Exploring the experiences of an exercise-based telerehabilitation program among Canadian community-dwelling adults with stroke.

Purpose: Telerehabilitation is emerging as a means for delivering stroke rehabilitation to address unmet lower extremity rehabilitation needs. However, there is currently limited and low-quality evidence supporting the use telerehabilitation interventions for lower extremity recovery after stroke. Thus, we developed an exercise-based telerehabilitation program (TRAIL) for safe and effective promotion of lower extremity function after stroke.

Stroke Survivors and their Physiotherapists' Perceptions of Recovery: A Multiple Methods Approach.

Purpose: This multiple-methods study examined perceptions of recovery among stroke survivors and their physiotherapists at discharge from an in-patient rehabilitation program.

Method: The Functional Independence Measure (FIM) and Chedoke McMaster Stroke Assessment Activity Inventory scores were collected from chart review and the following outcome measures were completed by interview: Stroke Impact Scale (SIS) global recovery, Hospital Anxiety Depression Scale, and Montreal Cognitive Assessment. Physiotherapists also completed the SIS global recovery for each participant.

Blood pressure trajectory of inpatient stroke rehabilitation patients from the Determining Optimal Post-Stroke Exercise (DOSE) trial over the first 12 months post-stroke.

Background: High blood pressure (BP) is the primary risk factor for recurrent strokes. Despite established clinical guidelines, some stroke survivors exhibit uncontrolled BP over the first 12 months post-stroke. Furthermore, research on BP trajectories in stroke survivors admitted to inpatient rehabilitation hospitals is limited.

TeleRehabilitation with Aims to Improve Lower extremity recovery in community-dwelling individuals who have had a stroke: protocol for a multisite, parallel group, assessor-blinded, randomised attention-controlled trial.

Introduction: Telerehabilitation is an accessible service delivery model that may support innovative lower extremity rehabilitation programmes that extend the stroke recovery continuum into the community. Unfortunately, there is limited evidence on the provision of exercises for lower extremity recovery after stroke delivered using telerehabilitation. In response, we developed the TeleRehabilitation with Aims to Improve Lower extremity recovery poststroke (TRAIL) programme, a 4-week progressive exercise and self-management intervention delivered synchronously using video-conferencing technology.

Higher intensity walking improves global cognition during inpatient rehabilitation: a secondary analysis of a randomized control trial.

Cognitive deficits are common poststroke. Cognitive rehabilitation is typically used to improve cognitive deficits. It is unknown whether higher doses of exercise to promote motor recovery influence cognitive outcomes.

Virtual Arm Boot Camp (V-ABC): study protocol for a mixed-methods study to increase upper limb recovery after stroke with an intensive program coupled with a grasp count device.

Background: Encouraging upper limb use and increasing intensity of practice in rehabilitation are two important goals for optimizing upper limb recovery post stroke. Feedback from novel wearable sensors may influence practice behaviour to promote achieving these goals. A wearable sensor can potentially be used in conjunction with a virtually monitored home program for greater patient convenience, or due to restrictions that preclude in-person visits, such as COVID-19.

Step Number and Aerobic Minute Exercise Prescription and Progression in Stroke: A Roadmap.

Background: While higher therapeutic intensity improves motor recovery after stroke, translating findings from successful studies is challenging without clear exercise intensity targets. We show in the DOSE trial more than double the steps and aerobic minutes within a session can be achieved compared with usual care and translates to improved long-term walking outcomes.

Objective: We modeled data from this successful higher intensity multi-site RCT to develop targets for prescribing and progressing exercise for varying levels of walking impairment after stroke.

Canadian Platform for Trials in Noninvasive Brain Stimulation (CanStim) Consensus Recommendations for Repetitive Transcranial Magnetic Stimulation in Upper Extremity Motor Stroke Rehabilitation Trials.

. To develop consensus recommendations for the use of repetitive transcranial magnetic stimulation (rTMS) as an adjunct intervention for upper extremity motor recovery in stroke rehabilitation clinical trials. .

An external focus of attention compared to an internal focus of attention improves anticipatory postural adjustments among people post-stroke.

Background: People after stroke often have postural impairments that can increase their risk of falling. Anticipatory postural adjustments (APAs) are changes in the activity of postural muscles prior to a voluntary movement in order to maintain vertical equilibrium. Previous research suggests that improving APAs leads to better postural control and reduces the risk of falls.

Higher Doses Improve Walking Recovery During Stroke Inpatient Rehabilitation.

Background And Purpose: We investigated the effect of higher therapeutic exercise doses on walking during inpatient rehabilitation, typically commencing 1 to 4 weeks poststroke.

