1
|
de Diego-Alonso C, Bellosta-López P, Blasco-Abadía J, Buesa-Estéllez A, Roldán-Pérez P, Medina-Rincón A, López-Royo MP, Giner-Nicolás R, Doménech-García V, Fini NA. The relationship between levels of physical activity and participation in everyday life in stroke survivors: A systematic review and meta-analysis. Disabil Health J 2024:101640. [PMID: 38777677 DOI: 10.1016/j.dhjo.2024.101640] [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: 03/08/2024] [Revised: 05/01/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Stroke survivors demonstrate decreased physical activity (PA) and take time to return to participation in everyday life, but the relationship between the two variables is unknown. OBJECTIVE To investigate the correlation and trajectory over time between levels of PA and participation in everyday life in stroke survivors. METHODS PubMed, Web of Science, Scopus, SPORTDiscus, Rehabilitation&Sport Medicine Source, and PEDro databases were searched from inception to January 2024. Cross-sectional and prospective studies evaluating both levels of PA and participation in stroke survivors were included. Two reviewers independently conducted the study selection, data extraction, and quality assessment. Meta-analyses of pooled correlation coefficients were calculated when at least two studies reported a correlation coefficient between the same PA and participation outcomes. RESULTS Of 4962 studies identified, 49 were included in the systematic review. Studies were rated high (55%%) or fair (45%) quality. A wide range of monitoring methodologies for assessing PA and participation were found in the 23 prospective studies. Seven studies were included in the meta-analyses, showing a positive moderate correlation between PA time and participation in activities of daily living (n = 148; r = 0.52; P < 0.01; I2 = 81%) in participants <6 months post-stroke, and between PA time and the participation in all areas (n = 126; r = 0.44; P < 0.01; I2 = 0%) in participants ≥6 months post-stroke. Overall, while PA showed significant improvements over time, participation only showed a tendency. CONCLUSIONS Despite the heterogeneity, consistent positive associations were found between PA time and participation levels in some areas. Establishing consensus is crucial to reduce heterogeneity and facilitate data pooling.
Collapse
Affiliation(s)
- Cristina de Diego-Alonso
- Universidad San Jorge. Campus Universitario, Autov, A23 km 299, 50830, Villanueva de Gállego, Zaragoza, Spain
| | - Pablo Bellosta-López
- Universidad San Jorge. Campus Universitario, Autov, A23 km 299, 50830, Villanueva de Gállego, Zaragoza, Spain.
| | - Julia Blasco-Abadía
- Universidad San Jorge. Campus Universitario, Autov, A23 km 299, 50830, Villanueva de Gállego, Zaragoza, Spain
| | - Almudena Buesa-Estéllez
- Universidad San Jorge. Campus Universitario, Autov, A23 km 299, 50830, Villanueva de Gállego, Zaragoza, Spain
| | - Patricia Roldán-Pérez
- Universidad San Jorge. Campus Universitario, Autov, A23 km 299, 50830, Villanueva de Gállego, Zaragoza, Spain
| | - Almudena Medina-Rincón
- Universidad San Jorge. Campus Universitario, Autov, A23 km 299, 50830, Villanueva de Gállego, Zaragoza, Spain
| | - María Pilar López-Royo
- Universidad San Jorge. Campus Universitario, Autov, A23 km 299, 50830, Villanueva de Gállego, Zaragoza, Spain
| | - Rafael Giner-Nicolás
- Universidad San Jorge. Campus Universitario, Autov, A23 km 299, 50830, Villanueva de Gállego, Zaragoza, Spain
| | - Víctor Doménech-García
- Universidad San Jorge. Campus Universitario, Autov, A23 km 299, 50830, Villanueva de Gállego, Zaragoza, Spain
| | - Natalie A Fini
- Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
2
|
Kringle EA, Kersey J, Lewis MA, Gibbs BB, Skidmore ER. Similarities and differences in factors associated with high and low sedentary behavior after stroke: a mixed methods study. Disabil Rehabil 2024:1-9. [PMID: 38632899 DOI: 10.1080/09638288.2024.2341867] [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: 05/14/2023] [Accepted: 04/08/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE To identify similarities and differences in factors affecting activity engagement between adults with stroke who are more and less sedentary. MATERIALS AND METHODS Data were pooled from two studies of adults with stroke (N = 36). Sedentary time was measured activPAL micro3. Participants completed activPAL interviews, which were analyzed using framework analysis. Participants were stratified into more and less sedentary groups based on activPAL data. Between-group similarities and differences were identified. RESULTS Adults with stroke (mean [SD] age = 65.8 [13.6] years, stroke chronicity = 40.5 [SD = 38.3] months, 36.1% female) were more sedentary (785.5 [64.7] sedentary minutes/day) and less sedentary (583.6 [87.4] sedentary minutes/day). Those who were more sedentary: engaged in basic activities of daily living, avoided activities, received assistance from other people, and did not use strategies to overcome barriers. Those who were less sedentary: engaged in instrumental and community activities, embraced new strategies, did activities with other people, and used strategies to overcome environmental barriers. CONCLUSIONS Factors affecting activity engagement differed between people who are more and less sedentary. Interventions that aim to reduce post-stroke sedentary behavior should consider the: (1) types of activities, (2) role of other people, and (2) application of strategies to overcome activity and environment-related barriers.
Collapse
Affiliation(s)
- Emily A Kringle
- School of Kinesiology, University of MN, Minneapolis, MN, USA
| | - Jessica Kersey
- Program in Occupational Therapy, School of Medicine, WA University, St. Louis, MO, USA
| | | | - Bethany Barone Gibbs
- Department of Epidemiology and Biostatistics, West VA University, Morgantown, WV, USA
| | - Elizabeth R Skidmore
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
3
|
Wade DT. A general theory of rehabilitation: Rehabilitation catalyses and assists adaptation to illness. Clin Rehabil 2024; 38:429-442. [PMID: 37885405 PMCID: PMC10898207 DOI: 10.1177/02692155231210151] [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: 04/02/2023] [Accepted: 10/05/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND There is no general theory of rehabilitation, only definitions and descriptions, with the biopsychosocial model of illness as a structure. OBJECTIVE To develop a general theory of rehabilitation that explains how healthcare rehabilitation changes outcomes and to evaluate its validity. NEED A general rehabilitation theory would help research, improve services, increase understanding, modify resource allocation and explain some anomalies, such as how rehabilitation helps when no natural recovery occurs. BUILDING BLOCKS People adapt to change throughout their lives. Illness is a change, and people adapt to their illness. Adaptation's purpose is to maintain an equilibrium in a person's life. The balanced components are related to Maslow's five needs: basic, safety, affiliation, status and self-fulfilment. The general theory of behaviour suggests that a person's behaviours change to maintain balance, regulated by a central homeostatic mechanism. THE THEORY Rehabilitation aids adaptation to changes associated with illness through accurate diagnosis and formulation, catalysing adaptation, optimising the environment and assisting the person in making necessary changes by safely practising activities and teaching self-management. IMPLICATIONS The theory makes the person the central active agent, emphasises the importance of the environment in facilitating adaptation, explains why all conditions may benefit, including progressive and static conditions, suggests that health can be equated to someone maintaining their equilibrium and explains why a small dose may be very effective. CONCLUSION The general theory of rehabilitation emphasises the catalytic effects of rehabilitation in facilitating and guiding adaptation and suggests areas for research and improvement.
