Dissertations / Theses on the topic 'Cerebrovascular disease – Patients – Rehabilitation'
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1
馮美玲 and Mei-ling Fung. "Stroke rehabilitation: predicting LOS and discharge placement." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B31970515.
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Vattanasilp, Wantana. "The contribution of neural and peripheral factors to muscle stiffness and function following stroke." Thesis, The University of Sydney, 1998. https://hdl.handle.net/2123/26242.
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The aim of these studies was to investigate the contributions of neural and peripheral factors to the increased resistance to movement and loss of function commonly observed following stroke. Three studies were undertaken to investigate the stiffness of the calf muscles in stroke subjects. Under relaxed conditions, neural factors such as spasticity and peripheral factors such as contracture and thixotropy were investigated. Under active conditions, the contribution of the tonic stretch reflex to functional movement, in this case walking, was investigated. These findings were compared to results retained from neurologically-normal subjects.
The clinical measurements of spasticity (Ashworth Scale and tendon jerk) were collected and the laboratory measurement (tonic stretch reflex) was measured in all studies. Clinical measurements of spasticity were performed to describe the stroke subjects clinically, whereas the laboratory measurement, ie, the measurement of the tonic stretch reflex recording EMG during sinusoidal stretching, was performed to provide a quantitative benchmark of spasticity in the gastrocnemius muscle. Measurement of the tonic stretch reflex was chosen because EMG can differentiate the neural and the peripheral contributions.
Under relaxed conditions, it was found that most stroke subjects exhibited resting tonic stretch reflexes, indicating the presence of spasticity. Stroke subjects also exhibited a thixotropic response which was within the range of normal responses. Some stroke subjects displayed muscle contracture. When the contributions of these various factors to stiffness were examined, contracture appeared to make the most significant contribution to the increased resistance to movement.
Under active conditions, the contribution of spasticity to walking dysfunction following stroke was investigated in a group of ambulant stroke subjects. The tonic stretch reflex was investigated under active conditions which mimicked the movement of the ankle joint during walking. Stroke subjects exhibited a smaller action tonic stretch reflex compared with normal subjects, and this finding was not statistically different. It was suggested that rather than exhibiting an ‘out of control’ tonic stretch reflex, stroke subjects had an impaired modulation of the tonic stretch reflex. Also, the action tonic stretch reflex of stroke subjects did not contribute as much as that of normal subjects to the resistance of calf muscles under active conditions. Therefore, it is suggested that an abnormal tonic stretch reflex does not routinely contribute to walking dysfunction following stroke. Furthermore, when the modulation of the tonic stretch reflex was measured at pre-ambulatory and ambulatory stages after early stroke, it was found that an improvement in function of the ankle joint was not accompanied by an ability to modulate the tonic stretch reflex in the gastrocnemius muscle.
Finally, a relation between the clinical and laboratory measurements of spasticity was found only for the tests of resistance to movement, but not for the tests of reflex activity. These findings suggested that clinical tests cannot adequately quantify spasticity, and that the resistance felt during passive movement cannot be differentiated using a clinical grading test such as the Ashworth Scale.
These studies add to the growing body of evidence that spasticity is not the major problem interfering with functional tasks after stroke. Therefore, it is not important to routinely reduce spasticity for the purpose of improvement in function. However, the need to prevent and/or minimise muscle contracture is essential in order to avoid the increase in passive stiffness which accompanies the contracture.
3
Rau, Marie Therese. "Elderly stroke patients and their partners: a longitudinal study of social support and well-being changes associated with a disabling stroke." PDXScholar, 1986. https://pdxscholar.library.pdx.edu/open_access_etds/478.
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This investigation explored the relationship of demographic, social network, social support, and stroke-related factors to depressive symptomatology and well-being in 50 elderly individuals who had recently suffered a first, completed stroke and their partners. Data were gathered at two points in time, with interviews scheduled six months apart. Outcome measures included the CES-D depression scale and the Index of Psychological Well-Being. Data were analyzed using descriptive statistics, correlational procedures, multiple regression, and change-focused regression analyses. For the caregivers, lower depression levels at Time 1 were associated with better subjective health, less concern about being able to care for the patient in the future, higher levels of patient ADL functioning, greater perceived pre-stroke instrumental support, and greater patient optimism. At Time 2, lower caregiver depression scores were associated with lower levels of perceived burden, fewer health problems or negative changes in health status, fewer negative network interactions, greater network density, greater frequency of network contacts, and fewer perceived personality and behavior changes in the patient. Best predictors of depression score for the caregivers at Time 1 were subjective health rating, the patient's level of ADL functioning, degree of concern about ability to care for the patient in the future, the proportion of the network providing instrumental support, and the percent of reciprocal confiding relationships reported. At Time 2, best predictors of depression were level of perceived caregiver burden, objective health score, and network density. The best predictor of caregiver depression level over time was Time 1 depression level. Perceived caregiver burden was also a strong predictor of depression score. For the patients, higher depression scores at Time 1 were associated with whether they felt they could have done anything to prevent the stroke, higher levels of concern about their partner's ability to care for them in the future, and greater reported frequency of pre-stroke disagreement with their partners. At Time 2, higher levels of depressive symptomatology were associated with decreased satisfaction with amount of social contact, a greater proportion of friends in the post-stroke network, a greater degree of perceived negative health change, and change in employment status.
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Tsang, Yuen. "The relationship between balance and functional outcomes of subacute in-patient rehabilitation in stroke patients." Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B3197224X.
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Urimubenshi, Gerard. "Profile of and challenges experienced by stroke patients admitted to Ruhengeri Hospital in Rwanda." Thesis, University of the Western Cape, 2009. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_3179_1273708790.
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Stroke is the world&rsquo
s third highest cause of death and a major cause of disability. In order to define optimal management for stroke, reliable data are needed. Although Ruhengeri Hospital in Rwanda receives many stroke patients, no in-depth study has been carried out on stroke patients admitted at the hospital. This study, therefore, identified the profile of stroke patients admitted at Ruhengeri Hospital in Rwanda and explored the challenges that they experienced. A concurrent mixed model design was used to collect data. With a data gathering instrument which was developed by the researcher, a quantitative retrospective approach was used to review existing patients&rsquo
records to collect information related to demographic characteristics, documented clinical features and risk factors for stroke, stroke onset-admission interval, length of hospital stay and the process of hysiotherapy for stroke patients. In-depth face-toface interviews were also used to collect data regarding the challenges experienced by stroke patients. The sample for the quantitative phase consisted of medical records of stroke patients admitted at Ruhengeri Hospital from January 1st, 2005 up to December 31st, 2008. In the qualitative phase, a purposive sample of 10 participants was selected.
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Chang, Chia-yu Stephanie Celeste. "Does social-demographic information predict residential outcomes in elderly stroke rehabilitation patients in Hong Kong?" Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B31971520.
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Mok, Siu-wai Kanness. "Use of elderly mobility scale as a functional predictor in stroke patients during inpatient rehabilitation." Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B31972056.
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Li, Sijian, and 李斯儉. "Evaluating the effectiveness of a stroke education programme in Wuhan City of China." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1999. http://hub.hku.hk/bib/B31221397.
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陸慧霞 and Wai-ha Veronica Luk. "Evidence-based DVT prophylactic guideline for stroke and neurosurgicalpatients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B43251419.
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Davison, Andrew Charles. "Development of a smart knee brace for early gait rehabilitation of stroke patients /." Access to citation, abstract and download form provided by ProQuest Information and Learning Company; downloadable PDF file, 68 p, 2007. http://proquest.umi.com/pqdweb?did=1251900481&sid=2&Fmt=2&clientId=8331&RQT=309&VName=PQD.
