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Eriksson, J., Nyberg, L., Elgh, E. & Hu, X.-L. (2023). Improvement of cognition across a decade after stroke correlates with the integrity of functional brain networks. NeuroImage: Clinical, 37, Article ID 103356.
Open this publication in new window or tab >>Improvement of cognition across a decade after stroke correlates with the integrity of functional brain networks
2023 (English)In: NeuroImage: Clinical, E-ISSN 2213-1582, Vol. 37, article id 103356Article in journal (Refereed) Published
Abstract [en]

Background and objective: We recently reported improvements of working memory across 10 years post stroke among middle-aged individuals. However, the mechanisms underlying working-memory recovery are largely unknown. This study investigated the associations between long-term improvement of working memory and resting-state functional connectivity in two frontoparietal networks: the frontoparietal network and the dorsal attention network.

Methods: Working memory was repeatedly assessed by the Digit Span Backwards task in 21 persons, within 1 year after stroke onset and again 10 years post stroke onset. Brain functional connectivity was examined by resting state functional magnetic resonance imaging at the 10-year follow-up.

Results: A significant improvement of working memory was found among 21 persons after stroke (median age = 64) at the 10-year follow-up compared to the within-one-year assessment. The magnitude of performance improvement on the Digit Span Backwards task was significantly positively correlated with stronger brain connectivity in the frontoparietal network (r = 0.51, p = 0.018) measured at the 10-year follow-up only. A similar association was observed in the dorsal attention network (r = 0.43, p = 0.052) but not in a visual network (r = -0.17, p = 0.46) that served as a control network. The association between functional connectivity within the above-mentioned networks and Digit Span Backwards scores at 10-year after stroke was in the same direction but did not reach significance.

Conclusions: The present work relate stronger long-term performance improvement on the Digit Span Backwards task with higher integrity of frontoparietal network connectivity.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Cognitive improvement, Functional connectivity, Long-term, Stroke, Working memory
National Category
Neurosciences Neurology
Identifiers
urn:nbn:se:umu:diva-205503 (URN)10.1016/j.nicl.2023.103356 (DOI)000975416600001 ()36842348 (PubMedID)2-s2.0-85148731680 (Scopus ID)
Funder
The Swedish Stroke AssociationRegion VästerbottenUmeå UniversityKnut and Alice Wallenberg Foundation
Available from: 2023-03-14 Created: 2023-03-14 Last updated: 2024-01-17Bibliographically approved
Marklund, I., Sefastsson, A., Fure, B., Klässbo, M., Liv, P., Stålnacke, B.-M. & Hu, X.-L. (2023). Lower-extremity constraint-induced movement therapy improved motor function, mobility, and walking after stroke. European Journal of Physical and Rehabilitation Medicine, 59(2), 136-144
Open this publication in new window or tab >>Lower-extremity constraint-induced movement therapy improved motor function, mobility, and walking after stroke
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2023 (English)In: European Journal of Physical and Rehabilitation Medicine, ISSN 1973-9087, E-ISSN 1973-9095, Vol. 59, no 2, p. 136-144Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: To regain the ability to walk is one of the most commonly stated goals for people who have had a stroke due to its importance in everyday life. Walking ability affects patients’ mobility, self-care, and social lives. Constraint-induced movement therapy (CIMT) is known to be effective in improving upper extremity outcomes post-stroke. However, there is insufficient evidence regarding its efficacy in improving lower extremity outcomes.AIM: To investigate whether a highly intensive CIMT for lower extremity (LE-CIMT) function post-stroke can improve motor function, functional mobility, and walking ability. Furthermore, it also aimed to investigate whether age, gender, stroke type, more-affected side, or time after stroke onset affect the efficacy of LE-CIMT on walking ability outcomes.

DESIGN: Longitudinal cohort study.

SETTING: Outpatient clinic in Stockholm, Sweden.

POPULATION: A total of 147 patients mean age 51 years (68% males; 57% right-sided hemiparesis), at the sub-acute or chronic phases post-stroke who had not previously undergone LE-CIMT.

METHODS: All patients received LE-CIMT for 6 hours per day over 2 weeks. The Fugl-Meyer Assessment (FMA) of the lower extremity, Timed Up and Go (TUG) test, Ten-Meter Walk Test (10MWT), and six-Minute Walk Test (6MWT) were used to assess functional outcomes before and directly after the 2-week treatment was complete as well at 3-month post-intervention.