Collapse
Affiliation(s)
- Derick T Wade
- Centre for Movement, Occupation and Rehabilitation Sciences (MOReS), Oxford Brookes University, Oxford, UK
| |
Collapse
|
4
|
Paterson S, Dawes H, Winward C, Bartram E, Dodds E, McKinon J, Gaskell H, Collett J. Use of the Capability, Opportunity and Motivation Behaviour model (COM-B) to Understand Interventions to Support Physical Activity Behaviour in People with Stroke: An Overview of Reviews. Clin Rehabil 2024; 38:543-557. [PMID: 38192225 PMCID: PMC10898199 DOI: 10.1177/02692155231224365] [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: 01/10/2024]
Abstract
OBJECTIVE Physical activity in people with stroke remains low despite considerable research. This overview aimed to provide high-level synthesis and aid clinical decision-making. The Capability, Opportunity, Motivation-Behaviour (COM-B) model was used to classify interventions to understand which components improve physical activity behaviour in people with stroke. DATA SOURCES CINAHL, Cochrane Database, MEDLINE, PEDro, PsychINFO, SPORTDiscus. REVIEW METHODS A systematic search was conducted (November 2023) to identify reviews of interventions to improve physical activity in people with stroke. Results were screened and assessed for eligibility. Participant characteristics, intervention classification using COM-B, and effect of intervention were extracted. Quality was assessed using AMSTAR2, and Corrected Cover Analysis for study overlap. Narrative synthesis was used to understand components of interventions to improve physical activity behaviour. RESULTS 1801 references were screened and 29 full-text references assessed for eligibility. Twenty reviews were included. Quality ranged from critically low (n = 3) to high (n = 10). Study overlap calculated using corrected cover area indicated slight overlap (0.028) and minimal reporting bias.The majority of participants were mobile with mild stroke and community dwelling. Twenty-three interventions were classified using COM-B. Three of twelve interventions classified to one aspect of the COM-B were effective. Fourteen of sixteen effective interventions combined at least two COM-B elements, ten of these combined capability and motivation. CONCLUSION Interventions including at least two elements of the COM-B are most likely to improve physical activity in mobile stroke survivors. Further research is needed to understand physical activity behaviour in those with moderate to severe stroke.
Collapse
Affiliation(s)
- Sarah Paterson
- Centre for Movement, Occupation and Rehabilitation Sciences (MOReS), Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Helen Dawes
- College of Medicine, Department of Public Health & Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Medical School Building, College of Medicine and Health, Exeter, UK
| | - Charlotte Winward
- Allied Health Professions Research Unit, John Radcliffe Hospital, Oxford, UK
| | - Emilia Bartram
- Oxford Centre for Enablement, Nuffield Orthopaedic Centre, Oxford, UK
| | - Emma Dodds
- Oxford Centre for Enablement, Nuffield Orthopaedic Centre, Oxford, UK
| | - Jane McKinon
- Oxford Centre for Enablement, Nuffield Orthopaedic Centre, Oxford, UK
| | - Helen Gaskell
- Oxford Centre for Enablement, Nuffield Orthopaedic Centre, Oxford, UK
| | - Johnny Collett
- Centre for Movement, Occupation and Rehabilitation Sciences (MOReS), Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| |
Collapse
|
5
|
Kwah LK, Doshi K, De Silva DA, Ng WM, Thilarajah S. What influences stroke survivors with physical disabilities to be physically active? A qualitative study informed by the Theoretical Domains Framework. PLoS One 2024; 19:e0292442. [PMID: 38547110 PMCID: PMC10977677 DOI: 10.1371/journal.pone.0292442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/20/2023] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Although the benefits of regular physical activity (PA) after stroke are well established, many stroke survivors do not achieve recommended PA levels. To date, studies exploring determinants to PA have not used a behaviour change theory and focused on stroke survivors with physical disabilities. As a precursor to an intervention development study, we aimed to use the Theoretical Domains Framework (TDF) to identify factors influencing PA in stroke survivors with physical disabilities in Singapore. METHODS Between November 2021 and January 2022, we conducted interviews with 19 community-dwelling stroke survivors with a weak arm and/or leg. An interview guide based on the TDF was developed. We analysed the data deductively by coding interview transcripts into the theoretical domains of the TDF, and then inductively by generating themes and belief statements. To identify relevant TDF domains, we prioritised the domains based on the frequencies of the belief statements, presence of conflicting belief statements and evidence of strong belief statements. RESULTS Eight of the 14 TDF domains were relevant, and included environmental context and resources, knowledge, social influences, emotion, reinforcement, behavioural regulation, skills and beliefs about capabilities. The lack of access, suitable equipment and skilled help often limited PA participation at public fitness spaces such as parks, gyms and swimming pools (environmental context and resources). While a few stroke survivors expressed that they had the skills to engage in regular PA, most expressed not knowing how much and how hard to work, which exercises to do, which equipment to use and how to adapt exercises and equipment (knowledge and skills). This often left them feeling afraid to try new activities or venture out to new places for fear of the unknown or adverse events (e.g., falls) (emotion). For some, doing the activities in a group encourage them to get out and engage in PA (social influences). CONCLUSIONS In stroke survivors with physical disabilities, environmental context and resources had a significant influence on PA participation, and this often had a spill over effect into other domains. Our results inform a complex behaviour change intervention to improve PA after stroke, and has implications for intervention design for people with physical disabilities.