Methods: This phase II, blinded-assessor, randomized controlled trial recruited from 6 Canadian inpatient rehabilitation units, between 2014 and 2018. Subjects (n=75; 25/group) were randomized into: control (usual care) physical therapy: typically, 1 hour, 5 days/week; Determining Optimal Post-Stroke Exercise (DOSE1): 1 hour, 5 days/week, more than double the intensity of Control (based on aerobic minutes and walking steps); and DOSE2: 2 hours, 5 days/week, more than quadruple the intensity of Control, each for 4 weeks duration.

Evaluation of a Game Based Tele Rehabilitation Platform for In-Home Therapy of Hand-Arm Function Post Stroke: Feasibility Study.

Background: There is a need for innovation to improve compliance and accessibility of rehabilitation programs for individuals with acquired brain injuries. A computer game-assisted tele-rehabilitation platform (GTP) has been developed to address this need. With the novel application of a miniature inertial computer mouse and taking advantage of the wide variety of computer games, the GTP can provide engaging exercises for rehabilitation of upper extremity motor skills.

Canadian Stroke Best Practice Recommendations: Rehabilitation, Recovery, and Community Participation following Stroke. 6th Edition Update 2019.

The sixth update of the is a comprehensive set of evidence-based guidelines addressing issues surrounding impairments, activity limitations, and participation restrictions following stroke. Rehabilitation is a critical component of recovery, essential for helping patients to regain lost skills, relearn tasks, and regain independence. Following a stroke, many people typically require rehabilitation for persisting deficits related to hemiparesis, upper-limb dysfunction, pain, impaired balance, swallowing, and vision, neglect, and limitations with mobility, activities of daily living, and communication.

Factors associated with community versus personal care home discharges after inpatient stroke rehabilitation: the need for a pre-admission predictive model.

: Improved risk factor management and interventions have both been shown to improve mortality in stroke patients. Although this has been a success for acute care, it has placed a higher burden on stroke rehabilitation resources.: This study sought to identify the pre-stroke rehabilitation admission factors that best predict personal care home discharge.

Determining optimal poststroke exercise: Study protocol for a randomized controlled trial investigating therapeutic intensity and dose on functional recovery during stroke inpatient rehabilitation.

Rationale: A top priority in stroke rehabilitation research is determining the appropriate exercise dose to optimize recovery. Although more intensive rehabilitation very early after stroke may be deleterious to recovery, inpatient rehabilitation, occurring after acute care, may be a more appropriate setting to assess therapeutic dose on neurological recovery.

Hypothesis: Individuals receiving higher intensity and dose exercise programs will yield greater improvements in walking ability over usual inpatient physical therapy care.

Examining Associations of Functional Deficits and Mood States With Empathic Responses of Stroke Family Caregivers.

Background: Stroke is one of the most prevalent chronic illnesses worldwide. Family caregivers can make a significant contribution toward patients' recovery. However, the patient's functional deficits and the caregiver's mood states can impact the caregiver's motivation to engage in empathic responses toward patients.

Development of a Telephone Interview Version of the Chedoke-McMaster Stroke Assessment Activity Inventory.

To develop a telephone version of the Chedoke-McMaster Stroke Assessment Activity Inventory (CMSA-AI) and estimate the test-retest reliability, interrater reliability (between participant and proxy), and construct validity of the scores for individuals with stroke. Adults with stroke and their caregivers or proxies were included. Participants were assessed with the CMSA-AI at discharge from a stroke rehabilitation unit and interviewed using the telephone version (TCMSA-AI).

Examining the Relationship Between Family Caregivers' Emotional States and Ability to Empathize with Patients with Multiple Sclerosis: A Pilot Study.

Background: Multiple sclerosis (MS) is the most common nontraumatic cause of disability affecting young adults in Canada. Caregivers of patients with MS are highly psychologically burdened. Empathy and helping behaviors are hallmarks of quality care, but when they are challenged, suboptimal patient care can result.

Alien hand syndrome: a case report and description to rehabilitation.

Background: Alien hand syndrome (AHS) is a neurological disorder in which movements are performed against conscious will. It is rare but significant due to its disability impact on everyday life. This case highlights the clinical features, recovery course and response to rehabilitation of a patient with a dominant anterior cerebral artery territory infarct.

A randomized, double-blinded, crossover pilot study assessing the effect of nabilone on spasticity in persons with spinal cord injury.

Objectives: To determine whether nabilone, a synthetic cannabinoid, alleviates spasticity in people with spinal cord injury (SCI).

Design: A double-blind, placebo-controlled crossover study.

Setting: Outpatient rehabilitation clinics.

Wheelchair-related thumb injury of multifactorial etiology: a case report.

A 56-year-old man presented with bilateral transtibial amputations secondary to peripheral vascular disease and diabetes. While using a hospital-owned wheelchair to descend a 27-m-long, 5.6 degrees slope in an underground tunnel connecting the rehabilitation center to a neighboring acute care facility, the patient had difficulty slowing the wheelchair to negotiate a turn.