Stroke rehabilitation: Which factors influence the outcome?

Dušica, Simić-Panić S; Devečerski, Gordana; Jovićević, M; Platiša, Nedeljko M

doi:10.4103/0972-2327.165480

Cited by 14 publications

(15 citation statements)

References 8 publications

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“…These results can be explained by the fact that SULCS is a highly-specific instrument aimed at evaluating upper limb functioning and not overall patient functionality or health status (as assessed in previous studies). As for the relationship between gender and functional recovery after stroke, this study is in agreement with previous evidence, indicating that gender is not significantly associated with functional prognosis [26,28]. The presence of spasticity in the upper limbs after stroke has been associated with impaired functionality and high levels of dependence [29].…”

Section: Discussionsupporting

confidence: 81%

“…Several factors associated with worse prognosis after stroke have been described in the literature, including advanced age, right hemisphere involvement, lesions of haemorrhagic nature, and cognitive impairment [26][27][28]. In this study, however, there were no statically significant associations between age, gender, aetiology, and laterality and upper limb functional capacity as measured by SULCS.…”

Section: Discussioncontrasting

confidence: 54%

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Assessing upper limb function: Transcultural adaptation and validation of the Portuguese version of the Stroke Upper Limb Capacity Scale

Branco

Pinheiro

2018

Annals of Physical and Rehabilitation Medicine

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Background: Brachial hemiparesis is one of the most frequent sequelae of stroke, leading to important functional disability given the role of the upper limb in executing activities of daily living (ADL). The Stroke Upper Limb Capacity Scale (SULCS) is a stroke-specific assessment instrument that evaluates functional capacity of the upper limb based on the execution of 10 tasks. The objective of this study is the transcultural adaptation and psychometric validation of the Portuguese version of the SULCS. Methods: A Portuguese version of the SULCS was developed, using the process of forward-backward translation, after authorisation from the author of the original scale. Then, a multicentre study was conducted in Portuguese stroke patients (n = 122) to validate the psychometric properties of the instrument. The relationship between sociodemographic and clinical characteristics was used to test construct validity. The relationship between SULCS scores and other instruments was used to test criterion validity. Results: Semantic and linguistic adaptation of the SULCS was executed without substantial issues and allowed the development of a Portuguese version. The application of this instrument suggested the existence of celling effect (19.7% of participants with maximum score). Reliability was demonstrated through the intraclass correlation coefficient of 0.98. As for construct validity, SULCS was sensible to muscle tonus and aphasia. SULCS classification impacted the scores of the Motor Evaluation Scale for Upper Extremity in Stroke (MESUPES) and the Stroke Impact Scale (SIS).

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Section: Discussionsupporting

confidence: 81%

Section: Discussioncontrasting

confidence: 54%

Assessing upper limb function: Transcultural adaptation and validation of the Portuguese version of the Stroke Upper Limb Capacity Scale

Branco

Pinheiro

2018

Annals of Physical and Rehabilitation Medicine

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“…Although this was purposefully designed to provide the most well-controlled and subtle differences between HMD-VR and the conventional environment, and previous studies have reported significant differences between HMD-VR and computer screen environments [19,[52][53][54], future work should examine whether presence, gender, age, video game use, or previous HMD-VR experience has an effect on HMD-VR motor skill transfer to more dynamic, real world physical applications (e.g., throwing a ball in HMD-VR versus throwing a ball in real life). Future research should also look to see if the identified factors apply to different clinical populations and examine whether mechanisms such as functional independence or cognitive status could predict success of HMD-VR rehabilitation interventions [55,56]. Another limitation was that our definition of motor skill transfer reflects the transfer of motor skill acquisition rather than motor skill learning.…”

Section: Discussionmentioning

confidence: 99%

Transfer of motor skill between virtual reality viewed using a head-mounted display and conventional screen environments

