Stroke Research & Rehabilitation
Stroke Ed Webinar
Just recently, our TRS Physiotherapists participated in the renowned “Stroke Ed’s” webinar that focussed on rehabilitation. The webinar was titled: The intensity of Practice: Overcoming challenges to implementation into practice and provided exciting research challenging our current rehabilitation model, asking are we really doing enough?
Rehabilitation following a stroke is designed to assist in neurological reorganisation and motor relearning, whereby the specific repetitive practice of a task is needed to relearn skills. There is a general consensus that more task-specific practice is better, but there seems to be a lack of understanding of exactly how much and what type of practice.
A Systematic Review was presented in the webinar by Emma Schneider’s team looking into how patients benefited from performing extra practice on top of their ‘usual’ exercise dosage. After collecting data from 15 studies, they were able to show that 240% or 3 times the normal amount (30-60mins) of specific task rehabilitation was needed to improve the likelihood that the extra rehab improves activity.
This figure, although challenging to achieve, can pave the way for future clinical guidelines and change the way physiotherapy rehabilitation is implemented. If we can motivate the patient to perform more supervised or unsupervised exercises, group class exercises, and family-assisted exercises they should achieve better results and reach their rehabilitation goals.
Rehabilitation physio learns what it takes to succeed in rehab.
The webinar displayed a rare insight into the practicality of intensity of practice and how it relates to a client going through the clinical process. A keynote speaker was Caitlin Reid, who is a rehab physiotherapist who sadly suffered a traumatic brain injury 12 months ago.
Having been a rehab physiotherapist and now a patient on the other side, Caitlin was able to challenge the mantra of practice what you preach and described that all her improvements were dose and intensity-dependent. The specific tasks she practiced the most were the things that she improved greatly on. Aside from continuous repetitive practice, Caitlin believes all her gains were a collective result of:
- Strong positive rapport with her therapists
- Rehab program must be individualized
- Includes family and friends in the rehab process
- Completion log/ diaries
- Participating in group exercises classes for comfort and motivation
These points that Caitlin attributed to her success are all evidence-based and are things we must consider throughout the rehab journey with our clients. Caitlin was able to overcome many of the challenges she faced but still understands there’s a long journey ahead of her.
Commencement of early exercises post-stroke predicts unassisted walking and speed
There is a large debate in the literature about how soon is too soon to commence rehab following a stroke or brain injury and do the benefits outweigh the risks. In a recent webinar our physios attended presented by Stroke Ed, Dr. Katherine Scrivener discussed the importance of exercise dose in the first week after admission.
Her team studied 200 patients that were admitted to the hospital following a stroke who needed physiotherapy rehabilitation. The aim of the study was to determine if exercise dosage in the first week can predict walking ability when discharged and does a larger amount of exercise results in faster recovery of the ability to walk independently.
Dr. Katherine Scrivner’s group showed that the ability to complete more rehabilitation repetitions in the first week after a stroke can achieve a quicker recovery of unassisted walking and walking speed.
The patients who could perform more exercise repetitions after the first week of their stroke were able to return to walking unassisted a lot faster. The participants who were unable to exercise as much took longer to recover their ability to walk.
This is exciting, as it highlights the importance of aiming to get patients walking and exercising once they are medically stable as early exercise success in the first week following a stroke, can give you a good idea of their likely recovery time. And we would everyone to recover as fast as they can and reach their goals.
“Steptember”- Steps forward for CP with Total Rehab Solutions
Cerebral Palsy (CP) is a neurodevelopmental condition affecting around 40,000 people in Australia with 1 in 700 children being diagnosed annually. CP is nonprogressive and usually manifests in early life pre or post-natally either from infection, lack of blood supply, or trauma. Cerebral Palsy affects everyone differently, some people have weakness in all limbs, while others only have problems with one side of their body. Some people will have increased muscle tone or tightness, muscle spasticity, delayed motor development, learning difficulties, visual and hearing disturbances, and communication issues.
At Total Rehab Solutions, we work with many clients with Cerebral Palsy assisting with exercise programs for strength and endurance, balance and coordination tasks, aid prescription and home modifications, gait retraining, and hands-on treatment. However, this year, we want to do a little bit more! This year we will be participating in “Steptember”.
Steptember is Australia’s leading health fundraising event where all donations go to kids with CP for things like new stem cell treatment, equipment, technology and innovations, programs, and rural support. Our challenge is to ride, swim or walk our way to 10,000 steps a day for 28 days of September while promoting awareness for CP.
If you want to reach out and support us during our Steptember fundraiser, be sure to look out for our socials to find out how you can help! Find out more information at https://www.steptember.org.au/.