Collapse
Affiliation(s)
- L. K. Kwah
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore
| | - K. Doshi
- Department of Psychology, National University of Singapore, Singapore, Singapore
| | - D. A. De Silva
- National Neuroscience Institute, Singapore General Hospital Campus, Singapore, Singapore
| | - W. M. Ng
- Department of Nursing, National Neuroscience Institute, Singapore, Singapore
| | - S. Thilarajah
- Physiotherapy Department, Singapore General Hospital, Singapore, Singapore
| |
Collapse
|
6
|
Delhey LM, Shi X, Morgenstern LB, Brown DL, Smith MA, Case EC, Springer MV, Lisabeth LD. Association of Neighborhood Recreation Centers and Poststroke Outcomes in a Population-Based Cohort. Stroke 2023; 54:2583-2592. [PMID: 37706339 PMCID: PMC10530069 DOI: 10.1161/strokeaha.122.041852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 08/14/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Higher neighborhood socioeconomic status has been favorably associated with stroke outcomes. This may be due to these areas having more beneficial resources such as recreational centers. We aimed to determine if neighborhood density of recreation centers is favorably associated with stroke outcomes. METHODS We conducted analyses of data from the Brain Attack Surveillance in Corpus Christi project, a cohort of stroke survivors ≥45 years of age residing in Nueces County, TX (2009-2020). We included non-Hispanic White and Mexican American incident stroke survivors, who were not institutionalized prestroke and completed baseline and follow-up assessments (N=1392). We calculated the density of fitness and recreational sports centers within their residential census tract during the year of their stroke. Outcomes included function (self-ratings on activities of daily living and instrumental activities of daily living), cognition (modified mini-mental state exam), depression (Patient Health Questionnaire-8), and quality of life (abbreviated Stroke-Specific Quality of Life Scale). We fit confounder-adjusted gamma-distributed mixed generalized linear models with a log link for each outcome and considered interaction with stroke severity. RESULTS On average, participants were 65 years old, 53% male, and 63% Mexican American. Median recreational centers were 1.60 per square mile (interquartile range, 0.41-3.06). Among moderate-severe stroke survivors, greater density of recreation centers (75th versus 25th percentile) was associated with more favorable function and possibly quality of life (activities of daily living/instrumental activities of daily living, 4.8% change [95% CI, -0.11% to -9.27%]; Stroke-Specific Quality of Life Scale, 3.7% change [95% CI, -0.7% to 8.2%]). Minimal nonsignificant differences were observed among the overall stroke population and those with mild stroke. CONCLUSIONS The availability of recreation centers may be beneficial for poststroke function and quality of life among those with moderate-severe stroke. If further research confirms recreation centers to be beneficial, this could inform rehabilitation following stroke.
Collapse
Affiliation(s)
- Leanna M Delhey
- Department of Epidemiology (L.M.D., L.B.M., M.A.S., E.C.C., L.D.L.), University of Michigan School of Public Health, Ann Arbor
| | - Xu Shi
- Department of Biostatistics (X.S.), University of Michigan School of Public Health, Ann Arbor
| | - Lewis B Morgenstern
- Department of Epidemiology (L.M.D., L.B.M., M.A.S., E.C.C., L.D.L.), University of Michigan School of Public Health, Ann Arbor
- Stroke Program, University of Michigan Medical School, Ann Arbor (L.B.M., D.L.B., M.V.S.)
| | - Devin L Brown
- Stroke Program, University of Michigan Medical School, Ann Arbor (L.B.M., D.L.B., M.V.S.)
| | - Melinda A Smith
- Department of Epidemiology (L.M.D., L.B.M., M.A.S., E.C.C., L.D.L.), University of Michigan School of Public Health, Ann Arbor
| | - Erin C Case
- Department of Epidemiology (L.M.D., L.B.M., M.A.S., E.C.C., L.D.L.), University of Michigan School of Public Health, Ann Arbor
| | - Mellanie V Springer
- Stroke Program, University of Michigan Medical School, Ann Arbor (L.B.M., D.L.B., M.V.S.)
| | - Lynda D Lisabeth
- Department of Epidemiology (L.M.D., L.B.M., M.A.S., E.C.C., L.D.L.), University of Michigan School of Public Health, Ann Arbor
| |
Collapse
|
7
|
de Diego-Alonso C, Blasco-Abadía J, Buesa-Estéllez A, Giner-Nicolás R, López-Royo MP, Roldán-Pérez P, Doménech-García V, Bellosta-López P, Fini N. Relationship between Participation in Daily Life Activities and Physical Activity in Stroke Survivors: A Protocol for a Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:2167. [PMID: 37570407 PMCID: PMC10419119 DOI: 10.3390/healthcare11152167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
Stroke survivors undertake low levels of physical activity and participation in daily life activities, but the correlation between these two domains still carries some degree of uncertainty. This systematic review and meta-analyses-based data synthesis will aim to describe and estimate the relationship between participation in daily life activities and physical activity in stroke survivors. Six databases (MEDLINE/PubMed, Web of Science, Scopus, PEDro, SPORTDiscus, and Rehabilitation & Sport Medicine Source) will be searched. Studies assessing participation alongside physical activity levels in adult stroke survivors in English or Spanish will be included. The study selection, assessment of the risk of bias, and data extraction will be conducted independently by two investigators. If available, correlation values between physical activity and participation outcomes will be extracted. The Hedges-Olkin method will be used for pooling correlation values between participation and physical activity measures. Subgroup analyses will be performed according to the time elapsed since the stroke (i.e., ≤6 months and >6 months). This will be the first systematic review with a meta-analysis to provide information on the relationship between physical activity and participation in stroke survivors. Findings are likely to inform the design of health prevention protocols and the development of healthy behavior change interventions.
Collapse
Affiliation(s)
- Cristina de Diego-Alonso
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, Villanueva de Gállego, 50830 Zaragoza, Spain; (C.d.D.-A.); (J.B.-A.); (A.B.-E.); (R.G.-N.); (M.P.L.-R.); (P.R.-P.); (V.D.-G.)
| | - Julia Blasco-Abadía
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, Villanueva de Gállego, 50830 Zaragoza, Spain; (C.d.D.-A.); (J.B.-A.); (A.B.-E.); (R.G.-N.); (M.P.L.-R.); (P.R.-P.); (V.D.-G.)
| | - Almudena Buesa-Estéllez
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, Villanueva de Gállego, 50830 Zaragoza, Spain; (C.d.D.-A.); (J.B.-A.); (A.B.-E.); (R.G.-N.); (M.P.L.-R.); (P.R.-P.); (V.D.-G.)
| | - Rafael Giner-Nicolás
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, Villanueva de Gállego, 50830 Zaragoza, Spain; (C.d.D.-A.); (J.B.-A.); (A.B.-E.); (R.G.-N.); (M.P.L.-R.); (P.R.-P.); (V.D.-G.)
| | - María Pilar López-Royo
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, Villanueva de Gállego, 50830 Zaragoza, Spain; (C.d.D.-A.); (J.B.-A.); (A.B.-E.); (R.G.-N.); (M.P.L.-R.); (P.R.-P.); (V.D.-G.)
| | - Patricia Roldán-Pérez
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, Villanueva de Gállego, 50830 Zaragoza, Spain; (C.d.D.-A.); (J.B.-A.); (A.B.-E.); (R.G.-N.); (M.P.L.-R.); (P.R.-P.); (V.D.-G.)
