Adherence to Postacute Rehabilitation Guidelines Is Associated With Functional Recovery in Stroke

Duncan, Pamela W.; Horner, Ronnie D.; Reker, Dean M.; Samsa, Gregory P.; Hoenig, Helen; Hamilton, Byron B.; LaClair, Barbara J.; Dudley, Tara K.

doi:10.1161/hs0102.101014

Cited by 276 publications

(167 citation statements)

References 37 publications

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“…When applicable, an assessment of family functioning with a tool such as the McMaster Family Assessment Device may serve to enhance adherence and improve long-term outcomes. 80,81 A primary barrier to any type of poststroke therapy is depression. The incidence of poststroke depression ranges from 18% to 68%.…”

Section: Barriers To Physical Activity and Exercise Training In Strokmentioning

confidence: 99%

Physical Activity and Exercise Recommendations for Stroke Survivors

Gordon¹,

Gulanick²,

Costa³

et al. 2004

Circulation

372

196

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Section: Barriers To Physical Activity and Exercise Training In Strokmentioning

confidence: 99%

Physical Activity and Exercise Recommendations for Stroke Survivors

Gordon¹,

Gulanick²,

Costa³

et al. 2004

Circulation

372

196

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“…As a result the brain is unable to function normally, and CVA is the leading cause of loss of social, mental, physical and functional abilities. Generally, 40% of patients with stroke are functionally challenged and 15-20% of stroke patients have several impairments 1,2) . Stroke patients tend to place 61-80% of their body weight on the sound side, leading to asymmetric posture, and 55-75% of patients experience functional limitation of their upper limbs 3) .…”

Section: Introductionmentioning

confidence: 99%

Virtual Reality Reflection Therapy Improves Motor Recovery and Motor Function in the Upper Extremities of People with Chronic Stroke

Jung

Lee

et al. 2012

J Phys Ther Sci

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Abstract.[Purpose] The main purpose of this study was to investigate the effects of Virtual Reality Reflection Therapy on motor recovery and motor function in the upper extremities of patients with chronic stroke. [Subjects] Nineteen participants patients with chronic stroke were randomly assigned to the experimental group (n=11) and the control group (n=8).[Methods] The experimental group performed a Virtual Reality Reflection Therapy program for 30 minutes a day, 5 days a week, during a 4 week period, in addition to conventional therapy. The control group received conventional therapy and performed sham program. All subjects were evaluated using by the Fugl-Meyer Assessment (upper limb section), the Modified Ashworth Scale (MAS), the Box and Block Test (BBT), the JebsenTaylor Hand Function Test and the Manual Function Test pre-and post-intervention.[Results] The experimental group and the control group effectively increased their upper-extremity motor recovery and motor function. Upperextremity motor recovery and motor function of the experimental group showed more significant increases than those of the control group.[Conclusion] Virtual Reality Reflection Therapy (even as a home treatment) with a conventional program in the early stages of treatment might be beneficial for improving hand function. Future studies need to investigate the effectiveness of Virtual Reality Reflection Therapy with optimal patient selection or duration and intensity of training.

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“…Numerous studies, including six RCTs [4,7,38,51,63,71], failed to show any positive effects on quality associated with practice guidelines [5,10,20,25,26,36]. Results were mixed in 12 studies, in which practice guidelines improved quality for certain outcomes or patient subgroups but not others [8,23,24,41,43,52,54,55,58,59,73,74]. Finally, three systematic reviews reported that clinical practice guidelines could improve the efficacy, efficiency, and cost-effectiveness of care; however, the size of effect was variable and generally small [6,27,47].…”

Section: Do Practice Guidelines Improve Quality Of Care?mentioning

confidence: 99%

“…Finally, three systematic reviews reported that clinical practice guidelines could improve the efficacy, efficiency, and cost-effectiveness of care; however, the size of effect was variable and generally small [6,27,47]. Studies found greater effect with explicit guidelines [6,13,21,23,50,55], defined as ''systematically developed statements to assist practitioner decisions about appropriate health care for specific clinical circumstances'' [27], although practice guidelines improved both processes and outcomes of care, including cost [14,29,53,62], and the results were greater for performance compared with patient outcomes. Clinician involvement in all aspects of guideline development was vital [5,46,53,73].…”

Section: Do Practice Guidelines Improve Quality Of Care?mentioning

confidence: 99%

The Use of Three Strategies to Improve Quality of Care at a National Level

Wright

2012

Clinical Orthopaedics &Amp; Related Research

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Background Improving the quality of care is essential and a priority for patients, surgeons, and healthcare providers. Strategies to improve quality have been proposed at the national level either through accreditation standards or through national payment schemes; however, their effectiveness in improving quality is controversial. Questions/purposes The purpose of this review was to address three questions: (1) does pay-for-performance improve the quality of care; (2) do surgical safety checklists improve the quality of surgical care; and (3) do practice guidelines improve the quality of care? These three strategies were chosen because there has been some research assessing their effectiveness in improving quality, and implementation had been attempted on a large scale such as entire countries.Methods We performed a literature review from 1950 forward using Medline to identify Level I and II studies. We evaluated the three strategies and their effects on processes and outcomes of care. When possible, we examined strategy implementation, patients, and systems, including provider characteristics, which may affect the relationship between intervention and outcomes with a focus on factors that may have influenced effect size. Results Pay-for-performance improved the process and to a lesser extent the outcome of care. Surgical checklists reduced morbidity and mortality. Explicit practice guidelines influenced the process and to a lesser extent the outcome of care. Although not definitively showed, clinician involvement during development of intervention and outcomes, with explicit strategies for communication and implementation, appears to increase the likelihood of positive results. Conclusion Although the cost-effectiveness of these three strategies is unknown, quality of care could be enhanced by implementing pay-for-performance, surgical safety checklists, and explicit practice guidelines. However, this review identified that the effectiveness of these strategies is highly context-specific.

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Adherence to Postacute Rehabilitation Guidelines Is Associated With Functional Recovery in Stroke

Cited by 276 publications

References 37 publications

Physical Activity and Exercise Recommendations for Stroke Survivors

Physical Activity and Exercise Recommendations for Stroke Survivors

Virtual Reality Reflection Therapy Improves Motor Recovery and Motor Function in the Upper Extremities of People with Chronic Stroke

The Use of Three Strategies to Improve Quality of Care at a National Level

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