ABSTRACT
To report the experiences of family caregivers caring for individuals with stroke during the COVID-19 pandemic, which emerged as an unexpected finding when investigating their quality of life and unmet needs. Data were collected using a cross-sectional, qualitative, semi-structured interview of family caregivers of individuals with stroke. Using the NVivo 12 software, an inductive thematic analysis was implemented. Participants were recruited from the general community. Eligible participants were (1) next of kin of individuals with stroke, (2) aged 18 and above, (3) have adequate communication skills. 17 adults (12 females, 5 males) were included in the final analysis. Not applicable. An outcome measure was an interview guide containing questions about family caregiver's experiences caring for individuals with stroke. Key themes described (1) the loss in valued activity and social participation, (2) systemic barriers of COVID-19, and (3) the positive impact of COVID-19. The pandemic has disrupted social participation, leading to a loss in valued activities. Systemic barriers of COVID-19 included an increased cost in hiring a helper, as well as finding a job during a critical time of caregiving, which had shown to exacerbate one's psychoemotional state. Some positive impact of COVID-19 included more time spent with family and kindness from the hospital staff. Family members of individuals with stroke reported numerous challenges during the COVID-19 pandemic. Clinicians should provide alternative mode of support and services, such as an online social support, to combat the loss in social activities during the pandemic. Future study can explore the role of virtual psychosocial support for family caregivers of individuals with stroke. None.
ABSTRACT
The objective of this systematic review was to explore the effect of vitamin D supplementation on functional outcomes among individuals post stroke(PROSPERO CRD42022296462). MEDLINE, PsycInfo, EMBASE, and CINAHL were searched for articles published in any language from database inception to January 5, 2022. Only interventional studies assessing vitamin D supplementation compared to placebo or usual care in adult stroke patients were selected. After duplicate removal, 2,825 studies were screened by two independent reviewers. A total of 41 studies underwent full text review;8 studies met inclusion criteria (6 randomized controlled trials [RCTs] and 2 observational studies). Data were extracted by two independent reviewers using Covidence software. Motor function (Brunnstrom Recovery Stage, Berg Balance Score), mobility (Functional Ambulation Category), activities of daily living (Barthel Index, Functional Independence Measure) and stroke impairment (Modified Rankin Scale, National Institutes for Health Stroke Severity, Scandinavian Stroke Severity) were the outcome measures of interest included in the studies. In total, 562 patients were studied for which 9 of 13 outcome measures showed improvement with vitamin D supplementation. The majority of studies showed an improvement in motor function, mobility, and stroke impairment with vitamin D supplementation;however, the evidence did not support an improvement in activities of daily living with treatment. Strong, methodologically sound RCTs are required to verify these findings. None.
ABSTRACT
The coronavirus disease-19 (COVID-19) pandemic may result in detrimental consequences for stroke patient's wellbeing. Family functioning and optimism could help stroke patients cope with crises leading to possible improvements in life satisfaction. This study aims to explore the protective effects of family functioning and optimism on life satisfaction among stroke patients during the COVID-19 pandemic in China. This study was designed as a cross-sectional survey. A total of 207 stroke inpatients who were receiving pharmacotherapy and rehabilitation in general public hospital of Liaoning province during the COVID-19 pandemic in China were consecutive selected and interviewed by online questionnaires via the WeChat platform effectively from April 8 to 30, 2020. The scales included: Satisfaction with Life Scale (SWLS), Family Adaptation, Partnership, Growth, Affection, and Resolve (APGAR) Scale and Revised Life Orientation Test (LOT-R). Hierarchical multiple regression (HMR) analysis was conducted to test the associated factors of life satisfaction. Stroke patient's life satisfaction was at a high level (Mean = 26.46, SD = 6.23) during the pandemic. Stroke patient's residence, duration of stroke, stroke type, and community shut down measures were the strong predictors of life satisfaction. Family functioning and optimism increased life satisfaction among stroke patients. This study contributes to the research on the association between family functioning and optimism on life satisfaction among stroke patients during the COVID-19 pandemic. Interventions that improve family functioning and enhance optimism should be provided in order to elevate life satisfaction for stroke patients.