| | - Víctor Doménech-García
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, Villanueva de Gállego, 50830 Zaragoza, Spain; (C.d.D.-A.); (J.B.-A.); (A.B.-E.); (R.G.-N.); (M.P.L.-R.); (P.R.-P.); (V.D.-G.)
| | - Pablo Bellosta-López
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, Villanueva de Gállego, 50830 Zaragoza, Spain; (C.d.D.-A.); (J.B.-A.); (A.B.-E.); (R.G.-N.); (M.P.L.-R.); (P.R.-P.); (V.D.-G.)
| | - Natalie Fini
- Department of Physiotherapy, Melbourne School of Health Sciences, University of Melbourne, Melbourne, VIC 3052, Australia;
| |
Collapse
|
8
|
Irvine L, Morris JH, Dombrowski SU, Breckenridge JP, Farre A, Ozakinci G, Lebedis T, Jones C. Keeping Active with Texting after Stroke (KATS): development of a text message intervention to promote physical activity and exercise after stroke. Pilot Feasibility Stud 2023; 9:105. [PMID: 37353847 DOI: 10.1186/s40814-023-01326-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 05/26/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Post-stroke physical activity reduces disability and risk of further stroke. When stroke rehabilitation ends, some people feel abandoned by services and struggle to undertake physical activities that support recovery and health. The aim of this study was to codesign a novel text message intervention to promote physical activity among people with stroke and provide support when formal rehabilitation ends. This manuscript describes the intervention development processes that will inform future pilot and feasibility studies. METHODS The planned intervention was a series of text messages to be sent in a predetermined sequence to people with stroke at the end of rehabilitation. The intervention, underpinned by behaviour change theory and using salient behaviour change techniques, would provide daily messages offering encouragement and support for the uptake and maintenance of physical activity following stroke. The intervention was codesigned by a Collaborative Working Group, comprised of people with stroke, rehabilitation therapists, representatives from stroke charities and academics. A four-step framework was used to design the intervention: formative research on physical activity post-stroke, creation of the behaviour change text message intervention, pre-testing and refinement. Formative research included a review of the scientific evidence and interviews with community-dwelling people with stroke. Data generated were used by the Collaborative Working Group to identify topics to be addressed in the intervention. These were mapped to constructs of the Health Action Process Approach, and salient behaviour change techniques to deliver the intervention were identified. The intervention was rendered into a series of text messages to be delivered over 12 weeks. The draft intervention was revised and refined through an iterative process including review by people with stroke, their spouses, rehabilitation therapists and experts in the field of stroke. The messages encourage regular physical activity but do not prescribe exercise or provide reminders to exercise at specific times. They use conversational language to encourage engagement, and some are personalised for participants. Quotes from people with stroke provide encouragement and support and model key behaviour change techniques such as goal setting and coping planning. DISCUSSION Co-design processes were critical in systematically developing this theory and evidence-based intervention. People with stroke and rehabilitation therapists provided insights into perceived barriers post-rehabilitation and identified strategies to overcome them. The structured multistep approach highlighted areas for improvement through successive rounds of review. The intervention will be tested for acceptability, feasibility and effectiveness in future studies. This co-design approach could be used for interventions for other heath behaviours and with different populations.
Collapse
Affiliation(s)
- Linda Irvine
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Jacqui H Morris
- School of Health Sciences, University of Dundee, Dundee, UK.
| | - Stephan U Dombrowski
- Faculty of Kinesiology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | | | - Albert Farre
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Gozde Ozakinci
- Faculty of Natural Sciences, Division of Psychology, University of Stirling, Stirling, UK
| | | | - Claire Jones
- School of Medicine, University of Dundee, Dundee, UK
| |
Collapse
|
9
|
de Diego-Alonso C, Alegre-Ayala J, Buesa A, Blasco-Abadía J, López-Royo MP, Roldán-Pérez P, Giner-Nicolás R, Güeita-Rodriguez J, Fini NA, Domenech-Garcia V, Bellosta-López P. Multidimensional analysis of sedentary behaviour and participation in Spanish stroke survivors (Part&Sed-Stroke): a protocol for a longitudinal multicentre study. BMJ Open 2023; 13:e065628. [PMID: 36792320 PMCID: PMC9933767 DOI: 10.1136/bmjopen-2022-065628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
INTRODUCTION Stroke survivors usually experience long-lasting functional, emotional and social consequences that might contribute to sedentary behaviour and participation restrictions, which are important targets to address during rehabilitation. However, the trajectory and inter-relationship between these factors are unknown. METHODS AND ANALYSIS Part&Sed is a research project based on an observational study design with 6 and 12 months of follow-ups in stroke survivors. In addition, a qualitative analysis of the impact of the stroke on the stroke survivor, validation of the Satisfaction with Daily Occupation-Occupational Balance assessment tool and analysis of the reliability of the Fitbit Inspire 2 activity tracker wristband will be carried out. Participants will be chronic stroke survivors with independent walking capacity. Sociodemographic and clinical data, physical activity, ambulation, sleep, quality of life, anxiety and depression, community participation, and occupational satisfaction and balance, as well as data provided by the activity tracker wristband, will be collected. In addition, if the participant has a primary caregiver, the caregiver will also be monitored. A minimum of 130 participants will be recruited to conduct a random-effects multiple regression model. Mixed models for repeated measures will assess the variation over time of the different variables associated with participation and sedentary behaviour. Psychometric properties (eg, internal consistency, construct validity, test-retest reliability) of the Satisfaction with Daily Occupation-Occupational Balance will be determined. Additionally, intraclass correlation coefficients and minimum detectable change will be calculated to assess intrasubject reliability of physical activity and sleep parameters recorded by the Fitbit Inspire 2. The qualitative analysis process will be carried out using the analysis proposed by Giorgi. ETHICS AND DISSEMINATION The study received ethical approval from the Spanish Regional Ethics Committee 'Comité de Ética de la Investigación de la Comunidad de Aragón' (PI21/333). The results will be made available via peer-reviewed publications, international conferences and official channels.
