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Winterbottom L, Nilsen DM. Motor Learning Following Stroke: Mechanisms of Learning and Techniques to Augment Neuroplasticity. Phys Med Rehabil Clin N Am 2024; 35:277-291. [PMID: 38514218 DOI: 10.1016/j.pmr.2023.06.004] [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] [Indexed: 03/23/2024]
Abstract
Sensorimotor impairments are common after stroke requiring stroke survivors to relearn lost motor skills or acquire new ones in order to engage in daily activities. Thus, motor skill learning is a cornerstone of stroke rehabilitation. This article provides an overview of motor control and learning theories that inform stroke rehabilitation interventions, discusses principles of neuroplasticity, and provides a summary of practice conditions and techniques that can be used to augment motor learning and neuroplasticity in stroke rehabilitation.
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Affiliation(s)
- Lauren Winterbottom
- Department of Rehabilitation & Regenerative Medicine, Columbia University, 180 Fort Washington Avenue, HP1, Suite 199, New York, NY 10032, USA; Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA.
| | - Dawn M Nilsen
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA; Department of Rehabilitation & Regenerative Medicine, Columbia University, 617 West 168th Street, 3rd Floor, Room 305, New York, NY 10032, USA
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Kitamura S, Otaka Y, Murayama Y, Ushizawa K, Narita Y, Nakatsukasa N, Matsuura D, Kondo K, Sakata S. Differences in the difficulty of subtasks comprising the toileting task among patients with subacute stroke: A cohort study. J Stroke Cerebrovasc Dis 2023; 32:107030. [PMID: 36709731 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION Toileting comprises multiple subtasks, and the difficulty of each is critical to determining the target and priority of intervention. The study aimed to examine the difficulty of subtasks that comprise toileting upon admission and the reacquisition of skills of subtasks during hospitalization. MATERIALS AND METHODS This was a single-center prospective cohort study. We enrolled 101 consecutive stroke patients (mean age: 69.3 years) admitted to subacute rehabilitation wards. The independence in each of the 24 toileting subtasks was assessed using the Toileting Tasks Assessment Form (TTAF) every two or four weeks. The number of patients who were independent upon admission, as well as those who were not independent upon admission but became independent during hospitalization, was examined in each subtask. RESULTS The most difficult subtask upon admission was "Lock the wheelchair brakes" (16.8% of patients were independent), followed by "Turn while standing (before urination/defecation)" (17.8%), "Pull the lower garments down" (18.0%), "Turn while standing (after urination/defecation)" (18.8%), "Pull the lower garments up and adjust them" (18.8%), and "Maintain a standing position (before urination/defecation)" (18.8%). The most difficult subtask for those who were not independent but became independent was "Dispose of incontinence pad/sanitary items" (19.3%), followed by "Press the nurse call button (after urination/defecation)" (28.3%), "Take the foot off the footrest and place it on the ground" (28.6%), and "Clean up after urination/defecation" (29.0%). CONCLUSIONS The difficult subtasks upon admission and those for reacquired skills were different. The most difficult subtasks upon admission were main tasks, and the difficult subtasks in reacquiring skills were preparatory tasks.
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Affiliation(s)
- Shin Kitamura
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Aichi, Japan; Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi 470-1192, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi 470-1192, Japan.
| | - Yudai Murayama
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
| | - Kazuki Ushizawa
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi 470-1192, Japan
| | - Yuya Narita
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Faculty of Rehabilitation, School of Health Sciences, Chiba Prefectural University of Health Sciences, Chiba, Japan
| | - Naho Nakatsukasa
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
| | - Daisuke Matsuura
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine, Brain Attack Center Ota Memorial Hospital, Hiroshima, Japan
| | - Kunitsugu Kondo
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
| | - Sachiko Sakata
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
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Difficulty of the subtasks comprising bed-wheelchair transfer in patients with subacute strokes: A cohort study. J Stroke Cerebrovasc Dis 2022; 31:106740. [PMID: 36054975 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106740] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/31/2022] [Accepted: 08/16/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Bed-wheelchair transfer comprises multiple subtasks; hence, it is important to know the difficulty of each subtask to identify and prioritize subtasks that must be practiced. This study aimed to investigate the difficulty of the subtasks that comprise bed-wheelchair transfer upon admission and reacquiring subtask skills during hospitalization. MATERIALS AND METHODS This was a single-center prospective cohort study. We enrolled 137 consecutive stroke patients (mean age: 69.8 years) admitted to subacute rehabilitation wards who used wheelchairs upon admission. The degree of independence in each of the 25 subtasks that comprised transferring was assessed using the Bed-wheelchair transfer Tasks Assessment Form every 2 weeks. The number of patients who were independent in the subtasks upon admission and those who were not but became independent during hospitalization were examined. RESULTS The most difficult subtask for independent patients upon admission was "Manipulate the handrail for the bed" (18.3%), followed by "Ready the wheelchair for transfer" (19.3%), "Maneuver the wheelchair toward the appropriate place for transfer to the bed" (20.6%), "Wear shoes/brace" (24.8%), and "Turn while standing" (25.5%). The most difficult subtask for those who were not independent but became independent was "Ready the wheelchair for transfer" (32.1%), followed by "Manipulate the handrail for the bed" (32.9%), "Press the nurse call button" (36.4%), "Press the nurse call button (wheelchair-to-bed)" (36.7%), and "Lock the wheelchair brakes" (37.3%). CONCLUSIONS Subtasks related to preparation for transfer were difficult upon admission, and this tendency became more pronounced during the skill acquisition process.
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Garcia C, Collins R, McCabe D, Galvin R, Boland P. Impact of visual field loss post-stroke on activities of daily living: a prospective cohort study. Neuropsychol Rehabil 2022:1-16. [PMID: 35679176 DOI: 10.1080/09602011.2022.2081219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study investigated the ADL performances of people with VFL after an acute stroke using an observation-based evaluation of ADL skills, the Assessment of Motor and Process Skills. The AMPS was administered on initial assessment and at ≥11 weeks follow-up on 58 adults with a mild stroke, with (n = 16) and without VFL (n = 42), over a 13-month period. The AMPS guidelines on clinically relevant difference of 0.30 logits were used to determine the differences of the groups' ADL performance on initial assessment and follow-up. The study found that the ADL motor and process scores did not differ significantly on initial assessment. The study observed no clinically relevant difference between the ADL motor and process scores of between the VFL and non-VFL on initial assessment and follow-up but demonstrated clinically relevant improvements in ADL motor and process scores of both groups from initial assessment to follow-up. VFL does not have an additional negative impact on ADL performance of those with a mild stroke and does not impede improvement of ADL performance over time.