Subject(s)
COVID-19 , Stroke , COVID-19/epidemiology , China/epidemiology , Cross-Sectional Studies , Humans , Pandemics , Patient Satisfaction , Personal Satisfaction , Protective Factors , Stroke/epidemiologyABSTRACT
Strokeis the main reason for disabilities of increasing geriatric population. It affects brain and motor function domains significantly reducing the life quality. Recent coronavirus pandemic raised a question on changing approaches to deliver post-stroke rehabilitation services to geriatric patients due to their high risk of serious illness. This paper presents an overview of current telerehabilitation approaches for motor function recovery and balance training of post-stroke patients. We used papers from peer-reviewed medical journals on stroke telerehabilitation. The review showed exergames, virtual reality (VR), web-platforms, and applications are extensively used in rehabilitation programs to gain clinical outcomes among geriatric stroke patients. Findings indicate telerehabilitation improves older patients' functional ability via systematic training, positively affecting their life quality. The treatment therapy of older adults using telerehabilitation can be organized synchronously and asynchronously in home-based environment or in-clinic conditions. Telerehabilitation can be used as complementary therapy or as an alternative to conventional treatment. However, further research is required to test a variety of telerehabilitation systems using larger samples of post-stroke geriatric patients.
ABSTRACT
The physical therapy generally requires direct assistance from therapists continuously, however, the time is very limited. Moreover, the social distancing policy in the COVID-19 pandemic period made the patient could not come to rehabilitation center for physical therapy. Remote physical therapy is suggested to reduce dependency of therapist for conducting the physical therapy. However, there is few information about the necessary parameters in lower limb monitoring of post-stroke patient. Therefore, in this paper, a review for designing a low-cost online homecare physical therapy monitoring system is proposed. Article finding had been done using online search engine Google Scholars to conclude the design of the online monitoring system. Several keywords had been used, such as “online stroke rehabilitation monitoring,” “stroke rehabilitation parameters,” “stroke monitoring Internet of Things,” and “lower limb stroke monitoring.” The results show that the necessary monitor parameters are lower limb kinematics and dynamics, which can be complimented by bio-signal data, such as EMG. The lower limb monitoring system can use IMU, muscle sensor, and footswitches to measure the necessary parameters. IMU measures the lower limb kinematics because it provides wide range of measurement. Muscle sensor, which compatible to microcontroller, measures the EMG. Lastly, the footswitches detect the gait phases, which classify the measured data for more in-depth analysis. The mentioned sensors are cheap and available in the online market of Indonesia, which is suitable to realize a low-cost lower limb monitoring system. The research finding also suggests quick and accurate feedback mechanism for improving the training quality, which the feedback is combination of therapist opinion and artificial intelligence prediction. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
ABSTRACT
COVID-19 pandemic adversely challenged the healthcare system in an unprecedented way. Access to neurorehabilitation programme for patients with stroke and other neurological disability was severely restricted including shutting down of most community-based and outpatient facilities. There is hardly any organised virtual programme of exploring any potential of stretching and exercising of muscles needed in a rehabilitation programme. There is an impetus to innovate service developments, while the risks and fear of contracting the coronavirus remain prevalent. We propose a framework for developing a novel tele-neurorehabilitation system that will guide the patients to perform therapeutic exercises, as proposed by the clinicians, remotely. The system will allow patients to directly interact with doctors through a secure audio–video online portal. Wearable motion tracking sensors will be integrated within a hardware-based home setting for gathering performance data live from patients while they are performing exercises. The paper describes the design components of the framework justifying the tools, hardware, and protocols required to implement a secure online portal for tele-neurorehabilitation. Specifications of the core architectural layers have been reported. Some preliminary work demonstrates how the framework specifies capturing and analysing of physiological data using wearable sensors, as well as displaying of gait parameters on a software dashboard. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.