Collapse
Affiliation(s)
- Cristina de Diego-Alonso
- Universidad San Jorge, Campus Universitario, Autov.A23 km 299, 50830, Villanueva de Gállego, Zaragoza, Spain
| | | | - Almudena Buesa
- Universidad San Jorge, Campus Universitario, Autov.A23 km 299, 50830, Villanueva de Gállego, Zaragoza, Spain
| | - Julia Blasco-Abadía
- Universidad San Jorge, Campus Universitario, Autov.A23 km 299, 50830, Villanueva de Gállego, Zaragoza, Spain
| | - María Pilar López-Royo
- Universidad San Jorge, Campus Universitario, Autov.A23 km 299, 50830, Villanueva de Gállego, Zaragoza, Spain
| | - Patricia Roldán-Pérez
- Universidad San Jorge, Campus Universitario, Autov.A23 km 299, 50830, Villanueva de Gállego, Zaragoza, Spain
| | - Rafael Giner-Nicolás
- Universidad San Jorge, Campus Universitario, Autov.A23 km 299, 50830, Villanueva de Gállego, Zaragoza, Spain
| | - Javier Güeita-Rodriguez
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine; Research Group of Humanities and Qualitative Research in Health Science (Hum&QRinHS), Universidad Rey Juan Carlos, Health Science Faculty, Alcorcón, Spain
| | - Natalie Ann Fini
- Physiotherapy, School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
- Physiotherapy, Alfred Health, Melbourne, Victoria, Australia
| | - Victor Domenech-Garcia
- Universidad San Jorge, Campus Universitario, Autov.A23 km 299, 50830, Villanueva de Gállego, Zaragoza, Spain
| | - Pablo Bellosta-López
- Universidad San Jorge, Campus Universitario, Autov.A23 km 299, 50830, Villanueva de Gállego, Zaragoza, Spain
| |
Collapse
|
10
|
Bodilsen SS, Aadahl M, Wienecke T, Thomsen TH. Development of a tailored intervention targeting sedentary behavior and physical activity in people with stroke and diabetes: A qualitative study using a co-creation framework. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1114537. [PMID: 36860816 PMCID: PMC9968882 DOI: 10.3389/fresc.2023.1114537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/23/2023] [Indexed: 02/15/2023]
Abstract
Purpose Type 2 diabetes and sedentary behavior pose serious health risks in stroke survivors. Using a co-creation framework, this study aimed to develop an intervention in collaboration with stroke survivors with type 2 diabetes, relatives, and cross-sectoral health care professionals to reduce sedentary behavior and increase physical activity. Materials and methods This qualitative explorative study used a co-creation framework consisting of a workshop and focus group interviews with stroke survivors with type 2 diabetes (n = 3), relative (n = 1), and health care professionals (n = 10) to develop the intervention. A content analysis was used to analyze data. Results The developed "Everyday Life is Rehabilitation" (ELiR) intervention consisted of a tailored 12-week home-based behavior change intervention with two consultations of action planning, goal setting, motivational interviewing, and fatigue management including education on sedentary behavior, physical activity, and fatigue. The intervention has a minimalistic setup using a double-page paper "Everyday Life is Rehabilitation" (ELiR) instrument making it implementable and tangible. Conclusions In this study, a theoretical framework was used to develop a tailored 12-week home-based behavior change intervention. Strategies to reduce sedentary behavior and increase physical activity through activities of daily living along with fatigue management in stroke survivors with type 2 diabetes were identified.
Collapse
Affiliation(s)
- Stefan Sjørslev Bodilsen
- Department of Neurology, Zealand University Hospital, Roskilde, Denmark,Department of Physiotherapy and Occupational Therapy, Zealand University Hospital, Køge-Roskilde, Denmark,Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark,Correspondence: Stefan Sjørslev Bodilsen
| | - Mette Aadahl
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark,Centre for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Troels Wienecke
- Department of Neurology, Zealand University Hospital, Roskilde, Denmark,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Trine Hørmann Thomsen
- Movement Disorder Clinic, Department of Brain - and Nerve Injuries, Rigshospitalet, Glostrup, Denmark,The Parkinson's Association, The House of Disabled People's Organizations, Copenhagen, Denmark
| |
Collapse
|
11
|
A Unified Model for Stroke Recovery and Rehabilitation: Why Now? Am J Phys Med Rehabil 2023; 102:S3-S9. [PMID: 36634323 DOI: 10.1097/phm.0000000000002141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
ABSTRACT The current model of stroke care delivery in the United States and in many parts of the world is fragmented, resulting in lack of continuity of care, inability to track recovery meaningfully across the continuum, and lack of access to the frequency, intensity, and duration of high-quality rehabilitation necessary to optimally harness recovery processes. The process of recovery itself has been overshadowed by a focus on length of stay and the movement of patients across levels of care. Here, we describe the rationale behind the recent efforts at the Johns Hopkins Sheikh Khalifa Stroke Institute to define and coordinate an intensive, strategic effort to develop effective stroke systems of care across the continuum through the development of a unified Sheikh Khalifa Stroke Institute model of recovery and rehabilitation.
Collapse
|
12
|
Dubach RA, Tripathi NS. Secondary Stroke Prevention Education: Occupational Therapy Practitioners’ Implementation and Perceptions. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2023. [DOI: 10.1080/02703181.2023.2165593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Rebecca A. Dubach
- Department of Occupational Therapy, College of Nursing and Health Professions, Valparaiso University, Valparaiso, Indiana, USA
| | - Neha S. Tripathi
- Department of Occupational Therapy, College of Nursing and Health Professions, Valparaiso University, Valparaiso, Indiana, USA
| |
Collapse
|
13
|
Saragih ID, Saragih IS, Tarihoran DETAU, Sharma S, Chou FH. A meta-analysis of studies of the effects of case management intervention for stroke survivors across three countries. J Nurs Scholarsh 2023; 55:345-355. [PMID: 36310396 DOI: 10.1111/jnu.12822] [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: 03/18/2022] [Revised: 08/05/2022] [Accepted: 09/09/2022] [Indexed: 12/31/2022]
Abstract
PURPOSE A stroke survivor who is discharged to home care faces many challenges during the transition from the hospital to home, including managing their care at home and engaging in rehabilitation and recovery. Case management was developed to ease the transition from hospital to home and help people with stroke cope with their care management challenges. However, the effects of case management intervention remain inconclusive. Case management was designed to direct care and may represent a novel method for reducing the burden of care. This study was designed to evaluate the effects of case management interventions on mental health outcomes, activities of daily living capacity, physical function, and social function among stroke survivors. DESIGN Systematic review and meta-analysis. METHODS This study included studies examining the impacts of case management interventions for stroke survivors that were published in English and identified by searching eight databases, from database inception to February 20, 2022. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were used to pool effect sizes using a random-effects model (in Stata 16.0). The revised Cochrane risk-of-bias tool for randomized trials (RoB-2) was used to assess the methodological quality of each study. FINDINGS The inclusion criteria were satisfied by eight studies (including a total of 1119 stroke survivors). Case management had positive effects on mental health (SMD: 0.26; 95% CI: 0.07 to 0.45, p = 0.001) and activities of daily living (SMD: 0.68; 95% CI: 00.37 to 0.99, p < 0.001). However, no significant effects were observed for either physical function or social function. CONCLUSION Case management appears to enhance the mental health and activities of daily living among stroke survivors. CLINICAL RELEVANCE Case management interventions hold promise as efficient, cost-effective, and accessible strategies to positively influence care for stroke survivors. This intervention strategy could be applied to the hospital-to-home transition to guide care among this population.
