[Abstract] Effects of virtual reality for stroke individuals based on the International Classification of Functioning and Health: a systematic review

Abstract

Objective: This review determines the effects of virtual reality interventions for stroke subjects based on the International Classification of Functioning, Disability,and Health (ICF) framework. Virtual reality is a promising tool for therapy for stroke rehabilitation, but the effects of virtual reality interventions on post-stroke patients based on the specific ICF domains (Body Structures, Body Functions, Activity, and Participation) have not been investigated.

Method: A systematic review was conducted, including trials with adults with a clinical diagnosis of a chronic, subacute, or acute stroke. Eligible trials had to include studies with an intervention protocol and follow-up, with a focus on upper limbs and/or lower limbs and/or balance. The Physiotherapy Evidence Database (PEDro) was used to assess the methodological quality of randomized controlled trials. Each trial was separated according to methodological quality into a high-quality trial (PEDro ≥ 6) and a low-quality trial (PEDro ≤ 6). Only high-quality trials were analyzed specifically based on the outcome of these trials.

Results: In total, 54 trials involving 1811 participants were included. Of the papers included and considered high quality, 14 trials evaluated areas of the Body Structures component, 20 trials of the Body Functions domain, 17 trials of the Activity component, and 8 trials of the Participation domain. In relation to ICF Part 2, four trials evaluated areas of the Personal Factors component and one trial evaluated domains of the Environmental Factors component.

Discussion: The effects of virtual reality on stroke rehabilitation based on the ICF framework are positive in Body Function and Body Structure. However, the results in the domains Activity and Participation are inconclusive. More high-quality clinical trials are needed to confirm the effectiveness of virtual reality in the domains of Activity and Participation.

Source: Effects of virtual reality for stroke individuals based on the International Classification of Functioning and Health: a systematic review: Topics in Stroke Rehabilitation: Vol 0, No 0

[Review] Hands-on physiotherapy interventions and stroke and International Classification of Functionality, Disability and Health outcomes

Abstract

The effectiveness of “hands-on” physiotherapy for stroke is unclear. The objective here is to analyze the effectiveness of such interventions on movement-related International Classification of Functionality, Disability and Health (ICF) categories. A systematic review was undertaken of randomized controlled trials published since 1980, using the following criteria: stroke, humans, ≥ 18 years, outcomes related to ICF movement-related categories, physiotherapeutic handling techniques, control group as placebo or no intervention, including experiments where both groups have the same intervention and the experimental group has one extra intervention. Nine studies were included and a best evidence synthesis is presented. Recommendations with limited evidence favor slow-stroke back massage for shoulder pain, range-of-motion exercises for upper-limb and lower-limb structures and functions of muscles and joints, proprioceptive neuromuscular facilitation (PNF) for gait step, walking backwards with hip facilitation for gait parameters and performance, and conventional physiotherapy with facilitation techniques for gait parameters. Recommendations with indicative findings favor PNF with trunk rhythmic stabilizations for function and mobility of upper limbs. Recommendations with limited evidence show the non-efficacy of Bobath therapy for upper-limb function and activity and facilitation of the step on body weight support treadmill training for gait parameters and performance. In conclusion, some hands-on interventions have limited evidence in stroke rehabilitation.

via Taylor & Francis Online :: Hands-on physiotherapy interventions and stroke and International Classification of Functionality, Disability and Health outcomes: A systematic review – European Journal of Physiotherapy –.

[ARTICLE] Difficulties in Daily Life Reported by Patients With Homonymous Visual Field Defects.Visual Fields

Abstract

Background: Homonymous visual field defects (HVFD) are common after postchiasmatic acquired brain injury and may have a significant impact on independent living and participation in society. Vision-related difficulties experienced in daily life are usually assessed using questionnaires. The current study 1) links the content of 3 of these questionnaires to the International Classification of Functioning, Disability and Health (ICF) and 2) provides analyses of vision-related difficulties reported by patients with HVFD and minimal comorbidities.

Methods: Fifty-four patients with homonymous hemianopia or quadrantanopia were asked about difficulties experienced in daily life because of their HVFD. This was performed during a structured interview including 3 standardized questionnaires: National Eye Institute Visual Functioning Questionnaire, Independent Mobility Questionnaire, and Cerebral Visual Disorders Questionnaire. The reported difficulties were linked to the ICF according to the ICF linking rules. Main outcome measures were presence or absence of experienced difficulties.

Results: The ICF linking procedure resulted in a classification table that can be used in future studies of vision-related difficulties. Besides well-known difficulties related to reading, orientation, and mobility, a high proportion of patients with HVFD reported problems that previously have not been documented in the literature, such as impaired light sensitivity, color vision, and perception of depth.

Conclusions: A systematic inventory of difficulties experienced in daily life by patients with HVFD was performed using the ICF. These findings have implications for future study, assessment and rehabilitation of patients with HVFD.

via Difficulties in Daily Life Reported by Patients With Homonym… : Journal of Neuro-Ophthalmology.

[REVIEW] Outcome Measures | EBRSR – Evidence-Based Review of Stroke Rehabilitation – Full Text PDF

Abstract

To enhance the clinical meaningfulness of the SREBR, the present review provides the best available information on how outcome measures might be classified and selected for use, based upon their measurement qualities. For this purpose, we have selected for review some of the most commonly-used measures in stroke rehabilitation. The ICF conceptual framework is used to classify measures in stroke rehabilitation and aspects of measurement theory pertinent for evaluating measures are discussed. Each measure reviewed in this chapter was evaluated in terms of appropriateness, reliability, validity, responsiveness, precision, interpretability, applicability and feasibility. All measures were assessed for the thoroughness with which its reliability, validity and responsiveness have been reported. The present document contains summary reviews of 38 assessment tools used in the evaluation of Body Structure (14 tools), Activity (15 tools) and Participation (9 tools) outcomes.

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via Outcome Measures | EBRSR – Evidence-Based Review of Stroke Rehabilitation.

[ARTICLE] Integrative Cognitive Rehabilitation Program: An Innovative, Multidisciplinary Approach

…To develop a comprehensive, patient centered and multidisciplinary cognitive rehabilitation program, using the theoretical foundations of distributed cognition, neural plasticity, activity theory, and ICF (WHO, 2001). Incorporate technology as cognitive prosthetics.Develop and reinforce compensatory strategies to optimize cognitive functioning…

via Integrative Cognitive Rehabilitation Program: An Innovative, Multidisciplinary Approach – Archives of Physical Medicine and Rehabilitation.