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Thesis (M.S.M.E.)--University of Delaware, 2006Principal faculty advisors: Sun, Jian-Qiao, Dept. of Mechanical Engineering; Katherine Rudolph, Dept. of Physical Therapy. Includes bibliographical references.
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De, la Cornillere Wendy-Lynne. "Participants’ experience of the Bishop Lavis Rehabilitation Centre stroke group." Thesis, Stellenbosch : University of Stellenbosch, 2007. http://hdl.handle.net/10019.1/1695.
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Thesis (MPhil (Interdisciplinary Health Sciences. Speech-Language and Hearing Therapy. Centre for Rehabilitation Studies))--University of Stellenbosch, 2007.Current emphasis for rehabilitation in South Africa remains on individual intervention within the move towards primary health care. Primary health care is the strategy that has been adopted by the South African department of health to bring access and equity in health care services. Even so, the burden of providing effective rehabilitative services with limited resources requires innovative strategies, such as the use of therapeutic groups, to address certain aspects of rehabilitation. These strategies must be proven effective. There is a paucity of literature detailing the uses of group therapy in physical rehabilitation, and particularly the use of interdisciplinary group work in stroke rehabilitation. Furthermore, evidence shows that stroke survivors feel ill equipped to return to their communities despite rehabilitation. Stroke is a major cause of death and disability in South Africa, and is a condition shown to benefit from rehabilitation. These factors led to the selection of the Bishop Lavis Rehabilitation Centre stroke group as the setting for this study, which aims to describe the range of experiences relating to attendance or non-attendance of those referred to this programme. This descriptive study, employing quantitative means (to describe the demographic details of the participants) and qualitative means (to describe the experiences of participants), was conducted with twenty participants. Data was collected by means of an administered questionnaire. Following that, a focus group discussion involving six participants was used to gather in-depth information. Quantitative data was analysed with the assistance of a statistician, utilising the computer program, Statistica. The Chi-Squared, Kruskal-Wallis and ANOVA tests were used, with p>0.05 showing statistical significance. Qualitative data was thematically analysed, whereby data was categorised by means of an inductive approach. The study population consisted of 20 participants, with an average age of 59 years, of whom 15 were female and five male. The stroke group provided meaning to participants on two levels. On a psychosocial level, the phenomena of universality (identifying with others in a similar position), development of socialising techniques, imparting information and cohesiveness emerged strongly. On the level of meaning related to stroke recovery, improvement in ability to execute activities of daily living, mobility and strength were most frequently mentioned. Transportation issues were most commonly mentioned as factors negatively influencing attendance. Staff attitude and activities of the programme were most often cited as positive factors. Given the positive response of study participants, and the programme’s ability to sustain intervention with limited resources, it was concluded that this programme has a valid place within stroke rehabilitation in Bishop Lavis. Recommendations in terms of the group programme included investigating methods of providing transportation, providing childcare facilities and expanding the content of educational sessions. Further recommendations were to maintain the positive attitude of staff and the current activities of the programme. Frequency of group outings should also be increased and compensatory strategies for inclement weather must be explored.
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Tsang, Yuen, and 曾苑. "The relationship between balance and functional outcomes of subacute in-patient rehabilitation in stroke patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B3197224X.
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Mo, Wing-yan Anita, and 巫詠欣. "Acute stroke patients age 65 years and older: outcome and predictors." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B45010298.
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Rhoda, Anthea. "The rehabilitation of stroke patients at community health centres in the Western Cape." Thesis, University of the Western Cape, 2010. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_5654_1318838292.
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The rehabilitation of stroke patients can occur at different settings. These include in-patient settings, such as stroke units or general rehabilitation wards and out-patient settings, such as out-patient departments attached to hospitals, day hospital departments and the patientsâ home. In South-Africa, day hospitals have been upgraded and are now referred to as Community Health Centres which provide comprehensive health services to the population. In the Western Cape these centres are faced with the rehabilitation of stroke patients who have been discharged early from hospital during the acute stage or who have never been admitted to hospitals. To date there is a lack of best practice guidelines and formal evaluations in terms of efficacy and effectiveness of rehabilitation at these centres. The aim of the study was therefore to investigate the rehabilitation of stroke patients at Community Health Centres in the Metropole Region of the Western Cape. The structure, process and outcomes (SPO) model was used as a conceptual framework in this study.
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Jones, Craig L. "Neuropsychological symptomatology associated with right and left hemisphere cerebral vascular accidents within an acute care rehabilitation setting." Virtual Press, 1992. http://liblink.bsu.edu/uhtbin/catkey/862284.
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The present study investigated the extent to which right and left hemisphere stroke patients, within an acute care rehabilitation unit, differ in neuropsychological symptomatology as reported on a self-report instrument.The subjects were 90 patients admitted to an acute care rehabilitation unit within a midwestern hospital. Two groups of 30 were obtained on the basis of stroke location, either right or left hemisphere. In addition, a group of 30 orthopedic patients were selected to serve as a comparison group.Data was collected using the Neuropsychological Symptom Inventory (Rattan, Dean & Rattan, 1989). A discriminant analysis revealed two discriminant functions which were used to classify group membership. Slightly more than 86% of both left hemisphere stroke patients and orthopedic patients were correctly classified. However, only 46% of right hemisphere stroke patients were accurately predicted. The results clearly support the ability to differentiate the groups and suggest a homogeneous character of the left hemisphere stroke and orthopedic groups. The right hemisphere group appears heterogeneous in make-up. Further statistical analysis revealed no significant difference (a<.05) between stroke groups when examining a factor related to emotional/depression symptoms. However, when stroke patients were compared to orthopedic patients on this factor, a high degree of significance was revealed (p<.001).These results suggest that right hemisphere patients cannot be treated as if they make up a single disorder group within the rehabilitation setting. The use of a self-report measure may prove beneficial with this group is assessing the level of neuropsychological impairment and to make modifications in treatment planning. Additionally, the existence of depression within the stroke group suggest that rehabilitation should focus more on these reactions within the first few weeks post-stroke.Department of Educational Psychology
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Cooper, Natalie R., and University of Lethbridge Faculty of Arts and Science. "Reduced peri-infarct dysfunction with pre-stroke exercise : molecular and physiological correlates." Thesis, Lethbridge, Alta. : University of Lethbridge, Faculty of Arts and Science, 2003, 2003. http://hdl.handle.net/10133/215.
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The effects of pre-stroke exercise and levesl of brain-derived neurotrophic factor (BDNF) on behavioural and functional recovery were examined following focal cortical ischemic infarct.
Intracortical microstimulation (ICMS) was used to derive topographical maps of forelimb
representations within the motor cortex and ischemia was induced via bipolar coagulation of surface vasculature. One month of excerise prior to ischemia significantly increased the
amount of peri-infarct movement represnetations and initiates vascular changes within motor
cortex. Further, this exercise-induced preservation of peri-infarct movement representations is associated with behavioural recovery and is dependent on BDNF levels in the motor cortex. These results provide further support for the idea that endurance exercise prior to stroke
may enhance functional and behavioural recovery.140 leaves : ill. (some col.) ; 29 cm.
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Andrews, Sheila Bernadette. "Skilled nursing facility based rehabilitation outcomes of the geriatric stroke patient." CSUSB ScholarWorks, 1995. https://scholarworks.lib.csusb.edu/etd-project/1000.
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Cawood, Judy. "Rehabilitation outcomes of uninsured stroke survivors in the Helderberg Basin." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/71858.
