Stroke survivors’ priorities for research related to life after stroke

Rudberg, Ann‐Sofie; Berge, Eivind; Laska, Ann‐Charlotte; Jutterström, Stina; Näsman, Per; Sunnerhagen, Katharina S.; Lundström, Erik

doi:10.1080/10749357.2020.1789829

Cited by 85 publications

(77 citation statements)

References 18 publications

(24 reference statements)

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“…Eighteen participants (IG: n=10, DG: n=8) were included, with a median (IQR) time post stroke of 8.6 weeks (5-12). No adverse events were experienced.…”

Section: Resultsmentioning

confidence: 99%

“…Participants were recruited consecutively from the inpatient rehabilitation unit of Jessa Hospital, Rehabilitation Campus Sint-Ursula in Belgium between May 2019 and March 2020. patients were eligible for the study if they (1) experienced a first-ever unilateral, supra-tentorial stroke as defined by the World Health Organization (35), (2) were minimally 18 years old, (3) had a residual inpatient stay of minimally 4 weeks, (4) had the ability to sit independently, as defined as a maximal score of 25 on item 3 of the trunk control test (36), and (5) experienced motor impairment in the upper limb, as defined, based on the JSU diagram (10), as a score of 8-17 on stage 2 (synergies) of the FMA-UE (37), or a score of <8 on stage 2 of the FMA-UE, combined with a score of >6 on stage 5 (hand) of the FMA-UE. The exclusion criteria were: (1) musculoskeletal and/or other neurological conditions with permanent damage that may interfere with the study procedures or assessments, (2) subdural hematoma, tumor, encephalitis or trauma, with stroke-like symptoms, and (3) severe communication or cognitive deficits which could hamper the assessment.…”

Section: Methodsmentioning

confidence: 99%

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Arm-hand boost therapy during inpatient stroke rehabilitation: a pilot randomized controlled trial

Meyer

Verheyden

Kempeneers

et al. 2021

Preprint

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ObjectiveIt was the aim to assess feasibility, safety and potential efficacy of a new intensive, focused arm-hand BOOST program and to investigate whether there is a difference between early versus late delivery of the program in the sub-acute phase post stroke.MethodsIn this pilot RCT, patients with stroke were randomized to the immediate group (IG): 4 weeks (4w) BOOST +4w CONTROL or the delayed group (DG): 4w CONTROL +4w BOOST, on top of their usual inpatient care program. The focused arm-hand BOOST program (1 hour/day, 5x/week, 4 weeks) consisted of group exercises with focus on scapula-setting, core-stability, manipulation and complex ADL tasks. Additionally, one hour per week the Armeo®Power (Hocoma AG, Switzerland) was used. The CONTROL intervention comprised a dose-matched program (24 one-hour sessions in 4w) of lower limb strengthening exercises and general reconditioning. At baseline, after 4 and 8 weeks of training, the Fugl-Meyer assessment upper extremity (FMA-UE), action research arm test (ARAT) and stroke upper limb capacity scale (SULCS) were administered.ResultsEighteen participants (IG: n=10, DG: n=8) were included, with a median (IQR) time post stroke of 8.6 weeks (5-12). No adverse events were experienced. After 4 weeks of training, significant between-group differences were found for FMA-UE (p=0.003) and SULCS (p=0.033) and a trend for ARAT (p=0.075) with median (IQR) change scores for the IG of 9 (7-16), 2 (1-3) and 12.5 (1-18) respectively, and for the DG of 0.5 (−3-3), 1 (0-1) and 1.5 (−1-9), respectively. In the IG, 80% of patients improved beyond the minimal clinical important difference of FMA-UE after 4 weeks, compared to none of the DG patients. Between 4 and 8 weeks of training, patients in the DG tend to show larger improvements when compared to the IG, however, between-group comparisons did not reach significance.ConclusionsResults of this pilot RCT showed that an intensive, specific arm-hand BOOST program, on top of usual care, is feasible and safe in the sub-acute phase post stroke and suggests positive, clinical meaningful effects on upper limb function, especially when delivered in the early sub-acute phase post stroke.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NCT04584177

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“…Eighteen participants (IG: n=10, DG: n=8) were included, with a median (IQR) time post stroke of 8.6 weeks (5-12). No adverse events were experienced.…”

