Objective: To evaluate the effect of mental practice on motor imagery ability and assess the influence of motor imagery on gait rehabilitation in sub-acute stroke. Design: Randomized controlled trial. Subjects: A total of 44 patients with gait dysfunction after first-ever stroke were randomly allocated to a motor imagery training group and a muscle relaxation group. Methods: The motor imagery group received 6 weeks of daily mental practice. The relaxation group received a muscle relaxation programme of equal duration. Motor imagery ability and lower limb function were assessed at baseline and after 6 weeks of treatment. Motor imagery ability was tested using a questionnaire and mental chronometry test. Gait outcome was evaluated using a 10-m walk test (near transfer) and the Fugl-Meyer assessment (far transfer). Results: Significant between-group differences were found, with the vividness of kinesthetic imagery and the walking test results improving more in the motor imagery group than in the muscle relaxation group. There was no group interaction effect for the far transfer outcome score. Conclusion: Motor imagery training may have a beneficial task-specific effect on gait function in sub-acute stroke; however, longer term confirmation is required.

Somatosensory impairments are common in subacute patients poststroke and are related to motor outcome. Visuospatial neglect was associated with more severe upper-limb somatosensory impairments.

Background The spread of COVID-19 has affected people’s daily lives, and the lockdown may have led to a disruption of daily activities and a decrease of people’s mental health. Aim To identify correlates of adults’ mental health during the COVID-19 lockdown in Belgium and to assess the role of meaningful activities in particular. Methods A cross-sectional web survey for assessing mental health (General Health Questionnaire), resilience (Connor-Davidson Resilience Scale), meaning in activities (Engagement in Meaningful Activities Survey), and demographics was conducted during the first Belgian lockdown between April 24 and May 4, 2020. The lockdown consisted of closing schools, non-essential shops, and recreational settings, employees worked from home or were technically unemployed, and it was forbidden to undertake social activities. Every adult who had access to the internet and lived in Belgium could participate in the survey; respondents were recruited online through social media and e-mails. Hierarchical linear regression was used to identify key correlates. Results Participants (N = 1781) reported low mental health (M = 14.85/36). In total, 42.4% of the variance in mental health could be explained by variables such as gender, having children, living space, marital status, health condition, and resilience (β = −.33). Loss of meaningful activities was strongly related to mental health (β = −.36) and explained 9% incremental variance (R2 change = .092, p < .001) above control variables. Conclusions The extent of performing meaningful activities during the COVID-19 lockdown in Belgium was positively related to adults’ mental health. Insights from this study can be taken into account during future lockdown measures in case of pandemics.

This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues.Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. Abstract Objectives: To evaluate fall risk in stroke patients based on single-and dual-task gait analyses, and to investigate the difference between 2 cognitive tasks in the dual-task paradigm. Design: Prospective cohort study. Setting: Rehabilitation hospitals. Participants: Subacute stroke patients (NZ32), able to walk without physical/manual help with or without walking aids, while performing a verbal task. Interventions: Not applicable. Main Outcome Measures: Functional gait measures were Functional Ambulation Categories (FAC) and use of a walking aid. Gait measures were evaluated by an electronic walkway system under single-and dual-task (DT) conditions. For the single-task, subjects were instructed to walk at their usual speed. One of the DTs was a verbal fluency dual task, whereby subjects had to walk while simultaneously enumerating as many different animals as possible. For the other DT (counting dual task), participants had to walk while performing serial subtractions. After inclusion, participants kept a 6-month falls diary. Results: Eighteen (56.3%) of the 32 included patients fell. Ten (31.3%) were single fallers (SFs), and 8 (25%) were multiple fallers (MFs). Fallers (Fs) more frequently used a walking aid and more frequently needed an observatory person for walking safely (FAC score of 3) than nonfallers (NFs). Two gait decrement parameters in counting dual task could distinguish potential Fs from NFs: decrement in stride length percentage (PZ.043) and nonparetic step length percentage (PZ.047). Regarding the division in 3 groups (NFs, SFs, and MFs), only MFs had a significantly higher percentage of decrement for paretic step length (PZ.023) than SFs. Conclusions: Examining the decrement of spatial gait characteristics (stride length and paretic and nonparetic step length) during a DT addressing working memory can identify fall-prone subacute stroke patients.