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Thesis (MPhil)--Stellenbosch University, 2012.ENGLISH ABSTRACT: Introduction: Rehabilitation is recognised as important in helping stroke survivors achieve their highest levels of functional independence and best quality of life. Conversely, a lack of rehabilitation services, and other environmental barriers, can prevent the attainment of optimal levels of functioning and advanced outcomes, such as community integration and employment. Aim of the study: To determine if uninsured stroke survivors living in the Helderberg Basin (Western Cape) reached their optimal rehabilitation outcome levels and if not, what environmental barriers contributed to this. Methods: A descriptive study was conducted. Quantitative data was obtained from 53 participants, who were selected through proportional stratified random sampling. Demographic information and the health status of participants were recorded. Other instruments utilised were the Stroke Impact Scale (SIS3), Modified Barthel Index (MBI), Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), language screening test and the ICF Core Set for Stroke (Environmental Factors). Outcome levels were categorised as described by Landrum, Schmidt and McLean, 1995. Data was subjected to statistical analysis. Qualitative data was obtained from five participants, who were chosen by means of purposive sampling. Data were analysed according to predetermined themes. Results: Six (11%) participants were classified as being on rehabilitation level 1; 21 (40%) on level 2; 16 (30%) on level 3; 8 (15%) on level 4; 2 (4%) on level 5. According to the MBI, 65% of participants required assistance with activities of daily living LOTCA scores showed that most difficulty was experienced with tests for visuomotor organization and thinking skills. Participants experienced varying degrees of difficulty with the speech and language test. A mean score of 50.84 for questions related to feelings on the SIS3 is indicative of underlying depression. Stroke survivors received limited physiotherapy and occupational therapy and even less speech therapy and dietary counselling. Occupational therapy had a significant impact on MBI (<0.01) and SIS3.6 (community mobility) (0.02) scores. Six (12%) reported assistance from a social worker. No psychological counselling was reported by any participant. A limited number of assistive devices, focussing mainly on mobility appliances had been issued. Participants regarded the most significant environmental barriers as being lack of assets (89%), transportation (88%) and general social support services, systems and policies (87%). Qualitative data showed a lack of counselling, education and training by health professionals regarding primary and secondary prevention of stroke and rehabilitation. Conclusion: Numerous environmental barriers impacted on the achievement of advanced rehabilitation outcomes. In addition to shortcomings in the primary and secondary prevention of stroke, many of the minimum standards for rehabilitation, as stipulated in the Western Cape Comprehensive Service Plan for the Implementation of Healthcare 2010, were not being met. Recommendations include establishing a designated stroke unit at Helderberg Hospital, ensuring transport, and improving the referral system to existing rehabilitation services. Increased input from core disciplines essential to stroke rehabilitation has the potential to improve outcomes. A concerted effort by health professionals is required in terms of counselling, education and training with regards to primary and secondary prevention of stroke and rehabilitation.
AFRIKAANSE OPSOMMING: Inleiding: Daar word algemeen aanvaar dat rehabilitasie na 'n beroerte uiters belangrik is, want dit kan beroerte oorlewendes help om die hoogste moontlike vlak van onafhanklikheid te bereik. Daarenteen kan‘n gebrek aan rehabilitasiedienste en omgewingsstruikelblokke verhoed dat ‘n oorlewende weer sy volwaardige plek in die samelewing en werksplek inneem. Doel van die projek: Om vas te stel of beroerte oorlewendes, woonagtig in die Helderberg Kom (Weskaap), sonder mediese versekering, wel hulle hoogste vlak van funksionering bereik het, en indien nie, om vas te stel watter omgewingsstruikelblokke bydraende faktore was. Metode: ‘n Beskrywende studie is uitgevoer. Kwantitatiewe data is verkry van 53 deelnemers wat lukraak gekies is deur gestratifiseerde, ewekansige steekproefneming. Demografiese inligting en die gesondheidstatus van deelnemers is aangeteken. Ander toetse wat gebruik is, is die Stroke Impak Skaal (SIS3), Gewysigde Barthel Indeks, Loewenstein Arbeidsterapie Kognitiewe Bepaling (LOTCA), taalsiftingstoets en die ICF kern stel vir beroerte (omgewingsfaktore). Uitkomsvlakke was bepaal, soos beskryf deur Landrum, Schmidt en McClean, 1995. Die data is statisties geanaliseer. Kwalitatiewe data was verkry van vyf deelnemers wat deur middel van doelgerigte steekproeftrekking gekies is. Tydens data analise is voorafbepaalde temas geidentifiseer. Resultate: Ses (11%) deelnemers was geklassifiseer as op rehabilitasie vlak 1; 21 (40%) op vlak 2; 16 (30%) op vlak 3; ag (15%) op vlak 4; twee (4%) op vlak 5. Volgens die MBI het 65% van die deelnemers bystand nodig vir daaglikse aktiwiteite. LOTCA uitslae toon dat die grootste probleme ondervind is met toetse vir visumotoriese organisasie en denkvermoëns. Deelnemers het verskillende grade van probleme ondervind met die spraak en taaltoets. ‘n Gemiddelde telling van 50.84 vir vrae met betrekking tot gevoelens in die SIS3, mag aanduidend wees van onderliggende depressie. Beroerte oorlewendes het min fisioterapie en arbeidsterapie ontvang en nog minder spraakterapie en raad van dieetkundiges. Arbeidsterapie insette het 'n beduidende impak op MBI telling (<0.01) en SIS3.6 (mobiliteit in die gemeenskap) (0.02) gehad. Ses (12%) het aangedui dat hulle hulp van maatskaplike werkers ontvang het. Nie een van die deelnemers het sielkundige berading ontvang nie. Beperkte hoeveelhede en tipes hulpmiddels is uitgereik, en was meesal om mobiliteit te verbeter. Volgens deelnemers was die grootste struikelblokke 'n gebrek aan bates (89%); vervoer (88%) en algemene sosiale ondersteuningsdienste, stelsels en beleid (87%). Kwalitatiewe data het 'n gebrek aan berading, onderrig en opleiding by gesondheidswerkers in terme van primêre en sekondêre voorkoming van beroerte en rehabilitasiedienste getoon.
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Fryer, Bradley James. "The relationship between task complexity and cerebral oxygenation in stroke patients." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/80371.
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Thesis (MSportSc)--Stellenbosch University, 2013.ENGLISH ABSTRACT: There are a growing number of men and women world-wide who are suffering strokes due to poor lifestyle-related habits. While there is evidence of the differences in cerebral haemodynamics between stroke patients and both elderly and young healthy individuals, limited evidence has examined the effect of rehabilitation on cerebral haemodynamics. Furthermore, most studies have examined changes in cerebral haemodynamics during cognitive and functional tasks in isolation, with no literature published on them simultaneously. The primary aim of this study was to examine whether differences in cerebral haemodynamics exist between stroke patients and healthy elderly individuals while performing a simple and complex cognitive task. Thirty two men and women (age 75 ± 8 years) volunteered to participate in the study and were split into an experimental (n = 14) group consisting of stroke patients and a control (n = 18) group consisting of healthy individuals. Each participant was required to attend one testing session where measurements of oxyhaemoglobin (O2Hb), deoxy-haemoglobin (HHb), tissue oxygenation index (TOI) and total haemoglobin index (THI) were obtained. Measurements were obtained with the participants at rest, while performing the Mini Mental State Exam (MMSE) and the modified Stroop Task as cognitive tests, and the Timed Up-and-Go (TuG) and six minute walk test (6MWT) or Toe Taps (TT) as the functional tests. Furthermore, the outcome scores of the various tests were also recorded. Change in O2Hb levels were lower in the experimental group than in the control group, especially in the left prefrontal cortex (LPFC) while HHb values were higher in the right prefrontal cortex (RPFC) (p > 0.05). There were almost no differences in TOI between the two groups in either the LPFC or RPFC, however, statistically significant differences were seen in THI in the RPFC during the MMSE (p = 0.03), rest period 2 (p = 0.03), the first modified Stroop Task (p = 0.04), as well as the TuG (p = 0.02). Furthermore, significant differences were seen between the two groups with respect to the time taken to complete the TuG, with the experimental group completing it much faster (p = 0.04). The experimental group participants who had received regular rehabilitation performed consistently better across most of the testing phases, with a number of practically significant findings. The results show that definite differences exist between stroke patients and healthy elderly individuals when performing a simple and complex task. The positive effect of low intensity exercise on task performance was clearly seen in both groups, and holds a great deal of practical significance for the development of exercise programmes for healthy individuals, as well as stroke patients. Furthermore, rehabilitation following a stroke has obvious benefits as shown by the positive results of the current study, however, limited research exists to validate these findings, highlighting the need for further research in this area.
