scholarly journals Effectiveness of home rehabilitation for ischemic stroke

2009 ◽  
Vol 1 (1) ◽  
pp. 36 ◽  
Author(s):  
Pakaratee Chaiyawat ◽  
Kongkiat Kulkantrakorn ◽  
Paskorn Sritipsukho
Keyword(s):  
Ischemic Stroke ◽  
Controlled Trial ◽  
Intervention Group ◽  
Stroke Care ◽  
Rehabilitation Program ◽  
Outcome Data ◽  
Depression Score ◽  
Control Group ◽  
Acute Stroke Care ◽  
Middle Cerebral Artery Infarction

The objective of this study was to develop and examine the effectiveness of an individual home rehabilitation program for patients with ischemic stroke. This was a randomized controlled trial in 60 patients with recent middle cerebral artery infarction. After hospital discharge for acute stroke care, they were randomly assigned to receive either a home rehabilitation program for three months (intervention group) or usual care (control group). We collected outcome data over three months after their discharge from the hospital. The Barthel Index (BI), the Modified Rankin Scale (MRS), the health-related quality-of-life index (EQ-5D), the Hospital Anxiety and Depression score (HADs), and the Thai Mental State Examination (TMSE) were used to analyze the outcomes. In the intervention group, all outcomes were significantly better (p

The Impact of Home-Based Exercise Rehabilitation on Functional Capacity in Patients With Acute Ischemic Stroke: A Randomized Controlled Trial

2019 ◽  
Vol 32 (3) ◽  
pp. 141-147
Author(s):  
Mohammad Saadatnia ◽  
Hossein Shahnazi ◽  
Fariborz Khorvash ◽  
Fatemeh Esteki-Ghashghaei
Keyword(s):  
Randomized Controlled Trial ◽  
Ischemic Stroke ◽  
Daily Living ◽  
Controlled Trial ◽  
Intervention Group ◽  
Rehabilitation Program ◽  
Control Group ◽  
Exercise Rehabilitation ◽  
Randomized Controlled ◽  
Home Based

One of the major consequences of stroke impairments is hemiparesis, which affects activities of daily living and contributes sedentary lifestyle. The purpose of this study was evaluation of the effectiveness of home-based exercise rehabilitation incentive on daily living activities and functional capacity among acute ischemic patients. This randomized controlled trial was done from August 2017 to September 2018. Iranian subjects with unilateral ischemic stroke were recruited from inpatient wards at educational hospital. Patients were randomly assigned to the home-based rehabilitation program (intervention group) or usual care (control group). National Institute of Health Stroke Scale (NIHSS), Barthel Index Score (BI), Modified Rankin Scale (MRS), and Fugl-Meyer Upper and Lower Extremity Sensorimotor Score were evaluated in both groups at baseline and 3 months later. Intervention group received home-based rehabilitation exercise program for 3 months. Control group did not receive home-based rehabilitation program and incentive telephone call. All data were collected and analyzed by SPSS software (Version 20.0; SPSS Inc., Chicago, Illinois) using chi-square test to compare demographic variables, and independent and paired t-tests to between- and within-group assessment, respectively. Forty ischemic stroke patients (20 intervention group and 20 control group) were examined. Results showed BI, Fugl-Meyer Upper and Lower Extremity Score, and MRS score in the interventional group were significantly higher than the control group after 3-month home-based exercise rehabilitation ( p < .001). Providing a home rehabilitation program in this study resulted in a motor recovery on ischemic stroke survivors in the acute phase of recovery. This was assumed to be cost-effective intervention in low-income countries

Abstract WP419: Secondary Prevention Of Cardiovascular Events With Lifestyle Intervention In Patients With Mild Ischemic Stroke - A Randomized Controlled Trial -

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Sumio Yamada ◽  
Yuji Kono ◽  
Kotaro Iwatsu ◽  
Hisako Okumura ◽  
Junko Yamaguchi ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Lifestyle Intervention ◽  
Lifestyle Modification ◽  
Controlled Trial ◽  
Intervention Group ◽  
Stroke Recurrence ◽  
Control Group ◽  
Vascular Events ◽  
Randomized Controlled ◽  
New Onset

