95 research outputs found
Supplemental_Material – Supplemental material for Dynamic Lycra® orthoses as an adjunct to arm rehabilitation after stroke: a single-blind, two-arm parallel group, randomized controlled feasibility trial
No full textSupplemental material, Supplemental_Material for Dynamic Lycra® orthoses as an adjunct to arm rehabilitation after stroke: a single-blind, two-arm parallel group, randomized controlled feasibility trial by Jacqui H Morris, Alexandra John, Lucy Wedderburn, Petra Rauchhaus and Peter T Donnan in Clinical Rehabilitation</p
Physical activity and mental health in individuals with multimorbidity during COVID-19: an explanatory sequential mixed method study
Full text linkObjective: to understand the physical activity and mental health of individuals living with long term conditions during the COVID-19 pandemicDesign: a sequential explanatory mixed-methods study with two phases: phase 1) quantitative survey, and phase 2) qualitative follow-up interviews.Setting: online. For the quantitative phase, an online survey launched in March 2021, using Microsoft Forms. For the qualitative phase, in depth semi-structured interviews were conducted via online.Participants: 368 adults over 18 years old living in the UK with at least one long term condition completed the survey. Interviews were conducted in a subsample of participants from previous quantitative phase, with 26 people. Data was analysed using thematic analysis.Results: responses from the survey, showed that people with one long term condition were significantly more physically active and spent less time sitting, than those with two or more conditions, presenting with significantly higher well-being (p<0.0001), and lower levels of anxiety (p<0.01), and depression (p<0.0001). Interviews found that that people developed a range of strategies to cope with the impact of changeability and consequences of their long-term condition on their physical activity.Conclusions: the number of long-term conditions influenced physical activity and how people coped with their condition during COVID-19. Findings will inform policy developments in preparation for future pandemics to support and remain people to remain physically active and mental health
Responses of the less affected arm to bilateral upper limb task training in early rehabilitation after stroke:a randomized controlled trial
No full textMorris JH, Van Wijck F. Responses of the less affected arm to bilateral upper limb task training in early rehabilitation after stroke: a randomized controlled trial. Arch Phys Med Rehabil 2012;93:1129-37.Objectives: To investigate effects of bilateral training (BT) on ipsilesional arm dexterity and activity limitation; to explore clinical and demographic factors that influence training effects; and to explore relationships between contralesional and ipsilesional recovery.Design: Single-blind randomized controlled trial with outcome assessment at baseline, postintervention (6wk), and follow-up (18wk).Setting: Inpatient acute and rehabilitation hospitals.Participants: Participants were randomized to a BT group in which training involved the ipsilesional and contralesional arms (n=56) or control training involving the contralesional arm only (n=50).Interventions: Supervised BT or control training for 20 minutes on weekdays over a 6-week period using a standardized program.Main Outcome Measures: Upper limb activity limitation: Action Research Arm Test; and dexterity: Nine-Hole Peg Test (9HPT).Results: Lower baseline scores were found for the ipsilesional arm on both measures compared with published normative values. The BT group demonstrated significantly greater change in dexterity (P=.03) during the intervention phase at 0 to 6 weeks (.06 +/-.07pegs/s) compared with the control group (.02 +/-.02pegs/s). The effect was lost for overall recovery at 0 to 18 weeks (P=.93). Younger participants (age <= 68y) performed the 9HPT faster at baseline than older participants (P=.04) and demonstrated greater overall recovery with BT than older participants (P=.04). There was no significant correlation between ipsilesional and contralesional recovery.Conclusions: The study suggests that BT may lead to clinically small improvements in ipsilesional performance of fine, rapid dexterity tasks. Younger participants responded better to BT. There was no relationship between contralesional and ipsilesional recovery, suggesting that different causes and recovery mechanisms may exist.</p
Optimising long-term participation in physical activities after stroke: Exploring new ways of working for physiotherapists
No full textThere is now good empirical evidence of physical and functional benefits for individuals with stroke from long-term engagement in a range of physical activities. However, long-term participation of stroke survivors in physical activity after rehabilitation is low, and maximum benefits are not being achieved. This article reviews relevant literature and evidence, and suggests that physiotherapists are ideally placed to support patients in long-term participation in activity as they prepare patients for the end of physical rehabilitation. However, this requires the development, testing and application of stroke-specific evidence-based behavioural and motivational interventions that are feasible in clinical practice, take account of the role of carers, and seek to address the barriers to activity faced by stroke survivors at the end of rehabilitation. It also requires physiotherapists to take a leading role in developing appropriate policies and strategies with other exercise professionals and services to address the transition from rehabilitation to an active lifestyle following stroke