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Affiliation(s)
| | | | - Djh McCabe
- Tallaght University Hospital, Dublin, Ireland.,Vascular Neurology Research Foundation, Dept of Neurology, and Stroke Services, Tallaght University Hospital, Dublin, Ireland.,Department of Clinical Neurosciences, Royal Free Campus, UCL Queen Square Institute of Neurology, London, UK.,Academic Unit of Neurology School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Rose Galvin
- School of Allied Health, University of Limerick, Limerick, Ireland.,Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Pauline Boland
- School of Allied Health, University of Limerick, Limerick, Ireland.,Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
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Jansa J, Ferdinand S, Milo M, Løyning IG, Huilla T, Kallmayer L, Ilsbroukx S, Filló N, Raats J, Jakobson J, Kos D. Performance of Activities of daily living in people with multiple sclerosis. Mult Scler Relat Disord 2022; 57:103342. [PMID: 35158429 DOI: 10.1016/j.msard.2021.103342] [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: 10/16/2020] [Revised: 10/15/2021] [Accepted: 10/17/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Multiple sclerosis (MS) may result in activity and participation limitations, including the performance of activities of daily living (ADL). This study aims at systematically investigate ADL performance by using Assessment of Motor and Process Skills (AMPS) in people with MS (PwMS) of all disease types and within the Kurtzke Expanded Disability Status Scale (EDSS) range from 1.0 - 8.0. METHODS Eight multiple sclerosis (MS) centres participated in data collection of a consecutive sample of PwMS. Participants were referred for assessment to occupational therapy (OT) by treating physician or recruited from neurology department in each hospital and assessed by EDSS and AMPS. The AMPS is an observational, criterion referenced ADL assessment, providing values for a person's ADL performance in terms of motor and process skills. Criterion referenced cut-off scores were established at 2.0 for motor skills and at 1.0 for process skills and both values above the cut-off score indicate competent (independent, safe, efficient and effortless) ADL performance. Process skills refer to the act of carrying out a series of actions and is summarized in terms of efficiency, like initiating without pauses, continuing actions through to completion, performing actions in logical order (sequences), choosing, and completing the task as planned (heeds). RESULTS Two hundred and ten PwMS were recruited (48 +/- 13 years of age, 145 women/65 men, average disease duration was 11.8 +/- 9.6 years, average EDSS was 4.8+/-1.8). Average motor skills score was 1.01+/- 1.12 (indicating need for assistance with evidence of increased clumsiness/physical effort) and average process skills score was 1.02 +/- 0.66 (risk zone, questionable efficiency and more likely to need assistance). Overall, motor skills and process skills decreased with increasing EDSS score. No need for assistance in motor skills was indicated in subjects with lower EDSS scores (1.0 - 2.5). In higher EDSS group (≥4.5), 57% of subjects needed assistance in motor skills and 27% in process skills. The competency in process skills was either questionable or reduced within all EDSS scores. However, 33-38% of subjects with higher EDSS scores (6.0-8.5) showed competent performance in process skills. Overall correlation between motor and process scores was moderate (r = 0.56, p<0.0001), but no significant relationships between motor and process skills were found in the lower EDSS (1-2.5) and high EDSS scores (8-8.5). Further, EDSS and disease type were significant predictors, explaining 52.7% of motor skills and 22.3% of process skills performance. CONCLUSION Problems in ADL performance were found in EDSS categories 1.0 to 8.0 and in all disease types, therefore it is advisable to screen all PwMS for ADL deficits and provide relevant rehabilitation interventions.
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Affiliation(s)
- Jelka Jansa
- University Medical Centre Ljubljana, Slovenia; Rehabilitation in MS (RIMS) - SIG Occupation group, Tervuursevest 101, 3001 Leuven, Belgium.
| | - Sofie Ferdinand
- National MS Center Melsbroek, Belgium; Rehabilitation in MS (RIMS) - SIG Occupation group, Tervuursevest 101, 3001 Leuven, Belgium.
| | - Meta Milo
- National MS Center Melsbroek, Belgium; Rehabilitation in MS (RIMS) - SIG Occupation group, Tervuursevest 101, 3001 Leuven, Belgium.
| | - Inger G Løyning
- MS-Senteret Hakadal, Norway; Rehabilitation in MS (RIMS) - SIG Occupation group, Tervuursevest 101, 3001 Leuven, Belgium.
| | - Tarja Huilla
- MS Center Masku, Finland; Rehabilitation in MS (RIMS) - SIG Occupation group, Tervuursevest 101, 3001 Leuven, Belgium.
| | - Lene Kallmayer
- The Multiple Sclerosis Hospital Ry, Denmark; Rehabilitation in MS (RIMS) - SIG Occupation group, Tervuursevest 101, 3001 Leuven, Belgium.
| | | | - Núria Filló
- MS Center of Catalonia, Cemcat, Universitat Autònoma de Barcelona, Spain; Rehabilitation in MS (RIMS) - SIG Occupation group, Tervuursevest 101, 3001 Leuven, Belgium.
| | - Joke Raats
- AZ Klina, RC De Mick, Belgium; Rehabilitation in MS (RIMS) - SIG Occupation group, Tervuursevest 101, 3001 Leuven, Belgium.
| | - Jytte Jakobson
- The Multiple Sclerosis Hospital Haslev, Denmark; Rehabilitation in MS (RIMS) - SIG Occupation group, Tervuursevest 101, 3001 Leuven, Belgium.
| | - Daphne Kos
- National MS Center Melsbroek, Belgium; KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; Rehabilitation in MS (RIMS) - SIG Occupation group, Tervuursevest 101, 3001 Leuven, Belgium.
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Effects of Hemispheric Stroke Localization on the Reorganization of Arm Movements within Different Mechanical Environments. Life (Basel) 2021; 11:life11050383. [PMID: 33922668 PMCID: PMC8145329 DOI: 10.3390/life11050383] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 01/24/2023] Open
Abstract
This study investigated how stroke’s hemispheric localization affects motor performance, spinal maps and muscle synergies while performing planar reaching with and without assistive or resistive forces. A lesion of the right hemisphere affected performance, reducing average speed and smoothness and augmenting lateral deviation in both arms. Instead, a lesion of the left hemisphere affected the aiming error, impairing the feedforward control of the ipsilesional arm. The structure of the muscle synergies had alterations dependent on the lesion side in both arms. The applied force fields reduced the differences in performance and in muscle activations between arms and among populations. These results support the hypotheses of hemispheric specialization in movement control and identify potential significant biomarkers for the design of more effective and personalized rehabilitation protocols.
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Williams E, Jackson H, Wagland J, Martini A. Community Rehabilitation Outcomes for Different Stroke Diagnoses: An Observational Cohort Study. Arch Rehabil Res Clin Transl 2021; 2:100047. [PMID: 33543075 PMCID: PMC7853334 DOI: 10.1016/j.arrct.2020.100047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Objective To determine the differences in functional and cognitive rehabilitation gains made in community-based rehabilitation following a stroke based on stroke diagnosis (left or right hemisphere, hemorrhagic, or ischemic). Design A 12-month follow-up observational retrospective cohort study. Setting Staged community-based brain injury rehabilitation. Participants Clients (N=61) with hemorrhagic left brain stroke (n=10), hemorrhagic right brain stroke (n=8), ischemic left brain stroke (n=27), or ischemic right brain stroke (n=16) participating in rehabilitation for at least 12 months. Intervention Not applicable. Main Outcome Measures The Mayo-Portland Adaptability Inventory-4 (MPAI-4) was completed at admission and 12 months post admission to staged community-based brain injury rehabilitation by consensus of a multidisciplinary team. Results After 12 months in staged community-based brain injury rehabilitation, the study population made significant gains in Total (P<.001) and across Ability (P<.001) and Participation (P<.001) subscales of the MPAI-4. All diagnostic groups made significant gains in Participation T-scores, and no groups made significant gains in Adjustment. The ischemic left and right hemisphere stroke groups also made significant gains in Ability and Total T-scores from admission to 12 months. Clients with ischemic left hemisphere stroke had more severe limitations in motor speech (P<.05) than clients with right hemisphere stroke at admission and/or review and were also more impaired in verbal communication (P<.01) than the hemorrhagic right hemisphere group at admission. Conclusions There are some differences in outcomes on presentation to rehabilitation based on type of stroke; there are also differences in rehabilitation gains. Improvement in physical ability does not always translate to improvement in social participation and independence; those with right brain stroke need further assistance to translate physical gains into participatory outcomes.
