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Book Details
Abstract
Practical and concise, Stroke Rehabilitation provides everyday clinical guidance on current methods, techniques, evidence, and controversies in this important area. This focused resource by Drs. Richard Wilson and Preeti Raghavan consolidates today’s available information in an easy-to-navigate format for today’s practicing and trainee physiatrists, as well as other members of the rehabilitation team.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Stroke Rehabilitation | i | ||
| Stroke Rehabilitation | iii | ||
| Copyright | iv | ||
| List of Contributors | v | ||
| Improving the Lives of Stroke Survivors | xi | ||
| Contents | xiii | ||
| 1 - Stroke Epidemiology and Prevention | 1 | ||
| INTRODUCTION | 1 | ||
| CLINICAL DEFINITION OF STROKE | 1 | ||
| BURDEN OF STROKE | 2 | ||
| PREVENTION | 5 | ||
| CLASSIFICATION AND DETERMINATION OF STROKE RISK FACTORS | 5 | ||
| MODIFIABLE RISK FACTORS | 6 | ||
| Air and Noise Pollution | 11 | ||
| INTERVENTIONS AND EDUCATIONAL APPROACHES | 12 | ||
| FUTURE DIRECTIONS AND CONCLUSIONS | 14 | ||
| REFERENCES | 14 | ||
| 2 - Prediction of Motor Recovery and Outcomes After Stroke | 23 | ||
| INTRODUCTION | 23 | ||
| WHAT CAN CLINICIANS USE TO GUIDE PREDICTIONS IN CLINICAL PRACTICE? | 24 | ||
| IS THIS PREDICTION MODEL OF MOTOR RECOVERY OR OUTCOME READY FOR USE IN CLINICAL PRACTICE? | 24 | ||
| Did the Development Study Recruit a Representative Cohort? | 25 | ||
| Did the Development Study Standardize Measurement of Predictors? | 26 | ||
| Did the Development Study Standardize Measurement of Outcomes? | 26 | ||
| Did the Validation Study Conduct External Validation? | 28 | ||
| WHICH PREDICTION MODEL OF MOTOR RECOVERY OR OUTCOME MIGHT BE READY FOR USE IN CLINICAL PRACTICE? | 32 | ||
| The ASTRAL Model | 32 | ||
| The ESSEN ICH Model | 38 | ||
| CONCLUSIONS: SUMMARY AND IMPLICATIONS FOR CLINICIANS AND RESEARCHERS | 40 | ||
| REFERENCES | 42 | ||
| 3 - Aphasia Rehabilitation | 49 | ||
| DEFINITION | 49 | ||
| CLASSIFICATION AND TYPES OF APHASIA | 49 | ||
| APHASIA REHABILITATION IN THE UNITED STATES | 50 | ||
| APHASIA TREATMENT PRINCIPLES | 50 | ||
| IMPAIRMENT-BASED TREATMENT APPROACHES | 52 | ||
| VERBAL PRODUCTION TREATMENT | 52 | ||
| Phonological-Based Treatment | 52 | ||
| Semantic-Based Treatment | 52 | ||
| Syntax Treatment | 53 | ||
| READING AND WRITING TREATMENT | 53 | ||
| Summary of Impairment Treatment-Related Progress in Research Studies | 54 | ||
| SOCIAL-COMMUNICATION TREATMENT APPROACHES | 55 | ||
| BIOLOGICAL TREATMENT APPROACHES | 55 | ||
| TREATMENT WITH MULTILINGUAL AND MULTICULTURAL INDIVIDUALS AND WORK WITH INTERPRETERS | 56 | ||
| CONCLUSIONS | 56 | ||
| REFERENCES | 57 | ||
| 4 - Swallowing Disorders After Stroke | 61 | ||
| Swallowing Epidemiology | 61 | ||
| Neural Control of Swallowing | 61 | ||
| Brainstem | 61 | ||
| Oropharyngeal sensation | 62 | ||
| Dorsal swallow group (DSG) | 62 | ||
| Ventral swallow group (VSG) | 62 | ||
| Supramedullary Control | 62 | ||
| Corticobulbar and extrapyramidal tracts | 62 | ||
| Insula | 62 | ||
