Abstract:
:Stroke is the leading cause of disability in older Americans. Each year 750,000 Americans suffer a stroke, two thirds of whom are left with neurological deficits that persistently impair function. Principal among them is hemiparetic gait that limits mobility and increases fall risk, promoting a sedentary lifestyle. These events propagate disability by physical deconditioning and "learned non-use," with further functional declines accelerated by the sarcopenia and fitness decrements of advancing age. Conventional rehabilitation care typically provides little or no structured therapeutic exercise beyond the subacute stroke recovery period, based on natural history studies showing little or no further functional motor recovery beyond 6 months after stroke. Emerging evidence suggests that new models of task-oriented exercise have the potential to improve motor function even years after stroke. This article presents treadmill as a task-oriented training paradigm to optimize locomotor relearning while eliciting cardiovascular conditioning in chronic stroke patients. Protocols for exercise testing and longitudinal aerobic training progression are presented that provide fundamental formulas that safely approach the complex task of customizing aerobic training to gait deficit severity in the high CVD risk stroke population. The beneficial effects of 6 months task-oriented treadmill exercise on cardiovascular-metabolic fitness, energy cost of hemiparetic gait, ADL mobility task performance, and leg strength are discussed with respect to the central and peripheral neuromuscular adaptations targeted by the training. Collectively, these findings constitute one initial experience in a much broader neuroscience and exercise rehabilitation development of task-oriented training paradigms that offer a multisystems approach to improving both neurological and cardiovascular health outcomes in the chronic stroke population.
journal_name
Top Stroke Rehabiljournal_title
Topics in stroke rehabilitationauthors
Macko RF,Ivey FM,Forrester LWdoi
10.1310/PJQN-KAN9-TTVY-HYQHkeywords:
subject
Has Abstractpub_date
2005-01-01 00:00:00pages
45-57issue
1eissn
1074-9357issn
1945-5119journal_volume
12pub_type
杂志文章,评审abstract::Stroke onset causes disruption of family roles as caregiving tasks are assumed. The current study presents a qualitative and quantitative analysis of the problems of 123 older, spousal stroke caregivers. Problems were coded into 14 categories; frequencies of occurrence and difficulty were also analyzed. Differences in...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/DDBP-TRCC-3KVA-4B94
更新日期:2002-04-01 00:00:00
abstract:PURPOSE:This study evaluated the impact of an educational intervention that integrates concepts of a community re-engagement framework (CR) and interprofessional collaboration (IPC) on health care providers' (HCP) practice with persons living with stroke (PLS). METHOD:A mixed-methods design was used in which HCPs (n =...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章,多中心研究
doi:10.1310/tsr1901-63
更新日期:2012-01-01 00:00:00
abstract::Stroke remains a leading cause of disability for older adults. While is it well established in the literature that exercise programs can have significant benefit, many stroke survivors do not receive specific recommendations for exercise or lack the motivation to continue exercising following discharge from rehabilita...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/tsr1602-140
更新日期:2009-03-01 00:00:00
abstract:INTRODUCTION:Poststroke, less-severe motor impairment occurs on the ipsilesional side of body. The objective of the present study was to evaluate the effectiveness of the motor training involving the less-affected side (MTLA) in stroke. METHODS:This was a randomized, controlled, double-blinded pilot study conducted in...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章,随机对照试验
doi:10.1179/1074935714Z.0000000022
更新日期:2015-10-01 00:00:00
abstract::Integrated networks add value to patient care through several mechanisms--sharing information and practice consistency based on evidence and access to a wide range of physicians and patient care venues. Successful networks are tied together through shared information systems and electronic medical records. The Domain ...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/K8W2-TR3D-8JQ0-DWYD
更新日期:2002-10-01 00:00:00
abstract::Background Stroke can compromise upper limb performance and influence the individual's participation in real life situations. Objective To investigate how components of body function and activity affect the individuals' self-perception of their participation after stroke. Methods In this observational study, the Inter...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1080/10749357.2017.1406177
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Stroke presents with heterogeneous recovery periods, severity, and manifestation of deficits, all of which may adversely impact fitness-to-drive. Little is known about the association between site of lesion and driving performance after stroke. OBJECTIVE:To investigate the association between site of stroke...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1179/1074935714Z.0000000018