AFRIKAANSE OPSOMMING: Daar is ʼn wêreld wye toename in die aantal mans en dames wat beroertes ondervind as gevolg van swak lewenstyl-verwante gewoontes. Alhoewel baie navorsing beskikbaar is oor die verskille in serebrale hemodinamika tussen beroerte pasiënte en bejaardes, asook jong gesonde individue, is daar ʼn beperkte aantal studies oor die effek van rehabilitasie op serebrale hemodinamika. Meeste van hierdie studies het die veranderinge in serebrale hemodinamika tydens kognitiewe of funksionele take in isolasie ondersoek, met geen literatuur waar die effek van albei gesamentlik gemeet word nie. Die hoofdoel van hierdie studie was om die verskille in serebrale hemodinamika tussen beroerte pasiënte en gesonde bejaardes, tydens die uitvoering van ʼn eenvoudige en komplekse kognitiewe taak, te ondersoek. Twee-en-dertig mans en vroue (ouderdom 75 ± 8 jaar) het aan die studie deelgeneem. Die eksperimentele groep (n = 14) het bestaan uit die beroerte pasïente en die kontrole groep (n = 18) was gesonde bejaardes. Elke deelnemer het een toets sessie bygewoon waartydens oksihemoglobien (O2Hb), deoksihemoglobien (HHb), weefsel oksigenasie indeks (TOI) en totale hemoglobien indeks (THI) gemeet is. Metings is tydens rus geneem, asook tydens die kognitiewe toetse, die “Mini Mental State Exam” (MMSE) en die gewysigde Stroop taak gemeet, en die funksionele toetse, naamlik die “Timed Up-and-Go” (TuG) en die ses minute loop toets (6MWT) of “Toe Taps” (TT). Die eksperimentele groep se O2Hb was laer as die kontrole groep, veral in die linker voor frontale korteks (LPFC), en die eksperimentele groep se HHb waardes was hoër in die regter voor frontale korteks (RPFC) (p > 0.05). Daar was geen statisties betekenisvolle verskille in TOI tussen die twee groepe nie, maar wel in die THI in die RPFC tydens die MMSE (p = 0.03), rusperiode twee (p = 0.03), die eerste gewysigde Stroop Taak (p = 0.04) en die TuG toets (p = 0.02). Die kontrole groep was statisties betekenisvol vinniger as die eksperimentele groep in die TuG toets (p = 0.04). Deelnemers in die eksperimentele groep wat gereelde rehabilitasie ontvang het, het konsekwent beter gevaar tydens die toets sessie, en ʼn aantal prakties betekenisvolle verskille is in sekere veranderlikes gevind. Die resultate dui aan dat daar wel ʼn verskil in serebrale hemodinamika bestaan tussen beroerte pasiënte en gesonde bejaardes terwyl hulle eenvoudige en komplekse take verrig. Die positiewe effek van lae intensiteit oefening op prestasie was duidelike sigbaar van beide groepe. Hierdie resultate is prakties betekenisvol as dit kom by die ontwikkeling van oefenprogramme vir gesonde individue asook beroerte pasiënte. Rehabilitasie na ʼn beroerte hou ooglopende voordele in soos aangedui deur die positiewe bevindinge van die huidige studie, hoewel daar beperkte navorsing beskikbaar is om hierdie bevindinge te staaf. Daar is dus ʼn behoefte vir verdere navorsing in hierdie gebied.
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Mok, Siu-wai Kanness, and 莫小慧. "Use of elderly mobility scale as a functional predictor in stroke patients during inpatient rehabilitation." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B31972056.
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Buckingham, David M. "Coping with a stroke : prediction using the belief constructs of just world, locus of control, attribution and reformulated learned helplessness." Virtual Press, 1986. http://liblink.bsu.edu/uhtbin/catkey/465787.
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Belief constructs appear to govern many aspects of life and may have an influence on coping with severe disability. This study investigated the extent to which coping with a stroke is identified by the belief constructs of just world, locus of control, attribution, and reformulated learned helplessness. The data were collected at a comprehensive rehabilitation center from thirty consenting stroke victims. The sample included 17 women and 12 men with a mean age of 64. The median number of days from the stroke to rehabilitation was 16. Twenty subjects had left hemiparesis and ten subjects had right hemiparesis.In addition to the belief-construct predictor variables, nature-of-stroke and demographic variables were collected during an initial evaluation. Demographic variables included sex, age, marital status, occupation, education, and recreation. Nature-of-stroke variables included period of time since stroke, diagnosis, severity, location, and aphasia as measured by the 'Aphasia Language Performance Scales' (Keenan & Brassell, 1975). The belief constructs were measured by the 'Just World Scale' (Rubin & Peplau, 1975), the 'Internal-External Locus of Control Scale" (Collins, 1974), and an adapted version of the 'Attribution Style Questionnaire' (Seligman, 1984). A coping measure was introduced as the criterion variable. It was administered 21 days following the initial evaluation and is based upon the ratings of the stroke victims' therapists. It includes a scale to more clearly define coping.The results of the study did not produce a clear definition of coping, although cognitive, emotional, and physical factors were evident. In addition, there was preliminary evidence of reliability and validity for measures of this construct. The linear composite of five variables was statistically significant (p < .01) and identified 56% of the variance in the coping measure. The significance of these variables suggests that successful coping is associated with older subjects who had passive premorbid recreation, were admitted relatively soon after their stroke, were rated as having a mild stroke, and made stable attributions about rehabilitation. The fact that one of the belief-construct variables (stability of attribution about rehabilitation) was significant, despite the small sample size, is encouraging and justifies further research in this area.
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Lee, Hongting Claudia, and 李康婷. "Mental practice with physiotherapy in gait rehabilitation in Chinese elderly." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B4501081X.
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Yip, Yun-chi, and 葉潤芝. "Barriers to implement evidence-based Chinese medicine." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46373524.
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Biggs, Debbie Lynn. "Health promotion needs of stroke patients accessing community health centres in the metropole region of the Western Cape." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&.
