Could Self-Control and Emotion Influence Physical Ability and Functional Recovery after Stroke?

The effects of gaze stability exercises on balance, gait ability, and fall efficacy in patients with chronic stroke: A 2-week follow-up from a randomized controlled trial

BACKGROUND

This study aimed to examine the effect of gaze stability exercises on balance, gait ability, and fall efficacy in patients with chronic stroke, as well as to investigate whether any observed effects were maintained 2 weeks later.

METHODS

In this experiment, 30 chronic stroke patients were selected. The patients were randomly divided into 3 groups (10 patients in each group). All patients in the 3 groups performed basic neurodevelopmental treatment. Group 1 performed balance exercises accompanied by gaze stability exercises. Group 2 performed gaze stability exercises, and group 3 performed balance exercises. Each exercise program for 40 minutes 3 times a week for 4 weeks. After the intervention period, the patient's balance, gait ability, and fall efficacy were measured again. In order to know whether the training effect is maintained, a 2-week follow-up test was conducted after the training.

RESULTS

The results of this study showed that there was a significant improve in balance (overall stability index, limit of stability test, and Berg Balance Scale), gait ability (gait velocity, cadence, step time and step length, Timed Up and Go [TUG] test), and fall efficacy over the different time within the 3 groups. The effect was observed to be maintained in follow-up tests after 2 weeks. In the comparison among 3 groups, the overall stability index, limit of stability test in the balance test and the gait velocity, cadence, step time, step length and Timed Up and Go test in the gait test all showed statistically significant differences, and the other items did not have significant differences. In most of the assessments, group 1 that used balance exercise combined with gaze stability exercise showed a better improvement than the other 2 groups.

CONCLUSION

As a result, for stroke patients, gaze stability exercise is an effective arbitration method to improve balance and gait ability and fall efficacy. With balance exercise combined with gaze stability exercise, a greater effect can be seen than with gaze stability exercise or balance exercise alone. Thus, this combination exercise program can be recommended as effective.

An machine learning model to predict quality of life subtypes of disabled stroke survivors

OBJECTIVE

Stroke causes serious physical disability with impaired quality of life (QoL) and heavy burden on health. The goal of this study is to explore the impaired QoL typologies and their predicting factors in physically disabled stroke survivors with machine learning approach.

METHODS

Non-negative matrix factorization (NMF) was applied to clustering 308 physically disabled stroke survivors in rural China based on their responses on the short form 36 (SF-36) assessment of quality of life. Principal component analysis (PCA) was conducted to differentiate the subtypes, and the Boruta algorithm was used to identify the variables relevant to the categorization of two subtypes. A gradient boosting machine(GBM) and local interpretable model-agnostic explanation (LIME) algorithms were used to apply to interpret the variables that drove subtype predictions.

RESULTS

Two distinct subtypes emerged, characterized by short form 36 (SF-36) domains. The feature difference between worsen QoL subtype and better QoL subtype was as follows: role-emotion (RE), body pain (BP) and general health (GH), but not physical function (PF); the most relevant predictors of worsen QoL subtypes were help from others, followed by opportunities for community activity and rehabilitation needs, rather than disability severity or duration since stroke.

INTERPRETATION

The results suggest that the rehabilitation programs should be tailored toward their QoL clustering feature; body pain and emotional-behavioral problems are more crucial than motor deficit; stroke survivors with worsen QoL subtype are most in need of social support, return to community, and rehabilitation.

The Impact of Upper Limb Apraxia on General and Domain-Specific Self-Efficacy in Post-Stroke Patients

BACKGROUND

Upper limb apraxia (ULA) is a neurological syndrome characterized by the inability to perform purposeful movements. ULA could impact individuals' perceptions, including perceived self-efficacy. The aim of this study is to investigate whether ULA is related to general self-efficacy and self-efficacy for managing symptoms in post-stroke patients.

