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Standardized tools for assessing balance and mobility in stroke clinical practice guidelines worldwide: a scoping review
Published 2023Subjects: “…Stroke rehabilitation…”
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Page will reload when a filter is selected or excluded.- Rehabilitation 9 results 9
- Stroke 4 results 4
- Ageing 3 results 3
- Education 3 results 3
- Higher Education 3 results 3
- — — — — — Special Education and Rehabilitation 3 results 3
- Audiological rehabilitation 2 results 2
- Disability 2 results 2
- Elderly 2 results 2
- Elderly population with comorbidity of hypertension and tinnitus is increasing across the world, and the dilemma in the management of such elderly patients across the neurology and audiology/otology clinics seems enormous due to the attendant effects of such health-related comorbid conditions and ageing. This has been observed to have negative effect on the general well-being of quite a number of the elderly patients identified with the comorbid health conditions. It has also increased the tinnitus severity and related psychosocial reactions of the elderly patients. Worse still, the situation causes undulating increase in the prevalence of the comorbid condition of advanced age both male and female irrespective of cultural differences. Due to the aforementioned, this chapter is written with the aim of highlighting the efficacy of audiological tinnitus management options considered essential in the rehabilitation of individuals with comorbidity of hypertension and tinnitus. The chapter also discusses the benefits of combined therapies in rehabilitating elderly patients with comorbidity of hypertension and tinnitus and concluded with some useful recommendations for effective management of the comorbid condition. 2 results 2
- Hypertension 2 results 2
- Physiotherapy 2 results 2
- Spinal cord injury 2 results 2
- Tinnitus 2 results 2
- Aim: To develop a Primary Healthcare-Based Physiotherapy Intervention (PHCPI) that requires simple, inexpensive, easy-to-use equipment for stroke rehabilitation and evaluate its effects on selected clinical indices of recovery among post-acute stroke survivors over a 10-week period. Methods: Three databases (Medline, Pubmed and PEDro) were used to identify treatment approaches with proven efficacy. The authors synthesised these treatment approaches to develop the PHCPI, which was used in a repeated measure design involving 25 (mean age=60.6 ± 10.2 years) consenting individuals with first-incidence stroke. These individuals were treated at a primary health centre, twice weekly for 10 consecutive weeks. Outcomes were assessed using the Modified Motor Assessment Scale (MMAS), the Short Form Postural Assessment Scale for Stroke (SF-PASS) and the Reintegration to Normal Living Index (RNLI), before the intervention and fortnightly thereafter. Walking speed and quality of life were also assessed before the intervention and at week 10 of it. Results: Within-subject multivariate analysis, after controlling for gender, showed a significant increase in motor function, postural balance, walking speed and quality of life. Their community reintegration scores also improved over the period. Conclusion: The PHCPI resulted in improved motor function, community reintegration, walking speed, postural balance and quality of life among community-dwelling stroke survivors. This intervention can be used for stroke rehabilitation at primary health centres. 1 results 1
- Animal care 1 results 1
- Animal health 1 results 1
- As age increases, word recognition and speech discrimination ability systematically decreases, in relation to decline along the auditory systems leading to a reduction in the ability to perceive high pitched sounds and discriminate speech correctly. Thus, this study evaluated the performance of two categories of aged on speech discrimination skills. The study was carried out through Pure- Tone Audiometric Test (PTA) and Speech Discrimination Test (SDT) based on phonetically balanced words. Two hundred and forty (240) aged comprising two groups of one hundred and twenty (120) each of rural and urban dwellers were selected using purposive sampling technique. With the aid of independent t-test statistics at 0.05 level of significance, the findings revealed a significant difference in the hearing sensitivity between the aged in rural and urban areas across the pure-tone audiometric tested frequencies (t.cal = 4.20; P < 0.05). The aged in urban area had a significantly better performance on the speech. discrimination test than their counterparts in rural area (t.cal. = 3.78; P < 0.05). The study found no significant difference in the performance of the two groups on speech discrimination test in line with their gender make-up (t.cal. = 0.57; P> 0.05). Based on the findings, the study establishes that the two categories of aged demonstrated poor speech discrimination abilities as a result of their reduced hearing efficiency as a consequence of ageing. Recommendations were therefore made to the aged and their family, society, rehabilitation experts (support services) and government on the need to sharpen the aged verball non-verbal and interpersonal oral communication abilities as well as to curtail the explosion of hearing disability as a result of ageing in Nigeria. 1 results 1
- Assistive technology 1 results 1
- Auditory performance 1 results 1
- Background: Cognitive rehabilitation (CR) is an important component of stroke rehabilitation. Most of the strategies used for this purpose are not readily affordable. This is the protocol of a trial to investigate the effects of over-ground walking (OGW) exercise and CR on cognitive function among stroke survivors. Methods: This is a three-centre, single blind, randomised controlled trial (RCT). Fifty-seven stroke survivors with mild to moderate cognitive impairments will be recruited from three healthcare facilities and randomly assigned into three groups. Group A will receive moderate intensity OGW exercise. Group B will receive CR using an adapted cognitive intervention comprising an attention and a memory tasks. Group C will receive combine OGW and CR exercise. All interventions will be thrice weekly for 8 weeks. Outcomes to be assessed at baseline, 4th and 8th week of interventions are cognition, brain-derived neurotrophic factor (BDNF), quality of life and participation using Mini-Mental State Examination, Melsin brand ELISA kit, stroke-specific quality of life and London Handicap Scale, respectively. Friedman and Kruskal–Wallis tests will be used for within-group and between-group comparison of data. Discussion: This trial is the first to examine the effect of OGW exercise on cognition and BDNF among stroke survivors. 1 results 1