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Stroke is the third leading cause of death and a major cause of disability in most societies. Individuals with physical disabilities are at risk of secondary complications due to the impact of the disability, which may be exacerbated by poor lifestyle choices. Although disabled persons desire to engage in wellnessenhancing activities, limited programmes based on their health promotion needs&rsquoassessment have been developed. The aim of the present study is to determine the health promotion needs of stroke patients accessing selected Community Health Centres in the Metropole region of the Western Cape. A cross-sectional survey, utilizing a self-administered questionnaire and in depth interviews with a purposively selected sample was used to collect the data. The quantitative data was analysed using Microsoft Excel ®
. Means, standard deviations and percentages were calculated for descriptive purposes and the chi-square test was used to test for associations between socio-demographic and health-related variables. Audiotape interviews were transcribed verbatim, the emerging ideas were reduced to topics, categories and themes and finally interpreted. In order to qualify for between-method triangulation used in the study, complementary strengths were identified by comparing textual qualitative data with numerical quantitative results and vice versa. The quantitative analysis revealed that the participants were engaging in health risk behaviours such as physical inactivity, substance usage, non-compliance to medication use and inappropriate diet modification. Lack of financial resources, facilities and access to information predisposed them to involvement in risky health behaviours. In-depth interviews supported the quantitative findings and revealed that numerous participants&rsquo
suffered from depression and frustration as a result of having a stroke. The necessary ethical considerations were upheld. The outcome of the study could contribute to the need to develop, encourage and promote wellness-enhancing behaviours and activities to improve the participants&rsquo
health status and ultimate quality of life.
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Ozimek, Elicia N. "The effect of body weight support treadmill training on paretic leg contribution in hemiparetic walking in persons with chronic stroke." Muncie, Ind. : Ball State University, 2009. http://cardinalscholar.bsu.edu/435.
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Rahe, Patricia A. "Self-efficacy perceptions of patients following a cerebral vascular accident before and after participation in a stroke rehabilitation program." Virtual Press, 1992. http://liblink.bsu.edu/uhtbin/catkey/845965.
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The purpose of this study was to determine if the perceived level of ability (self-efficacy) differed from actual performance ability for individuals with cerebral vascular accidents (CVA's). Patients were assessed for perception and actual ability level on Activities of Daily Living (ADL's) and Balance skills at admission and at discharge from an inpatient CVA rehabilitation program. Thirty patients with unilateral brain lesions (15 right and 15 left) constituted the study group. ANOVA and repeated measures were used in this quasi-experimental, quantitative study to examine data. All three research hypotheses were tested at an alpha level of .05 for significance. The first and third research hypotheses were supported: CVA patients' self-efficacy scores on ADL's and Balance Skills were significantly different from actual performance scores at time of admission to a CVA rehabilitation program; and the self-efficacy scores were significantly closer to actual performance scores for ADL skills at discharge. The improved accuracy in perception of Balance Skills was not supported by comparison of scores between admission and discharge measurements. The second hypothesis that right hemisphere CVA lesion patients self-efficacy and actual performance scores would be significantly different compared to the scores of patients with left hemisphere CVA lesions was not supported. A ttest for paired samples was also performed on the ADL scores data to investigate three-way significance for the third hypothesis. The patients studied successfully completed the prescribed therapeutic activities in a CVA rehabilitation program and were able to predict with significantly improved accuracy, performance ability on ADL skills at discharge.School of Nursing
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Tai, Lok-hei Chris, and 戴樂熙. "The effectiveness of EMG biofeedback in hand function training after stroke." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B45010419.
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Chang, Chia-yu Stephanie Celeste, and 張嘉瑜. "Does social-demographic information predict residential outcomes in elderly stroke rehabilitation patients in Hong Kong?" Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B31971520.
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Scobbie, Lesley. "The development and initial evaluation of a Goal setting and Action Planning (G-AP) framework for use in community based stroke rehabilitation." Thesis, University of Stirling, 2015. http://hdl.handle.net/1893/21909.
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Background: Goal setting is accepted ‘best practice’ in stroke rehabilitation however, there is no consensus about what the key components of goal setting interventions are, how they should be optimally delivered in practice and how best to involve stroke survivors in the process. This PhD by publication describes the development and initial evaluation of a theory-based goal setting and action planning framework (G-AP) to guide goal setting practice in community based stroke rehabilitation settings. Included studies: The Medical Research Council (MRC) framework for developing and evaluating complex interventions guided the development and conduct of a programme of research which included the following studies: (i) a review of the literature to identify theories of behaviour change with most potential to inform goal setting practice (Paper 1) (ii) a causal modelling exercise to map identified theoretical constructs onto a goal setting process and convening of a multi-disciplinary task group to develop the theoretical process into a Goal setting and Action Planning (G-AP) practice framework (Paper 2) (iii) a process evaluation of the G-AP framework in one community rehabilitation team (Paper 3) (iv) a United Kingdom (UK) wide survey to investigate the nature of services providing community based stroke rehabilitation across the UK and what goal setting practice is in these settings in order to understand the context into which an evaluation of the G-AP framework could be introduced (Paper 4) Main Findings: The review of the literature identified three theories of behaviour change that offered most potential to inform goal setting practice: Social Cognitive Theory, Health Action Process Approach and Goal Setting Theory. These theories contained constructs directly relevant to the goal setting practice: self-efficacy, outcome expectancies, goal attributes, action planning, coping planning and appraisal and feedback. The causal modelling and Task group exercise: (i) Informed development of the G-AP framework into a four stage, cyclical process that included (i) goal negotiation and setting (ii) planning and measuring confidence (iii) action and (iv) appraisal, feedback and decision making. (ii) Proposed mechanisms of action: successful completion of action plans resulting in incremental improvements in goal sub-skills and self-efficacy. (iii) Predicted outcomes G-AP was likely to impact on: goal attainment and improved rehabilitation outcomes. The process evaluation suggested that each stage of the G-AP framework had a distinct purpose and made a useful contribution to the overall process. Overall, G-AP was acceptable and feasible to use but implementation of novel aspects of the framework (coping planning and measuring confidence) was inconsistent and health professionals had concerns about the potential impact of unmet goals on patients’ wellbeing. Patient reports suggested that (i) the experience of goal non-attainment could facilitate adjustment to limitations resulting from stroke and (ii) feeling involved in the goal setting process can incorporate both patient-led and professional-led approaches. The survey findings highlighted the variability that exists in community based stroke rehabilitation services in the UK (e.g. the patients they see; the input they provide). Goal setting is reportedly used with all or most stroke survivors in these services; however, practice is variable and may be sub-optimal. Conclusions: G-AP is the first practice framework which has been explicitly developed to guide health professionals through a systematic, theoretically based and patient centred goal setting process in community based stroke rehabilitation. G-AP is a cyclical process that that has four key stages, proposed mechanisms of action and has shown promise as an acceptable, feasible and effective framework to guide goal setting practice. The complexity that exists within community based stroke rehabilitation services, and the variability in usual goal setting practice used within them, should be considered when designing a study to evaluate the effectiveness of G-AP in routine practice.
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Chan, Chi-wing Martin, and 陳志榮. "Is bilateral isokinematic training (BIT) more effective than unilateral limb training in improving the hemiplegic upper-limbfunction." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B45009909.
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Dreyer, Sonette. "An investigation into the immediate effect of patellar taping on knee control in patients with adult acquired hemiplegia due to stroke." Thesis, Stellenbosch : University of Stellenbosch, 2009. http://hdl.handle.net/10019.1/1671.
