their ability to drive or are not permitted to drive until they are free of seizures for a specific length of time.

The word epilepsy is from Ancient Greek ἐπιλαμβάνειν, ‘to seize, possess, or afflict’. Seizures Main article: Epileptic seizure The most common type (60%) of seizures are convulsive. Of these, one-third begin as generalized seizures from the start, affecting both hemispheres of the brain. Two-thirds begin as focal seizures (which affect one hemisphere of the brain) which may then progress to generalized seizures. The remaining 40% of seizures are non-convulsive. An example of this type is the absence seizure, which presents as a decreased level of consciousness and usually lasts about 10 seconds.

Focal seizures are often preceded by certain experiences, known as auras. They include sensory (visual, hearing, or smell), psychic, autonomic, and motor phenomena. Jerking activity may start in a specific muscle group and spread to surrounding muscle groups in which case it is known as a Jacksonian march. Automatisms may occur, which are non-consciously-generated activities and mostly simple repetitive movements like smacking of the lips or more complex activities such as attempts to pick up something. There are six main types of generalized seizures: tonic-clonic, tonic, clonic, myoclonic, absence and atonic seizures. They all involve loss of consciousness and typically happen without warning.

Regards,

Leza

Source: http://www.jopenaccess.com/blog/epilepsy-a-neurological-disorder-7531.html

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[Abstract] The predictors of proxy- and self-reported quality of life among individuals with acquired brain injury

Abstract

Purpose

Acquired brain injury (ABI) diminishes quality of life (QoL) of affected individuals and their families. Fortunately, new multidimensional instruments such as the calidad de vida en daño cerebral (CAVIDACE) scale are available. However, differences in self- and proxy-reported QoL remain unclear. Therefore, this study examined these differences and identified predictors of QoL among individuals with ABI.

Materials and methods

This cross-sectional study comprised 393 adults with ABI (men: 60%; M age = 54.65, SD = 14.51). Self-, family-, and professional-reported QoL were assessed using the CAVIDACE scale. Other personal and social variables were assessed as predictors of QoL.

Results

Professionals had the lowest QoL scores (M = 1.88, SD = 0.45), followed by family members (M = 2.02, SD = 0.44) and individuals with ABI (M = 2.10, SD = 0.43). Significant differences were found for almost all QoL domains, finding the highest correlations between family and professional proxy measures (r = 0.63). Hierarchical regression analysis revealed that sociodemographic, clinical, rehabilitation, personal, and social variables were significant predictors of QoL.

Conclusions

It is necessary to use both self- and proxy-report measures of QoL. Additionally, the identification of the variables that impact QoL permits us to modify the interventions that are offered to these individuals accordingly.

  • Implications for rehabilitation
  • Acquired brain injury (ABI) causes significant levels of disability and affects several domains of functioning, which in turn can adversely affect quality of life (QoL).
  • QoL is a multidimensional construct that is affected by numerous factors: sociodemographic, clinical, personal, social, etc; and also, with aspects related to the rehabilitation they receive after ABI.
  • Rehabilitation programs should address the different domains of functioning that have been affected by ABI.
  • Based on research findings about the QoL’s predictors, modifications could be made in the rehabilitation process; paying special attention to the depressive- and anosognosia process, as well as the importance of promoting social support, community integration, and resilience.

Source: https://www.tandfonline.com/doi/full/10.1080/09638288.2020.1803426?af=R&utm_source=researcher_app&utm_medium=referral&utm_campaign=RESR_MRKT_Researcher_inbound

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[Abstract + References] Assessment of Sex Differences in Recovery of Motor and Sensory Impairments Poststroke

Abstract

Background. Understanding potential sex differences in stroke recovery is important for prognosis, ensuring appropriate allocation of health care resources, and for stratification in research studies. Previously, functional measures have shown poorer outcomes for females, however, little is known about sex differences that may exist in specific motor and sensory impairments. 

Objective. The aim of this study was to utilize robotic assessments of motor and sensory impairments to determine if there are sex differences at the impairment level in stroke recovery over the first 6 months poststroke. 

Methods. We used robotic and clinical assessments of motor and sensory impairments at 1, 6, 12, and 26 weeks poststroke in 108 males and 52 females. Linear mixed models were used to examine the effect of sex on recovery poststroke, controlling for age and lesion volume. 

Results. In general, we did not find significant sex differences across a range of assessments. The exception to this was a sex × age interaction for the Purdue Pegboard Assessment, where we found that females had better performance than males at younger ages (<62 years), but males had better performance at older ages. 

Conclusions. While recruitment biases need to be acknowledged when generalizing our results to stroke recovery at-large, our results suggest that sex differences do not exist at the impairment level poststroke.

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Source: https://journals.sagepub.com/doi/abs/10.1177/1545968320935811

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