Juliano

Liew

2020

J NeuroEngineering Rehabil

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Background: Virtual reality viewed using a head-mounted display (HMD-VR) has the potential to be a useful tool for motor learning and rehabilitation. However, when developing tools for these purposes, it is important to design applications that will effectively transfer to the real world. Therefore, it is essential to understand whether motor skills transfer between HMD-VR and conventional screen-based environments and what factors predict transfer. Methods: We randomized 70 healthy participants into two groups. Both groups trained on a well-established measure of motor skill acquisition, the Sequential Visual Isometric Pinch Task (SVIPT), either in HMD-VR or in a conventional environment (i.e., computer screen). We then tested whether the motor skills transferred from HMD-VR to the computer screen, and vice versa. After the completion of the experiment, participants responded to questions relating to their presence in their respective training environment, age, gender, video game use, and previous HMD-VR experience. Using multivariate and univariate linear regression, we then examined whether any personal factors from the questionnaires predicted individual differences in motor skill transfer between environments. Results: Our results suggest that motor skill acquisition of this task occurs at the same rate in both HMD-VR and conventional screen environments. However, the motor skills acquired in HMD-VR did not transfer to the screen environment. While this decrease in motor skill performance when moving to the screen environment was not significantly predicted by self-reported factors, there were trends for correlations with presence and previous HMD-VR experience. Conversely, motor skills acquired in a conventional screen environment not only transferred but improved in HMD-VR, and this increase in motor skill performance could be predicted by self-reported factors of presence, gender, age and video game use.

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“…We also did not have information about whether stroke was of ischemic, hemorrhagic or embolic origin; stroke type has been shown to influence outcomes overall, and it is unclear whether it may affect non-use. 53 Additionally, we did not assess overall cognitive function, pain, or mental health. Pain of the contralesional limbs has been hypothesized to be associated with non-use.…”

Section: Study Limitationsmentioning

confidence: 99%

Predictors of arm non-use in chronic stroke: a preliminary investigation

Buxbaum

Varghese

Stoll

et al. 2019

Preprint

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Background:The phenomenon of non-use after stroke is characterized by failure to use the contralesional arm despite adequate capacity. It has been suggested that nonuse is a consequence of the greater effort and/or attention required to use the affected limb, but such accounts have not been tested, and we have poor understanding of the characteristics of individuals who exhibit non-use.Objective: We aimed to provide preliminary evidence regarding the demographic, neuropsychological, and psychological factors that may influence non-use in chronic stroke.Methods: Twenty chronic stroke survivors (10 left and 10 right hemisphere stroke) with mild-to-moderate sensory-motor impairment on the upper extremity Fugl-Meyer (UEFM)were assessed with the Actual Amount of Use Test (AAUT), which measures the disparity between amount of use and quality of movement in "spontaneous" versus "forced" conditions. Participants were als assessed with measures of limb apraxia, spatial neglect, attention/arousal, and self-efficacy (confidence in arm movement).Using stepwise multiple regression, we determined whether demographic information and/or performance on these measures predicted AAUT non-use scores.Results: Scores on the UEFM as well as attention/arousal and self-efficacy predicted the degree of non-use. Attention/arousal predicted non-use above and beyond UEFM. Conclusions:Given the complexity of the non-use phenomenon, it follows that a combination of impairment, attention/arousal, and perceived confidence predicted nonuse behavior. That a measure of attention/arousal predicted non-use behavior above and beyond sensory-motor functioning highlights the importance of motivated Predictors of non-use in stroke 3 engagement to drive use of the paretic limb. Larger-scale studies incorporating additional measures (e.g., mental health, lesion volume and white matter connectivity, pain, motivation) will be important for future investigations.

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Stroke rehabilitation: Which factors influence the outcome?

Cited by 14 publications

References 8 publications

Assessing upper limb function: Transcultural adaptation and validation of the Portuguese version of the Stroke Upper Limb Capacity Scale

Assessing upper limb function: Transcultural adaptation and validation of the Portuguese version of the Stroke Upper Limb Capacity Scale

Transfer of motor skill between virtual reality viewed using a head-mounted display and conventional screen environments

Predictors of arm non-use in chronic stroke: a preliminary investigation

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