更新日期:2015-08-01 00:00:00
abstract::Good end-of-life care requires that clinicians, families, and ethicists be aware of biases that influence patient cases, particularly in the acute care setting where the aim is primarily cure and return to optimal functional level. Persons with disabilities may pose unique challenges; their potential for quality of li...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章,评审
doi:10.1310/tsr1304-54
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:The brain mechanisms underlying successful recovery of hand fuenction after stroke are still not fully understood, although functional MRI (fMRI) studies underline the importance of neuronal plasticity. METHODS:We explored potential changes in brain activity in 7 patients with subacute to chronic stroke (69...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/tsr2004-308
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Aphasia is a serious consequence of stroke but aphasics patients have been routinely excluded from participation in some areas of stroke research. OBJECTIVE:To assess the role of specific linguistic and non-verbal cognitive abilities on the short-term motor recovery of patients with aphasia due to first-eve...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1080/10749357.2017.1305654
更新日期:2017-09-01 00:00:00
abstract::This article proposes to use information processing models of cognition to guide behaviorally based treatments of language deficits, specifically, single-word object naming. Our approach is illustrated with a clinical case of a transcortical sensory aphasic. Clinical neuropsychological and functional imaging data demo...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/K2HJ-YP2C-FMBW-0ME5
更新日期:1997-04-01 00:00:00
abstract::Postural control is an essential component to be considered in the rehabilitation of stroke survivors. This article attempts to provide the clinician with terminology and frameworks for classification in order to provide a more focused intervention. There is a comparison of some of the available assessments of impairm...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1080/10749357.1995.11754043
更新日期:1995-01-01 00:00:00
abstract::Musculoskeletal problems in stoke survivors are common reasons for disability and pain. Shoulder pain is present in 24% of stroke survivors among all complications, second only to depression in 26%. Diagnosis and treatment of the various shoulder pain etiologies can significantly improve quality of life in these patie...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章,评审
doi:10.1310/tsr1703-173
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:This study investigated whether or not individuals with ataxia from stroke improve their upper extremity motor function with intense motor practice. METHOD:Three individuals with ataxia from chronic stroke completed modified constraint-induced movement therapy (CIMT) protocols. Stroke Participants 1 and 2 co...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/tsr1503-262
更新日期:2008-05-01 00:00:00
abstract::This article describes the efforts made by the city of Chicago to promote total access and full participation for people with disabilities. The process that the Chicago Mayor's Office for People with Disabilities (MOPD) undertook to ensure that other city departments and sister agencies incorporated accessible program...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/tsr1502-75
更新日期:2008-03-01 00:00:00
abstract::The aims of this study were to document the readability of a stroke education brochure and to illustrate how the readability of this document might be improved. Readability analyses using three different formulas were conducted on a stroke education brochure from the Australian National Stroke Foundation. Consistent w...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/6UM4-6J7J-YTLC-K976
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Many people with mild disability after stroke are physically inactive despite the risk of recurrent stroke. A self-management program may be one strategy to increase physical activity in stroke survivors. OBJECTIVES:To investigate the feasibility of a self-management program, and determine whether self-mana...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1080/10749357.2017.1304876
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Stroke survivors experience functional loss in basic activities of daily living (ADLs) and in everyday community activities or instrumental activities of daily living (IADLs). Historically there has been a greater focus by rehabilitation professionals on basic ADLs than on IADLs. PURPOSE:The purpose of this...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/tsr1401-48
更新日期:2007-01-01 00:00:00