RESULTS: Compared to baseline values, FMA (P<0.001), TUG (P<0.001), 10MWT (P<0.001) and 6MWT (P<0.001) scores were statistically significantly improved directly after the LE-CIMT intervention. These improvements persisted at the 3-month post-intervention follow-up. Those who completed the intervention 1-6 months after stroke onset had statistically significant larger improvements in 10MWT compared to those who received the intervention later than 6 months after stroke onset. Age, gender, stroke type, and more-affected side did not impact 10MWT results.

CONCLUSIONS: In an outpatient clinic setting, high-intensity LE-CIMT statistically significant improved motor function, functional mobility, and walking ability in middle-aged patients in the sub-acute and chronic post-stroke phases. However, studies with more robust designs need to be conducted to deepen the understanding of the efficacy of LE-CIMT.

CLINICAL REHABILITATION IMPACT: High-intensity LE-CIMT may be a feasible and useful treatment option in outpatient clinics to improve post-stroke walking ability.

Place, publisher, year, edition, pages
Edizioni Minerva Medica, 2023
Keywords
Stroke rehabilitation, Exercise, Lower extremity, Physical therapy modalities
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-207044 (URN)10.23736/S1973-9087.23.07683-9 (DOI)000983180600002 ()36892520 (PubMedID)2-s2.0-85153120897 (Scopus ID)
Funder
Region VärmlandRegion VästerbottenUmeå UniversityThe Swedish Stroke Association
Available from: 2023-04-25 Created: 2023-04-25 Last updated: 2023-10-30Bibliographically approved
Elgh, E. & Hu, X.-L. (2023). Premorbid employment and education predicts improvement in general cognition ten years after stroke onset: a longitudinal cohort study. Journal of Neuroscience and Neurological Surgery, 13(1), Article ID 260.
Open this publication in new window or tab >>Premorbid employment and education predicts improvement in general cognition ten years after stroke onset: a longitudinal cohort study
2023 (English)In: Journal of Neuroscience and Neurological Surgery, ISSN 2578-8868, Vol. 13, no 1, article id 260Article in journal (Refereed) Published
Abstract [en]

Background: We have recently demonstrated significant general cognitive recovery with delayed improvement of working memory 10 years after stroke in a unique longitudinal cohort.Aim: This study investigated demographic and clinical characteristics relevant to improved cognitive functions 10-year after a first-ever stroke.   

Materials and Methods: A prospective longitudinal cohort study was carried out in 38 middle-aged (mean age =54 at stroke onset) stroke survivors. Cognition was assessed thrice at one week, seven months, and ten years after the stroke. Working memory and visuospatial function were assessed with the Digit Span and Block Design subtests, respectively. General cognition was evaluated with the Mini-Mental State Examination at the two later time points. Multivariate linear regression was used to identify the variables that may significantly predict improved cognitive functions at 10-year follow-up.

Results: We found that having a full-time job prior to the stroke, suffering an ischemic (as opposed to a hemorrhagic) stroke, and having a university education predicted significantly superior general cognitive function 10 years after stroke (R2 of 0.77, p <0.001), while working memory and visuospatial function at 1 week after stroke significantly predicted their respective functions at 10-year follow-up (R2 of 0.41, p = 0.003). 

Conclusions: Our results indicate that premorbid employment status and higher education as well as having suffered from an ischemic rather than a hemorrhagic stroke might predict superior cognitive recovery among middle-aged individuals 10 years after stroke. 

Place, publisher, year, edition, pages
Auctores Publishing, 2023
Keywords
cognitive improvement, cognitive reserve, education, employment, longitudinal study, stroke
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-207045 (URN)10.31579/2578-8868/260 (DOI)
Funder
The Swedish Stroke AssociationUmeå UniversityRegion Västerbotten
Available from: 2023-04-25 Created: 2023-04-25 Last updated: 2023-04-26Bibliographically approved
Hu, X.-L., Liv, P., Lundström, E., Norström, F., Lindahl, O. A., Borg, K. & Sunnerhagen, K. S. (2023). Study protocol for a randomized, controlled, multicentre, pragmatic trial with Rehabkompassen®: a digital structured follow-up tool for facilitating patient-tailored rehabilitation in persons after stroke. Trials, 24(1), Article ID 650.
Open this publication in new window or tab >>Study protocol for a randomized, controlled, multicentre, pragmatic trial with Rehabkompassen®: a digital structured follow-up tool for facilitating patient-tailored rehabilitation in persons after stroke
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2023 (English)In: Trials, E-ISSN 1745-6215, Vol. 24, no 1, article id 650Article in journal (Refereed) Published
Abstract [en]

Background: Stroke is a leading cause of disability among adults worldwide. A timely structured follow-up tool to identify patients’ rehabilitation needs and develop patient-tailored rehabilitation regimens to decrease disability is largely lacking in current stroke care. The overall purpose of this study is to evaluate the effectiveness of a novel digital follow-up tool, Rehabkompassen®, among persons discharged from acute care settings after a stroke.

