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Ho LYW, Lai CYY, Lai CKY, Ng SSM. Fatigue predicts level of community integration in people with stroke. Top Stroke Rehabil 2024; 31:464-473. [PMID: 38176421 DOI: 10.1080/10749357.2023.2298536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/15/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND The independent predictive power of fatigue for community integration has not been investigated, although there is an increasing amount of literature that recognizes the importance of fatigue in people with stroke. OBJECTIVES To examine the correlation between community integration and fatigue, walking endurance, and fear of falling; and to quantify the relative contribution of fatigue to community integration in people with stroke. METHODS This was a cross-sectional study with 75 community-dwelling people with stroke. Data were collected using the Community Integration Measure (CIM), Fatigue Assessment Scale (FAS), 6-minute walk test (6MWT), and Survey of Activities and Fear of Falling in the Elderly (SAFE). Multiple linear regressions (forced entry method) were used to quantify the relative power of the FAS score to predict community integration in a model covering distance in the 6MWT and the SAFE score. RESULTS After controlling for age, the CIM score significantly correlated with the scores for FAS (r=-0.48, p < 0.001), 6MWT distance (r = 0.24, p = 0.039), and SAFE (r=-0.39, p = 0.001). The entire model, including age, FAS score, 6MWT distance, and SAFE score, explained 26.1% of the variance in the CIM scores (F [4, 70] = 7.52, p < 0.001). The FAS scores independently explained 10.6% of the variance in the CIM scores. CONCLUSIONS This study suggests that fatigue is an independent predictor of community integration among people with stroke, taking into account walking endurance and fear of falling.
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Affiliation(s)
- Lily Y W Ho
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Cynthia Y Y Lai
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Claudia K Y Lai
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Polese JC, da Silva SLA, Lacerda CSA, Roza EA, Torriani-Pasin C. Community ambulation after chronic stroke: A cross-sectional study. J Bodyw Mov Ther 2022. [DOI: 10.1016/j.jbmt.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Torres JL, Andrade FB, Lima-Costa MF, Nascimento LR. Walking speed and home adaptations are associated with independence after stroke: a population-based prevalence study. CIENCIA & SAUDE COLETIVA 2022; 27:2153-2162. [PMID: 35649005 DOI: 10.1590/1413-81232022276.13202021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 08/16/2021] [Indexed: 12/13/2022] Open
Abstract
This study aimed at estimating the prevalence of stroke in older adults in Brazil, and at identifying the sociodemographic, health-related, health service-related, and environmental factors associated with independence in daily activities. Across-sectional, population-based study (Brazilian Longitudinal Study of Aging 2015-2016) was conducted. 536 individuals (≥ 50 years), from 9,412 participants, have had stroke and were included. Prevalence of stroke was 5.3% among individuals aged 50 years and over, increasing up to 8.0% among individuals aged 75 years and over, showing a dissimilar pattern between sex. Independence was associated with walking speed (Prevalence Ratio (PR) 2.72, 95%CI: 1.96 to 3.77), physical activity (PR 1.24; 95%CI: 1.04 to 1.47) and use of walking devices (PR 0.63; 95%CI: 0.41 to 0.96). A significant interaction was found between walking speed plus home adaptations and performance of daily living activities (PR 3.42; 95%CI: 1.04 to 11.29). The probability of independence was 40% among slow walkers (< 0.4 m/s), increasing up to 70% among fast walkers (> 0.8 m/s), and to 90% among those who also have home adaptations. Faster walking speed combined with home adaptations was the main factor associated with long-term independence after stroke.