Introduction: Lifestyle modification is associated with a substantially decreased risk of cardiovascular events. However, the role of lifestyle intervention for the secondary prevention in patients with ischemic stroke (IS) is inadequately defined. We assessed the hypothesis that lifestyle intervention which comprised exercise, salt reduction and nutrition advice could reduce new onset of vascular events in patients with mild IS. Methods: We conducted a single-blind randomized controlled trial that enrolled 66 patients (45 men, 21 women; mean age, 63.5 yo) with acute mild ischemic stroke. The patients were randomly allocated to a lifestyle intervention group (n = 33) or control group (n = 33). We performed lifestyle interventions, which comprised exercise training, salt restriction and nutrition advice for 24 weeks. The primary endpoint was ospitalization due to stroke recurrence and new onset of coronary heart disease. We also evaluated blood pressure, serum lipid profile and hemoglobin A1c to compare the efficacy of the lifestyle modification intervention. Results: This trial was terminated earlier than expected because the prespecified early stopping rule for efficacy had been met. After 24 weeks intervention period, the intervention group showed a significant decrease in the clinic and home blood pressure and significant increase in the high density lipoprotein cholesterol (HDL-C) levels from the baseline to the 6-month assessment (clinic and home SBP, P <0.001; HDL-C, P =0.018), with significant differences between the randomized groups (clinic and home SBP, P <0.001; HDL-C, P =0.022). Median duration of follow-up was 2.9 years, 12 patients allocated the control group and 1 patient allocated the lifestyle intervention group had at least one major vascular event. A sequential plans analysis indicated that lifestyle intervention superior to control in interim analysis. Kaplan-Meier survival curves after log-rank test showed significant prognostic difference between randomized groups ( P =0.005). Conclusions: In conclusion, the results of this study indicate that lifestyle intervention is beneficial for preventing stroke recurrence and other vascular events.

scholarly journals Early Mobilization in Ischemic Stroke: A Pilot Randomized Trial of Safety and Feasibility in a Public Hospital in Brazil

2015 ◽  
Vol 5 (1) ◽  
pp. 31-40 ◽  
Author(s):  
Simone Rosa Poletto ◽  
Letícia Costa Rebello ◽  
Maria Júlia Monteiro Valença ◽  
Daniele Rossato ◽  
Andrea Garcia Almeida ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Public Hospital ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Intervention Group ◽  
Total Duration ◽  
Early Mobilization ◽  
Functional Independence ◽  
Control Group

Background: The effect of early mobilization after acute stroke is still unclear, although some studies have suggested improvement in outcomes. We conducted a randomized, single-blind, controlled trial seeking to evaluate the feasibility, safety, and benefit of early mobilization for patients with acute ischemic stroke treated in a public teaching hospital in Southern Brazil. This report presents the feasibility and safety findings for the pilot phase of this trial. Methods: The primary outcomes were time to first mobilization, total duration of mobilization, complications during early mobilization, falls within 3 months, mortality within 3 months, and medical complications of immobility. We included adult patients with CT- or MRI-confirmed ischemic stroke within 48 h of symptom onset who were admitted from March to November 2012 to the acute vascular unit or general emergency unit of a large urban emergency department (ED) at the Hospital de Clínicas de Porto Alegre. The severity of the neurological deficit on admission was assessed by the National Institutes of Health Stroke Scale (NIHSS). The NIHSS and modified Rankin Scale (mRS, functional outcome) scores were assessed on day 14 or at discharge as well as at 3 months. Activities of daily living (ADL) were measured with the modified Barthel Index (mBI) at 3 months. Results: Thirty-seven patients (mean age 65 years, mean NIHSS score 11) were randomly allocated to an intervention group (IG) or a control group (CG). The IG received earlier (p = 0.001) and more frequent (p < 0.0001) mobilization than the CG. Of the 19 patients in the CG, only 5 (26%) underwent a physical therapy program during hospitalization. No complications (symptomatic hypotension or worsening of neurological symptoms) were observed in association with early mobilization. The rates of complications of immobility (pneumonia, pulmonary embolism, and deep vein thrombosis) and mortality were similar in the two groups. No statistically significant differences in functional independence, disability, or ADL (mBI ≥85) were observed between the groups at the 3-month follow-up. Conclusions: This pilot trial conducted at a public hospital in Brazil suggests that early mobilization after acute ischemic stroke is safe and feasible. Despite some challenges and limitations, early mobilization was successfully implemented, even in the setting of a large, complex ED, and without complications. Patients from the IG were mobilized much earlier than controls receiving the standard care provided in most Brazilian hospitals.