Collapse
Affiliation(s)
| | | | - Dame Elysabeth Tuty Arna Uly Tarihoran
- School of Nursing, Universitas Kristen Krida Wacana Jakarta, Indonesia.,School of Nursing Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Sapna Sharma
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Fan-Hao Chou
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| |
Collapse
|
14
|
Chau JPC, Lo SHS, Butt L, Liang S. Post-Stroke Experiences and Rehabilitation Needs of Community-Dwelling Chinese Stroke Survivors: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16345. [PMID: 36498415 PMCID: PMC9741278 DOI: 10.3390/ijerph192316345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/25/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
Stroke survivors encounter significant limitations in daily life activities and face increased risk of health complications such as stroke recurrence. Considering the escalating demand for personalised community rehabilitation services, this qualitative study was conducted to understand the current recovery experiences, needs, and expectations of community-dwelling stroke survivors. Fifty stroke survivors were recruited from two tertiary teaching hospitals and community centres in two provinces in mainland China. Semi-structured interviews were carried out, and participants were asked to describe their experiences of stroke, current lifestyles, exercise habits, and rehabilitation needs and expectations. Resulting data were thematically analysed. The majority of participants were first-time stroke survivors (80%) and lived with their family or caregivers (92%). Four main themes and twelve sub-themes emerged from the data: (1) shifts in social life, (2) shaken sense of self and perceived helplessness, (3) complex rehabilitation needs, and (4) perceptions and patterns of physical activity. Findings suggest that though survivors recognised their need for further rehabilitation, their demands remained unmet due to a combination of personal and external factors such as limited mobility and the absence of supportive companions and accessible facilities. The enhancement and diversification of home rehabilitation strategies are therefore necessary to make community rehabilitation more accessible and equitable.
Collapse
|
15
|
Espernberger K, Fini NA, Peiris CL. Identity, social engagement and community participation impact physical activity levels of stroke survivors: A mixed-methods study. Clin Rehabil 2022; 37:836-850. [PMID: 36448093 DOI: 10.1177/02692155221141977] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Objective To explore how personal characteristics and social engagement impact the physical activity levels of chronic stroke survivors. Design A mixed-methods study comprising in-depth semi-structured interviews and objective 24-h physical activity monitoring. Interviews were thematically analysed, and activity diaries were compared to activity monitor data to attain a complete picture of physical activity. Triangulation explored the relationship between perceptions, beliefs, activity levels and social engagement. Setting Community. Participants Community-dwelling, independently mobile, adult stroke survivors (n = 19). The mean age was 74 (11 SD) years, 52% female, mean time post-stroke 41 (SD 61) months. Main measures Qualitative and quantitative measures including individual semi-structured interviews, accelerometry, activity diaries, self-efficacy, Frenchay Activities Index and Barthel Index. Results Individual identity had the greatest perceived influence on post-stroke physical activity. Pre-stroke identity, meaningful activities and family culture contributed to identity; while social and community activities, self-efficacy, co-morbidities, stroke symptoms and exercise, also impacted physical activity. Participants averaged 5365 (IQR 3378–7854) steps per day and reported a mean self-efficacy for exercise score of 51 (SD 20). Triangulation showed convergent relationships between post-stroke physical activity levels and participant motivation, comorbidities, level of social and community participation, self-efficacy and pre-stroke activity levels. Conclusion Personal identity, social engagement and community participation are important factors to consider when implementing a person-centred approach to increasing physical activity participation post-stroke.
Collapse
Affiliation(s)
- Karl Espernberger
- La Trobe University, School of Allied Health, Human Services and Sport, Melbourne, Victoria, Australia
- Donvale Rehabilitation Hospital (Ramsay Health), Donvale, VIC, Australia
| | - Natalie A Fini
- Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Casey L Peiris
- La Trobe University, School of Allied Health, Human Services and Sport, Melbourne, Victoria, Australia
| |
Collapse
|
16
|
Güeita-Rodríguez J, Allendorfer J. Editorial: Prescription and execution of therapeutic exercise programs in neurological disorders. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:1060516. [DOI: 10.3389/fresc.2022.1060516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 11/07/2022] [Indexed: 11/22/2022]
|
17
|
Sunhary De Verville PL, Stubbs B, Etchecopar-Etchart D, Godin O, Andrieu-Haller C, Berna F, Aouizerate B, Capdevielle D, Chereau I, Clauss-Kobayashi J, Coulon N, Dorey JM, Dubertret C, Leignier S, Mallet J, Misdrahi D, Passerieux C, Pignon B, Rey R, Urbach M, Llorca PM, Schürhoff F, Lançon C, Boyer L, Fond G. Recommendations of the Schizophrenia Expert Center network for adequate physical activity in real-world schizophrenia (FACE-SZ). Eur Arch Psychiatry Clin Neurosci 2022; 272:1273-1282. [PMID: 35441901 DOI: 10.1007/s00406-022-01384-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/14/2022] [Indexed: 11/24/2022]
Abstract
The World Health Organization (WHO) recommends adults complete 150-300 min per week of moderate physical activity or 75-150 min of vigorous physical activity or an equivalent combination of both, to optimize health. To explore the factors associated with adequate MVPA in stabilized outpatients with schizophrenia. 425 stabilized outpatients were recruited in the national FACE-SZ cohort between 2015 and 2018 were evaluated with the International Physical Activity Questionnaire and a 1-day long standardized battery. We explored in multivariate analyses the clinical and pharmacological factors associated with MVPA (model 1) and the biological factors and patient-reported outcomes (model 2). Overall, only 86 (20.2%) of the 425 participants achieved the recommended MVPA threshold. In model 1, the adequate MVPA group was associated with younger age, mood stabilizers prescription and adherence to treatment, independent of sex, positive and depressive symptoms, first-generation antipsychotics prescription, anxiolytic medication, and akathisia. In model 2, adequate MVPA was associated with better glycemic and lipidic profile and better physical and psychological well-being, self-esteem, sentimental life, and resilience independently of age, sex, and current psychotic severity. The expert centers recommend the importance of promoting promote effective MVPA programs for stabilized patients with schizophrenia. Interventions studies suggest that MVPA may be a useful strategy to maximize physical and psychological well-being and self-esteem and potentially to prevent or manage metabolic disturbances.