Simultaneous bilateral training for improving arm function after stroke
Full text linkBackground Simultaneous bilateral training, the completion of identical activities with both arms simultaneously, is one intervention to improve arm function and reduce impairment. Objectives To determine the effects of simultaneous bilateral training for improving arm function after stroke. Search strategy We searched the Cochrane Stroke Trials Register (last searched August 2009) and 10 electronic bibliographic databases including the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 3, 2009), MEDLINE, EMBASE, CINAHL and AMED (August 2009). We also searched reference lists and trials registers. Selection criteria Randomised trials in adults after stroke, where the intervention was simultaneous bilateral training compared to placebo or no intervention, usual care or other upper limb (arm) interventions. Primary outcomes were performance in activities of daily living (ADL) and functional movement of the upper limb. Secondary outcomes were performance in extended activities of daily living and motor impairment of the arm. Data collection and analysis Two authors independently screened abstracts, extracted data and appraised trials. Assessment of methodological quality was undertaken for allocation concealment, blinding of outcome assessor, intention-to-treat, baseline similarity and loss to follow up. Main results We included 18 studies involving 549 relevant participants, of which 14 (421 participants) were included in the analysis (one within both comparisons). Four of the 14 studies compared the effects of bilateral training with usual care. Primary outcomes: results were not statistically significant for performance in ADL (standardised mean difference (SMD) 0.25, 95% confidence interval (CI) -0.14 to 0.63); functional movement of the arm (SMD -0.07, 95% CI -0.42 to 0.28) or hand (SMD -0.04, 95% CI -0.50 to 0.42). Secondary outcomes: no statistically significant results. Eleven of the 14 studies compared the effects of bilateral training with other specific upper limb (arm) interventions. Primary outcomes: no statistically significant results for performance of ADL (SMD -0.25, 95% CI -0.57 to 0.08); functional movement of the arm (SMD -0.20, 95% CI -0.49 to 0.09) or hand (SMD -0.21, 95% CI -0.51 to 0.09). Secondary outcomes: one study reported a statistically significant result in favour of another upper limb intervention for performance in extended ADL. No statistically significant differences were found for motor impairment outcomes. Authors' conclusions There is insufficient good quality evidence to make recommendations about the relative effect of simultaneous bilateral training compared to placebo, no intervention or usual care. We identified evidence that suggests that bilateral training may be no more (or less) effective than usual care or other upper limb interventions for performance in ADL, functional movement of the upper limb or motor impairment outcome
Body, Person and Environment:Why Promoting Physical Activity (PA) with Stroke Survivors Requires Holistic Thinking
Full text linkThe role of physical activity (PA) after stroke is increasingly recognised as important for function, fitness and wellbeing. Current evidence shows that targeted PA after stroke improves cardiovascular fitness, walking ability and muscle strength and may ameliorate depression and improve quality of life. Secondary stroke prevention and management of cardiovascular risk factors are further health benefits. Despite increasing emphasis on organised exercise classes for stroke, PA levels remain low and effects of organised exercise interventions are not maintained once programmes have finished. Barriers to PA after stroke are complex and innovative approaches to maintaining and promoting long-term engagement in activity are required. This commentary proposes that using the International Classification of Disability and Functioning (ICF) to guide thinking about PA after stroke may help us develop and apply comprehensive solutions that increase PA levels. This approach considers stroke survivors' PA engagement in terms of Body - the physical impairments imposed by stroke; Person - the role of identity, and psychological factors on PA; and Environment - the physical and social environments that influence PA engagement. The commentary discusses how innovative solutions addressing these issues may enable stroke survivors to be better supported to lead active lifestyles.</p
Erratum: Internet and mobile-based psychological interventions: Applications, efficacy and potential for improving mental health. A report of the EFPA E-Health Taskforce (European Psychologist (2018) 23 (167-187) DOI: 10.1027/1016-9040/a000318)
