Post-stroke Function: First 5 Years

June 2019: Rejnö et al  (In Press) Changes in functional outcome over five years after stroke. Brain and Behaviour https://doi.org/10.1002/brb3.1300

As the authors rightly claim, there is little evidence about the long-term, functional outcomes in survivors of stroke; which, when you think about it, is surprising! Stroke is a chronic disease, one that survivors will live with for the rest of their lives, yet we know very little about its long-term, functional impact. What I also find very surprising, is the lack of ongoing support that those with stroke, receive in the long-term. Australian researcher, Dr Jeni White, found that, once discharged, many feel “abandoned” by the healthcare system. So, its timely that we review an article about the long-term needs of people living with stroke. This article is freely available. Please find the abstract under Journal Club 2019, and my “humble opinion” attached as a comment to this post.

Sitting, Upper Limb Impairment and Falls

April 2019: Hanna et al (2019) Participation, Fear of Falling, and Upper Limb Impairment are Associated with High Sitting Time in People with Stroke, Occupational Therapy In Health Care, DOI: 10.1080/07380577.2019.1587675

OK, so I best confess that I’ve selected this article on the basis of the fact that it’s written by some of my closest colleagues, who I most admire, and it’s about topics that I’m very interested in! So, put that all together, and you have, in my humble opinion, a most engaging article. The investigators and their research questions exemplify the type of new knowledge that can be generated when the line between researcher, scientist and therapist, is so blurred, as to be indistinguishable.

This article is not publicly available, but you can always contact the corresponding author and request a copy. This study is an exploratory study only, but raises important questions and provides provisional answers. As always, you’ll find the abstract under Journal Club 2019 and “humble opinion” as a comment to this post.

Stroke & Horse Riding

Pohl et al (2018) A qualitative exploration of post-acute stroke participants’ experiences of a multimodal intervention incorporating horse riding. PLOS One, https://doi.org/10.1371/journal.pone.0203933

This is the final Journal Club entry for 2018. When it comes to stroke recovery, a collective “light bulb” moment has been the realisation that the average stroke recovery environment is bereft of stimuli, interest, reasons to participate and requirements to be involved in…well, almost anything and everything. So, here’s a stroke intervention that’s completely “out of the box”! It’s yet to be proven to be clinically effective, but for the 18 participants in the horse-riding group, the experience was transformative! I’m not sure we’d have ever considered rehabilitation could be transformative. They’re powerful words indeed. To find the abstract, go to the Journal Club page and to find “Humble Opinion”, go to the attached comment.

I hope 2018 has been a transformative year for you, in the smaller and/or greater experiences of life. For me, 2018 started with great sadness, but it’s finishing with gladness as I look towards a 2019 that’s heralding change. I wish you a hugely rewarding 2019 and here’s hoping you can enjoy some relaxing time over the Christmas/New Year break, with those precious to you.

A huge thank you to all my Changing Stroke followers and to those who have participated as learners and/or educators in my CPDLife® courses. I look forward to more Journal Clubs postings in 2019, but please note that these won’t re-start until February.

Shoulder Pain

October 2018 Journal Club: Lindgren et al (In Press) Pain management strategies amount persons with long-term shoulder pain after stroke – a quantitative study. Clinical Rehabilitation, Online early

How do survivors manage persistent shoulder pain after stroke? In 2007 [1], this same research group published findings indicating that 22% of all patients with stroke experienced shoulder pain and of these, at least three-quarters classified it as moderate to severe. One year later, some experienced no pain, but others, who started experiencing shoulder pain further down the track, were added to this cohort. What a complicated issue this is for those experiencing it and for health professionals managing it!

Since 2007, this research group has continued to investigate shoulder pain after stroke and their findings include a 2018 publication [2], which is also worth reading, if this is a topic of interest to you.

The October 2018 Journal Club publication reports the strategies the “experts” use to manage their shoulder pain in the long-term. This article is not freely available; but as I always say, if you contact the “corresponding author”, they’re usually only too happy to send it to you.

To find “humble opinion” see my posted comment and to read the abstract, use the Journal Club 2018 link.

[1] Lindgren et al (2007) Shoulder pain after stroke: A prospective population-based study. Stroke, 38, 343-348. https://www.ahajournals.org/doi/pdf/10.1161/01.STR.0000254598.16739.4e

[2] Lindgren et al (2018) Shoulder pain after stroke: Experiences, consequences in daily life and effects of interventions: a qualitative study. Disability and Rehabilitation, 40(10), 1176-1182. https://www.ncbi.nlm.nih.gov/pubmed/28637154