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Affiliation(s)
- Elly Williams
- Brightwater Care Group, Research Centre, Perth, Australia
| | - Hayley Jackson
- Brightwater Care Group, Research Centre, Perth, Australia.,University of Western Australia, Faculty of Science, School of Psychological Science, Perth, Australia
| | - Janet Wagland
- Brightwater Care Group, Research Centre, Perth, Australia
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Cuesta-Vargas A, Martin-Martin J, Gonzalez-Sanchez M, Merchan-Baeza JA, Perez-Cruzado D. Identification of Tools for the Functional and Subjective Assessment of Patients in an Aquatic Environment: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165690. [PMID: 32781711 PMCID: PMC7460483 DOI: 10.3390/ijerph17165690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 11/16/2022]
Abstract
Aquatic therapy is one of the most common treatments for alleviating musculoskeletal pathologies. Its effectiveness has been evaluated with functional tests and questionnaires. Functional tests are used in aquatic therapy; however, in most cases, they are carried out in a non-aquatic environment and, as such, their results may differ from those of tests performed in an aquatic environment. A systematic review was performed to assess the accuracy of functional tests and patient-reported outcomes to assess aquatic therapy interventions. The authors conducted a literature search in July 2019. In total, 70,863 records were identified after duplicates removed. Of these, 14 records were included about functional tests assessment in aquatic environment and 725 records for questionnaires. The majority of the tests had also been assessed in a dry environment, allowing differences and similarities between the tests in the two environments to be observed. Different variables have been assessed in tests included in the present systematic review (cardiorespiratory, neuromuscular, kinematic, physiological, kinetic responses and rating of perceived exertion) which are included in the manuscript. Visual Analogue Scale, Western Ontario and McMaster Universities Osteoarthritis Index and the 12-item Short Form Health Survey were the assessments most commonly used by the different authors.
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Affiliation(s)
- Antonio Cuesta-Vargas
- Department of Physiotherapy, Faculty of Health Science, University of Malaga, 29071 Malaga, Spain; (A.C.-V.); (M.G.-S.)
- Institute of Biomedical Research in Malaga (IBIMA), 29071 Malaga, Spain; (J.A.M.-B.); (D.P.-C.)
| | - Jaime Martin-Martin
- Institute of Biomedical Research in Malaga (IBIMA), 29071 Malaga, Spain; (J.A.M.-B.); (D.P.-C.)
- Legal Medicine Area, Department of Human Anatomy, Legal Medicine and History of Science, Faculty of Medicine, University of Malaga, 29010 Malaga, Spain
- Correspondence:
| | - Manuel Gonzalez-Sanchez
- Department of Physiotherapy, Faculty of Health Science, University of Malaga, 29071 Malaga, Spain; (A.C.-V.); (M.G.-S.)
- Institute of Biomedical Research in Malaga (IBIMA), 29071 Malaga, Spain; (J.A.M.-B.); (D.P.-C.)
| | - Jose Antonio Merchan-Baeza
- Institute of Biomedical Research in Malaga (IBIMA), 29071 Malaga, Spain; (J.A.M.-B.); (D.P.-C.)
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Science and Welfare, University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain
| | - David Perez-Cruzado
- Institute of Biomedical Research in Malaga (IBIMA), 29071 Malaga, Spain; (J.A.M.-B.); (D.P.-C.)
- Department of Occupational Therapy, Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain
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Abstract
OBJECTIVES To investigate whether the relationship between arm use and motor impairment post-stroke is influenced by the hemisphere of damage. METHODS Right-handed patients with unilateral left hemisphere damage (LHD) or right (RHD) (n=58; 28 LHD, 30 RHD) were recruited for this study. The Arm Motor Ability Test and Functional Impact Assessment were used to derive arm use patterns. The Fugl-Meyer motor assessment scale was used to quantify the level of motor impairment. RESULTS A significant interaction between patient group and impairment level was observed for contralesional, but not ipsilesional arm use. For lower impairment levels, contralesional (right arm for LHD and left arm for RHD) arm use was greater in LHD than RHD patients. In contrast, for greater levels of impairment, there were no arm use differences between the two patient groups. CONCLUSIONS When motor impairment is significant, it overrides potential effects of stroke laterality on the patterns of arm use. However, a robust influence of hemisphere of damage on the patterns of arm use is evident at lower impairment levels. This may be attributed to previously described arm preference effects. These findings suggest adoption of distinct strategies for rehabilitation following left versus right hemisphere damage in right-handers, at least when the impairment is moderate to low. (JINS, 2019, 25, 470-478).
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Demartino AM, Rodrigues LC, Gomes RP, Michaelsen SM. Hand function and type of grasp used by chronic stroke individuals in actual environment. Top Stroke Rehabil 2019; 26:247-254. [PMID: 30907287 DOI: 10.1080/10749357.2019.1591037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Knowledge of paretic upper limb (UL) use in the actual environment is crucial for defining treatment strategies that are likely to enhance performance. OBJECTIVE To quantify the hand function and type of grasp performed in the actual environment following stroke and determine if any differences in hand use are dependent on the degree of motor impairment. METHOD This cross-sectional study enrolled 41 participants with chronic hemiparesis classified as having either mild (11), moderate (20), or severe (10) UL impairment. A behavioral map was used while observing hand use over the 4-h experimental period, during which we checked: activity- unimanual, bimanual or non-task-related; hand function- stabilization, manipulation, reach-to-grasp, gesture, support or push; and type of grasp- digital or whole-hand. RESULTS Participants with severe impairment did not use the paretic UL spontaneously; analyzing the moderate and mild subgroup together, the predominant UL hand functions were stabilization and manipulation, the paretic UL performs the stabilization function using the whole-hand more frequently (71.2%) than digital (28.8%) grasp. In the subgroup analysis, the paretic and non-paretic UL in the moderate and the paretic UL in the mild subgroup perform the whole-hand stabilization more frequently than digital. Digital grasp is more accomplished by the non-paretic UL in reach-to-grasp hand function, particularly in the mild subgroup. CONCLUSION The paretic UL is predominantly employed for stabilization function using a whole-hand grasp. The type of grasp in the actual environment is affected by motor impairment, and greater motor impairment leads to the performance of less complex tasks.
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Affiliation(s)
| | - Letícia Cardoso Rodrigues
- a Department of Physical Therapy , Universidade do Estado de Santa Catarina , Florianópolis , Brazil
| | - Raquel Pinheiro Gomes
- a Department of Physical Therapy , Universidade do Estado de Santa Catarina , Florianópolis , Brazil
| | - Stella Maris Michaelsen
- a Department of Physical Therapy , Universidade do Estado de Santa Catarina , Florianópolis , Brazil
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Ding L, Wang X, Guo X, Chen S, Wang H, Jiang N, Jia J. Camera-Based Mirror Visual Feedback: Potential to Improve Motor Preparation in Stroke Patients. IEEE Trans Neural Syst Rehabil Eng 2018; 26:1897-1905. [PMID: 30106735 DOI: 10.1109/tnsre.2018.2864990] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Mirror visual feedback (MVF) is used widely for motor recovery after stroke, but an optimal training setup and systematic procedure are lacking. New optimization strategies have been proposed, one of which is a camera technique. We investigated the effects of a camera-based MVF setup on motor function and motor processes upstream for upper-limb rehabilitation. Seventy-nine stroke patients were assigned randomly to the MVF group (MG; ${N} = {38}$ ) or conventional group (CG; ${N} = {41}$ ), which, respectively, received camera-based MVF and dosage-equivalent physiotherapy or/and occupational therapy for 1 h/day and five days/week for four weeks. Two clinical scales were used to quantify the effect of the intervention methods: the Fugl-Meyer assessment-upper limb (FMA-UL) subscale and Barthel index. The hand laterality task was used to evaluate the ability of mental rotation, including the reaction time and accuracy. All measurements were improved significantly for both groups following intervention. FMA-UL was improved significantly in the MG compared with that in the CG. In lateralization tasks, the RT of the MG was significantly shorter than that of the CG at the endpoint. For all patients, judgments for the affected side were significantly slower and less accurate than for the less-affected side. Subgroup analyses suggested greater benefits of motor function, the activities of daily life, and mental rotation were achieved in subacute patients after MVF. A trend toward greater improvements in motor function for patients with severe-moderate motor impairment and patients with right-hemisphere damage were also revealed. Camera-based MVF has improved the motor function and ability of mental rotation for stroke patients, especially for patients in the subacute stage, which indicates the potential to improve motor preparation. Further studies might combine mental rotation with electroencephalography to investigate the neuro-mechanism of MVF.