Collapse
Affiliation(s)
- Pierre-Louis Sunhary De Verville
- Fondation FondaMental, Créteil, France.,AP-HM, Aix-Marseille Univ, Faculté de Médecine-Secteur Timone, EA 3279: CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Brendon Stubbs
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK.,Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Damien Etchecopar-Etchart
- Fondation FondaMental, Créteil, France.,AP-HM, Aix-Marseille Univ, Faculté de Médecine-Secteur Timone, EA 3279: CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Ophélia Godin
- Fondation FondaMental, Créteil, France.,Université Paris Est Creteil (UPEC), AP-HP, Hôpitaux Universitaires "H. Mondor", DMU IMPACT, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, 94010, Creteil, France
| | - Christelle Andrieu-Haller
- Fondation FondaMental, Créteil, France.,AP-HM, Aix-Marseille Univ, Faculté de Médecine-Secteur Timone, EA 3279: CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Fabrice Berna
- Fondation FondaMental, Créteil, France.,Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Bruno Aouizerate
- Fondation FondaMental, Créteil, France.,Pôle de Psychiatrie Générale Et Universitaire, Centre Hospitalier Charles Perrens, 33076 Université de Bordeaux, CNRS UMR 5287-INCIA, Bordeaux, France.,INRA, NutriNeuro, University of Bordeaux, U1286, 33076, Bordeaux, France
| | - Delphine Capdevielle
- Fondation FondaMental, Créteil, France.,Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
| | - Isabelle Chereau
- Fondation FondaMental, Créteil, France.,Université Clermont Auvergne, CMP-B, CHU, CNRS, Clermont Auvergne INP, Institut Pascal, 63000, Clermont-Ferrand, France
| | - Julie Clauss-Kobayashi
- Fondation FondaMental, Créteil, France.,Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Nathalie Coulon
- Fondation FondaMental, Créteil, France.,Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - Jean-Michel Dorey
- Fondation FondaMental, Créteil, France.,INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678, Bron Cedex, France
| | - Caroline Dubertret
- Fondation FondaMental, Créteil, France.,Department of Psychiatry, Université de Paris, AP-HP, Louis Mourier Hospital, Colombes, INSERM UMR 1266, Colombes, France
| | - Sylvain Leignier
- Fondation FondaMental, Créteil, France.,Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - Jasmina Mallet
- Fondation FondaMental, Créteil, France.,Department of Psychiatry, Université de Paris, AP-HP, Louis Mourier Hospital, Colombes, INSERM UMR 1266, Colombes, France
| | - David Misdrahi
- Fondation FondaMental, Créteil, France.,Pôle de Psychiatrie Générale Et Universitaire, Centre Hospitalier Charles Perrens, 33076 Université de Bordeaux, CNRS UMR 5287-INCIA, Bordeaux, France.,CNRS UMR 5287-INCIA, Paris, France
| | - Catherine Passerieux
- Fondation FondaMental, Créteil, France.,Service Universitaire de Psychiatrie d'Adultes et d'Addictologie, Centre Hospitalier de Versailles, 177 rue de Versailles, 78157, Le Chesnay, France.,DisAP-DevPsy-CESP, INSERM UMR1018, Université Paris-Saclay, Université Versailles Saint-Quentin-En-Yvelines, 94807, Villejuif,, France
| | - Baptiste Pignon
- Fondation FondaMental, Créteil, France.,Université Paris Est Creteil (UPEC), AP-HP, Hôpitaux Universitaires "H. Mondor", DMU IMPACT, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, 94010, Creteil, France
| | - Romain Rey
- Fondation FondaMental, Créteil, France.,INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678, Bron Cedex, France
| | - Mathieu Urbach
- Fondation FondaMental, Créteil, France.,Service Universitaire de Psychiatrie d'Adultes et d'Addictologie, Centre Hospitalier de Versailles, 177 rue de Versailles, 78157, Le Chesnay, France.,DisAP-DevPsy-CESP, INSERM UMR1018, Université Paris-Saclay, Université Versailles Saint-Quentin-En-Yvelines, 94807, Villejuif,, France
| | - Pierre-Michel Llorca
- Fondation FondaMental, Créteil, France.,Université Clermont Auvergne, CMP-B, CHU, CNRS, Clermont Auvergne INP, Institut Pascal, 63000, Clermont-Ferrand, France
| | - Franck Schürhoff
- Fondation FondaMental, Créteil, France.,Université Paris Est Creteil (UPEC), AP-HP, Hôpitaux Universitaires "H. Mondor", DMU IMPACT, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, 94010, Creteil, France
| | - Christophe Lançon
- Fondation FondaMental, Créteil, France.,AP-HM, Aix-Marseille Univ, Faculté de Médecine-Secteur Timone, EA 3279: CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Laurent Boyer
- Fondation FondaMental, Créteil, France.,AP-HM, Aix-Marseille Univ, Faculté de Médecine-Secteur Timone, EA 3279: CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Guillaume Fond
- Fondation FondaMental, Créteil, France. .,AP-HM, Aix-Marseille Univ, Faculté de Médecine-Secteur Timone, EA 3279: CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005, Marseille, France.
| | | |
Collapse
|
18
|
Sivertsen M, Arntzen EC, Alstadhaug KB, Normann B. Effect of innovative vs. usual care physical therapy in subacute rehabilitation after stroke. A multicenter randomized controlled trial. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:987601. [PMID: 36407967 PMCID: PMC9673903 DOI: 10.3389/fresc.2022.987601] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/30/2022] [Indexed: 12/04/2022]
Abstract
Background Research on stroke rehabilitation often addresses common difficulties such as gait, balance or physical activity separately, a fragmentation contrasting the complexity in clinical practice. Interventions aiming for recovery are needed. The purpose of this study was to investigate effects of a comprehensive low-cost physical therapy intervention, I-CoreDIST, vs. usual care on postural control, balance, physical activity, gait and health related quality of life during the first 12 weeks post-stroke. Methods This prospective, assessor-masked randomized controlled trial included 60 participants from two stroke units in Norway. Participants, who were randomized to I-CoreDIST (n = 29) or usual care physical therapy (n = 31), received 5 sessions/week when in-patients or 3 sessions/week as out-patients. Primary outcomes were the Trunk Impairment Scale-modified Norwegian version (TISmodNV) and activity monitoring (ActiGraphsWgt3X-BT). Secondary outcomes were the Postural Assessment Scale for Stroke, MiniBesTEST, 10-meter walk test, 2-minute walk test, force-platform measurements and EQ5D-3L. Stroke specific quality of life scale was administered at 12 weeks. Linear regression and non-parametric tests were used for statistical analysis. Results Five participants were excluded and seven lost to follow-up, leaving 48 participants in the intention-to-treat analysis. There were no significant between-group effects for primary outcomes: TIS-modNV (p = 0,857); daily average minutes of sedative (p = 0.662), light (p = 0.544) or moderate activity (p = 0.239) and steps (p = 0.288), or secondary outcomes at 12 weeks except for significant improvements on EQ5D-3L in the usual care group. Within-group changes were significant for all outcomes in both groups except for activity levels that were low, EQ5D-3L favoring the usual care group, and force-platform data favoring the intervention group. Conclusions Physical therapy treatment with I-CoreDIST improved postural control, balance, physical activity and gait during the first 12 weeks after a stroke but is not superior to usual care.
