LitRev 5

Author/ Theoretical/ Research Methodology Analysis and results Conclusions Implications for future Implications for practice
Date Conceptual Question(s)/ research
Framework Hypotheses

Nguyen The effects It aimed to It used a systematic review The study focused on several key It concluded that physical It is important to note that It highlights that the initial
, Chou, of assess the and meta-analysis outcome measures, including the therapy utilizing while this study six months following a
& Hsieh Propriocepti potential methodology. Studies up to Berg Balance Scale (BBS), Proprioceptive demonstrated positive stroke are crucial for
(2022) ve advantages of September 2020 are Functional Reach Test (FRT), Timed Neuromuscular Facilitation statistical effects, further movement recovery.
Neuromusc Proprioceptive included. Up and Go Test (TUG), and 10- (PNF) techniques has research in the field of During this period,
ular Neuromuscular Meter Walking Test (10MWT), to statistically significant neuroplasticity and patients may experience
Facilitation Facilitation assess the effects of Proprioceptive effects on enhancing advanced rehabilitation the most significant
(PNF) on (PNF) in Neuromuscular Facilitation (PNF) balance and gait speed in studies is necessary to improvements. Thus,
improveme improving intervention in patients with chronic individuals who have establish a consensus early identification and
nts of balance and gait stroke. A total of nineteen studies experienced a stroke at regarding the clinical and initiation of rehabilitation
balance functionality involving 532 participants were least six months prior. research significance of interventions, including
and gait among selected for analysis, with twelve the data, including the PNF-based physical
functions in individuals with studies comprising 327 participants specific components of the therapy, can be crucial for
patients long-term eligible for inclusion in the meta- PNF technique, optimal optimizing motor recovery
with chronic effects of stroke. analysis. The pooled data revealed dosage parameters, and outcomes. Practitioners
stroke only. statistically significant enhancements practice conditions. Future should encourage
in balance (BBS, FRT, and TUG) meta-analyses will individuals with chronic
with p-values below 0.05, as well as contribute to a more stroke to continue
improvements in gait velocity with a comprehensive engaging in intensive
p-value less than 0.001, when understanding of the therapy beyond six
comparing the PNF intervention relative efficacy of PNF in months. The study
group to the control group. These stroke rehabilitation. suggests that PNF-based
findings suggest that PNF may be a physical therapy can still
promising treatment approach for significantly affect balance
enhancing balance and gait speed in and gait speed
the rehabilitation of individuals with improvement even after
chronic stroke. this period. Understanding
the specific components
of PNF and its potential
benefits in enhancing
balance and gait speed
 can guide practitioners in
recommending
appropriate interventions
and developing
comprehensive care
plans.

Sreedh The The objective of This study conducted an The study included a total of 469 It concluded that the Future research should The study implies that
aran et prevalence this study was observational study participants, with an average age of majority of individuals delve deeper into tailoring dysphagia
al. and to examine the involving individuals who 61.04 years and a median NIHSS experiencing acute post- identifying additional management plans to the
(2022) predictors factors that can experienced acute score of 9.52. Upon admission, 75% stroke dysphagia exhibit predictors of severe specific needs of each
of predict the ischemic stroke. These of acute ischemic stroke (AIS) significant recovery within a swallow dysfunction at patient is crucial.
dysphagia occurrence of patients underwent a patients exhibited some degree of period of 3-4 weeks discharge. Exploring other Considering the predictors
after stroke dysphagia in formal swallow assessment dysphagia. The researchers following the stroke event. clinical and imaging identified in this study,
and its individuals within 24 hours of identified that the severity of stroke However, it is noteworthy variables, such as stroke there should be a close
impact on shortly after admission and were at admission and worsening during that patients with post- location or lesion monitoring of patients with
short and experiencing a followed up for one year. the hospital stay independently stroke dysphagia are more characteristics, may higher stroke severity and
long term stroke, as well Medical records were predicted the presence of severe prone to experiencing enhance our those at risk of in-hospital
outcome in as to assess the screened and swallow swallow dysfunction at discharge. neurological deterioration understanding of the worsening to address
patients outcomes of assessments were After 3-4 weeks post-stroke, only during their hospital stay. factors contributing to dysphagia and prevent
with acute these patients extracted using a 20.27% of patients initially diagnosed Additionally, the presence of dysphagia outcomes. associated complications.
ischemic after one year. predetermined format. The with moderate to severe dysphagia dysphagia continues to Moreover, conducting It also highlights
stroke (AIS) modified Rankin scale was required ongoing modifications in influence functional studies with extended screening tools like the
used to evaluate the their feeding regimen due to outcomes even up to one follow-up periods beyond Gugging screening tool,
outcomes at three months persistent swallowing difficulties. It year after the stroke one year would provide which is very useful for
and one year. Correlations was also observed that dysphagia incident. valuable insights into the assessing aspiration risk
were made with clinical maintained a significant association long-term trajectory of in stroke units, thereby
and imaging findings, in with patient outcomes at the one- dysphagia and its impact minimizing complications.
hospital worsening and year mark, irrespective of the on functional outcomes.
dysphagia at discharge severity of stroke upon admission.
with short and long term
functional outcome.