Methods: This multicentre, parallel, open-label, two-arm pragmatic randomized controlled trial with an allocation ratio of 1:1 will be conducted in Sweden. A total of 1106 adult stroke patients will have follow-up visits in usual care settings at 3 and 12 months after stroke onset. At the 3-month follow-up, participants will have a usual outpatient visit without (control group, n = 553) or with (intervention group, n = 553) the Rehabkompassen® tool. All participants will receive the intervention at the 12-month follow-up visit. Feedback from the end-users (patient and health care practitioners) will be collected after the visits. The primary outcomes will be the patients’ independence and social participation at the 12-month visits. Secondary outcomes will include end-users’ satisfaction, barriers and facilitators for adopting the instrument, other stroke impacts, health-related quality of life and the cost-effectiveness of the instrument, calculated by incremental cost per quality-adjusted life year (QALY).

Discussion: The outcomes of this trial will inform clinical practice and health care policy on the role of the Rehabkompassen® digital follow-up tool in the post-acute continuum of care after stroke.

Trial registration: ClinicalTrials.gov NCT04915027. Registered on 4 June 2021. ISRCTN registry ISRCTN63166587. Registered on 21 August 2023.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Cost-effectiveness, Daily activity, Digital tool, Effectiveness, ePROM, Health economy, Precision medicine, Social participation, Stroke rehabilitation, Structured follow-up
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:umu:diva-215396 (URN)10.1186/s13063-023-07673-7 (DOI)37803460 (PubMedID)2-s2.0-85173330866 (Scopus ID)
Funder
Swedish Research Council, 2022–00316Swedish Research Council, 2022– 00746Forte, Swedish Research Council for Health, Working Life and Welfare, 2020–00136Swedish Heart Lung Foundation, 2020676Västerbotten County Council, 2022–967513Vinnova, 2019–01389The Swedish Stroke Association
Available from: 2023-10-26 Created: 2023-10-26 Last updated: 2024-01-17Bibliographically approved
Devos, H., Ng, C., Santos, F. H., Sood, P., Hu, X.-L., Zanwar, P., . . . Heyn, P. (2023). Virtual reality for cognitive rehabilitation: a beginner’s guide for clinicians. Archives of Physical Medicine and Rehabilitation, 104(2), 355-358
Open this publication in new window or tab >>Virtual reality for cognitive rehabilitation: a beginner’s guide for clinicians
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2023 (English)In: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, Vol. 104, no 2, p. 355-358Article in journal (Refereed) Published
Abstract [en]

Despite the promising benefits of virtual reality (VR) cognitive rehabilitation and the affordable VR systems currently on the market, few VR tools have found their way into the clinic. The purpose of this Information and Education page is to assist clinicians in deciding which VR systems are useful for cognitive rehabilitation.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-207046 (URN)10.1016/j.apmr.2022.10.006 (DOI)
Available from: 2023-04-26 Created: 2023-04-26 Last updated: 2023-04-26Bibliographically approved
Kim, S., Mortera, M., Heyn, P., Sood, P., Wen, P.-S., Chen Wong, D., . . . Hu, X. (2022). An overview of systematic reviews on the pharmacological randomized controlled trials for reducing intracranial pressure after traumatic brain injury. Brain Injury, 36(7), 829-840
Open this publication in new window or tab >>An overview of systematic reviews on the pharmacological randomized controlled trials for reducing intracranial pressure after traumatic brain injury
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2022 (English)In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 36, no 7, p. 829-840Article, review/survey (Refereed) Published
Abstract [en]

Background: There is a need for an overview of systematic reviews (SRs) examining randomized clinical trials (RCTs) of pharmacological interventions in the treatment of intracranial pressure (ICP) post-TBI.

Objectives: To summarize pharmacological effectiveness in decreasing ICP in SRs with RCTs and evaluate study quality.