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Poncet F, Swaine B, Dutil E, Chevignard M, Pradat-Diehl P. How do assessments of activities of daily living address executive functions: A scoping review. Neuropsychol Rehabil 2017; 27:618-666. [PMID: 28075219 DOI: 10.1080/09602011.2016.1268171] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Executive functions (EF) allow persons to adapt to situations arising in daily life and can be affected following acquired brain injury (ABI). Measuring the impact of EF impairments on the accomplishment of activities of daily living (ADL) requires specific assessment tools, but choosing the right tool may be difficult. PURPOSE To conduct a scoping review on how assessments of ADL address EF and EF impairments in persons with ABI. METHOD A scoping review of literature (peer-reviewed and grey literature) published until August 2014 was conducted. Using a systematic procedure, literature was selected, results were charted, and tools were analysed with respect to their goals, underlying models, psychometric properties and applicability. The analysis also included how tools considered components of EF according to Lezak's model. RESULTS 12 tools, developed either to assess EF in ADL, independence in ADL considering EF or ADL capacities, were identified and analysed according to multiple criteria. CONCLUSIONS This review provides important information about existing tools to assist in tool selection and clinical decision-making related to ABI and EF.
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Affiliation(s)
- Frédérique Poncet
- a APHP, Service de Médecine Physique et de Réadaptation , Hôpital Pitié-Salpêtrière , Paris , France.,b Sorbonne Universités, UPMC Univ Paris 06, AP-HP, GRC n°18, Handicap cognitif et réadaptation (HanCRe); Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix , Paris , France.,c Centre for Interdisciplinary Rehabilitation Research of Greater Montreal (CRIR) - Centre de réadaptation Lucie-Bruneau , Montréal , Canada.,d School of Rehabilitation , Université de Montréal , Montréal , Canada
| | - Bonnie Swaine
- c Centre for Interdisciplinary Rehabilitation Research of Greater Montreal (CRIR) - Centre de réadaptation Lucie-Bruneau , Montréal , Canada.,d School of Rehabilitation , Université de Montréal , Montréal , Canada
| | - Elisabeth Dutil
- c Centre for Interdisciplinary Rehabilitation Research of Greater Montreal (CRIR) - Centre de réadaptation Lucie-Bruneau , Montréal , Canada.,d School of Rehabilitation , Université de Montréal , Montréal , Canada
| | - Mathilde Chevignard
- b Sorbonne Universités, UPMC Univ Paris 06, AP-HP, GRC n°18, Handicap cognitif et réadaptation (HanCRe); Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix , Paris , France.,e Department of Rehabilitation for Children with Acquired Brain Injury , Hôpitaux de Saint Maurice , Saint Maurice , France
| | - Pascale Pradat-Diehl
- a APHP, Service de Médecine Physique et de Réadaptation , Hôpital Pitié-Salpêtrière , Paris , France.,b Sorbonne Universités, UPMC Univ Paris 06, AP-HP, GRC n°18, Handicap cognitif et réadaptation (HanCRe); Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix , Paris , France
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Chard G. Implementing the Assessment of Motor and Process Skills (AMPS) in the Workplace: A Comparison of the Experiences of Occupational Therapists and New Graduates. Br J Occup Ther 2016. [DOI: 10.1177/030802260406700202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Learning to use new skills through continuing professional education courses is an important part of continuing professional development, contributing towards the evidence of competence to practise. Few studies have examined how such new learning is used in professional practice. This study investigated the experiences of occupational therapists when learning to use the Assessment of Motor and Process Skills (AMPS) and whether years of experience or clinical area affected how the AMPS was used in practice. Twenty-three occupational therapists who undertook a 5-day AMPS course completed three questionnaires over a 10-month period. Thirteen were senior level occupational therapists and 10 were new graduates about to commence employment in their first post. Significant differences between the two groups were found in three areas: the new graduates experienced more difficulties when starting to use the AMPS, completed fewer assessments and found workplace difficulties more time consuming. The two groups shared many difficulties when learning to use a new skill and implementing it within workplace teams, but the analysis of the ranking of these difficulties using the Mann-Whitney U test demonstrated no overall difference between the two groups. Successful implementation of the AMPS for all the participants depended on having sufficient time for new learning to take place and on support from managers so that they could change elements of practice to accommodate the use of new skills.
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McAdam K, Thomas W, Chard G. The Assessment of Motor and Process Skills: An Evaluation of the Impact of Training on Service Delivery. Br J Occup Ther 2016. [DOI: 10.1177/030802260106400706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Thirty-six occupational therapists that completed a training course on the Assessment of Motor and Process Skills (AMPS), held in the West Midlands, took part in a follow-up evaluation. This examined the effectiveness of the AMPS training on the occupational therapy service delivery. Twenty-eight structured interviews were carried out with occupational therapists from the West Midlands region and eight postal questionnaires returned from occupational therapists outside the region. The outcome indicated that observation skills had improved and that the AMPS was an appropriate tool to use for the purposes of assessment, guiding intervention and measuring outcomes of occupational therapy. There were variations in the ease with which the AMPS was administered with different client groups, but 89% of the occupational therapists were still using the AMPS at 9 months following training across a range of services. The main difficulties encountered were a lack of access to a computer and the additional support needed for the AMPS to be fully integrated into clinical practice. The adaptability of the AMPS as a standardised assessment and outcome measure makes it a good choice of tool to use across an occupational therapy service. The effects of the AMPS training on such a service are discussed, with recommendations for managers planning the distribution of limited training budgets and the implications for service development needs.
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Robinson SE, Fisher AG. Functional and Cognitive Differences between Cognitively-Well People and People with Dementia. Br J Occup Ther 2016. [DOI: 10.1177/030802269906201007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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16
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Fossey E, Harvey C, Plant G, Pantelis C. Occupational Performance of People Diagnosed with Schizophrenia in Supported Housing and Outreach Programmes in Australia. Br J Occup Ther 2016. [DOI: 10.1177/030802260606900904] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study compared the occupational performance in activities of daily living (ADL) of people diagnosed with schizophrenia in two settings: 25 people in residential rehabilitation facilities and 18 people receiving intensive outreach support in their homes in urban Australia. All participants were assessed with structured interviews, the Assessment of Motor and Process Skills (a performance-based measure of ADL ability) and the Life Skills Profile (an informant-report measure of disability). Hypothesised differences in ADL performance between the two settings were not supported. Mean ADL process ability, based on the AMPS process skills subscale, indicated that the majority (58%) of the 43 participants needed some assistance in community living, irrespective of where they lived and the types of support received. Many participants (42%) performed ADL tasks with relative ease, efficiency, safety and independence as measured by AMPS, indicating that they could live in housing arrangements with outreach support. However, the ADL process ability measures for two-thirds of these participants indicated that they would struggle in community living in the absence of outreach support. Given these findings, the eligibility criteria and screening for residential and outreach support services need re-examination and performance-based assessments of ADL ability could improve the identification of housing-related support needs. Occupational therapists have expertise in this area to develop individualised supports that enable a greater choice of living arrangements for people diagnosed with schizophrenia.
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Cooke KZ, Fisher AG, Mayberry W, Oakley F. Differences in Activities of Daily Living Process Skills of Persons with and without Alzheimer's Disease. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/153944920002000201] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to determine if persons with dementia of the Alzheimer type (DAT) differed from nondisabled older controls in the actual, experienced difficulty of specific process skills that affect performance of activities of daily living (ADL). A two-group comparison was performed and all participants were evaluated in either clinical or home environments to which they had been familiarized. Participants (341 persons with DAT and 287 controls) were selected from the standardization sample of the Assessment of Motor and Process Skills (AMPS) computer-scoring software. The demographic characteristics of the two groups were comparable. The AMPS was used to evaluate the effort, efficiency, safety, and independence of 20 ADL process skills that are compiled to enact performance of familiar ADL tasks. The raw data for each sample was subjected to many-faceted Rasch analysis to determine item difficulty calibrations of the ADL process skill items for each group. Actual item difficulty calibrations of 19 ADL process skills differed meaningfully between the two groups. The results indicated that it is possible to identify specific ADL process skills that are actually easier or more difficult for each group. In addition, the results supported earlier research that has demonstrated that the underlying cognitive and physical impairments demonstrated by persons with DAT do manifest as ADL disability, negatively impacting their ability to perform ADL tasks.
