1
|
Hazelton C, McGill K, Campbell P, Todhunter-Brown A, Thomson K, Nicolson DJ, Cheyne JD, Chung C, Dorris L, Gillespie DC, Hunter SM, Brady MC. Perceptual Disorders After Stroke: A Scoping Review of Interventions. Stroke 2022; 53:1772-1787. [PMID: 35468001 PMCID: PMC9022686 DOI: 10.1161/strokeaha.121.035671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Perceptual disorders relating to hearing, smell, somatosensation, taste, touch, and vision commonly impair stroke survivors’ ability to interpret sensory information, impacting on their ability to interact with the world. We aimed to identify and summarize the existing evidence for perceptual disorder interventions poststroke and identify evidence gaps. We searched 13 electronic databases including MEDLINE and Embase and Grey literature and performed citation tracking. Two authors independently applied a priori–defined selection criteria; studies involving stroke survivors with perceptual impairments and interventions addressing those impairments were included. We extracted data on study design, population, perceptual disorders, interventions, and outcomes. Data were tabulated and synthesized narratively. Stroke survivors, carers, and clinicians were involved in agreeing definitions and organizing and interpreting data. From 91 869 records, 80 studies were identified (888 adults and 5 children); participant numbers were small (median, 3.5; range, 1–80), with a broad range of stroke types and time points. Primarily focused on vision (34/80, 42.5%) and somatosensation (28/80; 35.0%), included studies were often case reports (36/80; 45.0%) or randomized controlled trials (22/80; 27.5%). Rehabilitation approaches (78/93; 83.9%), primarily aimed to restore function, and were delivered by clinicians (30/78; 38.5%) or technology (28/78; 35.9%; including robotic interventions for somatosensory disorders). Pharmacological (6/93; 6.5%) and noninvasive brain stimulation (7/93; 7.5%) approaches were also evident. Intervention delivery was poorly reported, but most were delivered in hospital settings (56/93; 60.2%). Study outcomes failed to assess the transfer of training to daily life. Interventions for stroke-related perceptual disorders are underresearched, particularly for pediatric populations. Evidence gaps include interventions for disorders of hearing, taste, touch, and smell perception. Future studies must involve key stakeholders and report this fully. Optimization of intervention design, evaluation, and reporting is required, to support the development of effective, acceptable, and implementable interventions.
Collapse
Affiliation(s)
- Christine Hazelton
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, United Kingdom (C.H., K.M., P.C., A.T.-B., K.T., M.C.B.)
| | - Kris McGill
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, United Kingdom (C.H., K.M., P.C., A.T.-B., K.T., M.C.B.)
| | - Pauline Campbell
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, United Kingdom (C.H., K.M., P.C., A.T.-B., K.T., M.C.B.)
| | - Alex Todhunter-Brown
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, United Kingdom (C.H., K.M., P.C., A.T.-B., K.T., M.C.B.)
| | - Katie Thomson
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, United Kingdom (C.H., K.M., P.C., A.T.-B., K.T., M.C.B.)
| | | | - Joshua D Cheyne
- Cochrane Stroke Group, University of Edinburgh, United Kingdom (J.D.C.)
| | - Charlie Chung
- Queen Margaret Hospital, National Health Service (NHS) Fife, United Kingdom (C.C.)
| | - Liam Dorris
- Paediatric Neurosciences, Royal Hospital for Children, NHS Greater Glasgow and Clyde, United Kingdom (L.D.)
| | - David C Gillespie
- Department of Clinical Neurosciences, Royal Infirmary of Edinburgh, NHS Lothian, United Kingdom (D.C.G.)
| | - Susan M Hunter
- School of Allied Health Professions, Keele University, United Kingdom (S.M.H.)
| | - Marian C Brady
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, United Kingdom (C.H., K.M., P.C., A.T.-B., K.T., M.C.B.)
| |
Collapse
|
2
|
Abstract
BACKGROUND Palliative care is an integral aspect of stroke unit care. In 2016, the American Stroke Association published a policy statement on palliative care and stroke. Since then there has been an expansion in the literature on palliative care and stroke. AIM Our aim was to narratively review research on palliative care and stroke, published since 2015. RESULTS The literature fell into three broad categories: (a) scope and scale of palliative care needs, (b) organization of palliative care for stroke, and (c) shared decision making. Most literature was observational. There was a lack of evidence about interventions that address specific palliative symptoms or improve shared decision making. Racial disparities exist in access to palliative care after stroke. There was a dearth of literature from low- and middle-income countries. CONCLUSION We recommend further research, especially in low- and middle-income countries, including research to explore why racial disparities in access to palliative care exist. Randomized trials are needed to address specific palliative care needs after stroke and to understand how best to facilitate shared decision making.
Collapse
Affiliation(s)
- Eileen Cowey
- Nursing & Health Care School, University of Glasgow, Glasgow, UK
| | - Markus Schichtel
- Institute of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Joshua D Cheyne
- Cochrane Stroke Group, Centre for Clinical Brain Sciences (CCBS), University of Edinburgh, Edinburgh, UK
| | | | - Richard Lehman
- Institute of Applied Health Research, Murray Learning Centre, University of Birmingham, Birmingham, UK
| | - Rita Melifonwu
- Life After Stroke Centre, Stroke Action Nigeria, Onitsha, Nigeria
| | | |
Collapse
|