Collapse
Affiliation(s)
- Marianne Sivertsen
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsoe, Norway
- Department of Medicine, Nordland Hospital Trust, Bodoe, Norway
- Correspondence: Marianne Sivertsen
| | - Ellen Christin Arntzen
- Department of Medicine, Nordland Hospital Trust, Bodoe, Norway
- Faculty of Nursing and Health Sciences, Nord University, Bodoe, Norway
| | - Karl Bjørnar Alstadhaug
- Department of Medicine, Nordland Hospital Trust, Bodoe, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsoe, Norway
| | - Britt Normann
- Department of Medicine, Nordland Hospital Trust, Bodoe, Norway
- Faculty of Nursing and Health Sciences, Nord University, Bodoe, Norway
| |
Collapse
|
19
|
Choi HJ, LeBlanc M, Moger TA, Valberg M, Aamodt G, Page CM, Tell GS, Næss Ø. Stroke survival and the impact of geographic proximity to family members: A population-based cohort study. Soc Sci Med 2022; 309:115252. [DOI: 10.1016/j.socscimed.2022.115252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 10/16/2022]
|
20
|
Høyer E, Opheim A, Moe-Nilssen R, Strand LI. Community living after in-hospital specialized rehabilitation in patients with severe disability after stroke: a long-term follow-up after a randomized controlled trial. Disabil Rehabil 2022; 45:1822-1829. [PMID: 35609214 DOI: 10.1080/09638288.2022.2076934] [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: 11/03/2022]
Abstract
PURPOSE Physical functioning after discharge from specialized rehabilitation is a concern. The purpose of this study was to investigate functioning and health after a long period of community living in participants with severe disability after stroke. MATERIALS AND METHODS An observational, longitudinal follow-up design was used to investigate 60 participants from a randomized controlled trial. Assessment tools: Short Form 36 health-survey, Functional Ambulation Categories, EU Walking, 10 Meter Walk Test, and questions concerning health and walking ability. RESULTS Forty-seven participants (78%) responded, mean age 51.2 years. Non-respondents demonstrated poorer function at hospital discharge. At follow-up, median 11.9 months after discharge, all but three respondents lived in their own home, and 85% received physiotherapy. Twenty-nine (64%) perceived their health as good to excellent, while four (9%) reported poor health. Activities requiring substantial strength and endurance were typically restricted. Most participants (83%) were independent walkers, and fewer (a 27% reduction) used a wheelchair. Among independent walkers, mean walking speed improved by 0.14 m/s. Time elapsed since hospital discharge was not found to correlate with change in walking speed. CONCLUSIONS This study demonstrates maintenance or progress in important aspects of functioning and health in most participants at long-term follow-up, but not in all.Implications for rehabilitationPatients with severe disability after stroke may maintain or improve their physical functioning and health after a long period of community living, when they receive continuous individualized rehabilitation including physiotherapy.Patients who maintain or improve walking ability and walking speed after living for a long time in the community, may still need assistance with daily activities, especially if they require substantial muscle strength and endurance.Expectations to long-term functional outcomes after institutional followed by community rehabilitation for patients after stroke, should be considered in light of functional status at hospital discharge.
Collapse
Affiliation(s)
- Ellen Høyer
- Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Arve Opheim
- Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.,Habilitation & Health, Region Västra Götaland, Gothenburg, Sweden.,Institute for Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Rolf Moe-Nilssen
- Department of Global Public Health and Primary Care, Physiotherapy Research Group, University of Bergen, Bergen, Norway
| | - Liv Inger Strand
- Department of Global Public Health and Primary Care, Physiotherapy Research Group, University of Bergen, Bergen, Norway
| |
Collapse
|
21
|
Evans N, Connelly DM, Hay ME. The process of commitment to exercise among stroke survivors in Canada. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e706-e716. [PMID: 34041792 DOI: 10.1111/hsc.13441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 04/20/2021] [Accepted: 04/26/2021] [Indexed: 06/12/2023]
Abstract
The objective of this research was to understand the process of commitment to exercise participation for functional recovery among community-living survivors of stroke following discharge from formal rehabilitation. Participants were recruited from a mid-sized city in south-western Ontario, Canada. Between September 2017 and March 2018, 10 individuals living in the community with the effects of stroke, who continued to engage in regular exercise post-stroke, were recruited for participation. Constructivist grounded theory methodology was employed, utilising in-depth individual interviews and theoretical sampling, whereby data collection and analysis occurred simultaneously. Analysis involved constant comparison between data and codes to reduce knowledge gaps and formulate the proposed theory. The process of commitment to exercise involved four phases. Initiation of the process followed a significant interaction with a healthcare provider who advocated for participants to learn the foundations of exercise. Through planned exercise, maintenance of a positive attitude and comparisons with their pre-stroke selves and peers, participants identified future goals and imparted the desire to get back to life before stroke. Over time individuals navigated exercise opportunities-trialling different types and environments-to learn what works. Finally, participants developed a commitment to exercise as a way of life, supported by social connections and reinforced with pride in successes-mastering self-care skills, improved mobility and meaningful function. The process of commitment to exercise among survivors of stroke required early interactions with healthcare providers to initiate exercise participation for long-term engagement, and navigation through various exercise elements fuelled by a desire to reconnect with their pre-stroke selves.
Collapse
Affiliation(s)
- Nicole Evans
- Health and Rehabilitation Sciences Program, Western University, London, ON, USA
| | - Denise M Connelly
- Graduate and Postdoctoral Studies, Faculty of Health Sciences, Western University, London, ON, USA
- Interprofessional Education and Practice (IPEP) Office, Western University, London, ON, USA
- School of Physical Therapy, Western University, London, ON, USA
| | - Melissa E Hay
- Health and Rehabilitation Sciences Program, Western University, London, ON, USA
- Graduate and Postdoctoral Studies, Faculty of Health Sciences, Western University, London, ON, USA
| |
Collapse
|
22
|
Neighbourhood Walkability as a Moderator of the Associations between Older Ghanaians’ Social Activity, and the Frequency of Walking for Transportation: A Cross-Sectional Study with Sensitivity Analyses. Arch Gerontol Geriatr 2022; 100:104660. [DOI: 10.1016/j.archger.2022.104660] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/28/2022] [Accepted: 02/11/2022] [Indexed: 11/21/2022]
|