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Thesis (MScPhysio (Physiotherapy))--University of Stellenbosch, 2009.The ability to walk has been rated by stroke patients as one of the most important goals of their rehabilitation. Knee control is a key element in normal gait. Currently, treatment options aimed at improving poor knee control in stroke patients are often costly, need specialised equipment and have poor patient compliance. The purpose of the current study was to assess whether medial patellar taping could improve knee control in stroke patients. Gait speed, dynamic standing balance, knee alignment and whether the subjects experienced any subjective stabilising effect on the knee after taping were tested. Twenty subjects diagnosed with hemiplegia after a stroke served as their own controls in a repeated measures experimental study. Results indicated that dynamic standing balance as tested by the Step Test (p=0.063) and the Timed-up-and-go test (p=0.099) (Wilcoxon test) showed marginal improvement after taping. This improvement in dynamic standing balance may indicate that neuro-motor control and/or eccentric knee control had improved. There was no change in walking speed and knee alignment as tested by change in the Q-angle (Wilcoxon test). However, a decrease in the Q-angle correlated with an improvement in dynamic standing balance as tested by the Step Test (p=0.029) (Spearman‟s test). Participants with decreased Q-angles after taping possibly had better knee alignment and were more willing to accept weight on their affected leg indicating a change in quadriceps activation. No change in walking speed (p=0.351) (Wilcoxon test) before and after taping may indicate that there was no change in the magnitude of contraction and/or concentric activity in the quadriceps muscle. Thirty percent of the participants reported a subjective change in knee stability after taping. Subjective change did not, however, significantly correlate with either of the balance tests, walking speed or Q-angle measurements. The possibility that medial patellar taping may be useful in treating poor knee control in stroke patients during dynamic balance activities should be investigated further.
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Hassan, Soelaylah A. M. "The impact of stroke on the primary caregiver." Thesis, Stellenbosch : University of Stellenbosch, 2009. http://hdl.handle.net/10019.1/3387.
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MPhil (Rehabilitation)Thesis (MPhil (Interdisciplinary Health Sciences))--University of Stellenbosch, 2009.
ENGLISH ABSTRACT: A stroke comes suddenly and has a devastating effect on the lives of the patient and the caregiver. It is disabling and often leaves the patient dependent on care. Providing this care can put tremendous physical, emotional, social and financial demands on the caregiver. The purpose of the study is to determine the impact of caregiving on the primary caregivers of patients who suffered a stroke and were admitted to the Western Cape Rehabilitation Centre (WCRC), for intensive rehabilitation during 2006. This is a descriptive study that utilised both quantitative and qualitative methods of data collection. Quantitative data were collected through two data coding forms, one for caregivers and one for patients, the Bartel Index, the Caregiver Strain Index (CSI) and the Satisfaction With Life Scale (SWLS). Qualitative data were collected through indepth interviews with caregivers. Fifty-seven caregivers participated in the study. According to CSI findings 58% of caregivers were under levels of strain high enough to require support and intervention. The SWLS indicated that the life areas most adversely affected were employment and self and social life. Loss of employment by the caregiver (p = 0.04) and financial difficulties (p = 0.06), cognitive and perceptual problems (p = 0.01), personality changes (p = 0.01), level of physical dependency of patient (0.0012) and nervous strain experienced by the caregiver (0.01) were found to significantly impact on caregiver strain. Caregivers perceived their caregiving duties as overwhelming and a great strain. This was aggravated in some instances by poor health care service delivery at the time of the stroke, no or inadequate explanations on stroke, poor or no training of caregivers, no home visits and a lack of follow-up services in the community. They experienced the period just after discharge as especially challenging and required support, assistance and guidance at that time. Caregivers identified a need for community rehabilitation facilities, adult day care centres, outpatient rehabilitation services, home-based nursing care and caregiver support groups in the community.
AFRIKAANSE OPSOMMING: ’n Beroerte gebeur skielik en sonder enige waarskuwing met ’n vernietigende uitwerking op die lewens van die pasiënt asook die versorger. Dit veroorsaak gestremdheid en laat dikwels die pasiënt afhanklik van sorg. Die voorsiening van hierdie sorg kan erge fisiese, emosionele, sosiale en finansiele eise aan die versorger stel. Die doel van die navorsing is om die impak van versorging op die primêre versorger van beroerte pasiënte, wat gedurende 2006 intensiewe rehabilitasie by WKRS ontvang het, te ondersoek. Dit is ’n beskrywende studie wat gebruik gemaak het van beide kwantitatiewe en kwalitatiewe metodes om data in te samel. Kwantitatiewe data was verkry deur twee datakoderingsvorms, een vir pasiente en een vir versorgers, die Bartel Index, die Caregiver Strain Index (CSI) en die Satisfaction With Life Scale (SWLS). In diepte onderhoude was gevoer met versorgers om kwalitatiewe data te verkry. Sewe en vygtig versorgers het aan die studie deelgeneem. Bevindinge van die CSI dui daarop dat 58% van versorgers hoë vlakke van spanning ervaar en ondersteuning sowel as intervensie benodig. Volgens die SWLS was die areas wat die ernstigste be-invloed was werk en eie en sosiale lewe. Die volgende areas het volgens resulate ’n statisties beduidende impak op die spanning wat versorgers ervaar het gehad: finansiële spanning en verlies van werk (p = 0.04), in gevalle waar pasiente persoonlikheids veranderinge ondergaan het (p = 0.01) of kognitiewe en perseptuale skade oorgehou het (p = 0.01) na die beroerte en die emosionele impak van versorging (p = 0.01). Versorgers het hulle versorgings take as oorweldigend en as ’n bron van groot spanning gesien. Dit is in sommige gevalle vererger deur swak ondersteuning van gesondheidssorgdienste direk na die beroerte, geen of swak verduidelikings oor wat ’n beroerte is, geen of swak opleiding aan versorgers, geen tuisbesoeke en ’n tekort aan opvolg dienste in die gemeenskap. Die tydperk direk na ontslag uit die rehabilitasie sentrum was besonder uitdagend en hulle het ondersteuning, hulp en leiding nodig in daardie tyd. Swak ondersteuning en ’n tekort aan of afwesigheid van hulpbronne in die gemeenskap het die situasie vererger. Versorgers het ’n behoefte aan gemeensskapsrehabilitasie fasiliteite, volwasse dagsorg sentrums, buite patiënte rehabilitasie dienste, tuis verpleegsorg en ondersteuningsgroepe uitgespreek.
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Labban, Wasim. "The effect of gluteal taping on gait in ambulant adults with hemiplegia." Thesis, Stellenbosch : University of Stellenbosch, 2009. http://hdl.handle.net/10019.1/2278.
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Thesis (MScPhysio (Physiotherapy))--University of Stellenbosch, 2009.Introduction Decreased hip extension in the paretic leg is a common impairment after stroke. Gluteal taping was introduced as a technique that helped in increasing hip extension of the paretic leg, and step length in the unaffected leg. The aim of this study was to further investigate the effect of gluteal taping on other temporal spatial and kinematic parameters using a 3D motion analysis system (Moven System). Methods The study was conducted in two phases. Phase 1 entailed examining the intra trial reliability of the Moven System, where eight subjects were recruited and tested twice at their normal pace of walking, and twice again at their maximum speed. Phase 2 involved studying the effect of gluteal taping on temporal spatial and kinematic parameters. Thirty subjects participated and were tested under three taping conditions (no tape, therapeutic tape, and placebo tape), while walking at their self selected walking speed. Intra-class correlation coefficient ICC determined around 95% confidence intervals was used to examine the intra trial reliability of the Moven System. Repeated measures-ANOVA was used to study the temporal spatial, and kinematic variables during the three taping conditions. Results The Moven showed moderate to excellent reliability in measuring the gait variables including temporal spatial parameters and sagittal kinematic parameters in addition to the lateral pelvic tilt. Taping caused significant increase in hip extension and reduction in knee flexion at terminal stance for the paretic leg. There was a trend toward better hip flexion at terminal stance, and a mild trend toward more planter flexion at terminal stance. Both treatment and placebo tapes caused an increase in the step lengths of either leg, and a significant increase in gait velocity and cadence. Conclusion Gluteal taping may be beneficial in producing important clinical effects post stroke, and can be used as an adjunct strategy during gait rehabilitation. Further research is needed to understand the mechanism of how taping produces effects, and to further explore its effect on kinetic and muscle activation variables.
