Effectiveness of Rehabilitation Nursing versus Usual Therapist-Led Treatment in Patients with Acute Ischemic Stroke: A Randomized Non-Inferiority Trial

Wang, Jianmiao; Zhang, Yuping; Chen, Yuanyuan; Li, Mei; Yang, Hongyan; Chen, Jinhua; Tang, Qiaomin; Jin, Jingfen

doi:10.2147/cia.s306255

Cited by 6 publications

(10 citation statements)

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“…In this study, we conducted a retrospective review of the data from consecutive patients who were recruited in the CIRCLE study (19) (ClinicalTrials.gov ID: NCT03702452) between 21 November 2018 and 19 November 2019. The CIRCLE study was designed to verify whether nursing-directed rehabilitation in patients who suffered ischemic strokes can compensate for the lack of professional rehabilitation therapists (20). The inclusion criteria were as follows: (1) patients aged between 18 and 90 years; (2) those having a diagnosis of ischemic stroke by CT or MRI and having met the diagnostic criteria prescribed by the WHO; (3) having an initial ischemic stroke within 7 days with limb dysfunction (muscle strength of the limbs is <5); (4) those maintaining consciousness (National Institutes of Health Neurological Deficit Score consciousness level 0 or 1); and (5) those who signed an informed consent form.…”

Section: Sample and Proceduresmentioning

confidence: 99%

The controlling nutritional status score and risk factors associated with malnutrition in patients with acute ischemic stroke

Chen

Yang²,

Lan³

et al. 2023

Front. Neurol.

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ObjectivesMalnutrition is an independent risk factor for poor outcomes in patients who suffered an acute ischemic stroke (AIS). The controlling nutritional status (CONUT) score can provide information for nutritional management in AIS patients. However, the risk factors associated with the CONUT score have not been established to date. Therefore, in this study, we aimed to investigate the CONUT score of patients with AIS and explore the potential risk factors associated with it.MethodsWe conducted a retrospective review of the data from consecutive AIS patients who were recruited in the CIRCLE study. Within 2 days of admission, we gathered the CONUT score, the Nutritional Risk Screening 2002, the Modified Rankin Scale, the National Institutes of Health Neurological Deficit Score (NIHSS), and demographic data from medical records. We used chi-squared tests to examine admission, and a logistic regression analysis was performed to explore the risk factors associated with CONUT in patients with AIS.ResultsA total of 231 patients with AIS participated in the study, with a mean age of 62.32 ± 13.0 years and a mean NIHSS of 6.77 ± 3.8. Of these patients, 41(17.7%) had hyperlipidemia. In terms of nutritional assessment, 137(59.3%) patients with AIS had high CONUT scores, 86(37.2%) patients with AIS had low or high BMI, and 117(50.6%) patients with AIS had NRS-2002 scores below 3. The chi-squared tests showed that age, NIHSS, body mass index (BMI), and hyperlipidemia were associated with the CONUT score (P < 0.05). The logistic regression analysis showed that low NIHSS scores (OR = 0.055 95% CI: 0.003–0.893), younger age (OR = 0.159 95% CI: 0.054–0.469), and hyperlipidemia (OR = 0.303 95% CI: 0.141–0.648) were independently associated with lower CONUT scores (P < 0.05), whereas BMI was not found to be independently associated with the CONUT.ConclusionsMore than half of the patients with AIS were at risk of malnutrition, with age and neurological deficits being identified as risk factors for nutritional control. Hyperlipidemia was found to be a protective factor of the CONUT, while NRS-2002 and BMI did not affect the nutritional control in patients with AIS.

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Section: Sample and Proceduresmentioning

confidence: 99%

The controlling nutritional status score and risk factors associated with malnutrition in patients with acute ischemic stroke

Chen

Yang²,

Lan³

et al. 2023

Front. Neurol.

Self Cite

View full text Add to dashboard Cite

show abstract

“…gov ID: NCT03702452) between 21 November 2018 and 19 November 2019. The CIRCLE study was to verify that nursing-directed rehabilitation in patients with stroke can compensate for the shortage of professional rehabilitation therapists ( 21 ). Inclusion criteria were: (1) patients who were between 18 and 90 years old; (2) patients who were diagnosed as having an ischemic stroke by computed tomography (CT) or magnetic resonance imaging (MRI) and who met the diagnostic criteria of the World Health Organization (WHO); (3) patients who had an initial ischemic stroke within 7 days, with limb dysfunction (muscular strength of the limbs is less than 5); (4) patients who maintain consciousness (the National Institutes of Health Stroke Scale (NIHSS) scale consciousness level 0 or 1); and (5) patients who signed an informed consent form.…”