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Background and purpose Dysphagia, dysarthria and aphasia are common symptoms following acute stroke; however, limited data are available from recent prospective clinical trials. The aim of this study was to determine the incidence and associated factors of dysphagia, dysarthria and aphasia following a first acute ischaemic stroke in patients admitted to a comprehensive stroke center. Methods All first ischaemic stroke patients admitted to the Stroke Unit of Ghent University Hospital within 48 h after symptom onset were enrolled in this prospective study between March 2018 and October 2019. Dysphagia and communication screenings were performed within 3 days after admission. When dysphagia, dysarthria and/or aphasia were assumed, standardized assessments were performed. Incidence rates were calculated as point estimates (%) with 95% confidence intervals (CI). Associated factors were calculated via multivariate binary logistic regression analyses. Results Dysphagia, dysarthria and aphasia were present in 23% (95% CI, 17–31), 44% (95% CI, 37–52) and 23% (95% CI, 17–30), respectively of 151 first ischaemic stroke patients [67 female, mean age 67 (SD 14) years]. Separate multivariate binary logistic regression analyses showed that dysphagia, dysarthria and aphasia were significantly associated with age‐adjusted stroke severity at baseline [odds ratio (OR), 1.16; 95% CI, 1.09–1.23; OR, 1.13; 95% CI, 1.07–1.20 and OR, 1.11; 95% CI, 1.05–1.17 respectively]. Corrected for stroke severity, the risk for aphasia increased by 4% per year of age (OR, 1.04; 95% CI, 1.00–1.07). Adjusted for age and stroke severity, aphasia was significantly associated with large artery atherosclerosis as stroke etiology (OR, 3.91; 95% CI, 1.18–12.98). Conclusions This trial showed a high incidence of dysphagia, dysarthria and aphasia following acute ischaemic stroke. Stroke severity was an associated factor for all three symptoms.

Computerized as well as paper-and-pencil tasks are applied in mapping visuospatial neglect in experimental research and clinical practice. This article presents a new kind of computer-based assessment method, using an electronic pen display and user-friendly software. The approach is tailored to specific spatial processes and highlights the usefulness of a pen display in neglect patients. The advantages of the introduced method are illustrated by a recently designed battery of classic, as well as new, types of tests. The development of the appropriate stimuli and the assorted scoring systems is addressed, as well as the resulting types of task implementation and data generation. The diagnostic value of the different visuospatial neglect tests is demonstrated by comparative analyses between a neglect group and a control group. Among the benefits of the proposed assessment method are (1) the opportunity to perform standardized repeated measurements to quantify recovery, (2) online performance monitoring, (3) flexible employment, (4) the collection of exact data over a short period, and (5) the easy availability of more refined quantitative as well as interesting qualitative information, especially as compared to classic or paper-and-pencil tasks. To indicate that this method also lends itself well to measures for treatment procedures, an illustration is given with respect to specific measurements during prism adaptation. The tasks of the Visuospatial Neglect Test Battery and the prism adaptation measures are illustrated by a case study. The outlined applications are discussed with respect to experimental as well as clinical purposes.

Closely examining the effects, optimal regime and time window of prism adaptation (PA) promotes guidelines for effective rehabilitation practice. The effects of short-term repetitive PA on spatial neglect manifestations were evaluated in patients with heterogeneous post-stroke delays, using a digital Visuospatial Neglect Test Battery. Subsequently, potential differences in PA effects between acute, subacute or chronic neglect were explored. A multicentre randomised controlled trial was conducted in 43 right-hemisphere neglect patients. They were treated with a mild PA regime: seven sessions of experimental or placebo prism training over 7-12 days. The outcome measures were diverse neglect variables related to peripersonal navigation, visual extinction, visuospatial memory, bisection, cancellation, drawing and visual search. The treatment effects were assessed after a short and a long time interval. Two to 24 hours after PA, conventional effects were found for drawing and centred bisection, and novel effects for peripersonal visuospatial navigation, visual extinction, and non-motor memory (with caution). No effects were found for visual search times and cancellation. The assessments after three months were still indicative of PA benefits for navigational, drawing and memory functions. PA did not prove to be more effective in acute, subacute or chronic patients. The extension of effects is theoretically framed within the debate about the levels of cognitive processing that are impacted by PA. Clinical suggestions are formulated regarding PA implementation in neglect treatment.