- Background: Knowledge of the specific expectations of patients with neurological conditions (NCs) from rehabilitation helps in setting attainable goals. Such expectations may vary from situation to situation. There are no studies investigating rehabilitation expectations amongst individuals with NCs in Nigeria. Objectives: The aim of our study was to explore the rehabilitation expectations of individuals with NCs. Method: This convergent mixed-methods study comprised a cross-sectional survey of 105 individuals with NCs and two sessions of Focus Group Discussions (FGDS) amongst eight individuals with NCs. The modified Needs Assessment Questionnaire was used to assess rehabilitation needs as a proxy for rehabilitation expectations, whilst disability was assessed using the World Health Organization Disability Assessment Schedule 2.0. Quantitative data were summarised using descriptive statistics and analysed using inferential statistics at p < 0.05. Thematic analysis was conducted on the qualitative data. Results: Sixty-one (58.1%) stroke survivors, 33 (31.4%) individuals with spinal cord injury (SCI) and 11 (10.5%) with traumatic brain injury (TBI) aged 46.48 ± 15.91 were surveyed. The need for social/recreational activity was the most expressed need (100%) amongst the participants. Mobility was reported as an important need constituting a barrier to enjoying life by 93 (88.6%) participants. Individuals with SCI expressed the greatest needs compared with the other two groups. Needs were significantly correlated with severity of disability (p < 0.05). Four overarching themes (physical health, financial, healthcare services/rehabilitation and emotional/social) representing major areas of needs emerged from the FGD data. Conclusion: Individuals with NCs in Nigeria have specified expectations of rehabilitation. Disability was a major driver of these expectations, irrespective of NC subtype. Clinical implications: Rehabilitation programmes for individuals with NCs should target expressed needs or expectations of each patient cohort and minimise disabilities associated with these conditions. 1 results 1
- Background: The adoption of Collaborative Goal Setting (CGS) is limited in most rehabilitation settings in Nigeria despite its recommendations in clinical practice guidelines. Objective: To explore the perceptions of physiotherapists and patients about CGS at a tertiary healthcare facility in Ibadan, Nigeria. Methods: We conducted focus group discussions among purposively selected physiotherapists (n = 8) and patients (4 stroke survivors, 3 patients with brain injury) to qualitatively explore their perceptions. Audio-taped discussions were transcribed verbatim and thematically analyzed. Results: We identified four themes around CGS which were: 1) paternalistic view of goal setting; 2) physiotherapists as goal setters; 3) perceived benefits of collaborative goal setting; and 4) barriers and facilitators to CGS. The physiotherapists articulated goals as expected outcomes from treat- ment and believed they were better poised and experienced to determine what patients could achieve during each phase of treatment. Patients' view of goal setting agreed with the physio- therapists', as they also opined that goal setting is the responsibility of physiotherapists. Time constraint, inadequate knowledge and the inability of patients to appropriately articulate their goals and expectations from treatment were barriers to CGS. Concerns about who to collaborate with when dealing with patients with impaired cognition and/or disorders of consciousness were raised by the physiotherapists. Participants in both groups indicated that education on how to set patient-oriented goals could facilitate CGS. Conclusions: Though rarely practiced, participants agreed that collaborative goal setting could be beneficial. Both the physiotherapists and patients require education on how to appropriately collaborate in setting goals of rehabilitation. 1 results 1
- Background: Use of standardized tools to assess balance and mobility limitations is a recommended practice in stroke rehabilitation. The extent to which clinical practice guidelines (CPGs) for stroke rehabilitation recommend specific tools and provide resources to support their implementation is unknown. Purpose: To identify and describe standardized, performance-based tools for assessing balance and/or mobility and describe postural control components challenged, the approach used to select tools, and resources provided for clinical implementation, in CPGs for stroke. Methods: A scoping review was conducted. We included CPGs with recommendations on the delivery of stroke rehabilitation to address balance and mobility limitations. We searched seven electronic databases and grey literature. Pairs of reviewers reviewed abstracts and full texts in duplicate. We abstracted data about CPGs, standardized assessment tools, the approach for tool selection, and resources. Experts identified postural control components challenged by each tool. Results: Of the 19 CPGs included in the review, 7 (37%) and 12 (63%) were from middle and high-income countries, respectively. Ten CPGs (53%) recommended or suggested 27 unique tools. Across 10 CPGs, the most commonly cited tools were the Berg Balance Scale (BBS) (90%), 6-Minute Walk Test (6MWT) (80%), Timed Up and Go Test (80%) and 10-Meter Walk Test (70%). The tool most frequently cited in middle- and high-income countries was the BBS (3/3 CPGs), and 6MWT (7/7 CPGs), respectively. Across 27 tools, the three components of postural control most frequently challenged were underlying motor systems (100%), anticipatory postural control (96%), and dynamic stability (85%). Five CPGs provided information in varying detail on how tools were selected; only 1 CPG provided a level of recommendation. Seven CPGs provided resources to support clinical implementation; one CPG from a middle-income country included a resource available in a CPG from a high-income country. Conclusion: CPGs for stroke rehabilitation do not consistently provide recommendations for standardized tools to assess balance and mobility or resources to facilitate clinical application. Reporting of processes for tool selection and recommendation is inadequate. Review findings can be used to inform global efforts to develop and translate recommendations and resources for using standardized tools to assess balance and mobility post-stroke. 1 results 1
- Balance 1 results 1
- Childhood hearing loss 1 results 1
- Clinical practice guideline 1 results 1
- Cognitive rehabilitation therapy 1 results 1
- Collaborative goal setting 1 results 1
- Communication 1 results 1
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