METHODS

A cross-sectional study was conducted involving 82 post-stroke patients. Regression analyses were implemented using a stepwise model including seven dimensions of ULA: imitation (non-symbolic, intransitive, and transitive), pantomime (non-symbolic, intransitive, and transitive), and dimension of apraxic performance in activities of daily living. These dimensions were independent variables, while general self-efficacy and symptom management self-efficacy dimensions were dependent variables.

RESULTS

The findings revealed that intransitive imitation accounted for 14% of the variance in general self-efficacy and 10% of self-efficacy for managing emotional symptoms. Transitive imitation explained 10% of the variance in self-efficacy for managing global symptoms and 5% for social-home integration symptoms. The combination of intransitive imitation, non-symbolic pantomime, and alterations in activities of daily living performance associated with ULA explained 24% of the variance in cognitive self-efficacy.

CONCLUSIONS

Hence, ULA dimensions seem to be related to the levels of general perceived self-efficacy and self-efficacy for managing symptoms among post-stroke patients.

Undergraduates' Negative Emotion and Academic Procrastination During COVID-19: Life Autonomy as a Mediator and Sense of School Belonging as a Moderator

Introduction

This study aims to investigate the impact of COVID-19 on undergraduate students' academic procrastination and negative emotions. It seeks to examine the relationship between negative affect and academic procrastination among university students, considering the mediating role of life autonomy and the moderating effect of a sense of school belonging.

Methods

The study sample consisted of 776 university students from the Guangxi Zhuang Autonomous Region, China. Data collection involved the use of the Negative Affect Scale, Academic Procrastination Scale, Life Autonomy Scale, and Sense of School Belonging Scale. SPSS version 26.0 and PROCESS V3.580 to conduct relationship analysis, test the mediation model (model 4) and the moderated mediating model (model 7).

Results

The findings revealed significant relationships among the variables. Negative emotions were negatively related with life autonomy and sense of school belonging, and positively related with academic procrastination. Academic procrastination showed a negative correlation with both life autonomy and sense of school belonging. Sense of school belonging exhibited a positive relationship with life autonomy. The study also identified life autonomy as a mediator in the relationship between negative emotions and academic procrastination. Additionally, the sense of school belonging moderated the initial segment of the negative emotion-life autonomy-academic procrastination pathway.

Discussion

This study contributes to a better understanding of the association between negative affect and academic procrastination. It highlights that negative emotions have a direct and indirect influence on academic procrastination through the mediating role of life autonomy. Moreover, the moderating role of sense of school belonging suggests that the relationship between negative affect and life autonomy is stronger when the sense of school belonging is weaker.

Effect of Cathodal Transcranial Direct Current Stimulation for Lower Limb Subacute Stroke Rehabilitation

Methods

A pilot double-blind and randomized clinical trial. Ninety-one subjects with subacute stroke were treated with cathodal/sham stimulation tDCS based on CGR (physiotherapy 40 min/d and occupational therapy 20 min/d) once daily for 20 consecutive working days. Computer-based stratified randomization (1 : 1) was employed by considering age and sex, with concealed assignments in opaque envelopes to ensure no allocation errors after disclosure at the study's end. Patients were evaluated at T0 before treatment, T1 immediately after the posttreatment assessment, and T2 assessment one month after the end of the treatment. The primary outcome index was assessed: lower limb Fugl-Meyer motor score (FMA-LE); secondary endpoints were other gait assessment and relevant stroke scale assessment.

Results

Patients in the trial group performed significantly better than the control group in all primary outcome indicators assessed posttreatment T1 and at follow-up T2: FMA-LE outcome indicators between the two groups in T1 (P = 0.032; effect size 1.00, 95% CI: 0.00 to 2.00) and FMA-LE outcome indicators between the two groups in T2 (P = 0.010; effect size 2.00, 95% CI: 1.00 to 3.00).

Conclusion

In the current pilot study, ctDCS plus CGR was an effective treatment modality to improve lower limb motor function with subacute stroke. The effectiveness of cathodal tDCS in poststroke lower limb motor dysfunction is inconclusive. Therefore, a large randomized controlled trial is needed to verify its effectiveness.