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Doble SE, Lewis N, Fisk JD, Rockwood K. Test-Retest Reliability of the Assessment of Motor and Process Skills in Elderly Adults. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/153944929901900303] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
We examined the test-retest reliability of the Assessment of Motor and Process Skills (AMPS) in a heterogeneous sample of 55 elderly adults. Subjects were reassessed within 1 to 10 days (M=4.0, SD=2.7 days). The subjects' Time 1 and Time 2 ability measures were highly correlated (Motor: r(55)=.88, P<.001; Process: r(55)=.86, P<.001). Measures were stable in 92% of the subjects. Significant variability occurred in only 8% (N=9) of the subjects' ability measures. Measurement error was a concern less than 2% of the time; 6% of the subjects' measures differed as a reflection of real changes in their task performances. Although some variability was attributed to fluctuations in subjects' medical conditions or motivation to adhere to the task requirements, not all of it could be attributed to a specific factor. These data provide support for the reliability of the AMPS, and serve as a reminder that not all test—retest differences represent measurement error.
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Björkdahl A, Nilsson AL, Grimby G, Sunnerhagen KS. Does a short period of rehabilitation in the home setting facilitate functioning after stroke? A randomized controlled trial. Clin Rehabil 2016; 20:1038-49. [PMID: 17148515 DOI: 10.1177/0269215506071230] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To assess the effect of three weeks of rehabilitation in the home setting for younger patients with stroke with the aim of improving activity level. Design: A randomized controlled study with blinded evaluations at discharge, three weeks, three months and one year after discharge. Setting: Home of the patient or the ordinary day rehabilitation clinic at the university hospital. Subjects: Fifty-eight patients (median age 53 years) consecutively discharged from inpatient rehabilitation with a first occurrence of stroke participated in training directly after discharge. Intervention: Rehabilitation was given for 9 hours/week over three weeks. The home group received individually tailored training, based on the patient's needs and desires, with a focus on activities in their natural context. Support and information were also given. The intervention in the day clinic group was aimed mainly at improved functions. Main measures: The main outcome was activity, assessed with the Assessment of Motor and Process Skill (AMPS). The impairment level was also evaluated. Costs were estimated. Result: There were no significant differences between the groups on any of the four assessments. However, there seemed to be an earlier improvement on some measures (including AMPS) for the home group. For both groups there was a greater improvement on the activity level than on the impairment level. The costs of the home group were less than half of the costs of the day clinic group. Conclusion: With the present results, both rehabilitation programmes could be recommended, however, further studies are needed to define patients who may specifically benefit from the home rehabilitation programme. Costs should be taken into consideration.
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Affiliation(s)
- Ann Björkdahl
- Institute of Clinical Neuroscience-Rehabilitation Medicine, Göteborg University, Guldhedsgatan 19, 413-45 Göteborg, Sweden.
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Kizony R, Katz N. Relationships between Cognitive Abilities and the Process Scale and Skills of the Assessment of Motor and Process Skills (AMPS) in Patients with Stroke. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2016. [DOI: 10.1177/153944920202200205] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was: 1) to determine the strength of the relationships between cognitive components at the body function/impairment level to the assessment of motor and process skills (AMPS) at the occupational performance/activities level in persons following stroke; and 2) to examine which cognitive components best explain the variance of the AMPS score. Stroke is a major cause of disability in older age that can result in motor and/or cognitive impairments leading to functional disability. The assessment of AMPS is an activity of daily living (ADL) and instrument activity of daily living (IADL) evaluation that measures two aspects enabling occupational performance and motor and process skills. Subjects included 30 hospitalized patients 4 to 5 weeks following stroke. Among them were 17 men and 13 women with a mean age of 71.33 (SD = 8.39) who had been independent in ADL prior to the event. Instruments included the AMPS IADL tasks, Thinking Operations from the LOTCA, Contextual Memory Test, Rey Complex Figure-copy, Star cancellation from the BIT, and COGNISTAT. The study supports the existence of moderate relationships between cognitive components and the AMPS' process scale and skills, and the results add information about relationships between cognitive impairments and occupational performance that can help in treatment planning.
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Huertas Hoyas E, Pedrero Pérez EJ, Águila Maturana AM, Rojo Mota G, Martínez Piédrola R, Pérez de Heredia Torres M. Outcomes of a multicomponent intervention on occupational performance in persons with unilateral acquired brain injury. FUNCTIONAL NEUROLOGY 2016; 31:109-15. [PMID: 27358224 DOI: 10.11138/fneur/2016.31.2.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Complications after unilateral acquired brain injury (ABI) can affect various areas of expertise causing (depending on the location of the lesion) impairment in occupational performance. The aim of this study was to analyze and compare the concepts of occupational performance and functional independence, both before and after a multicomponent intervention including occupational therapy, in persons with unilateral brain damage. This was a longitudinal quasi-experimental pretest post-test study in a sample of 58 patients with unilateral brain injury (28 with traumatic brain injury and 30 with ischemic stroke). The patients' level of independence was measured using the short version of the International Classification of Functioning, Disability and Health. We also measured quality of performance using the Assessment of Motor and Process Skills. The findings of this study showed that patients with injury in the right hemisphere improved more than those with left hemisphere damage (p<0.001). All the patients with ABI, especially those with right-sided injury, derived benefit from the multicomponent intervention, except in the area of motor skills. More research is needed on the specific techniques that might address such skills.
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Huertas Hoyas E, Pedrero Pérez EJ, Águila Maturana AM, García López-Alberca S, González Alted C. Functionality predictors in acquired brain damage. Neurologia 2015; 30:339-46. [PMID: 24560472 DOI: 10.1016/j.nrl.2014.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 01/09/2014] [Accepted: 01/16/2014] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION Most individuals who have survived an acquired brain injury present consequences affecting the sensorimotor, cognitive, affective or behavioural components. These deficits affect the proper performance of daily living activities. The aim of this study is to identify functional differences between individuals with unilateral acquired brain injury using functional independence, capacity, and performance of daily activities. METHOD Descriptive cross-sectional design with a sample of 58 people, with right-sided injury (n=14 TBI; n=15 stroke) or left-sided injury (n = 14 TBI, n = 15 stroke), right handed, and with a mean age of 47 years and time since onset of 4 ± 3.65 years. The functional assessment/functional independence measure (FIM/FAM) and the International Classification of Functioning (ICF) were used for the study. RESULTS The data showed significant differences (P<.000), and a large size effect (dr=0.78) in the cross-sectional estimates, and point to fewer restrictions for patients with a lesion on their right side. The major differences were in the variables 'speaking' and 'receiving spoken messages' (ICF variables), and 'Expression', 'Writing' and 'intelligible speech' (FIM/FAM variables). In the linear regression analysis, the results showed that only 4 FIM/FAM variables, taken together, predict 44% of the ICF variance, which measures the ability of the individual, and up to 52% of the ICF, which measures the individual's performance. Gait alone predicts a 28% of the variance. CONCLUSIONS It seems that individuals with acquired brain injury in the left hemisphere display important differences regarding functional and communication variables. The motor aspects are an important prognostic factor in functional rehabilitation.
