Recovery

23 Apr 2019 20:45
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When an individual suffers a stroke the nature and severity of the lingering effects of the stroke depend on which part of the brain the stroke affected and how badly damaged the brain tissue is. Both sides of the brain work together, but it has been noted that there is likely one side of the brain that is more dominant than the other in most people. However, one study of cardiac monitoring of stroke patients in rehabilitation indicated that heart rates in stroke patients during physical therapy sessions were generally in the target heart rate ranges for conditioning programs, which suggests that patients may have derived a cardiovascular training effect from their functional exercise program.

When functional rehabilitation is stopped, stroke survivors frequently preserve chronic sensorimotor dysfunctions as well as metabolic and cardiovascular complications 1 Moreover, they are still subjected to recurrent stroke within 5 years despite optimal medical management 2 Therefore, home exercises for stroke patients it is crucial that scientists and therapists continue to investigate the effectiveness of different stroke rehabilitation components in order to improve functional recovery and reduce both dependence and the economic burden associated with the lack of effective treatments.

Dynamometry; timed up and go; six-minute walk test; stair climbing test; sit and stand up test; isokinetic strength; walking speed; peak FC; peak VO2; 1MR; quality of life; balance; scales used to monitor perception of effort; EMG; strength platform.

19 In another recent meta-analysis comprising 22 RCTs evaluating lifestyle interventions in over 2500 patients post-TIA, no significant effect was found on cardiovascular morbidity or mortality or lipids profile; however, from subgroup analyses focused on trials with exercise training that lasted longer than 4 months, interventions that used at least three behaviour change techniques (BCTs) showed significant reductions in systolic blood pressure.

Neurophysiological observations suggest that changes in the process of sensorimotor integration do not occur at the peripheral level but depend on abnormal central processing of sensory input ( 29 ). These study results showed that proprioceptive sensory changes improved by 43% and 23% through multi-sensorimotor training and treadmill gait training, respectively.

The Stroke Onset Study used a case-crossover design, a variation of a case-control design that is appropriate when a brief exposure (physical activity) causes a transient change in the risk of an acute outcome (ischemic stroke) ( 20 , 21 ). We compared a subject's physical activity during the hour prior to onset of stroke symptoms (the hazard period) with the same subject's usual frequency of physical activity during the prior year (the control period).

It was hypothesized that advanced rehabilitation therapy combined with conventional rehabilitation therapy consisting of sensorimotor exercises would be superior to the usual treadmill training for proprioception variation and balance ability in subacute stroke patients.

31 From meta-analysis, self-efficacy with respect to each of balance (r2 =0.14) and falls (r2 =0.16) was reported to have significant positive correlations with poststroke PA. 29 Risk factors associated with falling include impaired mobility, reduced balance, use of sedative or psychotropic medications, impaired self-care, depression, cognitive impairment and previous falling.

Stroke survivors are, undoubtedly, patients who deserve special attention during the performance of the exercise training, once they present increased risk of falls, muscle weakness, exacerbated fatigue, autonomic dysfunction, and hemodynamic instability, to quote a few clinical symptoms.

1.1.16 After transfer of care from hospital, people with disabilities after stroke (including people in care homes) should be followed up within 72 hours by the specialist stroke rehabilitation team for assessment of patient-identified needs and the development of shared management plans.

1.9.23 Offer people repetitive task training after stroke on a range of tasks for upper limb weakness (such as reaching, grasping, pointing, moving and manipulating objects in functional tasks) and lower limb weakness (such as sit-to-stand transfers, walking and using stairs).

The exercise program consisted of 5 minutes of warm-up, 10 minutes of lower-extremity stretching exercises, 10 minutes of lower-extremity strengthening exercises, 20 minutes balance and gait training (walking, side stepping), 5 minutes of a light cool down, and 10 minutes of gentle stretching out of the water.

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