Methods: Comprehensive literature searches were conducted in MEDLINE, PubMed, EMBASE, PsycINFO, and Cochrane Library databases for English SRs through October 2020. Inclusion criteria were SRs with RCTs that examined pharmacological interventions to treat ICP in patients post-TBI. Data extracted were participant characteristics, pharmacological interventions, and ICP outcomes. Study quality was assessed with AMSTAR-2.

Results: Eleven SRs between 2003 and 2020 were included. AMSTAR-2 ratings revealed 3/11 SRs of high quality. Pharmacological interventions included hyperosmolars, neuroprotectives, anesthetics, sedatives, and analgesics. Study samples ranged from 7 to 1282 patients. Hyperosmolar agents and sedatives were beneficial in lowering elevated ICP. High bolus dose opioids had a more deleterious effect on ICP. Neuroprotective agents did not show any effects in ICP management. RCT sample sizes and findings in the SRs varied. A lack of detailed data syntheses was noted. AMSTAR-2 analysis revealed moderate-to-high quality in most SRs. Future SRs may focus on streamlined reporting of dosing and clearer clinical recommendations.

Conclusions: PROSPERO-Registration: CRD42015017355.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
Keywords
intracranial pressure, pharmacological interventions, randomized control trials, Systematic review, traumatic brain injury
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-197731 (URN)10.1080/02699052.2022.2087102 (DOI)000812091200001 ()35708261 (PubMedID)2-s2.0-85132383691 (Scopus ID)
Available from: 2022-07-04 Created: 2022-07-04 Last updated: 2023-03-24Bibliographically approved
Hu, X.-L., Jonzén, K., Karlsson, M. & Lindahl, O. A. (2022). Assessments of a novel digital follow-up tool Rehabkompassen® to identify rehabilitation needs among stroke patients in an outpatient setting. Digital Health, 8
Open this publication in new window or tab >>Assessments of a novel digital follow-up tool Rehabkompassen® to identify rehabilitation needs among stroke patients in an outpatient setting
2022 (English)In: Digital Health, E-ISSN 2055-2076, Vol. 8Article in journal (Refereed) Published
Abstract [en]

Introduction: It remains a huge challenge to identify individual rehabilitation needs in a time-efficient manner for providing patient-tailored rehabilitation during the continuum of stroke care. We have recently demonstrated the usefulness of a paper-version Rehab-Compass as a follow-up tool. The aim of the current study was to develop a digital version of the Rehab-Compass and evaluate its usability and feasibility.

Methods: The novel digital tool Rehabkompassen® was developed by an iterative and participatory design process. Patients' rehabilitation needs were visualized by the tool and used before, during, and after the consultation. The usability and feasibility of the tool was assessed by task completion rate, the System Usability Scale, and satisfaction questionnaires among 2 physicians and 24 adult stroke patients in an outpatient clinical setting.

Results: Rehabkompassen® identified and graphically visualized a panoramic view of the stroke patients' multidimensional needs in individual- and group levels. The instrument appeared to be feasible and time efficient in clinical use with a 100% overall task completion rate for both patients and physicians. A majority of the patients reported that it was very easy or fairly easy to answer the digital questionnaires and to understand their own digital Rehab-Compass graph. Two physicians reported a high mean score on the System Usability Scale (95/100) and were positive about using the tool in the future.

Conclusions: The current results indicated that Rehabkompassen® was a feasible, useful, and time-saving follow-up tool for the identification of rehabilitation needs among stroke survivors in the post-acute continuum of care after stroke. Further research is needed to evaluate the efficacy of the digital instrument among stroke patients.

Place, publisher, year, edition, pages
Sage Publications, 2022
Keywords
digital tool, eHealth, feasibility, follow-up, need assessment, outcome assessment, outpatient setting, Stroke rehabilitation, usability
National Category
Neurology Physiotherapy
Identifiers
urn:nbn:se:umu:diva-203057 (URN)10.1177/20552076221104662 (DOI)000808094000001 ()35677783 (PubMedID)2-s2.0-85131291490 (Scopus ID)
Funder
Vinnova, 2019-01389The Swedish Stroke AssociationForte, Swedish Research Council for Health, Working Life and Welfare, 2020-00136Swedish Heart Lung Foundation, 2020676Region VästerbottenUmeå University, RV-967513
Available from: 2023-01-16 Created: 2023-01-16 Last updated: 2024-01-17Bibliographically approved
Hu, X.-L., Jonzén, K., Lindahl, O. A., Karlsson, M., Norström, F., Lundström, E. & Stibrant Sunnerhagen, K. (2022). Digital Graphic Follow-up Tool (Rehabkompassen) for Identifying Rehabilitation Needs among People after Stroke: Randomized Clinical Feasibility Study. JMIR Human Factors, 9(3), Article ID e38704.
Open this publication in new window or tab >>Digital Graphic Follow-up Tool (Rehabkompassen) for Identifying Rehabilitation Needs among People after Stroke: Randomized Clinical Feasibility Study
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2022 (English)In: JMIR Human Factors, E-ISSN 2292-9495, Vol. 9, no 3, article id e38704Article in journal (Refereed) Published
Abstract [en]