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Affiliation(s)
- E Huertas Hoyas
- Universidad Rey Juan Carlos, Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Alcorcón, Madrid, España.
| | - E J Pedrero Pérez
- Instituto de Adicciones de Madrid, Ayuntamiento de Madrid, Madrid, España
| | - A M Águila Maturana
- Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Alcorcón, Madrid, España
| | - S García López-Alberca
- Centro de Rehabilitación integral a personas con daño cerebral adquirido, POLIBEA, Madrid, España
| | - C González Alted
- Centro de Referencia Estatal de Atención al Daño Cerebral Adquirido, CEADAC, Madrid, España
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Huertas Hoyas E, Pedrero Pérez E, Águila Maturana A, García López-Alberca S, González Alted C. Functionality predictors in acquired brain damage. NEUROLOGÍA (ENGLISH EDITION) 2015. [DOI: 10.1016/j.nrleng.2015.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Taule T, Strand LI, Assmus J, Skouen JS. Ability in daily activities after early supported discharge models of stroke rehabilitation. Scand J Occup Ther 2015; 22:355-65. [PMID: 26005768 PMCID: PMC4673522 DOI: 10.3109/11038128.2015.1042403] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
UNLABELLED More knowledge is needed about how different rehabilitation models in the municipality influence stroke survivors' ability in activities of daily living (ADL). OBJECTIVES To compare three models of outpatient rehabilitation; early supported discharge (ESD) in a day unit, ESD at home and traditional treatment in the municipality (control group), regarding change in ADL ability during the first three months after stroke. METHODS A group comparison study was designed within a randomized controlled trial. Included participants were tested with the Assessment of Motor and Process Skills (AMPS) at baseline and discharged directly home. Primary and secondary outcomes were the AMPS and the modified Rankin Scale (mRS). RESULTS AND CONCLUSIONS Included were 154 participants (57% men, median age 73 years), and 103 participants completed the study. There were no significant group differences in pre-post changed ADL ability measured by the AMPS. To find the best rehabilitation model to improve the quality of stroke survivors' motor and process skills needs further research. Patients participating in the ESD rehabilitation models were, compared with traditional treatment, significantly associated with improved ADL ability measured by the mRS when controlling for confounding factors, indicating that patients with social needs and physical impairment after stroke may benefit from ESD rehabilitation models.
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Affiliation(s)
- Tina Taule
- Department of Occupational Therapy, Haukeland University Hospital (HUH) , Bergen , Norway
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25
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Okkema KA, Culler KH. Functional Evaluation of Upper Extremity Use following Stroke: A Literature Review. Top Stroke Rehabil 2015. [DOI: 10.1310/710m-w1qq-83pp-e08h] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Eriksson G, Aasnes M, Tistad M, Guidetti S, von Koch L. Occupational Gaps in Everyday Life One Year After Stroke and the Association With Life Satisfaction and Impact of Stroke. Top Stroke Rehabil 2015; 19:244-55. [DOI: 10.1310/tsr1903-244] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ntsiea MV, Van Aswegen H, Lord S, Olorunju S S. The effect of a workplace intervention programme on return to work after stroke: a randomised controlled trial. Clin Rehabil 2014; 29:663-73. [PMID: 25322870 DOI: 10.1177/0269215514554241] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 09/12/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine the effect of a workplace intervention programme on the rate of return to work of previously employed stroke survivors in the Gauteng province of South Africa. DESIGN A randomised controlled trial. SETTING Participants' workplaces and three hospitals with stroke rehabilitation facilities. SUBJECTS Eighty stroke survivors between the ages of 18 and 60 years who were employed at the time of stroke onset. INTERVENTION The workplace intervention programme was tailored according to functional ability and workplace challenges of each stroke survivor. The control group received usual stroke care which took into consideration job requirements but without workplace intervention. MAIN OUTCOMES The primary outcome was return to work rate. Secondary outcomes included activities of daily living (ADLs), mobility, basic cognitive function and perceived quality of life. RESULTS At six months follow-up 60% (n = 24) of stroke survivors in the intervention group returned to work compared to 20% (n = 8) in the control group (P <0.001). The odds ratio for return to work for stroke survivors in the intervention group was 5.2. For every unit increase in the ADLs and cognitive assessment score, the odds of return to work increased by 1.7 and 1.3 respectively; those who returned to work had better quality of life than those who did not return to work (P = 0.05). CONCLUSION A workplace intervention consisting of workability assessments and workplace visits was effective in facilitating return to work for stroke survivors in the Gauteng province of South Africa.
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Affiliation(s)
- M V Ntsiea
- Department of Physiotherapy, Faculty of Health Sciences, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - H Van Aswegen
- Department of Physiotherapy, Faculty of Health Sciences, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - S Lord
- Institute of Neuroscience, Newcastle University, UK
| | - S Olorunju S
- Biostatistics Unit, Medical Research Council of South Africa, South Africa
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Mani S, Przybyla A, Good DC, Haaland KY, Sainburg RL. Contralesional Arm Preference Depends on Hemisphere of Damage and Target Location in Unilateral Stroke Patients. Neurorehabil Neural Repair 2014; 28:584-93. [PMID: 24523143 DOI: 10.1177/1545968314520720] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Previous research has shown that during simulated activities of daily living, right-handed stroke patients use their contralesional arm more after left- than right-hemisphere stroke. These findings were attributed to a hand preference effect. However, these decisions about when to use the contralesional arm may be modulated by where in the work space the task is performed, a factor that could be used in physical rehabilitation to influence recovery by decreasing learned nonuse. Objective To examine how target location and side of stroke influences arm selection choices for simple reaching movements. Methods A total of 14 right-handed stroke patients (7 with left-hemisphere and 7 with right-hemisphere damage [RHD]), with similar degrees of hemiparesis (Fugl-Meyer motor score), and 16 right-handed controls participated in this experiment. In a pseudorandom fashion, 32 targets were presented throughout the reachable horizontal plane work space, and the participants were asked to select 1 hand to reach the target on each trial. Results The group with left-hemisphere damage chose their contralesional arm significantly more often than the group with RHD. Patients with RHD also chose their left (contralesional) arm significantly less often than the control group. However, these patterns of choice were most pronounced in the center of the workspace. Conclusion Both the side of hemisphere damage and work space location played a significant role in the choice of whether to use the contralesional arm for reaching. These findings have implications for structuring rehabilitation for unilateral stroke patients.
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Affiliation(s)
- Saandeep Mani
- Pennsylvania State University, University Park, PA, USA
| | | | - David C Good
- Penn State College of Medicine, Hershey, PA, USA
| | - Kathleen Y Haaland
- NM VA Healthcare System, Albuquerque, NM, USA University of New Mexico, Albuquerque, NM, USA
| | - Robert L Sainburg
- Pennsylvania State University, University Park, PA, USA Penn State College of Medicine, Hershey, PA, USA
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Pulsipher DT, Stricker NH, Sadek JR, Haaland KY. Clinical Utility of the Neuropsychological Assessment Battery (NAB) after Unilateral Stroke. Clin Neuropsychol 2013; 27:924-45. [DOI: 10.1080/13854046.2013.799714] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Poulin V, Korner-Bitensky N, Dawson DR. Stroke-specific executive function assessment: A literature review of performance-based tools. Aust Occup Ther J 2013; 60:3-19. [DOI: 10.1111/1440-1630.12024] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2012] [Indexed: 11/30/2022]
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Mani S, Mutha PK, Przybyla A, Haaland KY, Good DC, Sainburg RL. Contralesional motor deficits after unilateral stroke reflect hemisphere-specific control mechanisms. ACTA ACUST UNITED AC 2013; 136:1288-303. [PMID: 23358602 DOI: 10.1093/brain/aws283] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We have proposed a model of motor lateralization, in which the left and right hemispheres are specialized for different aspects of motor control: the left hemisphere for predicting and accounting for limb dynamics and the right hemisphere for stabilizing limb position through impedance control mechanisms. Our previous studies, demonstrating different motor deficits in the ipsilesional arm of stroke patients with left or right hemisphere damage, provided a critical test of our model. However, motor deficits after stroke are most prominent on the contralesional side. Post-stroke rehabilitation has also, naturally, focused on improving contralesional arm impairment and function. Understanding whether contralesional motor deficits differ depending on the hemisphere of damage is, therefore, of vital importance for assessing the impact of brain damage on function and also for designing rehabilitation interventions specific to laterality of damage. We, therefore, asked whether motor deficits in the contralesional arm of unilateral stroke patients reflect hemisphere-dependent control mechanisms. Because our model of lateralization predicts that contralesional deficits will differ depending on the hemisphere of damage, this study also served as an essential assessment of our model. Stroke patients with mild to moderate hemiparesis in either the left or right arm because of contralateral stroke and healthy control subjects performed targeted multi-joint reaching movements in different directions. As predicted, our results indicated a double dissociation; although left hemisphere damage was associated with greater errors in trajectory curvature and movement direction, errors in movement extent were greatest after right hemisphere damage. Thus, our results provide the first demonstration of hemisphere specific motor control deficits in the contralesional arm of stroke patients. Our results also suggest that it is critical to consider the differential deficits induced by right or left hemisphere lesions to enhance post-stroke rehabilitation interventions.