Efficacy of Integrated Rehabilitation Techniques of Traditional Chinese Medicine for Ischemic Stroke: A Randomized Controlled Trial

2013 ◽  
Vol 41 (05) ◽  
pp. 971-981 ◽  
Author(s):  
Yong Zhang ◽  
He Jin ◽  
Dayong Ma ◽  
Yuanbo Fu ◽  
Yanming Xie ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Controlled Trial ◽  
Alternative Therapy ◽  
Intervention Group ◽  
Lower Limbs ◽  
Control Group ◽  
Significant Difference ◽  
Long Term Observation

This study aimed to determine the efficacy of Integrated Rehabilitation Techniques of Traditional Chinese Medicine (IRT-TCM) on patients with ischemic stroke as an alternative therapy to conventional rehabilitation techniques. Sixty-nine patients with ischemic stroke were randomly assigned to receive either IRT-TCM (intervention group, n = 46) or conventional rehabilitation techniques (control group, n = 23). The IRT-TCM consisted of a sequential combination of acupuncture and massage techniques. The Fugl-Meyer Assessment (FMA), National Institutes of Health Stroke Scale (NIHSS), Barthel index (BI) and modified Rankin Scale (mRS) were measured on day 0 (baseline, before treatment), day 21, and day 90. We observed that the scores in FMA and BI were increased, and NIHSS were decreased in both groups on day 21 and 90, compared with the baseline (day 0). Furthermore, significantly better scores in FMA of lower limbs and NIHSS were found in patients treated with IRT-TCM on day 21 and 90. For mRS, the percentage of patients ranking 0 and 1 in the intervention group presented a striking contrast to the control group on day 90 but with no significant difference. The results indicated that, as a feasible alternative therapy, IRT-TCM is beneficial for patients with ischemic stroke. Further research with larger sample size, long-term observation, and strict blinding are still in need to confirm the efficacy of IRT-TCM.

scholarly journals Effect of counselling during pulmonary rehabilitation on self-determined motivation to be physically active for people with chronic obstructive pulmonary disease: a pragmatic RCT

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anne-Kathrin Rausch Osthoff ◽  
Swantje Beyer ◽  
David Gisi ◽  
Spencer Rezek ◽  
Ariane Schwank ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Controlled Trial ◽  
Intervention Group ◽  
Rehabilitation Program ◽  
Control Group ◽  
Chronic Obstructive ◽  
Long Term Effects ◽  
Obstructive Pulmonary Disease