| Lesion laterality | 62 | ||
| Screening for Dysphagia in Acute Stroke Patients | 63 | ||
| Assessment of Dysphagia After Stroke | 63 | ||
| Clinical Evaluation | 63 | ||
| Instrumental Assessment | 63 | ||
| Treatment Approaches for the Patient With Dysphagia | 65 | ||
| Dysphagia Treatment: External Factors | 65 | ||
| Principles of Dysphagia Therapy | 65 | ||
| Liquids or Food Texture Modification | 65 | ||
| Maneuvers | 65 | ||
| Chin tuck | 65 | ||
| Head turn and tilt | 65 | ||
| Effortful swallow | 65 | ||
| Supraglottic and super-supraglottic swallow | 65 | ||
| Mendelsohn maneuver | 66 | ||
| Restorative Approaches | 66 | ||
| Tongue hold | 66 | ||
| Shaker exercises | 66 | ||
| Other Treatment Approaches | 66 | ||
| Oral Versus Nonoral Feeding in Neurologic Dysphagia | 66 | ||
| Nasogastric tubes | 66 | ||
| Percutaneous endoscopic gastrostomy tubes | 66 | ||
| Oral care | 67 | ||
| Dysphagia and nonoral feeding | 67 | ||
| Conclusion | 68 | ||
| References | 68 | ||
| 5 - Right Brain Stroke Syndromes | 71 | ||
| INTRODUCTION | 71 | ||
| Lateralization of Function in the Cerebral Hemispheres | 71 | ||
| SPATIAL NEGLECT | 73 | ||
| Definitions/History | 73 | ||
| Pathophysiology/Neuroanatomy | 73 | ||
| Clinical Presentation | 73 | ||
| Rehabilitation of Spatial Neglect | 75 | ||
| ANOSOGNOSIA OR UNAWARENESS OF DEFICIT | 76 | ||
| Definitions/History | 76 | ||
| Pathophysiology/Neuroanatomy | 76 | ||
| Clinical Presentation | 76 | ||
| Rehabilitation of Anosognosia for Hemiparesis | 78 | ||
| EMOTIONAL PROCESSING DEFICITS, INCLUDING EMOTIONAL APROSODIA | 78 | ||
| Definitions/History | 78 | ||
| Pathophysiology/Neuroanatomy | 80 | ||
| Clinical Presentation | 80 | ||
| Rehabilitation of Emotional Processing Deficits | 81 | ||
| ALIEN HAND SYNDROME | 82 | ||
| Definitions/History | 82 | ||
| Pathophysiology/Neuroanatomy | 82 | ||
| Clinical Presentation | 83 | ||
| Rehabilitation of Alien Hand Syndrome | 83 | ||
| CONCLUSIONS AND FUTURE DIRECTIONS | 84 | ||
| ACKNOWLEDGMENTS | 84 | ||
| REFERENCES | 84 | ||
| 6 - Musculoskeletal Pain | 91 | ||
| RISK FACTORS | 91 | ||
| Joint Pain | 91 | ||
| Shoulder Pain | 93 | ||
| SOFT TISSUE INJURY | 93 | ||
| BICIPITAL TENDONITIS | 96 | ||
| SHOULDER SUBLUXATION | 96 | ||
| CAPSULITIS AND RELATED CONDITIONS | 97 | ||
| SPASTICITY | 97 | ||
| CENTRAL HYPERSENSITIVITY | 98 | ||
| SUMMARY | 99 | ||
| DISCLOSURE STATEMENT | 99 | ||
| REFERENCES | 99 | ||
| 7 - Central Pain and Complex Regional Pain Syndromes | 105 | ||
| INTRODUCTION | 105 | ||
| CENTRAL POST-STROKE PAIN | 105 | ||
| Neuroanatomy of CPSP | 105 | ||
| The spinothalamic tract | 106 | ||
| The medullary tracts | 106 | ||
| The cerebral cortex | 108 | ||
| What Is Known About the Pathophysiology of CPSP | 108 | ||
| Treatments for CPSP | 109 | ||
| Antidepressants | 109 | ||
| Anticonvulsants | 109 | ||
| Corticosteroids | 109 | ||
| Nonpharmacologic treatments | 110 | ||
| COMPLEX REGIONAL PAIN SYNDROME | 110 | ||
| Pathophysiology of CRPS | 111 | ||
| Treatment of CRPS in Stroke | 111 | ||
| CONCLUSION | 112 | ||
| REFERENCES | 112 | ||
| 8 - Upper Limb Impairment | 115 | ||