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Affiliation(s)
- Juliana L Torres
- Departmento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais. Av. Professor Alfredo Balena 190. 30130-100. Belo Horizonte MG Brasil.
| | - Fabíola B Andrade
- Instituto René Rachou, Fundação Oswaldo Cruz. Belo Horizonte MG Brasil
| | | | - Lucas R Nascimento
- Centro de Ciências da Saúde, Fisioterapia, Universidade Federal do Espírito Santo. Vitória ES Brasil
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Avelino PR, Nascimento LR, Menezes KKP, Ada L, Teixeira-Salmela LF. Canes may not improve spatiotemporal parameters of walking after stroke: a systematic review of cross-sectional within-group experimental studies. Disabil Rehabil 2022; 44:1758-1765. [PMID: 32857674 DOI: 10.1080/09638288.2020.1808088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE To examine whether using a cane would improve spatiotemporal parameters of walking, i.e., speed, stride length, cadence, and symmetry after stroke. MATERIAL AND METHODS Searches were conducted in eight databases. The experimental condition was walking with a cane. Four outcomes were of interest: walking speed, stride length, cadence, and symmetry. RESULTS Twelve studies were included. Results from nine studies suggested that individuals with stroke walked 0.01 m/s (SD 0.06) slower with a single-point cane, compared with no cane. Two studies suggested a reduction in cadence (MD-5 steps/min, SD2) and an increase in stride length (MD 0.08 m, SD 0.01). Three studies suggested that individuals walked 0.06 m/s (SD 0.07) slower with a four-point cane, compared with no cane. Four studies suggested that individuals walked 0.06 m/s (SD 0.04) faster with a single- point cane compared with a four-point cane. Results regarding other outcomes were inconclusive. CONCLUSIONS Results showed no worthwhile improvements in spatiotemporal parameters of walking with a single-point cane and a slight reduction with a four-point cane, compared with no cane. Individuals walked slightly faster with a single-point cane compared with a four-point cane, but the evidence is insufficient to support this superiority.IMPLICATIONS FOR REHABILITATIONA single-point cane may not improve spatiotemporal parameters of walking after stroke.Walking with a four-point cane may slightly decrease spatiotemporal parameters of walking.Canes may be prescribed without the fear of negatively impairing walking kinematics.
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Affiliation(s)
- Patrick R Avelino
- NeuroGroup, Discipline of Physiotherapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lucas R Nascimento
- NeuroGroup, Discipline of Physiotherapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Center of Health Sciences, Discipline of Physiotherapy, Universidade Federal do Espírito Santo, Espírito Santo, Brazil
| | - Kênia K P Menezes
- NeuroGroup, Discipline of Physiotherapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Louise Ada
- Discipline of Physiotherapy, The University of Sydney, Sydney, Australia
| | - Luci F Teixeira-Salmela
- NeuroGroup, Discipline of Physiotherapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Ho LYW, Lai CKY, Ng SSM. Psychometric properties testing of a Cantonese version of the Life-Space Assessment in people with stroke. Sci Rep 2021; 11:20614. [PMID: 34663852 PMCID: PMC8523561 DOI: 10.1038/s41598-021-00140-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 10/07/2021] [Indexed: 12/03/2022] Open
Abstract
The Life-Space Assessment (LSA) advances measurements of mobility by determining the extent of the spatial area in which a person moves in real life. Yet there is no Cantonese version of the LSA. This study aimed to translate and culturally adapt the LSA into Cantonese (C-LSA) and examine its psychometric properties in people with stroke. Psychometric properties were examined in 112 people with stroke. The life-space of stroke survivors was compared with that of healthy older people with and without depressive symptoms. The content validity of the C-LSA was good. The Cronbach’s α was 0.73. The test–retest reliability was 0.95. The standard error of measurement was 4.21 and the minimal detectable change was 11.66, without any ceiling or floor effects in the C-LSA composite score. The composite score correlated significantly with the Fugl-Meyer Assessment of lower extremities score (rs = 0.31), the Five Times Sit-To-Stand time (rs = − 0.43), and the Frenchay Activities Index score (rs = 0.48). People with stroke had significantly lower C-LSA composite scores than healthy older people. Depressive symptoms worsened the composite and assisted life-space scores only of people with stroke. The C-LSA is a reliable and valid tool for measuring life-space in stroke populations.
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Affiliation(s)
- Lily Y W Ho
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Claudia K Y Lai
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China.