Abstract Background Counselling is considered to be a promising approach to increasing physical activity (PA) in people with chronic obstructive pulmonary disease (COPD). The aim of the current study was to investigate whether a PA counselling program for people with COPD, when embedded in a comprehensive outpatient pulmonary rehabilitation (PR) program, increased their daily PA. Methods A two-armed, single blind randomized controlled trial was conducted as a component of a 12-week outpatient pulmonary rehabilitation program. The participants randomized into the intervention group received five counselling sessions, based on the principles of motivational interviewing (MI), with a physiotherapist. The participants’ steps per day and other proxies of PA were measured using an accelerometer (SenseWear Pro®) at baseline, at the end of the PR program, and three months later. The group-by-time interaction effect was analyzed. Results Of the 43 participants,17 were allocated to the intervention group and 26 to the usual-care control group (mean age 67.9 ± 7.9; 21 (49%) males; mean FEV1 predicted 47.1 ± 18.6). No difference between groups was found for any measure of PA at any point in time. Conclusions In this study, counselling, based on MI, when embedded in a comprehensive PR program for people with COPD, showed no short-term or long-term effects on PA behavior. To investigate this potentially effective counselling intervention and to analyze the best method, timing and tailoring of an intervention embedded in a comprehensive outpatient PR program, further adequately powered research is needed. Trial registration: Clinical Trials.gov NCT02455206 (05/21/2015), Swiss National Trails Portal SNCTP000001426 (05/21/2015).

scholarly journals Lower Reinjury Rate with a Coach-Controlled Rehabilitation Program in Amateur Male Soccer

2007 ◽  
Vol 35 (9) ◽  
pp. 1433-1442 ◽  
Author(s):  
Martin Hägglund ◽  
Markus Walden ◽  
Jan Ekstrand
Keyword(s):  
Cox Regression ◽  
Controlled Trial ◽  
Intervention Group ◽  
Rehabilitation Program ◽  
Return To Play ◽  
Control Group ◽  
Level Of Evidence ◽  
Cox Regression Analysis ◽  
Limb Injuries ◽  
Soccer Teams

Background Soccer injuries are common, and athletes returning to play after injury are especially at risk. Few studies have investigated how to prevent reinjury. Hypothesis The rate of reinjury is reduced using a coach-controlled rehabilitation program. Study Design Randomized controlled trial; Level of evidence, 1. Methods Twenty-four male amateur soccer teams were randomized into an intervention (n = 282) and control group (n = 300). The intervention was implemented by team coaches and consisted of information about risk factors for reinjury, rehabilitation principles, and a 10-step progressive rehabilitation program including return to play criteria. During the 2003 season, coaches reported individual exposure and all time loss injuries were evaluated by a doctor and a physiotherapist. Four teams (n = 100) withdrew from the study after randomization, leaving 10 teams with 241 players for analysis in both groups. Results There were 90 injured players (132 injuries) in the intervention group, and 10 of these (11%) suffered 14 reinjuries during the season. In the control group, 23 of 79 injured players (29%) had 40 recurrences (134 injuries). A Cox regression analysis showed a 66% reinjury risk reduction in the intervention group for all injury locations (hazard ratio [HR] 0.34, 95% confidence interval [CI] 0.16-0.72, P = .0047) and 75% for lower limb injuries (HR 0.25, 95% CI 0.11-0.57, P < .001). The preventive effect was greatest within the first week of return to play. Injured players in the intervention group complied with the intervention for 90 of 132 injuries (68%). Conclusion The reinjury rate in amateur male soccer players was reduced after a controlled rehabilitation program implemented by coaches.

scholarly journals Early rehabilitation for children with visual processing dysfunctions from 1 year of age: a Randomized Controlled Trial protocol

2019 ◽  
Author(s):  
Marlou Kooiker ◽  
Yoni van der Linden ◽  
Jenneke van Dijk ◽  
Ymie J van der Zee ◽  
Renate MC Swarte ◽  
...  
Keyword(s):  
Visual Processing ◽  
Controlled Trial ◽  
Clinical Care ◽  
Intervention Group ◽  
Visual Outcome ◽  
Placebo Treatment ◽  
Rehabilitation Program ◽  
Control Group ◽  
Visual Rehabilitation ◽  
Extremely Preterm