Section: Methodsmentioning

confidence: 99%

Section: Sample and Proceduresmentioning

confidence: 99%

Limb heaviness as a sensorimotor disorder alters rehabilitation adherence after a stroke

et al. 2022

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IntroductionTo the best of our knowledge, it is still unknown how perceived limb heaviness affects rehabilitation adherence. As rehabilitation adherence is very important for the functional recovery of patients with stroke, it is important to explore the relationship between perceived limb heaviness and rehabilitation adherence.MethodsWe retrospectively reviewed the data of patients with consecutive stroke recruited in the CIRCLE study. The influence of age, gender, time from onset to enrollment, educational background, hypertension, diabetes, Modified Rankin Scale (MRS), and National Institutes of Health Stroke Scale (NIHSS) on rehabilitation adherence was analyzed. Multiple linear regression analysis was used to examine the association between perceived limb heaviness and rehabilitation adherence changes.ResultsA total of 108 participants completed the study. About 40 (37.0%) participants felt limb heaviness. The mean scores on the Medical Research Council (MRC) scale for the upper affected limb strength were 3.05 ± 1.7, and the mean score on the exercise adherence questionnaire (EAQ) was 34.27 ± 8.9. Univariate analysis showed that rehabilitation adherence levels differed in upper limb muscle strength and whether they perceived limb heaviness. After adjustment for independent predictors, we found that perceived limb heaviness was associated with rehabilitation adherence (B = −9.681 ± 1.494, p < 0.05) and R2 was 0.332 and 0.074 if the muscle strength of the upper limb and perceived limb heaviness were included in the model and the model was without perceived limb heaviness, respectively.ConclusionBy identifying patients with stroke with limb heaviness, it led to lower levels of motor functional rehabilitation adherence. We must pay more attention to limb heaviness and provide effective interventions to improve rehabilitation adherence and promote patient recovery.

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“…China has a high number of stroke patients in the world. There are ∼2.4 million new stroke cases in China every year, and ∼70%−80% of AIS patients are accompanied by a disability and cannot live independently (5). Limb dysfunction is the most common dysfunction in stroke patients.…”

Section: Introductionmentioning

confidence: 99%

Effect of the physical rehabilitation program based on self-care ability in patients with acute ischemic stroke: a quasi-experimental study

Liu¹,

Wang²,

Liu³

et al. 2023

Front. Neurol.

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IntroductionIt is the most practical goal of limb rehabilitation for stroke patients to make the upper limb, trunk, and lower limb joints link together as a whole and restore the ability to self-care. However, many previous studies focused on the single joint or single muscle group movement of stroke patients and did not integrate self-care ability training into the whole process of rehabilitation, which lacks accuracy, integrity, and systematization.MethodsA quasi-experimental study was conducted in a tertiary hospital. Eligible patients were recruited according to the inclusion criteria and exclusion criteria and then divided into an experimental group (n = 80) and a control group (n = 80) by the medical district. The control group received the routine physical rehabilitation intervention. The experimental group adopted the physical rehabilitation program based on self-care ability led by the nurses specializing in stroke rehabilitation to carry out the multi-joint coordinated exercise based on the control group. The training time and frequency were the same in both groups (45 min per session, one session per day for three consecutive months). The primary outcome was myodynamia. Secondary outcomes were the modified Barthel Index (MBI) and Stroke Specific Quality of Life Scale (SS-QOL). The primary and secondary outcomes were assessed before the intervention and at 1 and 3 months of intervention. In this study, the TREND checklist was followed for non-randomized controlled trials.ResultsA total of 160 participants completed the study. The physical rehabilitation program based on self-care ability was better than the routine rehabilitation program. With the prolongation of intervention time, all outcomes improved gradually in the experimental group (P < 0.05), and the myodynamia of lower limbs recovered faster than that of upper limbs. In the control group, the myodynamia of the affected limb was not significantly improved (P > 0.05), with only a small increase in MBI and SS-QOL scores (P < 0.05).ConclusionThe physical rehabilitation program based on self-care ability after stroke was beneficial for acute ischemic stroke patients and improved the patient's myodynamia, quality of life, and self-care ability within the third month.

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Effectiveness of Rehabilitation Nursing versus Usual Therapist-Led Treatment in Patients with Acute Ischemic Stroke: A Randomized Non-Inferiority Trial

Cited by 6 publications

References 53 publications

The controlling nutritional status score and risk factors associated with malnutrition in patients with acute ischemic stroke

The controlling nutritional status score and risk factors associated with malnutrition in patients with acute ischemic stroke

Limb heaviness as a sensorimotor disorder alters rehabilitation adherence after a stroke

Effect of the physical rehabilitation program based on self-care ability in patients with acute ischemic stroke: a quasi-experimental study

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