| INTRODUCTION | 115 | ||
| NONUSE | 115 | ||
| BAD-USE | 117 | ||
| LACK OF DEXTERITY | 117 | ||
| CONCLUSION | 119 | ||
| REFERENCES | 119 | ||
| 9 - Lower Limb Impairments After Stroke | 123 | ||
| Introduction | 123 | ||
| Motor Impairment | 123 | ||
| Somatosensory Impairment | 126 | ||
| Spasticity | 127 | ||
| Motor Coordination and Balance | 128 | ||
| Conclusions | 129 | ||
| References | 130 | ||
| 10 - Current Concepts in Assessment and Management of Spasticity | 133 | ||
| INTRODUCTION | 133 | ||
| PATHOPHYSIOLOGY | 133 | ||
| CLINICAL PRESENTATION, ASSESSMENT, AND GOAL-SETTING | 135 | ||
| Clinical Presentations | 135 | ||
| Clinical and Quantitative Assessment | 135 | ||
| Goal-Setting | 138 | ||
| MANAGEMENT | 139 | ||
| Physical Modalities | 140 | ||
| Oral Spasmolytics | 140 | ||
| Focal Treatment—Botulinum Toxins | 141 | ||
| Clinical Issues Related to the Use of BoNT | 141 | ||
| Focal Treatment–Nerve Block (Neurolysis) | 144 | ||
| Intrathecal Baclofen (ITB) Therapy | 145 | ||
| Surgical Intervention | 146 | ||
| Emerging Therapy–Hyaluronidase Injections | 146 | ||
| Other Emerging Therapies | 147 | ||
| REFERENCES | 147 | ||
| 11 - Depression and Other Neuropsychiatric Issues Following Stroke | 155 | ||
| DISCLOSURE STATEMENT | 155 | ||
| INTRODUCTION | 155 | ||
| PREVALENCE | 155 | ||
| RISK FACTORS | 155 | ||
| IMPACT | 156 | ||
| Disability | 156 | ||
| Cognition | 156 | ||
| Mortality | 156 | ||
| MECHANISM | 157 | ||
| DIAGNOSIS | 157 | ||
| DIFFERENTIAL DIAGNOSIS | 158 | ||
| Adjustment Disorder | 158 | ||
| Apathy | 159 | ||
| Aprosodia | 159 | ||
| Delirium | 159 | ||
| Psychosis | 159 | ||
| Pathological Laughing and Crying | 159 | ||
| Fatigue | 160 | ||
| Anxiety | 160 | ||
| Bipolar Depression | 161 | ||
| Poststroke Mania | 161 | ||
| TREATMENT | 161 | ||
| Selective Serotonin Reuptake Inhibitors | 162 | ||
| Other Antidepressants | 162 | ||
| Additional Interventions | 163 | ||
| Prevention of Poststroke Depression | 164 | ||
| CONCLUSION | 164 | ||
| FINANCIAL DISCLOSURE AND ACKNOWLEDGMENTS | 164 | ||
| REFERENCES | 164 | ||
| 12 - Visuospatial Impairment | 169 | ||
| OVERVIEW OF VISION-RELATED PRESENTATIONS FOLLOWING STROKE | 169 | ||
| VISION SCREENING FOR THE REHABILITATION PROFESSIONAL | 169 | ||
| COMMON AFFERENT VISION DEFICITS | 172 | ||
| Visual Field Impairment | 172 | ||
| Potential Causes of Blurred Vision: Changes in Refractive Error, Optic Nerve Damage, or Cortical Vision Loss | 174 | ||
| MANAGEMENT OF AFFERENT DEFICITS | 174 | ||
| Post-Stroke Impaired Visual Field Integrity | 174 | ||
| Poststroke Blurred Vision | 174 | ||
| COMMON EFFERENT VISION DEFICITS | 175 | ||
| Cranial Nerve Palsies | 175 | ||
| Internuclear Ophthalmoplegia | 176 | ||
| Gaze Palsies | 176 | ||
| One-and-a-Half Syndrome | 177 | ||
| Weber Syndrome | 177 | ||
| Ptosis | 177 | ||
| Lagophthalmos | 177 | ||
| MANAGEMENT OF EFFERENT DEFICITS | 177 | ||
| Poststroke Eye Movement Disorders | 177 | ||
| Poststroke Eyelid Disorders | 177 | ||
| VISUAL PERCEPTUAL DISORDERS | 178 | ||
| ACKNOWLEDGMENTS | 182 | ||
| REFERENCES | 182 | ||
| 13 - Pharmacological Interventions to Enhance Stroke Recovery | 185 | ||
