OBJECTIVES: To assess the effectiveness of a home-based carer-assisted in comparison to hospital-based therapist-delivered therapy for community-dwelling stroke survivors.
METHODS: An assessor blinded randomised controlled trial was conducted on 91 stroke survivors (mean age 58.9±10.6 years, median time post-onset 13.0 months, 76.5% males) who had completed individual rehabilitation. The control group received hospital-based group therapy delivered by physiotherapists as out-patients and the test group was assigned to a home-based carer-assisted therapy. Targeted primary outcomes were physical functions (mobility, balance, lower limb strength and gait speed). A secondary outcome index was health-related quality of life. An intention-to-treat analysis was used to evaluate outcomes at week 12 of intervention.
RESULTS: Both therapy groups improved significantly in all the functional measures; mobility (p 0.05).
CONCLUSIONS: The home-based carer-assisted therapy is as effective as the hospital-based therapist-delivered training in improving post-stroke functions and quality of life.
OBJECTIVE: The present study aimed to investigate the effect of physiotherapy interventions on brain neuroplasticity by evaluating the brain plasticity regeneration, balance and functional ability.
METHODS: A randomized controlled trial was conducted with 64 stroke patients from three hospitals in the Surakarta region, Indonesia. Control groups (n = 32) received conventional physiotherapy and intervention groups (n = 32) received neurorestoration protocol, which both lasted for seven days. Efficacy of the interventions were measured on brain-derived neurotropic factor serum analysis, Berg Balance Scale and Barthel Index, respectively.
RESULTS: Both groups showed improvements in all parameters but only balance and functional performance had a statistically significant outcome.
CONCLUSION: Neurorestoration protocol that combined several established physiotherapy interventions was effective in improving balance and functional ability of stroke patients in only a seven days period.
METHOD: A group of 56 adults was assessed at approximately 6 months, 1 year, and 5 years following injury.
RESULTS: Impairment was evident on all measures but prevalence and rate of improvement varied. Overall, by 5 years post-injury over 85% of patients were not impaired on measures of general intelligence, simple attention, and visual perception. However, 28% of patients continued to show some degree of impairment on complex attention and verbal fluency, and performance on verbal memory remained impaired for 60% of patients. There was also evidence for deterioration in complex attention and verbal memory between 1 year and 5 years. ANOVAs showed that improvement occurred on most measures between 6 months and 1 year, but there was both improvement and decline on some measures between 1 year and 5 years.
CONCLUSIONS: The findings show that there is considerable heterogeneity in cognitive outcome following TBI, with some deterioration evident over the long term.
OBJECTIVE: This Cochrane Review aimed to determine the effects of alternating pressure (active) air beds, overlays or mattresses compared with any support surface in preventing pressure ulcers.
METHODS: The population addressed was people at risk of and with existing pressure ulcers. Studies comparing alternating pressure (active) air surfaces with any beds, overlays or mattresses were included. The outcomes studied were pressure ulcer incidence, patient support-surface-associated comfort, adverse events, health-related quality of life and cost-effectiveness.
RESULTS: There were 32 studies with a total of 9058 participants. There is low certainty evidence that alternating pressure (active) air surfaces compared with foam surfaces may reduce the incidence of pressure ulcers. It is uncertain whether there is a difference in the proportion of people developing new pressure ulcers between alternating pressure (active) air surfaces and reactive water-filled, fibre, air, gel or standard hospital surfaces.
CONCLUSION: The use of alternating pressure (active) air surfaces may reduce the incidence of pressure ulcers compared to foam surfaces. However, it is uncertain if it is superior to reactive air surfaces, water surfaces and fiber surfaces in preventing pressure ulcers.
OBJECTIVE: The aim of this Cochrane review was to assess the effects of active or passive information provision for stroke survivors or their carers.
METHODS: The population addressed in this review included stroke survivors, their carers, or both. The intervention studied was provision of active or passive information compared to standard care or where information and another therapy were compared with the other therapy alone, or where the comparison was between active and passive information provision. The primary outcomes were knowledge about stroke and stroke services, and anxiety.
CONCLUSIONS: The authors concluded that the active provision of information may improve stroke survivors stroke-related knowledge and quality of life. It may reduce the cases and symptoms of anxiety and probably depression. The effect of active information provision to carers and passive information provision is still unclear; however, passive information may worsen stroke patients' symptoms of anxiety and depression.