Background: Stroke is a leading cause of disability among adults, with heavy social and economic burden worldwide. A cost-effective solution is urgently needed to facilitate the identification of individual rehabilitation needs and thereby provide tailored rehabilitations to reduce disability among people who have had a stroke. A novel digital graphic follow-up tool Rehabkompassen has recently been developed to facilitate capturing the multidimensional rehabilitation needs of people who have had a stroke.

Objective: The aim of this study was to evaluate the feasibility and acceptability of conducting a definitive trial to evaluate Rehabkompassen as a digital follow-up tool among people who have had a stroke in outpatient clinical settings.

Methods: This pilot study of Rehabkompassen was a parallel, open-label, 2-arm prospective, proof-of-concept randomized controlled trial (RCT) with an allocation ratio of 1:1 in a single outpatient clinic. Patients who have had a stroke within the 3 previous months, aged ≥18 years, and living in the community were included. The trial compared usual outpatient visits with Rehabkompassen (intervention group) and without Rehabkompassen (control group) at the 3-month follow-up as well as usual outpatient visit with Rehabkompassen at the 12-month follow-up. Information on the recruitment rate, delivery, and uptake of Rehabkompassen; assessment and outcome measures completion rates; the frequency of withdrawals; the loss of follow-up; and satisfaction scores were obtained. The key outcomes were evaluated in both groups.

Results: In total, 28 patients (14 control, 14 Rehabkompassen) participated in this study, with 100 patients screened. The overall recruitment rate was 28% (28/100). Retention in the trial was 86% (24/28) at the 12-month follow-up. All participants used the tool as planned during their follow-ups, which provided a 100% (24/24) task completion rate of using Rehabkompassen and suggested excellent feasibility. Both patient- and physician-participants reported satisfaction with the instrument (19/24, 79% and 2/2, 100%, respectively). In all, 2 (N=2, 100%) physicians and 18 (N=24, 75%) patients were willing to use the tool in the future. Furthermore, modified Rankin Scale as the primary outcome and various stroke impacts as secondary outcomes were both successfully collected and compared in this study.

Conclusions: This study demonstrated the high feasibility and adherence of the study protocol as well as the high acceptability of Rehabkompassen among patients who have had a stroke and physicians in an outpatient setting in comparison to the predefined criterion. The information collected in this feasibility study combined with the amendments of the study protocol may improve the future definitive RCT. The results of this trial support the feasibility and acceptability of conducting a large definitive RCT.

Place, publisher, year, edition, pages
JMIR Publications, 2022
Keywords
acceptability, adherence, clinical setting, digital health, digital tool, eHealth, feasibility, needs assessment, outcome assessment, outpatient, randomized controlled trial, Rankin scale, RCT, rehabilitation, stroke, structured follow-up: follow-up
National Category
Neurology Physiotherapy
Identifiers
urn:nbn:se:umu:diva-199203 (URN)10.2196/38704 (DOI)000908436900032 ()2-s2.0-85136901479 (Scopus ID)
Funder
Vinnova, 2019-01389Region VästerbottenUmeå UniversityThe Swedish Stroke AssociationSwedish Heart Lung Foundation, 2020676Forte, Swedish Research Council for Health, Working Life and Welfare, 2020-00136
Available from: 2022-09-09 Created: 2022-09-09 Last updated: 2023-09-05Bibliographically approved
Wen, P.-S., Vora, A., Mortera, M., Sasson, N., Reed, W. R., Ehsanian, R., . . . Kim, S. (2022). Perceptions and use of complementary and integrative health practices among rehabilitation professionals: a survey. European Journal of Integrative Medicine, 55, Article ID 102173.
Open this publication in new window or tab >>Perceptions and use of complementary and integrative health practices among rehabilitation professionals: a survey
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2022 (English)In: European Journal of Integrative Medicine, ISSN 1876-3820, E-ISSN 1876-3839, Vol. 55, article id 102173Article in journal (Refereed) Published
Abstract [en]

Introduction: Despite increasing use of complementary and integrative health (CIH) by rehabilitation providers, information on rehabilitation professionals’ perceptions and utilization of CIH is limited. The purpose of this study was to investigate rehabilitation professionals’ perceptions, utilization, barriers and research of CIH in the United States.

