Selecting Measures for Balance and Mobility to Improve Assessment and Treatment of Individuals After Stroke

Kegelmeyer, Deb; Kloos, Anne; Siles, Amelia

doi:10.1310/tsr2104-303

Cited by 8 publications

(5 citation statements)

References 37 publications

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“…Therapists consider many variables when choosing a standardized measure, such as patients' needs and goals, stroke severity, psychometric properties, and the feasibility of using standardized assessments in the context of a given setting (Barak & Duncan, 2006;Kegelmeyer, Kloos, & Siles, 2014). Before planning interventions to increase the use of standardized assessments, it is important to understand the barriers.…”

Section: Barriers and Facilitators For Using Standardized Assessmentsmentioning

confidence: 99%

“…In physical therapy, the Stroke Evaluation Database to Guide Effectiveness (StrokEDGE) is a unique resource because it recommends specific standardized assessments across the care continuum (Kegelmeyer et al, 2014). These recommendations were made using a modified Delphi method to identify the best assessments across the levels of the International Classification of Functioning, Disability and Health (ICF) model and stages of stroke recovery.…”

Section: Researchmentioning

confidence: 99%

“…In addition, a majority of the physical therapy respondents reported using the APTA memberonly online resource, StrokEDGE, which recommends specific consensus-driven outcome measures for use with stroke survivors across the care continuum (Kegelmeyer et al, 2014). In fact, StrokEDGE II, a recent update to StrokEDGE, was shared with the Rehab Measures Database (Academy of Neurologic Physical Therapy, 2018) because it contains reviewed tests, including instructions, psychometrics, and minimally clinically important differences.…”

Section: Online Resources To Increase Use Of Standardized Assessmentsmentioning

confidence: 99%

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Use of Standardized Assessments and Online Resources in Stroke Rehabilitation

Lin¹,

Bosch²,

Rowe³

et al. 2019

The Open Journal of Occupational Therapy

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Background: The extent to which movement-related standardized assessments and online resources are used in stroke rehabilitation is unclear in the United States. Method: The researchers used a cross-sectional descriptive survey that examined (a) therapists use of movement-related standardized assessments, (b) factors influencing learning of new assessments, and (c) use of frequency of online resources by occupational therapists and physical therapists in the United States. Results: Of 151 respondents (46.4% occupational therapists, 53.6% physical therapists), the most frequently used movement-related assessments by occupational and physical therapists were the Berg and Fugl-Meyer Assessment, respectively. More physical therapists use motor-related standardized assessments regularly than occupational therapists, and physical therapists showed more consensus among standardized assessments. Both professions cited quality of patient care for motivating them to integrate outcome measures into practice. Most therapists in stroke rehabilitation used online resources to access movement-related standardized assessment content at least 25% of the time. The Rehabilitation Measures Database was the most frequently used website. Conclusion: Both occupational and physical therapists use online resources for movement-related standardized assessments on a regular basis. However, occupational therapists do not use standardized assessments as frequently as physical therapists. A systematic study of factors that impact the integration of standardized assessments is needed to further identify barriers and inform clinical practice change. Comments The authors report that they have no conflicts of interest to disclose.

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Section: Barriers and Facilitators For Using Standardized Assessmentsmentioning

confidence: 99%

Section: Researchmentioning

confidence: 99%

Section: Online Resources To Increase Use Of Standardized Assessmentsmentioning

confidence: 99%

See 1 more Smart Citation

Use of Standardized Assessments and Online Resources in Stroke Rehabilitation

Lin¹,

Bosch²,

Rowe³

et al. 2019

The Open Journal of Occupational Therapy

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“…Aerobic exercise training is well known as an effective approach to improve aerobic fitness [20]. Exercises on a cycle ergometer performed for both the upper and lower limbs allow the patient to perform an activity load with a focus on the range of motion, coordination, muscle strengthening and increased exercise tolerance [20,21]. These exercises are also well tolerated in patients with stroke [22].…”

Section: Introductionmentioning

confidence: 99%

Addition of proprioceptive neuromuscular facilitation to cardiorespiratory training in patients poststroke: study protocol for a randomized controlled trial

