Reaching out to Patients with Long COVID to Better Understand Their Life Experiences and How to Support Their Recovery: A Patient-Oriented Knowledge Sharing Session.

This article reports on participants' experiences with long COVID-19 (LC) (symptoms, impact, healthcare use, and perceived needs) and satisfaction with a patient-oriented knowledge-sharing session organized by a multidisciplinary team of healthcare professionals, researchers, and a patient partner. Twenty-six participants completed a pre-session survey. On average, they were 21 months post-COVID-19 infection (SD 10.9); 81% of them were female, and 84% were 40+ years old. The main symptoms reported included fatigue (96%), cognitive problems (92%), and general pain or discomfort (40%). More than half of the participants reported that LC has had a significant impact on their health-related quality of life. Eighty-one percent of the participants reported seeking medical help for their LC symptoms and found the services provided by physical therapists, primary care providers, and acupuncturists to be helpful in managing their condition. Participants would like to have access to healthcare providers and clinics specializing in LC. They liked the session and found the information presented useful. This information helps to better understand the experiences of people living with LC and how to support their recovery.

Constraint-Induced Movement Therapy Compared to Dose-Matched Interventions for Upper-Limb Dysfunction in Adult Survivors of Stroke: A Systematic Review with Meta-analysis.

PURPOSE: To summarize the existing literature examining constraint-induced movement therapy (CIMT), relative to dose-matched control interventions, for upper-limb (UL) dysfunction in adult survivors of stroke. METHODS: CINAHL, Cochrane Library, Embase, NARIC/CIRRIE-Rehabdata, PEDro, PubMed, Scopus, and Web of Science were searched from their inception to February 2011. Trial quality was described using the PEDro scale. The findings were summarized with meta-analysis. RESULTS: For the 22 trials identified, the mean (SD) PEDro score was 6.4 (1.2). Meta-analysis showed CIMT to be superior to dose-matched interventions based on indicators of UL motor capacity (15 trials, n=432; standardized mean difference [SMD]=0.47, 95% CI, 0.27-0.66) and UL ability (14 trials, n=352; SMD=0.80, 95% CI, 0.57-1.02); Functional Independence Measure scores (6 trials, n=182; mean difference [MD]=5.05, 95% CI, 2.23-7.87); and Motor Activity Log scores (Amount of Use: 12 trials, n=318; MD=1.05, 95% CI, 0.85-1.24; Quality of Movement: 11 trials, n=330; MD=0.89, 95% CI, 0.69-1.08). CONCLUSIONS: Compared to control interventions of equal duration and dose, CIMT produced greater improvements in a variety of indicators of UL function in adult survivors of a stroke with residual movement of their upper limb.

Objectif : Faire la synthèse de la littérature existante traitant de la thérapie par contrainte induite (TCI) par rapport aux interventions de contrôle avec dosage équivalent dans les cas de dysfonctions des membres supérieurs chez les adultes ayant survécu à un accident vasculaire cérébral. Méthode : Une recherche a été effectuée dans CINAHL, dans la bibliothèque de Cochrane, dans Embase, NARIC/CIRRIE­Rehabdata, PEDro, PubMed, Scopus, et Web of Science depuis leur mise en ligne jusqu'en février 2011. La qualité des recherches a été évaluée à l'aide de l'échelle PEDro. Les conclusions ont été résumées à l'aide d'une méta-analyse. Résultats : Au total, 22 essais ont été répertoriés; la moyenne de leur cote à l'échelle PEDro était de 6,4 (SD1 de 0,2). La méta-analyse a révélé que la TCI est supérieure aux interventions de contrôle avec dosage équivalent pour les indicateurs de capacité motrice des membres supérieurs (15 essais, n=432; MDS=0,47; 95%IC, 0,27­0,66); capacité des membres supérieurs (14 essais, n=352; MDS=0,80; 95%IC, 0,57­1,02); mesure de l'autonomie fonctionnelle [Functional Independence Measure] (6 essais, n=182; DM=5,05; 95%IC, 2,23­7,87); et score du journal de l'activité motrice [Motor Activity Log] (quantité d'utilisation : 12 essais, n=318; DM=1,05; 95%IC, 0,85­1,24; qualité du mouvement : 11 essais, n=330; DM=0,89; 95%IC 0,69­1,08). Conclusions : Si on la compare aux interventions de contrôle de durée et avec dosage équivalents, la TCI suscite de plus grandes améliorations dans une variété d'indicateurs de la fonction des membres supérieurs chez les adultes ayant survécu à un AVC avec mouvement résiduel de leurs membres supérieurs.