No full textThe article entitled Internet and mobile-based psychological interventions: Applications, efficacy and potential for improving mental health. A report of the EFPA E-Health Taskforce. by Ebert, D. D., Van Daele, T., Nordgreen, T., Karekla, M., Compare, A., Zarbo, C., Brugnera, B., Overland, S., Trebbi, G., Jensen, K. L., Kaehlke, F. (on behalf of the EFPA E-Health Taskforce), & Baumeister, H. (2018, European Psychologist, 23(2), 167-187. https://doi.org/ 10.1027/1016-9040/a000318) contained an error on the first page: The author Jacqui Taylor is missing and the list of authors should correctly read as follows: David Daniel Ebert1, Tom Van Daele2, Tine Nordgreen3, Maria Karekla4, Angelo Compare6, Cristina Zarbo5, Agostino Brugnera5, Svein Overland7, Glauco Trebbi8, Kit L. Jensen9, Fanny Kaehlke (on behalf of the EFPA E-Health Taskforce)1, Harald Baumeister10, and Jacqui Taylor11 1Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University of Erlangen- Nrnberg, Erlangen, Germany 2Department of Applied Psychology, Thomas More University of Applied Sciences, Antwerp, Belgium 3Division of Psychiatry, Haukeland University Hospital, Bergen, Norway 4Department of Psychology, University of Cyprus, Nicosia, Republic of Cyprus 5Department of Human and Social Science, University of Bergamo, Bergamo, Italy 6Human Factors and Technology in Healthcare, University of Bergamo, Bergamo, BG, Italy 7SuperEgo AS, Trondheim, Norway 8Trebbipsicologie, Luxembourg & Societe Luxembourgeoise de Psychologie SLP, Luxembourg 9Private Practice, Skagen, Denmark 10Department of Clinical Psychology and Psychotherapy, University of Ulm, Germany 11Psychology Department, Bournemouth University, UK The authors regret any inconvenience or confusion this error may have caused
Erratum: Internet and mobile-based psychological interventions: Applications, efficacy and potential for improving mental health. A report of the EFPA E-Health Taskforce (European Psychologist (2018) 23 (167-187) DOI: 10.1027/1016-9040/a000318)
Full text link© 2018 2018 Hogrefe Publishing. The article entitled Internet and mobile-based psychological interventions: Applications, efficacy and potential for improving mental health. A report of the EFPA E-Health Taskforce. by Ebert, D. D., Van Daele, T., Nordgreen, T., Karekla, M., Compare, A., Zarbo, C., Brugnera, B., Overland, S., Trebbi, G., Jensen, K. L., Kaehlke, F. (on behalf of the EFPA E-Health Taskforce), & Baumeister, H. (2018, European Psychologist, 23(2), 167-187. https://doi.org/ 10.1027/1016-9040/a000318) contained an error on the first page: The author Jacqui Taylor is missing and the list of authors should correctly read as follows: David Daniel Ebert1, Tom Van Daele2, Tine Nordgreen3, Maria Karekla4, Angelo Compare6, Cristina Zarbo5, Agostino Brugnera5, Svein Overland7, Glauco Trebbi8, Kit L. Jensen9, Fanny Kaehlke (on behalf of the EFPA E-Health Taskforce)1, Harald Baumeister10, and Jacqui Taylor11 1Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University of Erlangen- Nrnberg, Erlangen, Germany 2Department of Applied Psychology, Thomas More University of Applied Sciences, Antwerp, Belgium 3Division of Psychiatry, Haukeland University Hospital, Bergen, Norway 4Department of Psychology, University of Cyprus, Nicosia, Republic of Cyprus 5Department of Human and Social Science, University of Bergamo, Bergamo, Italy 6Human Factors and Technology in Healthcare, University of Bergamo, Bergamo, BG, Italy 7SuperEgo AS, Trondheim, Norway 8Trebbipsicologie, Luxembourg & Societe Luxembourgeoise de Psychologie SLP, Luxembourg 9Private Practice, Skagen, Denmark 10Department of Clinical Psychology and Psychotherapy, University of Ulm, Germany 11Psychology Department, Bournemouth University, UK The authors regret any inconvenience or confusion this error may have caused
User involvement in a Cochrane systematic review: using structured methods to enhance the clinical relevance, usefulness and usability of a systematic review update
Full text linkBackground: This paper describes the structured methods used to involve patients, carers and health professionals in an update of a Cochrane systematic review relating to physiotherapy after stroke and explores the perceived impact of involvement.Methods: We sought funding and ethical approval for our user involvement. We recruited a stakeholder group comprising stroke survivors, carers, physiotherapists and educators and held three pre-planned meetings during the course of updating a Cochrane systematic review. Within these meetings, we used formal group consensus methods, based on nominal group techniques, to reach consensus decisions on key issues relating to the structure and methods of the review.Results: The stakeholder group comprised 13 people, including stroke survivors, carers and physiotherapists with a range of different experience, and either 12 or 13 participated in each meeting. At meeting 1, there was consensus that methods of categorising interventions that were used in the original Cochrane review were no longer appropriate or clinically relevant (11/13 participants disagreed or strongly disagreed with previous categories) and that international trials (which had not fitted into the original method of categorisation) ought to be included within the review (12/12 participants agreed or strongly agreed these should be included). At meeting 2, the group members reached consensus over 27 clearly defined treatment components, which were to be used to categorise interventions within the review (12/12 agreed or strongly agreed), and at meeting 3, they agreed on the key messages emerging from the completed review. All participants strongly agreed that the views of the group impacted on the review update, that the review benefited from the involvement of the stakeholder group, and that they believed other Cochrane reviews would benefit from the involvement of similar stakeholder groups.Conclusions: We involved a stakeholder group in the update of a Cochrane systematic review, using clearly described structured methods to reach consensus decisions. The involvement of stakeholders impacted substantially on the review, with the inclusion of international studies, and changes to classification of treatments, comparisons and subgroup comparisons explored within the meta-analysis. We argue that the structured approach which we adopted has implications for other systematic reviews.</p
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