Do empowered stroke patients perform better at self-management and functional recovery after a stroke? A randomized controlled trial

Sit, Janet W H; Chair, Sek Ying; Choi, Kyoung-Seong; Chan, Carmen W.H.; Lee, Diana TF; Chan, Aileen Wk; Cheung, Jo LK; Tang, Siu Wai; Chan, Priscilla; Taylor-Piliae, Ruth E.

doi:10.2147/cia.s109560

Cited by 71 publications

(106 citation statements)

References 27 publications

(32 reference statements)

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“…These include participation based therapy ( 290 – 294 ), quality of life centered care ( 240 , 295 – 310 , 345 ), community based rehabilitation ( 311 – 315 ), home based rehabilitation ( 132 , 193 , 316 – 335 ), self-management ( 336 , 337 ), family or care giver-led training ( 340 – 342 , 350 , 353 , 354 ), telerehabilitation ( 317 , 343 , 346 , 349 ), and early therapy/rehabilitation ( 174 , 338 , 339 , 347 , 348 , 351 , 352 , 355 , 356 ).…”

Section: Resultsmentioning

confidence: 99%

“…Though rarely used in the context of stroke ( 384 ), application of self-management interventions for stroke rehabilitation has stimulated research interest in recent years ( 337 ), Despite the fact that stroke is an acute event, stroke survivors experience physical and psychosocial challenges in the recovery trajectory which renders stroke a chronic condition ( 385 ). Challenges faced include depression, functional and mobility disability, reduction in life roles, and a lack of social support ( 386 ).…”

Section: Discussionmentioning

confidence: 99%

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Pragmatic Solutions for Stroke Recovery and Improved Quality of Life in Low- and Middle-Income Countries—A Systematic Review

et al. 2020

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Background: Given the limited healthcare resources in low and middle income countries (LMICs), effective rehabilitation strategies that can be realistically adopted in such settings are required. Objective: A systematic review of literature was conducted to identify pragmatic solutions and outcomes capable of enhancing stroke recovery and quality of life of stroke survivors for low- and middle- income countries. Methods: PubMed, HINARI, and Directory of Open Access Journals databases were searched for published Randomized Controlled Trials (RCTs) till November 2018. Only completed trials published in English with non-pharmacological interventions on adult stroke survivors were included in the review while published protocols, pilot studies and feasibility analysis of trials were excluded. Obtained data were synthesized thematically and descriptively analyzed. Results: One thousand nine hundred and ninety six studies were identified while 347 (65.22% high quality) RCTs were found to be eligible for the review. The most commonly assessed variables (and outcome measure utility) were activities of daily living [75.79% of the studies, with Barthel Index (37.02%)], motor function [66.57%; with Fugl Meyer scale (71.88%)], and gait [31.12%; with 6 min walk test (38.67%)]. Majority of the innovatively high technology interventions such as robot therapy (95.24%), virtual reality (94.44%), transcranial direct current stimulation (78.95%), transcranial magnetic stimulation (88.0%) and functional electrical stimulation (85.00%) were conducted in high income countries. Several traditional and low-cost interventions such as constraint-induced movement therapy (CIMT), resistant and aerobic exercises (R&AE), task oriented therapy (TOT), body weight supported treadmill training (BWSTT) were reported to significantly contribute to the recovery of motor function, activity, participation, and improvement of quality of life after stroke. Conclusion: Several pragmatic, in terms of affordability, accessibility and utility, stroke rehabilitation solutions, and outcome measures that can be used in resource-limited settings were found to be effective in facilitating and enhancing post-stroke recovery and quality of life.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pragmatic Solutions for Stroke Recovery and Improved Quality of Life in Low- and Middle-Income Countries—A Systematic Review

et al. 2020

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“…Bandura's cognition theory was commonly applied for stroke self-management program, and this kind of program contained meaningful and physical activities to further improve self-e cacy. [45][46][47] Similar to stroke self-management program, VR can provide task-oriented, imitative, and repetitive activities, and it also has the advantage to integrate these four principles. Additionally, according to theoretical concepts of Bandura's self-e cacy, the most feasible way to assist participants to obtain and improve self-e cacy is to use self-e cacy-related four principles.…”