Souza

Brandão

Martins

et al. 2020

Trials

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Background: Individuals affected by stroke present with changes in cardiovascular and respiratory functions. Cardiorespiratory training (CRT) is one of the classic intervention guidelines for cardiorespiratory fitness. CRT in association with the proprioceptive neuromuscular facilitation (PNF) technique for respiratory muscles could improve the quality of life, cardiorespiratory function and gait parameters of patients after stroke. Objective: To assess the effects of respiratory and trunk patterns of CRT associated with PNF on the quality of life, gait, oxygen consumption, respiratory muscle strength and thoracic volumes. Methods/design: A blind, randomized clinical trial with allocation confidentiality will be performed. Forty patients will be randomized into four groups: CRT-lower limb (LL) plus PNF; CRT-LL and respiration; CRT-upper limb (UL) plus PNF; or CRT-UL and respiration. Individuals will be evaluated at three different times (pretreatment, after 20 days of treatment and 1 month after the end of treatment). The treatment protocol consists of respiratory exercises, 30 min of CRT (cycle ergometer) and then repetition of the respiratory exercises, performed three times a week over a period of 20 days. Primary outcome measures are quality of life, gait, balance, peak oxygen uptake and rib cage compartment volumes. As secondary outcomes, respiratory function and maximal inspiratory and expiratory pressures will be measured. Discussion: The association of PNF with CRT may be a viable and accessible alternative to increase cardiorespiratory function in patients with stroke. Trial registration: ClinicalTrials.gov, NCT03171012. Registered on 6 June 2017.

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“…Balance assessment is critical to identify individuals who are at increased risk of falling . Both clinical and instrumented measures have been used to qualitatively and quantitatively assess instability during standing and walking to identify who may benefit from balance interventions, to tailor treatments according to individual needs, and to assess the effects of various rehabilitation approaches on balance and mobility in people with neurologic disorders …”

Section: Introductionmentioning

confidence: 99%

Instrumented Version of the Modified Dynamic Gait Index in Patients With Neurologic Disorders

Anastasi

Carpinella

Gervasoni

et al. 2019

PM&R

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Background: Gait instability is common in adults with neurologic disorders and the modified Dynamic Gait Index (mDGI) was recently introduced to assess dynamic balance. However, instrumental assessment is needed to provide quantitative measures. Objective: To develop and validate an instrumented version of the mDGI. Design: Cross-sectional study. Setting: Clinical setting. Participants: Thirty adults with neurologic disorders (10 with multiple sclerosis, 10 with Parkinson disease, and 10 with stroke) and 20 healthy volunteers. Methods: Participants were assessed with the Timed Up and Go test (TUG) and with the mDGI. During the assessment of mDGI, data were collected by a single Inertial Measurement Unit (IMU) positioned on the sternum. Principal component analysis (PCA) was performed on the instrumented data extracting eight PC scores (ImPC) describing dynamic balance. The instrumented overall score (ImDGI) was then calculated as the sum of the mPCs. PCA revealed two components associated with stride features and regularity (ImDGI_Gait_Pattern) and trunk movements (ImDGI_Trunk_Sway). Spearman coefficients were calculated between mDGI and ImDGI, whereas Mann-Whitney (U) and Kruskal-Wallis (H) tests assessed differences between groups and neurologic conditions. Main Outcome Measurements: ImDGI. Results: ImDGI did not show ceiling effects, and good correlations were found between ImDGI and mDGI (r = .84), and TUG (r = .84) for people with neurologic disorders (P < .001). Significant differences among pathologies (H test (2) =12.5, P = .002) and between healthy participants and adults with neurologic disorders (U test = 47.0, P = .001) were found. ImDGI_Trunk_Sway discriminated between people using or not using walking aids and among the three pathologies (H (2) = 10.0, P = .007). Conclusions:The ImDGI test seems to provide valid measures to objectively assess dynamic balance in neurologic conditions and possibly quantify balance deficits also in adults with neurologic disorders.

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Selecting Measures for Balance and Mobility to Improve Assessment and Treatment of Individuals After Stroke

Cited by 8 publications

References 37 publications

Use of Standardized Assessments and Online Resources in Stroke Rehabilitation

Use of Standardized Assessments and Online Resources in Stroke Rehabilitation

Addition of proprioceptive neuromuscular facilitation to cardiorespiratory training in patients poststroke: study protocol for a randomized controlled trial

Instrumented Version of the Modified Dynamic Gait Index in Patients With Neurologic Disorders

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