Abstract Background An increasing amount of children suffer from brain damage-related visual processing dysfunctions (VPD). At present, there is a lack of evidence-based rehabilitation methods that can be used early in development. We developed a visual rehabilitation protocol suitable from 1 year of age. The protocol contains objective, quantitative outcomes and is structured, comprehensive and individually-adaptive. Our aim is to investigate effectiveness of this first visual rehabilitation program for young children with (a risk of) VPD. Methods We conduct a single-blind, placebo-controlled trial that is embedded within standard clinical care. The study population consists of 100 children born very or extremely preterm (<30 weeks) of 1 year of corrected age (CA), of whom 50% are expected to have VPD. First, children undergo a visual screening at 1 year CA. If they are classified as being at risk of VPD, they are referred to standard care: an ophthalmic and visual function assessment and a (newly developed) visual rehabilitation program. This program consist of a general protocol (standardized and similar for all children) and a supplement protocol (adapted to specific needs of the child), and employs quantitative parameters of visual outcome. Children are randomly allocated to an intervention group (starting upon inclusion at 1 year CA), or a control group (postponed: starting at 2 years CA). The control group will receive a placebo treatment. The effectiveness of early visual rehabilitation will be examined with follow-up visual and neurocognitive assessments after 1 year (upon completion of the direct intervention) and after 2 years (upon completion of the postponed intervention). Discussion Through this RCT we will establish the effectiveness of a new and early visual rehabilitation program. Combining a general and supplement protocol enables structured comparisons between participants and groups, and custom rehabilitation that is tailored to the children’s specific needs. The design ensures that all included children will benefit from participation by advancing the age at which they start receiving rehabilitation. We expect results to be applicable to all children with (a risk of) VPD early in life.

scholarly journals Effect of accelerometer-based feedback on physical activity in hospitalized patients with ischemic stroke: a randomized controlled trial

2018 ◽  
Vol 32 (8) ◽  
pp. 1047-1056 ◽  
Author(s):  
Masashi Kanai ◽  
Kazuhiro P Izawa ◽  
Miki Kobayashi ◽  
Akira Onishi ◽  
Hiroki Kubo ◽  
...  
Keyword(s):  
Physical Activity ◽  
Randomized Controlled Trial ◽  
Ischemic Stroke ◽  
Controlled Trial ◽  
Intervention Group ◽  
Hospitalized Patients ◽  
Control Group ◽  
Baseline Measurement ◽  
Randomized Controlled

Objective: To evaluate the effect of accelerometer-based feedback on physical activity in hospitalized patients with ischemic stroke. Design: Randomized controlled trial. Setting: Acute care hospital. Subjects: A total of 55 patients with ischemic stroke who could walk without assistance were randomly assigned to the intervention group ( n = 27) or the control group ( n = 28). Interventions: At the baseline measurement, patients did not receive accelerometer-based feedback. At follow-up, a physical therapist provided instruction on accelerometer-based feedback, discussed physical activity targets and encouraged the patients to walk more until discharge. Main measures: The average daily number of steps taken was used as the index of daily hospitalized physical activity. Results: The study sample consisted of 48 patients, of whom 23 patients comprised the intervention group and 25 patients comprised the control group. Although there were no significant differences in physical activity values between the two groups at the baseline measurement, the values in the intervention group at follow-up were significantly higher than those in the control group (5180.5 ± 2314.9 vs. 3113.6 ± 1150.9 steps/day, P = 0.0003). The effect size of physical activity values (Cohen’s d = 1.15) at follow-up was large between the two groups. Conclusion: Exercise training combined with accelerometer-based feedback effectively increased physical activity in hospitalized patients with ischemic stroke.

scholarly journals Predictors of improvement following early exercises rehabilitation program for patients undergoing open lumbar discectomy

2020 ◽  
Vol 10 (6) ◽  
pp. 86
Author(s):  
Rasha Ali Ahmed Abdelmowla ◽  
Rania M. Gamal ◽  
Mirette M. Aziz ◽  
Walid A. Abdel Ghany ◽  
Roshdy Elkhayat
Keyword(s):  
Social Life ◽  
Oswestry Disability Index ◽  
Controlled Trial ◽  
Intervention Group ◽  
Rehabilitation Program ◽  
Lumbar Discectomy ◽  
Index Score ◽  
Control Group ◽  
Early Exercise ◽  
Oswestry Disability Index Score