Doumb The The aim of this A retrospective It found that chorea was observed in The study concluded that Conducting longitudinal The study highlights early
ouya et epidemiolo study was to observational study was a total of fourteen patients following Post-stroke chorea in studies with extended recognition in the
al. gical, provide a conducted over a five-year their stroke, corresponding to a tropical regions has follow-up periods will occurrence of chorea in
(2023) clinical, and comprehensive period from 2015 to 2020, frequency of 0.6%. The average age received limited research provide valuable stroke patients,
imaging description of focusing on stroke patients of the patients was 57.1 years, with a attention. It is important to information about the long- particularly in those with
characterist the with chorea who were higher prevalence among males. consider the possibility of term outcomes of acute abnormal
ics of post- epidemiological, admitted to the Half of the patients had hypertension post-stroke chorea when individuals with post- movements and
stroke clinical, and department. The study as a cardiovascular risk factor, while observing acute abnormal stroke chorea. This can cardiovascular risk
chorea in imaging collected and analyzed three patients (21.4%) had diabetes. movements in individuals help determine the factors. Raising
Conakry, characteristics epidemiological, clinical, Notably, chorea manifested as the with cardiovascular risk persistence of symptoms, awareness about this
Guinea. of post-stroke and imaging data related to initial symptom of the stroke in eight factors. Early identification recurrence rates, and the complication can lead to
chorea in a these patients. patients (57.1%). Among the cases, and prompt treatment can impact on functional early diagnosis and
tropical setting, thirteen patients (92.9%) lead to rapid recovery in abilities and quality of life prompt initiation of
specifically experienced an ischemic stroke, these cases. over time. Moreover, appropriate treatment.
within the whereas one patient had a cerebral further research is needed Providing information
context of a hemorrhage. The middle cerebral to explore the underlying about the importance of
stroke epidemic. artery (MCA) was affected in nine pathophysiological early intervention and
patients (64.3%), the anterior mechanisms of post- adherence to prescribed
cerebral artery (ACA) in three stroke chorea. therapies can empower
patients (21.4%), and two patients patients to actively
(14.3%) exhibited involvement of the participate in their own
posterior cerebral artery (PCA). care and improve their
Regarding the location of the lesions, outcomes.
five patients (35.7%) showed cortical
involvement, an additional five
patients (35.7%) had lesions in deep
structures, and four patients (28.6%)
had a combination of deep and
cortical lesions. Specifically, the
lentiform nucleus was affected in
50% of the cases, followed by the
insula (35.7%), caudate nucleus
(14.3%), and thalamus (14.3%).

Hsu et The study The aim of this It employed a single- The study was completed by a total The findings of the study Further studies should be The study highlights
al. hypothesize study was to blinded randomized of fifty-two participants. The analysis suggest that VR-MT shows conducted to validate and emerging technologies
(2022) s that VR- compare and controlled trial design. A did not reveal any statistically promise in improving upper build upon the findings of and interventions such as
MT has the analyze the total of 54 participants, significant group-by-time interaction extremity motor function in this study regarding the VR-MT in stroke
potential to distinct impacts consisting of individuals effects on the Fugl-Meyer motor chronic stroke patients. effects of VR-MT on the rehabilitation.
 be more of conventional with chronic stroke, were assessment for the upper extremities However, due to the limited sensorimotor function of Practitioners should
effective in occupational randomly assigned. score. However, there were strength of evidence, further the upper limb in chronic acquire the necessary
reducing therapy (COT), Alongside 20-minute significant group-by-time interaction confirmatory studies are stroke patients. This will knowledge and skills to
impairment mirror therapy sessions of task-specific effects observed for the wrist sub- needed to fully establish the help to establish a effectively integrate these
and (MT), and virtual training, participants score of the FM-UE and the results benefits of combining VR stronger evidence base innovative approaches
improving reality-based underwent 30 minutes of of the box and block test. The with MT in enhancing the and confirm the potential into their practice.
activity mirror therapy VR-MT, MT, or COT findings of this study provided some primary outcome as benefits of using VR-MT in
participatio (VR-MT) programs twice a week for support for the hypothesis that VR- observed in this study. stroke rehabilitation.
n compared interventions on 9 weeks, according to their MT may yield superior outcomes in Additionally, future
to the assigned group. The improving motor function of the research could explore the
traditional sensorimotor primary outcome measure, affected upper limb in individuals optimal duration,
MT and function of the the Fugl-Meyer motor who have experienced a stroke. frequency, and intensity of
COT for upper limb in assessment for the upper VR-MT interventions for
individuals individuals with extremities (FM-UE), was chronic stroke patients.
who have chronic stroke. recorded at pre-treatment, This will provide valuable
experience post-intervention, and 12- insights into the most
d a chronic week follow-up, alongside effective treatment
stroke. additional assessments protocols and guide
such as the Semmes- clinicians in designing
Weinstein monofilament rehabilitation programs.
test, motor activity log,
modified Ashworth scale,
and the box and block test.