Methods: A cross-sectional online survey was conducted on the perceptions, utilization, barriers and research regarding CIH. Survey invitations were posted on community boards of rehabilitation associations and sent to rehabilitation institutions listserv in 2020.

Results: Of 405 respondents, the majority of respondents were physical therapists (PTs) (34%), then, occupational therapists (OTs) (20%), and physicians (16.8%). Most respondents (68%) worked in settings offering integrative health. Forty three percent of respondents were trained and 22% were certified in CIH practice. Breathing exercises, meditation, massage, and yoga were the most commonly utilized practices for self-care and patient care. Physicians and PTs were more likely than OTs to initiate discussion about CIH with patients (p=.001 and p=.046 respectively), and senior practitioners were more likely to initiate these discussions than junior practitioners (p=.037 and p<.001, respectively). Peer-reviewed publications, clinical experience, and personal experience with CIH were the most selected factors affecting respondents’ attitudes toward CIH practices. Rehabilitation clinicians reported that insufficient provider reimbursement and insufficient skills were the primary obstacles to CIH practice. Rehabilitation researchers reported that insufficient funding as the primary obstacle to conducting CIH research.

Conclusions: Rehabilitation professionals commonly utilize CIH in practices for self-care and patient care, and they perceive insufficient training, clinical reimbursement and research funding as the main barriers to advancing CIH.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Alternative medicine, Complementary medicine, Complementary therapies, Perception, Rehabilitation professional, Survey and questionnaire
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-198902 (URN)10.1016/j.eujim.2022.102173 (DOI)000930904100002 ()2-s2.0-85135953606 (Scopus ID)
Available from: 2022-09-07 Created: 2022-09-07 Last updated: 2023-09-05Bibliographically approved
Burns, S. P., Fleming, T. K., Webb, S. S., Kam, A. S., Fielder, J. D. .., Kim, G. J., . . . Kringle, E. A. (2022). Stroke Recovery During the COVID-19 Pandemic: A Position Paper on Recommendations for Rehabilitation. Archives of Physical Medicine and Rehabilitation, 103(9), 1874-1882
Open this publication in new window or tab >>Stroke Recovery During the COVID-19 Pandemic: A Position Paper on Recommendations for Rehabilitation
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2022 (English)In: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 103, no 9, p. 1874-1882Article in journal (Refereed) Published
Abstract [en]

Health care delivery shifted and adapted with the COVID-19 pandemic caused by the novel severe acute respiratory syndrome coronavirus 2. Stroke care was negatively affected across the care continuum and may lead to poor community living outcomes in those who survived a stroke during the ongoing pandemic. For instance, delays in seeking care, changes in length of stays, and shifts in discharge patterns were observed during the pandemic. Those seeking care were younger and had more severe neurologic effects from stroke. Increased strain was placed on caregivers and public health efforts, and community-wide lockdowns, albeit necessary to reduce the spread of COVID-19, had detrimental effects on treatment and recommendations to support community living outcomes. The American Congress of Rehabilitation Medicine Stroke Interdisciplinary Special Interest Group Health and Wellness Task Force convened to (1) discuss international experiences in stroke care and rehabilitation and (2) review recently published literature on stroke care and outcomes during the pandemic. Based on the findings in the literature, the task force proposes recommendations and interdisciplinary approaches at the (1) institutional and societal level; (2) health care delivery level; and (3) individual and interpersonal level spanning across the care continuum and into the community.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
COVID-19, Delivery of health care, Rehabilitation, Stroke, Stroke rehabilitation
National Category
Nursing Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Rehabilitation Medicine
Identifiers
urn:nbn:se:umu:diva-197278 (URN)10.1016/j.apmr.2022.04.004 (DOI)000862840000021 ()35533736 (PubMedID)2-s2.0-85132818966 (Scopus ID)
Available from: 2022-06-26 Created: 2022-06-26 Last updated: 2022-12-29Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-9864-7432

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