Section: Discussionmentioning

confidence: 99%

Effects of virtual reality training on occupational performance and self-efficacy of patients with stroke: a randomized controlled trial

Long

Ouyang

Zhang

2020

Preprint

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Background—Virtual reality (VR) has been broadly applied in post-stroke rehabilitation. However, studies on occupational performance and self-efficacy as primary outcomes of stroke rehabilitation using VR are lacking. Thus, this study aims to investigate the effects of VR training on occupational performance and self-efficacy in patients with stroke.Methods—This was an assessor-blinded, randomized controlled trial. Sixty participants with first-ever stroke (< 1-year onset) underwent rehabilitation in a single acute hospital. Participants were randomly assigned to either the VR group (n = 30) or control group (n = 30). Both groups received dose-matched conventional rehabilitation (i.e., 45 min, five times per week over 3 weeks). The VR group received additional 45-min VR training for five weekdays over 3 weeks. The primary outcome measures were the Canadian Occupational Performance Measure and Stroke Self-Efficacy Questionnaire. Secondary outcome measures included Modified Barthel Index, Fugl-Meyer Assessment-Upper Extremity, and Functional Test for the Hemiplegic Upper Extremity. The assessment was conducted at baseline and after the 3-week intervention.Results—A total of 52 participants (86.7%) completed the trial. Significant between-group differences in Stroke Self-Efficacy Questionnaire (Median Difference = 8, P = 0.043) and Modified Barthel Index (Median Difference = 10, P = 0.030) were found; however, no significant between-group differences in Canadian Occupational Performance Measure, Fugl-Meyer Assessment-Upper Extremity, and Functional Test for the Hemiplegic Upper Extremity were noted. No serious adverse reactions related to the program were reported.Conclusions—Additional VR training could help improve the self-efficacy and activities of daily living of patients with stroke; however, it was not superior to conventional training in the improvement of upper limb functions, occupational performance, and satisfaction. Nevertheless, VR could be integrated into conventional rehabilitation programs to enhance self-efficacy of patients after stroke.Trial Registration—This study was successfully registered under the title “Effects of virtual reality training on occupational performance and self-efficacy of patients with stroke” on October 13 2019 and could be located in http://www.chictr.org with the study identifier ChiCTR1900026550.

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“…Hence, these benefits are best transferred to daily life only when the program is personalized (mode of delivery, frequency, duration). In an empowerment intervention on stroke patients’ self-efficacy, Sit et al (2016) found that empowered patients reported better functional recovery, especially in activities of daily living, and better self-management of their cognitive symptoms than a control group receiving standard therapy.…”

Section: Patient Empowermentmentioning

confidence: 99%

Virtual Reality as a Vehicle to Empower Motor-Cognitive Neurorehabilitation

Pérez-Marcos¹,

Bieler-Aeschlimann

Serino

2018

Front. Psychol.

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In this paper, we advocate the combination of four key ingredients that we believe are necessary to design long-lasting effective treatments for neurorehabilitation: (i) motor-cognitive training, (ii) evidence-based neuroscience principles, in particular those related to body perception, (iii) motivational games, and (iv) empowerment techniques. Then, we propose virtual reality (VR) as the appropriate medium to encompass all the requirements mentioned above. VR is arguably one of the most suitable technologies for neurorehabilitation able to integrate evidence-based neurorehabilitation techniques and neuroscience principles into motivating training approaches that promote self-management by empowering patients to own their recovery process. We discuss the advantages and challenges of such an approach on several exemplary applications and outline directions for future developments. We strongly believe that the combination of positive psychology and positive technology mediated by VR-based interventions can heavily impact the rehabilitation outcomes of motor-cognitive functions along all the stages of the rehabilitation path.

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Do empowered stroke patients perform better at self-management and functional recovery after a stroke? A randomized controlled trial

Cited by 71 publications

References 27 publications

Pragmatic Solutions for Stroke Recovery and Improved Quality of Life in Low- and Middle-Income Countries—A Systematic Review

Pragmatic Solutions for Stroke Recovery and Improved Quality of Life in Low- and Middle-Income Countries—A Systematic Review

Effects of virtual reality training on occupational performance and self-efficacy of patients with stroke: a randomized controlled trial

Virtual Reality as a Vehicle to Empower Motor-Cognitive Neurorehabilitation

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