Early, more-intensive, UL training was associated with greater changes in activation in putative motor (supplementary motor area and cerebellum) and attention (anterior cingulate) regions, providing support for the role of these regions and functions in early recovery poststroke.
Objective. Neurological dysfunction commonly occurs in the upper limb contralateral to the hemisphere of the brain in which stroke occurs; however, the impact of stroke on function of the ipsilesional upper limb is not well understood. This study aims to systematically review the literature relating to the function of the ipsilesional upper limb following stroke and answer the following research question: Is the ipsilesional upper limb affected by stroke? Data Source. A systematic review was carried out in Medline, Embase, and PubMed. Review Methods. All studies investigating the ipsilesional upper limb following stroke were included and analysed for important characteristics. Outcomes were extracted and summarised. Results. This review captured 27 articles that met the inclusion criteria. All studies provided evidence that the ipsilesional upper limb can be affected following stroke. Conclusion. These findings demonstrate that clinicians should consider ipsilesional upper limb deficits in rehabilitation and address this reduced functional capacity. Furthermore, the ipsilesional upper limb should not be used as a “control” measure of recovery for the contralateral upper limb.
There has been an increase in the number of stroke units in Australia owing to evidence proving their clinical effectiveness. This study aimed to explore the conventional care provided by an occupational therapist and physiotherapist employed in the acute stroke unit of an Australian hospital and then compare the findings to national stroke guidelines. Mixed methodologies were used in a case study format. Results showed that conventional care was based primarily on an efficient initial investigative process which occurred in a work place under pressure. Other findings highlighted patient-centered care and hypothesis-driven clinical reasoning. The study revealed that, in general, the conventional care provided by the two therapists met the national stroke guidelines. This case study has explored the use of combined methodologies for studying complex packages of care and has also provided a basis on which to propose a model of practice.
This is the first study to map national usage of post-stroke assessments and review that usage against the evidence. It generates new knowledge concerning what assessments we currently use post stroke, what we should be using and makes some practical post stroke clinical recommendations.
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