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Arm-hand boost therapy during inpatient stroke rehabilitation: a pilot randomized controlled trial

Meyer

Verheyden

Kempeneers

et al. 2021

Preprint

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“…The current results partly support this theory by showing a reduction in trait fatigue a week post-tDCS. Fatigue has been identified as one of the top unmet needs for chronic stroke survivors within the community and interferes most with their activities of daily living [ 3 , 4 ]. Currently, there are no effective interventions for PSF [ 49 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

“…Debilitating fatigue that persists for months and sometimes years after stroke is relatively common in stroke survivors with a prevalence as high as 70% [1,2]. Post-stroke fatigue (PSF) has been identified as the top unmet need among stroke survivors living in the community and is a top priority for further research [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Effect of transcranial direct current stimulation on post-stroke fatigue

2021

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Background Fatigue is one of the most commonly reported symptoms post-stroke, which has a severe impact on the quality of life. Post-stroke fatigue is associated with reduced motor cortical excitability, specifically of the affected hemisphere. Objective The aim of this exploratory study was to assess whether fatigue symptoms can be reduced by increasing cortical excitability using anodal transcranial direct current stimulation (tDCS). Methods In this sham-controlled, double-blind intervention study, tDCS was applied bilaterally over the primary motor cortex in a single session in thirty stroke survivors with high severity of fatigue. A questionnaire-based measure of trait fatigue (primary outcome) was obtained before, after a week and 5 weeks post stimulation. Secondary outcome measures of state fatigue, motor cortex neurophysiology and perceived effort were also assessed pre, immediately post, a week and 5 weeks post stimulation. Results Anodal tDCS significantly improved fatigue symptoms a week after real stimulation when compared to sham stimulation. There was also a significant change in motor cortex neurophysiology of the affected hemisphere and perceived effort, a week after stimulation. The degree of improvement in fatigue was associated with baseline anxiety levels. Conclusion A single session of anodal tDCS improves fatigue symptoms with the effect lasting up to a week post stimulation. tDCS may therefore be a useful tool for managing fatigue symptoms post-stroke. Trial registration NCT04634864 Date of registration 17/11/2020–“retrospectively registered”.

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“…Debilitating fatigue that persists for months and sometimes years after stroke is relatively common in stroke survivors with prevalence as high as 70% [1,2]. Post-stroke fatigue (PSF) has been identified as the top unmet need among stroke survivors living in the community and is a top priority for further research [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Effect of transcranial direct current stimulation on post-stroke fatigue

Doncker

Ondobaka

Kuppuswamy³

2020

Preprint

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BackgroundFatigue is one of the most commonly reported symptoms post-stroke, which has a severe impact on quality of life. Post-stroke fatigue is associated with reduced motor cortical excitability, specifically of the affected hemisphere.ObjectiveThe aim of this exploratory study was to assess whether fatigue symptoms can be reduced by increasing cortical excitability using anodal transcranial direct current stimulation (tDCS).MethodsIn this sham-controlled, double-blind intervention study, tDCS was applied bilaterally over the primary motor cortex in a single session in thirty stroke survivors with high severity of fatigue. A questionnaire-based measure of trait fatigue (primary outcome) was obtained before, after a week and a month post stimulation. Secondary outcome measures of state fatigue, motor cortex neurophysiology and perceived effort were also assessed pre, immediately post, a week and a month post stimulation.ResultsAnodal tDCS significantly improved fatigue symptoms a week after real stimulation when compared to sham stimulation. There was also a significant change in motor cortex neurophysiology of the affected hemisphere and perceived effort, a week after stimulation. The degree of improvement in fatigue was associated with baseline anxiety levels.ConclusionA single session of anodal tDCS improves fatigue symptoms with the effect lasting up to a week post stimulation. tDCS may therefore be a useful tool for managing fatigue symptoms post-stroke.

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Stroke survivors’ priorities for research related to life after stroke

Cited by 85 publications

References 18 publications

Arm-hand boost therapy during inpatient stroke rehabilitation: a pilot randomized controlled trial

Arm-hand boost therapy during inpatient stroke rehabilitation: a pilot randomized controlled trial

Effect of transcranial direct current stimulation on post-stroke fatigue

Effect of transcranial direct current stimulation on post-stroke fatigue

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