Disability and rehabilitation
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Explore the potential benefits of using priming methods prior to an active hand task in the acute phase post-stroke in persons with severe upper extremity hemiparesis. ⋯ This study suggests that an early hand-based intervention using visual and movement based priming activities and a scaled motor task allows participation by persons without the motor control required for traditionally presented rehabilitation and testing. Implications for Rehabilitation Rehabilitation of individuals with severely paretic upper extremities after stroke is challenging due to limited movement capacity and few options for therapeutic training. Long-term functional recovery of the arm after stroke depends on early return of active hand control, establishing a need for acute training methods focused distally. This study demonstrates the feasibility of an early hand-based intervention using virtual reality based priming and scaled motor activities which can allow for participation by persons without the motor control required for traditionally presented rehabilitation and testing.
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Randomized Controlled Trial
Self-training to improve UE function at the chronic stage post-stroke: a pilot randomized controlled trial.
On-going practice and use of the weaker upper extremity (UE) are important for maintaining and improving function in individuals with chronic stroke. The effectiveness of two self-training programs for UE function and daily-use was compared. ⋯ UE functional improvement can be achieved by self-training at the chronic stage and, therefore, should be encouraged by clinicians. Implications for rehabilitation Video-games or traditional self-training programs can be used to practice repetitive UE movements without the supervision of a clinician Self-training of the UE is beneficial at the chronic stage post-stroke and, therefore, should be encouraged The type of self-training (video-games or traditional) should be suited to the client's abilities and preferences. The compliance of self-training using video-games during the follow-up period was higher than the traditional self-training. This is important since self-training programs for chronic stroke need to be long-term and sustainable.
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The aim of this study was to test the validity and reliability of the translated Norwegian version of the Chronic Pain Acceptance Questionnaire (CPAQ-20) and the shorter version CPAQ-8 based on the same data. ⋯ The Norwegian versions of CPAQ-20 and CPAQ-8 are reliable assessment tools with good construct validity for measurement of acceptance. Future studies should validate the scales in other Norwegian samples. Implication for Rehabilitation CPAQ-20 and CPAQ-8 are valid Norwegian instruments for measuring acceptance of pain. Acceptance of pain is an important process in the rehabilitation of persons with chronic widespread pain. Treatment models supporting acceptance can now be developed and measured further in Norway.
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This international study aims to examine the size and determinants of the impact of stroke on five-year survivors' health-related quality of life (HRQoL) in four different European countries. ⋯ Five years after stroke, mean HRQoL of stroke survivors showed large variability and was more than ½ SD below population norm. Forty percent had a HRQoL level below, 52% on, and 8% above population norm. The variability could only partially be explained by the variables considered in this study. Longitudinal studies are needed to increase our understanding of the size and determinants of the impact of stroke on the HRQoL of long-term stroke survivors. Implications for rehabilitation The current European concept of stroke rehabilitation is focused on the acute and sub-acute rehabilitation phase, i.e., in the first months after stroke. The results of this study show that at five years after stroke, the mean level of HRQoL of stroke survivors remains below the healthy population level. This finding shows the need for continuation of rehabilitation in the chronic phase. At five years after stroke, higher patients' levels of depression, anxiety and disability were associated with lower scores for HRQoL. This finding implicates that chronic rehabilitation programs should be multi-faceted in order to increase long-term survivors' psychosocial outcomes.
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The study evaluated a group-based cognitive behavioral intervention aimed at promoting the quality of life and the psychological well-being of recently diagnosed multiple sclerosis (MS) patients (up to 3 years since the diagnosis). ⋯ Preliminary evidence suggests that the proposed intervention fosters the quality of life and the psychological well-being of recently diagnosed MS patients by reducing negative affect and promoting mental health and optimism, particularly in the long term. Implications for Rehabilitation Preliminary evidence suggests that a group-based cognitive behavioral intervention focused on identity redefinition, sense of coherence and self-efficacy promotes the quality of life (increased mental health) and psychological well-being (decreased negative affect and increased optimism) of recently diagnosed MS patients (up to 3 years since the diagnosis). The first years following the MS diagnosis should be considered a good time for a psychological intervention aimed at promoting the patient's adjustment to the illness. Strategies should be found to increase the participation of recently diagnosed MS patients in psychological interventions.