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Kang YS, Cho KH. Changes in lower limb muscle activation and gait function according to cane dependence in chronic stroke patients. Technol Health Care 2021; 29:133-141. [PMID: 32444585 DOI: 10.3233/thc-192075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Few quantitative analyses have been performed on muscle activation and gait function according to cane dependence. OBJECTIVE The purpose of this study was to measure changes in the lower limb muscle activation and gait function according to reduced cane dependence using a weight-bearing feedback cane (WBFC) that had been designed to quantitatively measure cane dependence in stroke patients during walking. METHODS Twenty-four subjects were recruited from a local rehabilitation hospital. The WBFC measured the average weight support (AWS, kg) loaded on the cane during walking through a Bluetooth connection to laptop software. All subjects walked 20 m using a WBFC set in the three levels of weight support (WSR, 100%, 60%, and 20%) based on the measured AWS. Paretic lower limb muscle activation and gait function (velocity, cadence, paretic side stride length, and symmetry index) were measured using wireless surface EMG and a 3-axis accelerometer during walking. RESULTS The paretic side lower limb muscle activation of the 20% WSR on the cane was significantly higher than that of the 100% WSR on the cane (p< 0.05). Gait functions of the 20% WSR on the cane were significantly lower than those of the 100% WSR on the cane (p< 0.05). CONCLUSION These findings suggest that indiscreet weight support on the cane during walking can interfere with lower limb muscle activation and gait function. Therefore, in a clinical setting, reducing cane dependence during stroke gait training should be carefully considered.
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Affiliation(s)
- Young Sic Kang
- Department of Physical Therapy, Graduate School, Korea National University of Transportation, Republic of Korea
| | - Ki Hun Cho
- Department of Physical Therapy, Korea National University of Transportation, Republic of Korea
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Avelino PR, Nascimento LR, Ada L, de Menezes KKP, Teixeira-Salmela LF. Using a cane for one month does not improve walking or social participation in chronic stroke: An attention-controlled randomized trial. Clin Rehabil 2021; 35:1590-1598. [PMID: 34053229 DOI: 10.1177/02692155211020864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To examine the effects of the provision of a cane, delivered to ambulatory people with chronic stroke, for improving walking and social participation. DESIGN Two-arm, randomized trial. SETTING Community-based. PARTICIPANTS Ambulatory individuals with chronic stroke. INTERVENTIONS The experimental intervention was the provision of a single-point cane during one month. The control group received a placebo intervention. OUTCOME MEASURES Walking speed, step length, cadence, walking capacity, and walking confidence were measured without the cane to examine its rehabilitative effect. Walking speed was also measured with the cane for inclusiveness, and social participation was measured for examining carry over effects. Outcomes were measured at baseline, and after one and two months. RESULTS Fifty individuals were included. In the experimental group, mean age was 69 years (SD 14), and walking speed was 0.58 m/s (SD 0.17). In the control group, mean age was 68 years (SD 13), and walking speed was 0.63 m/s (SD 0.15). When walking without the cane, after one and after two months, there were no between-group differences in any measures. When walking with the cane, after one month, the experimental group walked 0.14 m/s (95% CI 0.05-0.23) faster than the control group and after two months, they were still walking 0.18 m/s (95% CI 0.06-0.30) faster. CONCLUSION Use of a cane improved walking speed, only when participants walked with the cane. Use of cane for one month did not improve walking outcomes, when walking without the cane. People with stroke would need to continue to use the cane to maintain any benefits in walking speed.
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Affiliation(s)
| | - Lucas Rodrigues Nascimento
- Department of Physiotherapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Discipline of Physiotherapy, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Louise Ada
- Discipline of Physiotherapy, University of Sydney, Sydney, NSW, Australia
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Souza PBD, Mantovani MDF, Silva ÂTMD, Paz VP. Perception of post-stroke patients on case management conducted by nurses. Rev Esc Enferm USP 2021; 55:e03703. [PMID: 33978142 DOI: 10.1590/s1980-220x2019026703703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 10/20/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To identify the perception of post-stroke patients on the case management conducted by nurses. METHOD Qualitative descriptive study with 13 post-stroke patients, followed-up with case management conducted by a nurse for six months, and interviewed at home one month after the end of the follow-up. The interviews were recorded, transcribed in full and analyzed with the help of a software. RESULTS Of the 13 participants, 57.14% were men and 50% were between 50 and 59 years. Content analysis resulted in three categories: "Self-management of care", which addressed changes in attitudes towards treatment, mainly due to concern of recurrence in a short period of time; "Sequelae and late repercussions of the stroke", which presents participants' difficulties after the event; and "Support received after a stroke", which emphasizes the actions and attitudes of the case manager nurse during the follow-up period. CONCLUSION Case management was perceived by the participant as a health-promoting tool capable of increasing treatment adherence.