Mental practice for treating upper extremity deficits in individuals with hemiparesis after stroke.

BACKGROUND: Activity limitations of the upper extremity are a common finding for individuals living with stroke. Mental practice (MP) is a training method that uses cognitive rehearsal of activities to improve performance of those activities. OBJECTIVES: To determine if MP improves the outcome of upper extremity rehabilitation for individuals living with the effects of stroke. SEARCH STRATEGY: We searched the Cochrane Stroke Group Trials Register (November 2010), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, November 2009), PubMed (1965 to November 2009), EMBASE (1980 to November 2009), CINAHL (1982 to November 2009), PsycINFO (1872 to November 2009), Scopus (1996 to November 2009), Web of Science (1955 to November 2009), the Physiotherapy Evidence Database (PEDro), CIRRIE, REHABDATA, ongoing trials registers, and also handsearched relevant journals and searched reference lists. SELECTION CRITERIA: Randomised controlled trials involving adults with stroke who had deficits in upper extremity function. DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials for inclusion. We considered the primary outcome to be the ability of the arm to be used for appropriate tasks (i.e. arm function). MAIN RESULTS: We included six studies involving 119 participants. We combined studies that evaluated MP in addition to another treatment versus the other treatment alone. Mental practice in combination with other treatment appears more effective in improving upper extremity function than the other treatment alone (Z = 3.48, P = 0.0005; standardised mean difference (SMD) 1.37; 95% confidence interval (CI) 0.60 to 2.15). We attempted subgroup analyses, based on time since stroke and dosage of MP; however, numbers in each group were small. We evaluated the quality of the evidence with the PEDro scale, ranging from 6 to 9 out of 10; we determined the GRADE score to be moderate. AUTHORS' CONCLUSIONS: There is limited evidence to suggest that MP in combination with other rehabilitation treatment appears to be beneficial in improving upper extremity function after stroke, as compared with other rehabilitation treatment without MP. Evidence regarding improvement in motor recovery and quality of movement is less clear. There is no clear pattern regarding the ideal dosage of MP required to improve outcomes. Further studies are required to evaluate the effect of MP on time post stroke, volume of MP that is required to affect the outcomes and whether improvement is maintained long-term. Numerous large ongoing studies will soon improve the evidence base.

A modified constraint-induced movement therapy regimen for individuals with upper extremity hemiplegia.

BACKGROUND: The Constraint-Induced Movement Therapy approach has been identified as a promising method to address deficits in upper limb function experienced by some stroke survivors. There is some question regarding whether the intervention administered in the research setting could be translated into clinical practice. PURPOSE: This paper describes the modified version of Constraint-Induced Movement Therapy developed at St. Boniface General Hospital, Winnipeg, Canada. METHOD: This modified regimen involves practice of upper limb tasks for four hours per day for 10 weekdays over two weeks, concurrent with participants attempting to wear a restraint mitten on the less involved hand for 90% of their waking hours. RESULTS: The primary outcome measure was the Canadian Occupational Performance Measure. Two case reports illustrate how the regimen is administered. IMPLICATIONS: The need for further research of this regimen in terms of the selection of participants, the measurement tools, and the effectiveness is discussed.