abstract::Subarachnoid hemorrhage affects more than 25,000 Americans yearly and is most commonly caused by a ruptured, saccular, cerebral aneurysm. Current measures to evaluate and manage patients with nontraumatic subarachnoid hemorrhage are detailed. Areas of future progress are presented. The diagnosis and treatment of intra...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1080/10749357.1996.11754101
更新日期:1996-03-01 00:00:00
abstract:OBJECTIVE:Modifying assessments for people with aphasia has the potential to increase the validity of healthcare assessments across professional domains. This pilot study addressed the challenges of giving people with aphasia the power to fully participate in the assessment process. The study aimed to investigate the f...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1179/1074935714Z.0000000034
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:The effects of whole body vibration (WBV) on chronic stroke (CS) patients have been investigated by some previous studies. However, controversy still exists. OBJECTIVE:The objective of this meta-analysis was to review existing studies that assess the effects of WBV training on CS patients. METHODS:We searc...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章,meta分析,评审
doi:10.1179/1074935714Z.0000000005
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Participation which entails involvement in life situations and represents a higher level of functioning can be severely restricted after a stroke. This study investigated the impact of social support on participation of stroke survivors in Nigeria. METHODS:Ninety-six community-residing stroke survivors were...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1080/10749357.2016.1155279
更新日期:2016-10-01 00:00:00
abstract::In terms of integration of the paretic upper extremity in activities of daily living (ADLs), outcome is poor after stroke. Furthermore, amount of real-world arm use appears only weakly correlated with laboratory motor function scales. Therefore, amount of arm use may depend critically on the location, extent, and type...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/tsr1604-237
更新日期:2009-07-01 00:00:00
abstract::Telemedicine allows prompt assessment of acute stroke patients. This new technology has increased the administration of intravenous recombinant tissue plasminogen activator (rtPA) to eligible patients. In addition, telemedicine is being utilized in the rehabilitation of patients with cerebrovascular disease. This arti...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章,评审
doi:10.1310/tsr2002-101
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Virtual reality (VR) is becoming a popular alternative to traditional upper and lower limb rehabilitation following a stroke. OBJECTIVE:To conduct a systematic review and meta-analysis on the effectiveness of VR interventions for improving balance in a chronic stroke (≥6 months) population. DATA SOURCES:A ...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章,meta分析,评审
doi:10.1080/10749357.2016.1192361
更新日期:2017-01-01 00:00:00
abstract::Informal care provision presents many challenges. As the population ages, more people are forced to enter the role of informal caretaker. Despite the increase in the need for caregivers and the importance of providing care, there is little empirical research examining how men and women approach and cope with providing...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/CJVW-WCPK-2FCV-369P
更新日期:2006-01-01 00:00:00
abstract::Objectives The objective of this study was to assess the short-term effects of dry needling on spasticity, gait, and muscle architecture of patients with chronic stroke. Methods A case series study was designed; and six chronic stroke patients with ankle spasticity and gait impairment received a single session of dry ...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1080/10749357.2018.1460946
更新日期:2018-07-01 00:00:00
abstract::The Medicare Modernization Act of 2003 (MMA'03) did more than introduce a prescription drug benefit for Medicare beneficiaries; it also laid the groundwork for several far-reaching changes in the Medicare program. These changes must be considered in the context of the "American devolution"--a much larger shift in Amer...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/R28D-5XJQ-B0TX-R4VM
更新日期:2005-04-01 00:00:00
abstract:PURPOSE:Education is a key component of post stroke care, but patients and carers often report dissatisfaction with information provided. A small number of studies have reported challenges surrounding the provision of information to this population, but patients' perspectives have not been explored in detail. The aim o...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/tsr1702-69
更新日期:2010-03-01 00:00:00
abstract::Objectives The sit to stand (STS) movement is key to independence and commonly affected by stroke. Repetitive practice is likely to improve STS ability during rehabilitation, however current practice levels are unknown. The objective of this study was simply to count the number of STS movements performed during the re...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章,随机对照试验
doi:10.1080/10749357.2017.1374687
更新日期:2017-12-01 00:00:00