45 research outputs found
sj-docx-1-otj-10.1177_15394492221111730 – Supplemental material for Cognition and Daily Life Activities in Stroke: A Network Analysis
No full textSupplemental material, sj-docx-1-otj-10.1177_15394492221111730 for Cognition and Daily Life Activities in Stroke: A Network Analysis by Stephen C. L. Lau, Lisa Tabor Connor, Allen W. Heinemann and Carolyn M. Baum in OTJR: Occupation, Participation and Health</p
sj-doc-1-nnr-10.1177_15459683241230027 – Supplemental material for Associations of Circadian Rest-Activity Rhythms With Affect and Cognition in Community-Dwelling Stroke Survivors: An Ambulatory Assessment Study
No full textSupplemental material, sj-doc-1-nnr-10.1177_15459683241230027 for Associations of Circadian Rest-Activity Rhythms With Affect and Cognition in Community-Dwelling Stroke Survivors: An Ambulatory Assessment Study by Stephen C. L. Lau, Lisa Tabor Connor and Elizabeth R. Skidmore in Neurorehabilitation and Neural Repair</p
Task-Evoked BOLD Responses Are Normal in Areas of Diaschisis After Stroke
No full textObjective. Cerebral infarction can cause diaschisis, a reduction of blood flow and metabolism in areas of the cortex distant from the site of the lesion. Although the functional magnetic resonance imaging (fMRI) blood oxygen level dependent (BOLD) signal is increasingly used to examine the neural correlates of recovery in stroke, its reliability in areas of diaschisis is uncertain. Design. The effect of chronic diaschisis as measured by resting positron emission tomography on task-evoked BOLD responses during word-stem completion in a block design fMRI study was examined in 3 patients, 6 months after a single left hemisphere stroke involving the inferior frontal gyrus and operculum. Results. The BOLD responses were minimally affected in areas of chronic diaschisis. Conclusions. Within the confines of this study, the mechanism underlying the BOLD signal, which includes a mismatch between neuronally driven increases in blood flow and a corresponding increase in oxygen use, appears to be intact in areas of chronic diaschisis
Prediction of Discharge Walking Ability From Initial Assessment in a Stroke Inpatient Rehabilitation Facility Population
No full textObjectives: To (1) determine which clinical assessments at admission to an inpatient rehabilitation facility (IRF) most simply predict discharge walking ability, and (2) identify a clinical decision rule to differentiate household versus community ambulators at discharge from an IRF. Design: Retrospective cohort study. Setting: IRF. Participants: Two samples of participants (n=110 and 159) admitted with stroke. Interventions: A multiple regression determined which variables obtained at admission (age, time from stroke to assessment, Motricity Index, somatosensation, Modified Ashworth Scale, FIM, Berg Balance Scale, 10-m walk speed) could most simply predict discharge walking ability (10-m walk speed). A logistic regression determined the likelihood of a participant achieving household (= 0.4-0.8m/s; >0.8m/s) ambulation at the time of discharge. Validity of the results was evaluated on a second sample of participants. Main Outcome Measure: Discharge 10-m walk speed. Results: Admission Berg Balance Scale and FIM walk item scores explained most of the variance in discharge walk speed. The odds ratio of achieving only household ambulation at discharge was 20 (95% confidence interval [CI], 6-63) for sample I and 32 (95% CI, 10-96) for sample 2 when the combination of having a Berg Balance Scale score of <= 20 and a FIM walk item score of 1 or 2 was present. Conclusions: A Berg Balance Scale score of <= 20 and a FIM walk item score of 1 or 2 at admission indicates that a person with stroke is highly likely to only achieve household ambulation speeds at discharge from an IRF
Performance and Participation Outcomes for Individuals with Neurological Conditions
No full textThis eBook is a collection of articles from a Frontiers Research Topic. Frontiers Research Topics are very popular trademarks of the Frontiers Journals Series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author by contacting the Frontiers Editorial Office: frontiersin.org/about/contac
Descriptive Data Analysis Examining How Standardized Assessments Are Used to Guide Post-Acute Discharge Recommendations for Rehabilitation Services After Stroke