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Ch'ng, Amanda Majella. "Understanding the relationship between coping self-efficacy, coping behaviour and psychological wellbeing during recovery from stroke." University of Western Australia. School of Psychology, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0228.
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Although self-efficacy has long been established as an important variable for psychological wellbeing across a range of contexts, coping self-efficacy, a subtype of self-efficacy specific to the function of coping, has only recently begun to receive research attention. In addition, despite support from both self-efficacy theory and coping theory, the relationship between coping self-efficacy and coping behaviour in the face of stressful events has not previously been considered. This thesis explores the importance of coping self-efficacy for psychological wellbeing in a new context, recovery after stroke, and investigates the relationship between coping self-efficacy and coping behaviour in the face of this stressor. Stroke was selected as a suitable context for this exploration given its high incidence, lengthy recovery period and the prevalence of significant post stroke psychological distress. The thesis explores four key questions: (i) is coping self-efficacy related to psychological wellbeing for people recovering from stroke, (ii) what types of coping behaviours are related to coping self-efficacy during recovery, (iii) does coping behaviour mediate the relationship between coping self-efficacy and psychological outcomes, and (iv) what is the role of individual dispositional traits (optimism and trait anxiety) in these relations. The implications of these relationships for clinical intervention were a secondary focus of the project.
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Al-Talahma, Mohammad Y. M. "Investigation into the immediate effect of ankle taping on temporal spatial gait parameters and affected ankle kinematics in ambulant adult hemiplegic patients." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/20057.
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Thesis (MScPhysio)--Stellenbosch University, 2012ENGLISH ABSTRACT: SYSTEMATIC REVIEW ABSTRACT - BACKGROUND: Ankle Foot Orthoses (AFOs) are considered as the most suitable lower limb orthosis to correct gait deficits related to ankle instability. AFOs are recommended to minimize gait deviations and to correct drop foot or equinus foot in hemiplegic patients. OBJECTIVES - To identify the effectiveness of different ankle orthoses and/or supports on the temporal, spatial, kinetic and kinematic gait parameters. To critically appraise the methodological quality of the included studies and to provide a description of the studies with a view to identify opportunities to improve future research quality. METHODS - Search strategy A comprehensive search was conducted between March and October 2010, and updated in August 2011. Thirteen computerized bibliographic databases were individually searched, namely PubMed Central, Cohrane Library, CINAHL, OT Seeker, SPORTDiscus, PsyARTICLE, PEDro, Proquest, Biomed Central, Science Direct, Clinicaltrials.gov, Web of Science, and Ingenta Connect. All databases were searched since their inception. The following key terms were used: stroke, hemipleg*, assistive device*, ankle foot orthos*, AFO, (splint*), taping, and strapping. A secondary search (pearling) was conducted by screening the reference lists of all eligible full text studies. The authors of the unpublished studies were conducted to minimize publication bias. Selection criteria The following selection criteria applied: all relevant randomized and non-randomized controlled trails published in English; participants were post-stroke patients older than eighteen years; interventions included any type of ankle foot orthosis (AFO), ankle taping or strapping and ankle foot splint without any additional intervention and the comparison/control groups were limited to walking without support, either barefoot or walking with shoes only. Studies were excluded when the outcome measures did not focus on at least one of the following: temporal spatial gait parameters, kinetic gait parameters or kinematic gait parameters. Data collection and analysis Two reviewers independently selected trials for inclusion and assessed methodological quality. The data was extracted by the primary reviewer and validated by a second reviewer. In event of disagreement, a third reviewer was asked to re-evaluate until consensus could be reached. Homogenous data were statistically summarized in sub-group meta-analysis using Revman© Review Manager Software. The results of heterogeneous data were summarized in a narrative form. MAIN RESULTS - The search yielded 11134 initial hits. Sixteen studies met the inclusion/exclusion criteria. The studies investigated the immediate effect of various types of AFOs on a broad range of temporal spatial gait parameters mainly gait speed, cadence, stride and step length. Only two studies reported on the kinetic and six on various kinematic gait parameters. The meta-analysis yielded significant improvement in gait speed (0.06 m/s; 95% CI 0.04, 0.08. p < 00001), walking cadence (5.41; 95% CI 3.79, 7.03. p < 00001), stride length (6.67; 95% CI 3.29, 10.06. p < 00001) and step length (2.66; 95% CI 1.59, 3.72. p < 0.00001). CONCLUSION - AFOs are effective to improve mobility, gait speed, cadence, stride and step length for post-stroke patients and may have a positive impact on the daily function of post-stroke patients. . The long term benefit or adverse effects of AFOs are still inconclusive. The effectiveness of AFOs on the kinetic and the frontal- or transverse- plane joint kinematics is largely unresolved. There is insufficient evidence to either support or refute the effectiveness of taping/strapping and splinting of the ankle on hemiplegic gait. EXPERIMENTAL STUDY ABSTRACT - BACKGROUND: Temporal, spatial and affected ankle kinematic gait parameters of adults with hemiplegia are significantly different from the normal able-bodied population. Enabling hemiplegic patients to walk is a major goal of rehabilitation programs. Taping of the plegic ankle could be utilized by therapists as external support of the ankle to improve foot position and placement during gait rehabilitation. OBJECTIVE - The purpose of the study was to describe the immediate effect of neutral ankle taping on temporal spatial gait parameters and ankle joint kinematics of the affected ankle in ambulant adult hemiplegic patients. METHODS - A clinical trial using a crossover randomized testing order was conducted on a convenient sample of ten ambulant hemiplegic patients at the Physiotherapy and Motion Analysis Clinic, Faculty of Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa. The affected ankle joint was taped in a neutral talocrural dorsiflexion/ plantarflexion and neutral hindfoot inversion/ eversion position using rigid adhesive tape (5 cm). The gait parameters were analysed according to the Plug-In Gait Model using a motion analysis system (Vicon Nexus 1.1.7; Vicon Motion System Limited, Oxford, UK). The analyses were repeated six times for each testing condition and the average values were used for further analysis. The data were analyzed using Least Square Means tests and post hoc Fisher (Least Significant Difference) LSD multiple comparison tests to determine the significant differences at 95% confidence level. RESULTS - The main results of the study indicate that taping of the affected ankle joint in a neutral position does not significantly improve (p>0.5) temporal spatial gait parameters and ankle joint kinematics in ambulant adult hemiplegic patients. The following positive trends were however found and need to be further explored in larger homogeneous study samples: ankle taping of ambulant adult hemiplegic patients has limited benefits on selected temporal parameters as ankle taping could potentially improve cadence. Ankle taping could decrease plantarflexion of the plegic leg at initial contact. CONCLUSIONS - A systematic review revealed no conclusive evidence either to support or refute the beneficial effects of ankle taping on gait parameters of ambulant adult hemiplegic patients. Ankle taping of ambulant adult hemiplegic patients has potential clinical benefits on temporal, spatial and affected ankle kinematics, gait cadence and affected leg swing and stance duration.
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Johnson, Jessie M. "Factors That Influence the Decision-Making of an Integrated Rehabilitation Team When Choosing a Post-Hospital Discharge Destination For Survivors of Stroke." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2014. https://ro.ecu.edu.au/theses/1420.