Background and aims: Low back pain is mostly due to disc herniation and has a burden upon economy and social aspects of life. Failure to improve after open lumbar discectomy is frustrating. Therefore, identifying predictors of improvement is of great clinical benefit. Aims: This research was conducted to evaluate whether an early exercises rehabilitation program using educational booklet would provide benefit to patients following open lumbar discectomy and determine potential factors of improvement.Patients and methods: Design: Single blind randomized controlled trial. Eighty-eight patients scheduled for open lumbar discectomy from January 2017 to January 2019 at Assiut and Ain Shams Universities hospitals in Egypt were randomly assigned to two groups. Control group (n = 44) received routine postoperative instructions while intervention group (n = 44) received routine instructions in addition to early exercises rehabilitation program and were also provided with a specifically designed educational booklet. Patients were followed up after six months using Oswestry disability index.Results: There was significant improvement among intervention group as compared to control group in several domains of Oswestry disability index (walking, sitting, standing, sleeping, travelling and sexual and social life). Better pre-operative Oswestry disability index score and early application of exercises rehabilitation program using an educational booklet predicted better postoperative Oswestry disability index score after six months.Conclusion: Application of an early exercise rehabilitation program and providing patients with a specifically designed educational booklet would be helpful for patients following open lumbar discectomy. Clinical Relevance: Early exercises rehabilitation program can be used by nursing staff as a reference in management of patients following open lumbar discectomy.

A novel model of home-based, patient-tailored and mobile application-guided cardiac telerehabilitation in patients with atrial fibrillation: A randomised controlled trial

2021 ◽  
pp. 026921552110323
Author(s):  
Cheng Cai ◽  
Zhipeng Bao ◽  
Nan Wu ◽  
Fengming Wu ◽  
Guozhen Sun ◽  
...  
Keyword(s):  
Physical Activity ◽  
Atrial Fibrillation ◽  
Cardiac Rehabilitation ◽  
Mobile Application ◽  
Controlled Trial ◽  
Intervention Group ◽  
Rehabilitation Program ◽  
Control Group ◽  
Cardiac Rehabilitation Program ◽  
Randomised Controlled

Objective: To assess the effectiveness of tele-monitored cardiac rehabilitation in patients who have undergone ablation for atrial fibrillation. Design: Single-centre, prospective, assessment-blinded, randomised controlled trial. Setting: Domiciliary rehabilitation with support from a tertiary care hospital. Subjects: One hundred patients who underwent ablation for atrial fibrillation were recruited. Interventions: Participants were randomly allocated to a 12-week standard rehabilitation treatment (control group) or a comprehensive, domiciliary, mobile application-guided and tele-monitored cardiac rehabilitation program (intervention group) in a 1:1 fashion. Main outcome measures: The primary endpoint was the improvement in VO2peak. The secondary outcomes included adherence, physical activity, beliefs related to cardiovascular disease and exercise self-efficacy. Results: Ninety-seven patients completed follow-up. The mean VO2peak increased significantly in both the intervention group ( n = 49) (baseline vs 12 weeks: 19.1 ± 4.7 vs 27.3 ± 5.6 ml/(min kg), P < 0.01) and the control group ( n = 48) (baseline vs 12 weeks: 18.7 ± 4.9 vs 22.9 ± 6.3 ml/(min kg), P < 0.01). The results of the between-group analysis of aerobic capacity were significantly in favour of the intervention group. During the 12-week program, patients in the intervention group exhibited better adherence than those in the control group. Moreover, self-reported physical activity improved more in the intervention group than in the control group, as did the beliefs related to cardiovascular disease and exercise self-efficacy (all P < 0.01). Conclusions: Our domiciliary, mobile application-guided and tele-monitored cardiac rehabilitation program could lead to a more significant improvements in physical fitness, adherence and health beliefs than standard cardiac rehabilitation in patients who have undergone ablation for atrial fibrillation.

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