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Kaptein AA, van der Meer PB, Florijn BW, Hilt AD, Murray M, Schalij MJ. Heart in art: cardiovascular diseases in novels, films, and paintings. Philos Ethics Humanit Med 2020; 15:2. [PMID: 32050992 PMCID: PMC7017445 DOI: 10.1186/s13010-020-0086-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 01/01/2020] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Understanding representations of disease in various art genres provides insights into how patients and health care providers view the diseases. It can also be used to enhance patient care and stimulate patient self-management. METHODS This paper reviews how cardiovascular diseases are represented in novels, films, and paintings: myocardial infarction, aneurysm, hypertension, stroke, heart transplantation, Marfan's disease, congestive heart failure. Various search systems and definitions were used to help identify sources of representations of different cardiovascular diseases. The representations of the different diseases were considered separately. The Common Sense Model was used a theoretical model to outline illness perceptions and self-management in the various identified novels, films, and paintings. RESULTS Myocardial infarction followed by stroke were the most frequently detailed diseases in all three art genres. This reflects their higher prevalence. Representations ranged from biomedical details through to social and psychological consequences of the diseases. CONCLUSIONS Artistic representations of cardiovascular diseases reflect cognitions, emotions, and images of prevalent disease. These representations shape views and behaviour of ill and healthy persons regarding heart diseases. As these representations are amenable to change, they deserve further research, which may be instrumental in improving the quality of life of persons struck by cardiovascular diseases. Changing illness perceptions appears to be a method to improve self-management and thereby quality of life in patients with various cardiovascular diseases.
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Affiliation(s)
- Ad A Kaptein
- Medical Psychology, Leiden University Medical Centre, Leiden, the Netherlands.
| | - Pim B van der Meer
- Neurology, Leiden University Medical Centre, PO Box 9600, 2300 RC, Leiden, the Netherlands
| | - Barend W Florijn
- Nephrology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Alexander D Hilt
- Cardiology, Leiden University Medical Centre, Leiden, the Netherlands
| | | | - Martin J Schalij
- Cardiology, Leiden University Medical Centre, Leiden, the Netherlands
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Benfica PDA, Roza EA, Lacerda CSA, Polese JC. Força muscular e habilidade de locomoção em indivíduos pós-acidente vascular encefálico crônico. FISIOTERAPIA E PESQUISA 2019. [DOI: 10.1590/1809-2950/18032126022019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo do estudo foi verificar se existem diferenças na força muscular dos membros inferiores (MMII) e na habilidade de locomoção de indivíduos pós-acidente vascular encefálico (AVE) crônico, classificados como deambuladores comunitários ou não comunitários. Foi realizado um estudo transversal em 60 indivíduos pós-AVE crônico, divididos em deambuladores comunitários (n=33) e não comunitários (n=27) pela velocidade de marcha. A força muscular de sete grupos musculares bilaterais de MMII foi avaliada por meio do teste do esfigmomanômetro modificado e habilidade de locomoção pelo ABILOCO. Estatísticas descritivas foram utilizadas para caracterizar a amostra, e o teste t de Student para amostras independentes, a fim de comparar os dois grupos de indivíduos pós-AVE. Observou-se que os deambuladores comunitários apresentaram maiores valores de força muscular para a maioria dos grupos musculares de MMII (−0,973≥t≥−3,189; p≤0,04), e na habilidade de locomoção (t=−2,841; p=0,006). Os indivíduos pós-AVE crônico deambuladores comunitários possuem maior força muscular de MMII e mais habilidade de locomoção em comparação aos deambuladores não comunitários. Sugere-se que a avaliação fisioterapêutica de indivíduos pós-AVE inclua, além da mensuração da força muscular de MMII e seu tratamento, a mensuração da percepção da habilidade de locomoção, para análises da evolução do paciente e da eficácia da conduta terapêutica.
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