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Stroke is one of the more disabling conditions which may result in the inability for survivors to care for themselves independently. Stroke survivors benefit most when they receive early onset assessment, treatment, and rehabilitation. Increasingly, stroke care in Canadian hospitals relies on an interdisciplinary rehabilitation team approach to provide immediate rehabilitation services and to make decisions about discharge destination for stroke survivors. Currently, there is little research on how interdisciplinary rehabilitation teams decide upon rehabilitation placements for stroke survivors or how individuals on the team, stroke survivors, or their families participate in and contribute to this decision. This research studied the culture of the interdisciplinary rehabilitation team to understand the specific client, clinical, and family situations considered by team members and how that information was communicated and evaluated by them during their decision-making.
To address the research question, the researcher undertook an ethnographic study of a health care team on a stroke unit of a Canadian hospital. Based on observations of the interdisciplinary rehabilitation team and interviews with team members, the study found that decisions about post-hospital discharge destination were conditioned by variables related to the social, economic, and policy context; interactions among members of the team; and the condition of stroke survivors or their families and their ability and willingness to contribute to home care.
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Botha, J. H. "The refinement of a booklet on stroke care at home." Thesis, Stellenbosch : University of Stellenbosch, 2008. http://hdl.handle.net/10019.1/1903.
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Thesis (MScMedSc (Rehabilitation))--University of Stellenbosch, 2008.Stroke is the second commonest cause of mortality worldwide and remains a leading cause of adult physical disability. It is estimated that sixty percent of South African stroke survivors require assistance with at least one activity of daily living. This burden is predominantly on the shoulders of mostly untrained caregivers. The process of enabling caregivers to make choices conducive to their own health as well as the health of the stroke survivors is multidimensional. One of the cornerstones of this process is the provision of information. In 1995, the Centre for Rehabilitation Studies of the University of Stellenbosch started to develop a training package for stroke care at home. The training takes the form of an interactive workshop and a booklet with practical information. The aim of this study was to refine and pilot this booklet for implementation with the training. The study found that existing guidelines to evaluate the appropriateness of written material for developing communities (measured by Hugo’s grading model), were inadequate. Consequently, a new checklist, based on twenty existing checklists, was compiled. This list, as well as the Suitability Assessment of Material (SAM), was used to evaluate the booklet and make recommendations for a pre-pilot refinement. Even though this checklist has not been validated, it revealed similar results to the SAM when applied to the booklet. After cosultation with the authors, improvements were effected to the booklet The booklet was tested with four samples of the target audience. The functional literacy of the participants was determined using a standardised literacy test. A fifth sample completed a questionnaire on their preference between the pre- and postrefined booklet. Experts in the field of rehabilitation and graphic design also commented on the booklet. This study confirmed the need of stroke survivors and their caregivers for written health information. The refined booklet was found to be an appropriate tool to address the needs of the target audience. The participants perceived the booklet as useful and comprehensible and the readability level was shown to correspond with the tested literacy level of the samples. However, there is a need for printed material on topics related to stroke not currently covered in the booklet, e.g. spasticity. This study showed that the checklist could be used to tailor written health information that is preferred by the target audience. It confirmed that the testing of printed material with stakeholders could expose additional gaps after applying the checklist. Recommendations for further improvements were made based on the comments of the participants. It is foreseen that the new checklist could be a valuable tool for developing future written health material. Finally, it is recommended that an interdisciplinary team that includes a graphic designer be involvement from the planning stages.
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Fung, Mei-ling. "Stroke rehabilitation : predicting LOS and discharge placement /." Hong Kong : University of Hong Kong, 2002. http://sunzi.lib.hku.hk/hkuto/record.jsp?B25101298.
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Chau, Cheuk-man, and 周卓敏. "Effectiveness of acupuncture in stroke rehabilitation." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B44525412.
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Hoffmann, Tammy Coral. "Development and evaluation of a computer-generated individualised written education package for patients following stroke and their carers /." [St. Lucia, Qld.], 2005. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18924.pdf.
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Ellis, Graham. "Stroke liaison workers for patients and carers." Thesis, Connect to e-thesis, 2008. http://theses.gla.ac.uk/288/.
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Thesis (MD.) - University of Glasgow, 2007.MD. thesis submitted to the Division of Cardiovascular and Medical Sciences, Faculty of Medicine, University of Glasgow, 2007. Includes bibliographical references. Print version also available.
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Kwok, Wing-yee Eunice. "Early supported discharge program for stroke patients." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B40720883.
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Willats, Lisa. "Improved quantification of perfusion in patients with cerebrovascular disease." Thesis, University College London (University of London), 2008. http://discovery.ucl.ac.uk/1445148/.
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In recent years measurements of cerebral perfusion using bolus-tracking MRI have become common clinical practice in the diagnosis and management of patients with stroke and cerebrovascular disease. An active area of research is the development of methods to identify brain tissue that is at risk of irreversible damage, but amenable to salvage using reperfusion treatments, such as thrombolysis. However, the specificity and sensitivity of these methods are limited by the inaccuracies in the perfusion data. Accurate measurements of perfusion are difficult to obtain, especially in patients with cerebrovascular diseases. In particular, if the bolus of MR contrast is delayed and/or dispersed due to cerebral arterial abnormalities, perfusion is likely to be underestimated using the standard analysis techniques. The potential for such underestimation is often overlooked when using the perfusion maps to assess stroke patients. Since thrombolysis can increase the risk of haemorrhage, a misidentification of 'at-risk' tissue has potentially dangerous clinical implications. This thesis presents several methodologies which aim to improve the accuracy and interpretation of the analysed bolus-tracking data. Two novel data analysis techniques are proposed, which enable the identification of brain regions where delay and dispersion of the bolus are likely to bias the perfusion measurements. In this way true hypoperfusion can be distinguished from erroneously low perfusion estimates. The size of the perfusion measurement errors are investigated in vivo, and a parameterised characterisation of the bolus delay and dispersion is obtained. Such information is valuable for the interpretation of in vivo data, and for further investigation into the effects of abnormal vasculature on perfusion estimates. Finally, methodology is presented to minimise the perfusion measurement errors prevalent in patients with cerebrovascular diseases. The in vivo application of this method highlights the dangers of interpreting perfusion values independently of the bolus delay and dispersion.
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Lee, Hongting Claudia. "Mental practice with physiotherapy in gait rehabilitation in Chinese elderly /." View the Table of Contents & Abstract, 2006. http://sunzi.lib.hku.hk/hkuto/record/B36434541.
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Cotter, Paul Eoin. "Cardiac parameters in young patients with cryptogenic stroke." Thesis, University of Cambridge, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.648802.
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Sit, Bik-yan Sonia. "Cognitive function in Chinese stroke patients /." View the Table of Contents & Abstract, 2005. http://sunzi.lib.hku.hk/hkuto/record/B31595923.
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Wan, Wai-kuen Christina, and 尹慧娟. "An exploratory design of an empowerment group for the strokesurvivors." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1996. http://hub.hku.hk/bib/B31978228.
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郭穎怡 and Wing-yee Eunice Kwok. "Early supported discharge program for stroke patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B40720883.
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Tsang, Sai-ling. "Community readjustment of discharged stroke patients : an exploratory study /." [Hong Kong : University of Hong Kong], 1985. http://sunzi.lib.hku.hk/hkuto/record.jsp?B12322490.
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張晶凝 and Ching-ying Crystal Cheung. "Facial emotion recognition after subcortical cerebrovascular diseases." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2000. http://hub.hku.hk/bib/B31224155.
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