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Affiliation(s)
- Saandeep Mani
- Department of Kinesiology, Pennsylvania State University, 29 Recreation Bldg, University Park, PA 16802, USA
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Kottorp A, Ekstam L, Petersson Lie I. Differences in awareness between persons with left and right hemispheric stroke. Scand J Occup Ther 2012; 20:37-44. [DOI: 10.3109/11038128.2012.688864] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Fioravanti AM, Bordignon CM, Pettit SM, Woodhouse LJ, Ansley BJ. Comparing the responsiveness of the assessment of motor and process skills and the functional independence measure. The Canadian Journal of Occupational Therapy 2012; 79:167-74. [PMID: 22822694 DOI: 10.2182/cjot.2012.79.3.6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Selecting and utilizing appropriate assessments to evaluate outcomes is an important aspect of evidence-based occupational therapy practice. The Functional Independence Measure (FIM), to which occupational therapists contribute motor and cognitive scores, is currently the only required assessment for evaluating change from admission to discharge on an inpatient rehabilitation unit. However, occupational therapists are also using the motor and process scales from the Assessment of Motor and Process Skills (AMPS) to assess clients and evaluate change. PURPOSE To compare responsiveness of the AMPS and the FIM on an inpatient rehabilitation unit. METHODS A retrospective chart review of AMPS measures and FIM scores at admission and discharge was undertaken. Standardized response means and effect sizes were calculated to estimate responsiveness. FINDINGS No significant difference was found in the ability of the AMPS motor and FIM motor scales to detect change. The AMPS process scale was more responsive to change than the FIM cognitive scale. IMPLICATIONS Using the AMPS as an assessment to evaluate outcomes allows practitioners to detect changes that may not be detected through the exclusive use of the FIM.
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Haaland KY, Mutha PK, Rinehart JK, Daniels M, Cushnyr B, Adair JC. Relationship between arm usage and instrumental activities of daily living after unilateral stroke. Arch Phys Med Rehabil 2012; 93:1957-62. [PMID: 22634230 DOI: 10.1016/j.apmr.2012.05.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Revised: 03/27/2012] [Accepted: 05/10/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine whether the preferred pattern of arm use after unilateral hemispheric damage was associated with better everyday functioning. Our previous work showed that right-handed stroke patients with right hemisphere damage (RHD) used their right, ipsilesional arm most frequently, while those with left hemisphere damage (LHD) used both arms together most frequently. This effect was explained by right-hand preference, but its relationship to functional performance is not known. DESIGN Observational cohort. SETTING Research laboratory. PARTICIPANTS Stroke patients (n=60; 30 RHD, 30 LHD) and healthy controls (n=52). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The Functional Impact Assessment was used to assess performance on instrumental activities of daily living (IADLs). RESULTS The preferred patterns of arm use were similar to those in our previous report. However, it was the greater use of both arms together that was associated with better IADL performance in both stroke groups. Ipsilesional arm use alone was not significantly associated with IADL performance in the RHD group and was associated with poorer performance in the LHD group. CONCLUSIONS The modal arm use pattern did not always optimize IADL functioning. Better IADL functioning in both stroke groups was associated with the use of both arms together, which is the most common arm use pattern of healthy individuals doing these same IADLs. An important practical question that arises from these findings is whether bilateral arm rehabilitation should be emphasized, because using both arms together is the best predictor of better performance on everyday tasks.
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Affiliation(s)
- Kathleen Y Haaland
- New Mexico Veterans Affairs Healthcare System, Albuquerque, NM; University of New Mexico, Albuquerque, NM 87108, USA.
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Merritt BK. Validity of using the Assessment of Motor and Process Skills to determine the need for assistance. Am J Occup Ther 2012; 65:643-50. [PMID: 22214108 DOI: 10.5014/ajot.2011.000547] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This study evaluated the validity of using Assessment of Motor and Process Skills (AMPS) measures as evidence of the need for assistance in the community. METHOD In a retrospective analysis of existing data (N = 64,466), receiver operating characteristic (ROC) curves were generated, and a split-sample method was used to validate the predictions. RESULTS When identifying people who need assistance versus those who do not need assistance in the community, activity of daily living (ADL) motor and ADL process measures have fair and good discriminating value, respectively (areas under the ROC curves were .78 and .84). Evidence supports placing ADL motor and ADL process independence cutoff measures at 1.50 logits (sensitivity = .67, specificity = .72) and 1.00 logit (sensitivity = .81, specificity = .70), respectively. Accuracy was highest when matched motor and process decisions occurred (sensitivity = .85, specificity = .83). CONCLUSION Evidence supports using ADL ability measures from the AMPS to provide evidence of a client's need for assistance in the community.
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Affiliation(s)
- Brenda K Merritt
- School of Occupational Therapy at Dalhousie University, Halifax, Nova Scotia, Canada.
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Performance-based everyday functioning after stroke: relationship with IADL questionnaire and neurocognitive performance. J Int Neuropsychol Soc 2011; 17:832-40. [PMID: 21880170 DOI: 10.1017/s1355617711000841] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Neuropsychologists frequently are asked to comment on everyday functioning, but the research relies mostly on questionnaire-based assessment of daily functioning. While performance-based assessment of everyday functioning has many advantages over commonly used questionnaires, there are few empirically validated comprehensive performance-based measures. We present data here on a performance-based battery of daily living skills, the Functional Impact Assessment (FIA) in 47 unilateral stroke patients and 37 matched healthy controls. The FIA was validated by comparing it to performance on the self- and informant-report version of the Functional Activities Questionnaire (FAQ). We also examined the relationship between the FIA and cognitive functioning using the Neuropsychological Assessment Battery (NAB). The stroke group's performance on the FIA, FAQ (self and informant), and NAB (total and domain scores) was significantly (d's ≥ .80) lower than the control group. The NAB total score and all domain scores were highly correlated with the FIA in the stroke group (r's > .7), and only one NAB domain score (visuospatial) was a unique predictor. This may be due to the fact that most of the NAB domains have a statistical problem of multicollinearity, which may explain why only the spatial domain was a unique predictor. While the informant FAQ was significantly correlated with FIA total score (r = .48, p < .01), the NAB total score was a significantly better predictor (r = .83, p < .001) than the informant FAQ. NAB total scaled score of less than 86 predicted impairment on the FIA with 92% sensitivity and 84% specificity. Our findings argue that the FIA is sensitive to deficits associated with stroke and is highly associated with all neuropsychological domains (attention, executive functions, language and spatial skills, and memory).
