Post-stroke rehabilitation

Rakesh, Neal; Boiarsky, Daniel; Athar, Ammar; Hinds, Shaliesha; Stein, Joel

doi:10.1097/md.0000000000015934

Cited by 30 publications

(8 citation statements)

References 25 publications

(18 reference statements)

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Section: Introductionmentioning

confidence: 99%

“…Many of those who are discharged from hospital after a stroke have tenacious impairments, including weakness, balance difficulty, cognitive impairment, immobility, and dependency in activities of daily living (16,17). These severe physical, social, and psychological consequences can be devastating and coping with the outcome tends to be extremely difficult with an abundance of adjustments and variations in young adults' physical abilities, social integration, and family roles (3,(18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

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Why Me?: A Qualitative Study on the Experiences of Young Stroke Survivors in the Accra Metropolis of Ghana, West Africa

Opoku¹,

Eliason

Akpalu

2020

Journal of Patient Experience

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Young stroke survivors are affected gravely when diagnosed with stroke between the ages of 18 to 45 years. The psychological and social effects of young stroke require stringent coping factors geared toward recovery and regeneration of self. A qualitative exploratory design was used to explore coping experiences and purposive sampling technique was employed to recruit 10 participants. Data were collected using tape recorded interviews which lasted between 45 minutes to 1 hour 30 minutes and guided by a semistructured interview guide which was informed by the research objectives and literature review. Thematic content analysis was used to analyze the transcribed data and 6 themes namely: psychological disruption, disruption to social identity, spiritual practices and beliefs, self-determination, support, and herbal medicine were derived. These themes gave insight into how these young stroke victims experienced and coped with physical signs and symptoms which negatively impacted their activities of daily living and resulted in social isolation, fear, anxiety, depression, guilt, and suicidal ideations. Provision of continuity of care for young adults living with stroke is highly recommended.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Why Me?: A Qualitative Study on the Experiences of Young Stroke Survivors in the Accra Metropolis of Ghana, West Africa

Opoku¹,

Eliason

Akpalu

2020

Journal of Patient Experience

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“…33 Individuals in urban areas are having strokes at younger ages, and younger individuals are less likely to be recommended subacute rehabilitation compared with older adults with stroke, which demonstrates another reason why this association may persist. 34…”

Section: Discussionmentioning

confidence: 99%

Geographic Distribution of Social Service Resources for Stroke Survivors in Ohio Varies by Rurality

Wing,

Rajczyk,

Burke

2023

Stroke

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BACKGROUND: Both social service resources and stroke prevalence vary by geography, and health care resources are scarcer in rural areas. We assessed whether distributions of resources relevant to stroke survivors were clustered around areas of the highest stroke prevalence in Ohio and whether this is varied by rurality using an ecological study design. METHODS: Census tract (CT)–level self-reported stroke prevalence estimates (Centers for Disease Control and Prevention PLACES–2019 Behavioral Risk Factor Surveillance System) were linked with sociodemographic and rurality data (2019 American Community Survey) and geographic density of resources in Ohio (2020 findhelp data). Resources were grouped into categories: housing, in-home, financial, transportation, education, and therapy. Negative binomial regression models estimated the mean number of resources within 25 miles and 30 minutes of a CT centroid and quartiles of stroke prevalence for each resource group by rurality status (rural, urban, and suburban). Models were sequentially adjusted for total population and CT demographics. RESULTS: In Ohio, stroke prevalence was 3.9% (0.4%–14.2%). The highest stroke prevalence quartile (versus lowest) was associated with fewer resources within 25 miles overall (resource ratio [RR], 0.57–0.98). The most pronounced disparities were in rural CT; rural CTs with the highest quartile stroke prevalence had fewer housing (RR, 0.49 [95% CI, 0.32–0.75]), in-home (RR, 0.31 [95% CI, 0.20–0.49]), and therapy (RR, 0.23 [95% CI, 0.13–0.43]) resources compared with those with the lowest quartile stroke prevalence (reference: mean, 1.2 housing, 5.1 in-home, and 4.9 therapy resources, respectively). Rural disparities no longer persisted after adjustment for federal poverty limit (rural: housing [RR, 0.69 (95% CI, 0.40–1.20)], in-home [RR, 0.65 (95% CI, 0.34–1.23)], and therapy [RR, 0.66 (95% CI, 0.33–1.32)]). CONCLUSIONS: Stroke social service resources are inversely distributed relative to stroke prevalence in Ohio, particularly in rural areas. This inverse link in rural Ohio is likely explained by geographic differences in poverty. Stroke-specific resource-related interventions may be needed and should consider the roles of rurality and poverty.

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“…On the basis of clinical literature review, [19][20][21][22][23] several domains were identified by the authors to be pertinent to rehabilitation needs. These included: ► New functional dependency, indicated by an increased level of physical assistance required for mobility, personal care and/or the need for assistive equipment (such as a mobility aid).…”

Section: Design Developing a Proactive Rehabilitation Screening (Presmentioning

confidence: 99%

Targeted rehabilitation may improve patient flow and outcomes: development and implementation of a novel Proactive Rehabilitation Screening (PReS) service

Misa

Shiner

et al. 2021

BMJ Open Qual

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Rehabilitation programmes can be delivered to patients receiving acute care (‘in-reach rehabilitation’) and/or those who have completed acute care but experience ongoing functional impairments (‘subacute rehabilitation’). Access to these programmes depends on a rehabilitation assessment, but there are concerns that referrals for this assessment are often triggered too late in the acute care journey. We describe a Proactive Rehabilitation Screening (PReS) process designed to systematically screen patients during an acute hospital admission, and identify early those who are likely to require specialist rehabilitation assessment and intervention. The process is based on review of patient medical records on day 5 after acute hospital admission, or day 3 after transfer from intensive care to an acute hospital ward. Screening involves brief review of documented care needs, pre-existing and new functional disabilities, the need for allied health interventions and non-medical factors delaying discharge. From May 2017 to February 2019, the novel screening process was implemented as part of a service redesign of the rehabilitation consultation service. Four thousand consecutive screens were performed at the study site. Of those ‘ruled in’ by screening as needing a rehabilitation assessment, 86.0% went on to receive inpatient rehabilitation interventions. Of those ‘ruled out’ by screening, 92.1% did not go on to receive a rehabilitation intervention, while 7.9% did receive some form of rehabilitation intervention. Of all patients accepted into a rehabilitation programme (n=516), PReS was able to identify 53.6% (n=282) of them before the acute care teams made a referral (based on traditional criteria). In conclusion, we have designed and implemented a systematic, PReS service in one metropolitan Australian hospital. The process described was found to be time efficient and feasible to implement in an acute hospital setting. Further, it appeared to identify the majority of patients who went on to receive formal inpatient rehabilitation interventions.

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Post-stroke rehabilitation

Cited by 30 publications

References 25 publications

Why Me?: A Qualitative Study on the Experiences of Young Stroke Survivors in the Accra Metropolis of Ghana, West Africa

Why Me?: A Qualitative Study on the Experiences of Young Stroke Survivors in the Accra Metropolis of Ghana, West Africa

Geographic Distribution of Social Service Resources for Stroke Survivors in Ohio Varies by Rurality

Targeted rehabilitation may improve patient flow and outcomes: development and implementation of a novel Proactive Rehabilitation Screening (PReS) service

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