| INTRODUCTION | 185 | ||
| GENERAL PRINCIPLES | 186 | ||
| NEUROTRANSMITTER ANATOMY AND PHYSIOLOGY | 186 | ||
| MEDICATIONS TO PROMOTE MOTOR RECOVERY | 187 | ||
| Selective Serotonin Reuptake Inhibitors | 187 | ||
| Rationale | 187 | ||
| SSRI Evidence Supporting Recovery | 187 | ||
| Catecholaminergic Agents | 188 | ||
| Rationale | 188 | ||
| Amphetamines | 188 | ||
| Dopamine | 189 | ||
| Medications to Promote Language Recovery | 189 | ||
| Catecholaminergic Agents | 189 | ||
| Piracetam | 190 | ||
| Aceytlcholine | 190 | ||
| Memantine | 190 | ||
| MEDICATIONS FOR COGNITIVE IMPAIRMENT AFTER STROKE | 191 | ||
| CONCLUSION | 191 | ||
| REFERENCES | 192 | ||
| FURTHER READING | 197 | ||
| 14 - Neuromuscular Electrical Stimulation and Stroke Recovery | 199 | ||
| INTRODUCTION | 199 | ||
| MOTOR DYSFUNCTION AFTER STROKE | 199 | ||
| PURPOSES OF NMES IN STROKE MOTOR REHABILITATION | 200 | ||
| NMES FUNDAMENTALS | 200 | ||
| NMES Device Components | 200 | ||
| External NMES | 201 | ||
| Implanted NMES | 201 | ||
| Mechanisms of Action for NMES-Mediated Motor Relearning After Stroke | 201 | ||
| UPPER EXTREMITY NMES | 201 | ||
| Cyclic Stimulation | 201 | ||
| EMG-, Switch-, and Sensor-Triggered Stimulation | 202 | ||
| Contralaterally Controlled Stimulation | 203 | ||
| Implanted NMES Control | 203 | ||
| LOWER EXTREMITY NMES | 203 | ||
| Peroneal Nerve NMES for Foot Drop | 203 | ||
| Multijoint NMES for Walking | 205 | ||
| NMES FOR SWALLOWING | 206 | ||
| NMES for Shoulder Pain | 207 | ||
| NMES FOR SPASTICITY | 207 | ||
| ANALYSIS OF NMES FOR STROKE REHABILITATION | 208 | ||
| Strengths | 208 | ||
| Weaknesses | 208 | ||
| Opportunities | 208 | ||
| Threats | 209 | ||
| CONCLUSION | 209 | ||
| ACKNOWLEDGEMENT | 210 | ||
| REFERENCES | 210 | ||
| 15 - Returning to Work After Stroke | 215 | ||
| INTRODUCTION | 215 | ||
| STROKE IN WORKING AGES | 216 | ||
| Incidence of Stroke Among People in the Working Ages | 216 | ||
| Proportions of People Not Returning to Work After Stroke | 216 | ||
| PREDICTORS FOR RETURNING OR NOT RETURNING TO WORK AFTER STROKE | 216 | ||
| SYSTEMS AND ORGANIZATIONS FOR RETURN-TO-WORK | 217 | ||
| REHABILITATION INTERVENTION FOR RETURN-TO-WORK | 217 | ||
| Current evidence-based knowledge of vocational rehabilitation for people with stroke | 217 | ||
| Vocational Rehabilitation Intervention Programs | 218 | ||
| The Workplace Intervention Program | 218 | ||
| Outline of the Workplace Intervention Program | 218 | ||
| The Resource Facilitation Program | 219 | ||
| Early Stroke Specific Vocational Rehabilitation Program | 219 | ||
| Early Intervention and Work Preparation | 219 | ||
| Phased Return-to-Work | 219 | ||
| Sustaining Work Return | 220 | ||
| COORDINATOR | 220 | ||
| ASSESSMENTS USED IN THE RETURN-TO-WORK PROCESS | 220 | ||
| THE EXPERIENCE OF RETURN-TO-WORK OF PEOPLE WITH STROKE, THE MEANING OF WORK | 221 | ||
| EXPERIENCES OF CO-WORKERS AND EMPLOYERS | 222 | ||
| REFERENCES | 222 | ||
| 16 - Driving Rehabilitation | 225 | ||
| INTRODUCTION | 225 | ||
| DRIVING TRAINING METHODS | 225 | ||
| Paper-and-Pencil-Based Driving Training | 225 | ||