Wonder The The aims of this This prospective study The study found that, in general, the It concluded that the The study suggests that The findings suggest that
gem et relationship study were to builds upon the findings of participants in the study experienced movement behavior further confirmatory incorporating VR
al. between examine (1) the the RISE longitudinal an initial improvement in physical patterns observed in studies are needed to technology into
“peoples'” trajectory of cohort study, which functioning from the time of individuals with a first-ever strengthen the evidence rehabilitation
(2022)
movement physical encompassed a sample of discharge up to the six-month mark. stroke after returning home regarding the interventions, such as
behavior functioning 200 individuals who had However, their physical functioning have significant effectiveness of adding mirror therapy, may have
patterns during the initial experienced their first-ever showed a decline from six months to associations with and virtual reality (VR) to potential benefits for
(the two years stroke and were two years post-stroke. Notably, predictive value for the mirror therapy (MT) for restoring upper extremity
composition following stroke subsequently discharged individuals classified as sedentary trajectory of physical improving the primary motor function in chronic
of discharge and from the hospital to their exercisers demonstrated stable functioning. Specifically, outcome, which is the stroke patients. It
sedentary (2) the homes. The participants' physical functioning throughout the those who exhibit high upper extremity motor highlights the integration
behavior correlation physical functioning was first two years after stroke. On the levels of sedentary behavior function in chronic stroke of VR technology into
and between evaluated at three-week
physical physical intervals, as well as at six
activity functioning and months, one year, and two
during baseline years after discharge. This
waking movement assessment involved the
hours) behavior use of the Stroke Impact
directly patterns. Scale (SIS) 3.0 subscale
after stroke physical and the five-meter
and the walk test (5MWT). Distinct
developme movement behavior
nt of patterns among
physical participants at baseline
functioning were identified: (1)
over time. sedentary exercisers (2)
sedentary movers and (3)
sedentary prolongers. It
utilized longitudinal
generalized estimating
equations analyzes to
determine the association
between these movement
behavior patterns and the
trajectory of physical
functioning over time.
other hand, sedentary movers and
sedentary prolongers experienced
an initial improvement in physical
functioning during the first six
months after discharge, followed by
a deterioration in the subsequent six
months. Moreover, sedentary
prolongers exhibited a further decline
in physical functioning (as measured
by the SIS) from one to two years.
Similar patterns were observed when
assessing physical functioning using
the 5-meter walk test (5MWT).
and inactivity experience
less favorable outcomes
over time compared to
individuals who engage in
higher levels of physical
activity, including light-
intensity activity.
Encouraging improvements
in daily habitual movement
behavior may help protect
against the decline of
physical functioning.
Consequently, tailored
interventions targeting
behavioral movement
changes for those classified
as sedentary prolongers,
are necessary to address
these issues effectively.
patients. Future research
should aim to replicate the
study with a larger sample
size and diverse
population to validate the
findings. Additionally,
future research could
compare the effectiveness
of conventional
occupational therapy
(COT), MT, and VR-based
MT (VR-MT) in a larger
sample of chronic stroke
patients. This would help
to establish the
comparative benefits of
each intervention and
determine if VR-MT offers
superior outcomes
compared to COT or MT
alone.
clinical practice and
collaboration with
rehabilitation specialists to
implement VR-MT
interventions. Moreover,
tailored interventions are
necessary to address
movement behavior
patterns and promote
positive physical
functioning outcomes. The
development of a
personalized care plan
should include strategies
to increase physical
activity levels, decrease
sedentary behavior, and
promote daily habitual
movement.

References:
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of Ignace Deen Hospital of Conakry, Guinea. Cureus, 15(2), e35515. https://doi.org/10.7759/cureus.35515
Hsu, H. Y., Kuo, L. C., Lin, Y. C., Su, F. C., Yang, T. H., & Lin, C. W. (2022). Effects of a Virtual Reality-Based Mirror Therapy Program on Improving Sensorimotor Function of
Hands in Chronic Stroke Patients: A Randomized Controlled Trial. Neurorehabilitation and neural repair, 36(6), 335–345. https://doi.org/10.1177/15459683221081430
Nguyen, P. T., Chou, L. W., & Hsieh, Y. L. (2022). Proprioceptive Neuromuscular Facilitation-Based Physical Therapy on the Improvement of Balance and Gait in Patients with
Chronic Stroke: A Systematic Review and Meta-Analysis. Life (Basel, Switzerland), 12(6), 882. https://doi.org/10.3390/life12060882
Sreedharan, S. E., Sayed, J. V., Vipina, V. P., Mohan, P. M., Jissa, V. T., & Sylaja, P. N. (2022). Dysphagia continues to impact recovery at one year after stroke-an
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Wondergem, R., Pisters, M. F., Wouters, E. J., de Bie, R. A., Veenhof, C., & Visser-Meily, J. M. (2022). The course of physical functioning in the first two years after stroke
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