No full textBackground. Use of standardized assessments in acute rehabilitation is continuing to grow, a key objective being to assist clinicians in determining services needed postdischarge. Objective. The purpose of this study was to examine how standardized assessment scores from initial acute care physical therapist and occupational therapist evaluations contribute to discharge recommendations for poststroke rehabilitation services. Design. A descriptive analysis was conducted. Methods. A total of 2,738 records of patients admitted to an acute care hospital with a diagnosis of stroke or transient ischemic attack were identified. Participants received an initial physical therapist and occupational therapist evaluation with standardized assessments and a discharge recommendation of home with no services, home with services, inpatient rehabilitation facility (IRF), or skilled nursing facility (SNF). A K-means clustering algorithm determined if it was feasible to categorize participants into the 4 groups based on their assessment scores. These results were compared with the physical therapist and occupational therapist discharge recommendations to determine if assessment scores guided postacute care recommendations. Results. Participants could be separated into 4 clusters (A, B, C, and D) based on assessment scores. Cluster A was the least impaired, followed by clusters B, C, and D. In cluster A, 50% of the participants were recommended for discharge to home without services, whereas 1% were recommended for discharge to an SNF. Clusters B, C, and D each had a large proportion of individuals recommended for discharge to an IRF (74%-80%). There was a difference in percentage of recommendations across the clusters that was largely driven by the differences between cluster A and clusters B, C, and D. Limitations. Additional unknown factors may have influenced the discharge recommendations. Conclusions. Participants poststroke can be classified into meaningful groups based on assessment scores from their initial physical therapist and occupational therapist evaluations. These assessment scores, in part, guide poststroke acute care discharge recommendations
The brain recovery core: Building a system of organized stroke rehabilitation and outcomes assessment across the continuum of care
No full textThis Special Interest article describes a multidisciplinary, interinstitutional effort to build an organized system of stroke rehabilitation and outcomes measurement across the continuum of care. This system is focused on a cohort of patients who are admitted with the diagnosis of stroke to our acute facility, are discharged to inpatient and/or outpatient rehabilitation at our free-standing facility, and are then discharged to the community. This article first briefly explains the justification, goals, and purpose of the Brain Recovery Core system. The next sections describe its development and implementation, with details on the aspects related to physical therapy. The article concludes with an assessment of how the Brain Recovery Core system has changed and improved delivery of rehabilitation services. It is hoped that the contents of this article will be useful in initiating discussions and potentially facilitating similar efforts among other centers
Clinician Adherence to a Standardized Assessment Battery Across Settings and Disciplines in a Poststroke Rehabilitation Population
No full textObjectives: (1) To examine clinician adherence to a standardized assessment battery across settings (acute hospital, inpatient rehabilitation facilities [IRFs], outpatient facility), professional disciplines (physical therapy [PT], occupational therapy, speech-language pathology), and time of assessment (admission, discharge/monthly), and (2) to evaluate how specific implementation events affected adherence. Design: Retrospective cohort study. Setting: Acute hospital, IRF, and outpatient facility with approximately 118 clinicians (physical therapists, occupational therapists, speech-language pathologists). Participants: Participants (N=2194) with stroke who were admitted to at least 1 of the above settings. All persons with stroke underwent standardized clinical assessments. Interventions: Not applicable. Main Outcome Measures: Adherence to Brain Recovery Core assessment battery across settings, professional disciplines, and time. Visual inspections of 17 months of time-series data were conducted to see if the events (eg, staff meetings) increased adherence >= 5% and if so, how long the increase lasted. Results: Median adherence ranged from .52 to .88 across all settings and professional disciplines. Both the acute hospital and the IRF had higher adherence than the outpatient setting (P = 5% increase in adherence the following month, with 6 services (60%) maintaining their increased level of adherence for at least 1 additional month. Conclusions: Actual adherence to a standardized assessment battery in clinical practice varied across settings, disciplines, and time. Specific events increased adherence 40% of the time with those gains maintained for >1 month 60% of the time. (C) 2013 by the American Congress of Rehabilitation Medicin
Putting Executive Performance in a Theoretical Context
No full text This article provides a theoretical context to understand the role of executive functions in occupational performance. The authors provide definitions of the components of executive functions and their occupational significance. Assessment and intervention strategies for individuals with executive function deficits are discussed. </jats:p