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Cederfeldt M, Widell Y, Andersson EE, Dahlin-Ivanoff S, Gosman-Hedström G. Concurrent Validity of the Executive Function Performance Test in People with Mild Stroke. Br J Occup Ther 2011. [DOI: 10.4276/030802211x13153015305673] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Introduction: Studies have shown that executive dysfunction is common in adults after stroke. Occupational therapists working in acute care assess the performance of activities of daily living; most instruments focus on personal care. However, the assessment of instrumental activities of daily living has been shown to discriminate executive dysfunction more effectively. An instrument for assessing executive dysfunction in more complex activities that is easy to handle in acute care is consequently required for clinical use. The Executive Function Performance Test (EFPT) was recently introduced into Sweden. The purpose of this study was to evaluate the concurrent validity of the EFPT in acute care for patients with mild stroke. Method: Twenty-three patients from an acute stroke unit were assessed with both the EFPT and the Assessment of Motor and Process Skills (AMPS). Results: The correlation between the EFPT and the AMPS assessments was highly significant (p = 0.003) and the concurrent validity was rho = 0.61. Conclusion: Since there is a risk that adult patients with mild stroke are discharged without rehabilitation, and there is a lack of a relevant instrument for occupational therapists that discriminates executive dysfunction in acute stroke care, the EFPT may be a suitable instrument to use with these patients.
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Affiliation(s)
- Marie Cederfeldt
- PhD, Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, and Vårdalinstitutet, the Swedish Institute for Health Sciences, Universities of Lund and Gothenburg, Sweden
| | - Yvonne Widell
- Registered Occupational Therapist, Occupational Therapy Department, Skaraborg Hospital, Skövde, Sweden
| | - Elisabeth Elgmark Andersson
- Assistant Professor, School of Health Sciences, Department of Rehabilitation, Jönköping University, Jönköping, Sweden
| | - Synneve Dahlin-Ivanoff
- Professor, Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, and Vårdalinstitutet, the Swedish Institute for Health Sciences, Universities of Lund and Gothenburg, Sweden
| | - Gunilla Gosman-Hedström
- Associate Professor, Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, and Vårdalinstitutet, the Swedish Institute for Health Sciences, Universities of Lund and Gothenburg, Sweden
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Larsson Lund M, Lövgren Engström AL, Lexell J. Response actions to difficulties in using everyday technology after acquired brain injury. Scand J Occup Ther 2011; 19:164-75. [DOI: 10.3109/11038128.2011.582651] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Poole JL, Sadek J, Haaland KY. Meal preparation abilities after left or right hemisphere stroke. Arch Phys Med Rehabil 2011; 92:590-6. [PMID: 21440704 DOI: 10.1016/j.apmr.2010.11.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Revised: 11/15/2010] [Accepted: 11/21/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To examine meal preparation ability after right or left hemisphere damage (RHD, LHD) caused by stroke and whether cognitive (spatial abilities, aphasia, limb apraxia) and motor deficits are differentially associated with meal preparation. DESIGN Observational cohort design. SETTING Primary care Veterans Affair Medical Center and private medical center. PARTICIPANTS Volunteer right-handed sample of adults with LHD (n=30) or RHD (n=16) caused by stroke and healthy demographically matched adults (n=63) (N=109). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Total completion time, number and type of errors, and level of independence for a meal preparation task consisting of making a hot beverage and toast, eating part of the meal, and clean-up. RESULTS Both stroke groups took significantly more time to complete the meal preparation task than the control group. Total errors and level of independence were worse in the group with LHD than other groups, but individual errors did not significantly differ between the 2 stroke groups. While correlations should be interpreted cautiously, especially in the relatively small RHD group, poorer ipsilesional motor performance was associated with longer completion time in the RHD group, and poorer contralesional motor performance and greater aphasia were associated with less independence in the LHD group. CONCLUSIONS These findings demonstrate impaired meal preparation after LHD or RHD but greater impairment after LHD. Poorer meal preparation is associated with different cognitive and motor deficits in the 2 stroke groups.
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Affiliation(s)
- Janet L Poole
- Department of Pediatrics Occupational Therapy Graduate Program, University of New Mexico School of Medicine, Albuquerque, USA
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Holmqvist K, Kamwendo K, Ivarsson AB. Occupational therapists' practice patterns for clients with cognitive impairment following acquired brain injury: development of a questionnaire. Scand J Occup Ther 2011; 19:150-63. [DOI: 10.3109/11038128.2011.576428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Dickerson AE, Reistetter T, Davis ES, Monahan M. Evaluating Driving as a Valued Instrumental Activity of Daily Living. Am J Occup Ther 2011; 65:64-75. [DOI: 10.5014/ajot.2011.09052] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Wæhrens EE, Amris K, Fisher AG. Performance-based assessment of activities of daily living (ADL) ability among women with chronic widespread pain. Pain 2010; 150:535-541. [DOI: 10.1016/j.pain.2010.06.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2009] [Revised: 05/05/2010] [Accepted: 06/11/2010] [Indexed: 10/19/2022]
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Merritt BK. Utilizing AMPS ability measures to predict level of community dependence. Scand J Occup Ther 2010; 17:70-6. [DOI: 10.3109/11038120903165107] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Dickerson A, Reistetter T, Trujillo L. Using an IADL Assessment to Identify Older Adults Who Need a Behind-the-Wheel Driving Evaluation. J Appl Gerontol 2009. [DOI: 10.1177/0733464809340153] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Occupational therapists need to routinely assess driving ability in hospital and/or rehabilitation settings. The purpose of this study is to determine if the Assessment of Motor and Process Skills (AMPS), an observational tool of instrumental activities of daily living, could discriminate between older adult drivers who pass, pass with restrictions, or fail a behind-the-wheel (BTW) evaluation. Forty-six participants were evaluated with a BTW driving assessment and the AMPS. Two one-way ANOVAs found significant differences for both the motor and process scores suggesting the AMPS can be used as a screening tool for driving. Results also showed no significant difference in age between those participants who passed, failed, or needed restrictions supporting the concept that driving abilities are related more to function, not age. Exploration of minimum scores is discussed.
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Marom B, Jarus T, Josman N. The Relationship Between the Assessment of Motor and Process Skills (AMPS) and the Large Allen Cognitive Level (LACL)Test in Clients with Stroke. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2009. [DOI: 10.1080/j148v24n04_03] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kottorp A, Bernspång B, Fisher AG, Bryze KA. IADL Ability Measured with the AMPS: Relation to two Classification Systems of Mental Retardation. Scand J Occup Ther 2009. [DOI: 10.3109/11038129509106804] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Waehrens EE, Fisher AG. Improving quality of ADL performance after rehabilitation among people with acquired brain injury. Scand J Occup Ther 2009; 14:250-7. [PMID: 17852966 DOI: 10.1080/11038120601182974] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The aim of this study was to evaluate whether people with brain injury show improvements in quality of performance of activities of daily living (ADL) after rehabilitation. A retrospective pre- and post-test design with no control group was used. Subjects received interdisciplinary rehabilitation consisting of restorative and compensatory strategies. Thirty-six adults with moderate to severe disability following acquired brain injury were evaluated using the Assessment of Motor and Process Skills (AMPS), an observational evaluation of the quality of ADL task performance. Paired t-tests revealed significant increase in ADL ability after intervention; effect sizes were medium. Improvements occurred across ages, within all diagnostic groups, and with no relation to time post-injury. It was concluded that people with moderate to severe disability following acquired brain injury improved in ADL ability after participating in an intensive, interdisciplinary rehabilitation programme. Although lack of a control group prevented a conclusively conclusion that the changes were due to the intervention provided, the fact that the subjects had shown slow spontaneous recovery and minimal improvements before the study was implemented supports the likelihood that their gains were largely the result of the intervention.
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Affiliation(s)
- Eva Ejlersen Waehrens
- Department of Community Medicine and Rehabilitation, Division of Occupational Therapy, Umeå University, Umeå, Sweden.
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Camilla Girard, Anne G. Fisher, Margaret A. Short, Leslie Duran. Occupational Performance Differences Between Psychiatric Groups. Scand J Occup Ther 2009. [DOI: 10.1080/110381299443708] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Molly L. Hartman, Anne G. Fisher, Leslie Duran. Assessment of Functional Ability of People with Alzheimer's Disease. Scand J Occup Ther 2009. [DOI: 10.1080/110381299443690] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Invited Editorial. Scand J Occup Ther 2009. [DOI: 10.1080/110381299443672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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