| Computerized Video-Based Driving Training | 226 | ||
| Dynavision-Based Driving Training | 226 | ||
| Simulator-Based Driving Training | 227 | ||
| On-Road Driving Training | 228 | ||
| COMMON MODELS OF DRIVING | 228 | ||
| PARADIGMS UNDERLYING DIFFERENT TRAINING APPROACHES | 229 | ||
| AN EXAMPLE OF A STRUCTURED SIMULATOR-BASED TRAINING PROGRAM | 230 | ||
| Vehicle Modification and Adaptive Equipment | 231 | ||
| Alternative to Driving Resumption | 232 | ||
| SUMMARY AND TAKE-HOME MESSAGES | 232 | ||
| REFERENCES | 232 | ||
| 17 - Rehabilitation Robotics for Stroke | 235 | ||
| REHABILITATION ROBOTICS FOR STROKE | 235 | ||
| DEFINITION OF A ROBOT | 235 | ||
| BENEFITS OF ROBOTICS IN REHABILITATION | 235 | ||
| CATEGORIES OF REHABILITATION ROBOTICS | 236 | ||
| Workstation Robots—Upper Extremity | 236 | ||
| Dosing and Timing of Robotic Therapy | 242 | ||
| Workstation Robots—Lower Extremity | 242 | ||
| Wearable Robots | 243 | ||
| Disadvantages of Wearable Robots | 244 | ||
| Limitations of Workstation Robots | 244 | ||
| Robots for ADL Assistance | 244 | ||
| Limitations of ADL Robots | 245 | ||
| CONCLUSION | 245 | ||
| REFERENCES | 245 | ||
| 18 - Efficacy of Noninvasive Brain Stimulation for Motor Rehabilitation After Stroke | 249 | ||
| NONINVASIVE BRAIN STIMULATION: REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION AND TRANSCRANIAL DIRECT CURRENT STIMULATION | 249 | ||
| SAFETY CONSIDERATIONS | 250 | ||
| NONINVASIVE BRAIN STIMULATION APPLICATION FOR THE STROKE BRAIN | 251 | ||
| EFFICACY OF NONINVASIVE BRAIN STIMULATION TO IMPROVE MOTOR FUNCTION IN PATIENTS WITH STROKE | 252 | ||
| FACTORS AFFECTING EFFICACY OF NONINVASIVE BRAIN STIMULATION TO IMPROVE MOTOR FUNCTION IN PATIENTS WITH STROKE | 253 | ||
| TIME SINCE STROKE | 253 | ||
| SEVERITY OF IMPAIRMENT | 260 | ||
| STROKE LESION LOCATION AND ITS RELATION TO STIMULATION TARGETS | 261 | ||
| SUMMARY | 262 | ||
| REFERENCES | 263 | ||
| 19 - Children and Stroke | 267 | ||
| Definition | 267 | ||
| Epidemiology/Risk | 267 | ||
| Etiology | 267 | ||
| Complications | 269 | ||
| Mobility | 269 | ||
| Dysphagia | 271 | ||
| Cognitive | 271 | ||
| Therapies | 271 | ||
| School | 274 | ||
| Transition | 275 | ||
| Conclusion | 276 | ||
| References | 276 | ||
| 20 - Promoting Healthy Behaviors in Stroke Survivors | 279 | ||
| PHYSICAL ACTIVITY | 279 | ||
| NUTRITION AND WEIGHT MANAGEMENT | 281 | ||
| MEDICATION ADHERENCE | 282 | ||
| BEHAVIOR CHANGE STRATEGIES | 284 | ||
| SOCIAL COGNITIVE THEORY | 284 | ||
| TRANSTHEORETICAL MODEL | 284 | ||
| ENCOURAGING GOAL-SETTING AND SELF-MONITORING | 285 | ||
| IDENTIFYING BARRIERS AND PROVIDING FEEDBACK | 286 | ||
| RESHAPING THE PHYSICAL AND SOCIAL ENVIRONMENT | 286 | ||
| REFERENCES | 287 | ||
| Index | 291 | ||
| A | 291 | ||
| B | 292 | ||
| C | 292 | ||
| D | 293 | ||
| E | 293 | ||
| F | 293 | ||
| G | 294 | ||
| H | 294 | ||
| I | 294 | ||
| J | 294 | ||
| K | 294 | ||
| L | 294 | ||
| M | 294 | ||
| N | 295 | ||
| O | 296 | ||
| P | 296 | ||
| Q | 297 | ||
| R | 297 | ||
| S | 297 | ||
| T | 298 | ||
| U | 299 | ||
| V | 299 | ||
| W | 299 | ||
| Y | 299 |