What is “usual care” in the rehabilitation of upper limb sensory loss after stroke? Results from a national audit and knowledge translation study

Selective sentinel lymph node biopsy (SLNB) represents a minimally invasive surgery in patients with breast cancer. The purpose of this study was to explore the possible effect of an early physiotherapy intervention for the recovery of the upper limb and the surgical scars after SLNB in comparison with usual care. A total of 40 patients were enrolled in either the control group (n = 20) or the experimental group (n = 20). The intervention group performed an early physiotherapy program based on functional exercises, scar manual therapy, and educational tips. The control group received usual care. Shoulder range of motion (ROM), grip strength, upper limb pain and disability (SPADI), scar recovery (POSAS), myofascial adhesions (MAP-BC), quality of life (EORTCQLA-BR-23) and the presence of axillary web syndrome (AWS) and lymphoedema were assessed at baseline and immediately after intervention. A follow-up period of 6 months was performed for lymphoedema surveillance. Between groups significant differences in favor of the intervention were found for ROM (r = 0.43), grip strength (r = 0.32), SPADI (d = 0.45), POSAS (d = 1.28), MAP-BC (d = 1.82) and EORTCQLQ-BR 23 general function subscale (d = 0.37) (p < 0.05 for all variables). Our results suggest that an early physical therapy program seems to be more effective than usual care in women after SLNB. However, results should be interpreted with caution and future randomized trial with a larger sample size is needed.

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Four-hour swallow screening target for stroke – from guidelines to practice: A mixed methods knowledge translation study

International Journal of Speech-Language Pathology ◽

10.1080/17549507.2020.1858157 ◽

2021 ◽

pp. 1-25

Author(s):

Joanne Murray ◽

Jana Havlis ◽

Nicolette Varvounis

Keyword(s):

Mixed Methods ◽

Knowledge Translation ◽

Translation Study ◽

Swallow Screening

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Effects of Adding Interferential Therapy Electro-Massage to Usual Care after Surgery in Subacromial Pain Syndrome: A Randomized Clinical Trial

Journal of Clinical Medicine ◽

10.3390/jcm8020175 ◽

2019 ◽

Vol 8 (2) ◽

pp. 175

Author(s):

Manuel Albornoz-Cabello ◽

Jose Sanchez-Santos ◽

Rocio Melero-Suarez ◽

Alberto Heredia-Rizo ◽

Luis Espejo-Antunez

Keyword(s):

Usual Care ◽

Pain Intensity ◽

Manual Therapy ◽

Upper Limb ◽

Pain Syndrome ◽

Control Group ◽

Upper Limb Function ◽

Subacromial Pain Syndrome ◽

Interferential Therapy ◽

Massage Group

Subacromial pain syndrome (SAPS) is a prevalent condition that results in loss of function. Surgery is indicated when pain and functional limitations persist after conservative measures, with scarce evidence about the most-appropriate post-operative approach. Interferential therapy (IFT), as a supplement to other interventions, has shown to relieve musculoskeletal pain. The study aim was to investigate the effects of adding IFT electro-massage to usual care after surgery in adults with SAPS. A randomized, single-blinded, controlled trial was carried out. Fifty-six adults with SAPS, who underwent acromioplasty in the previous 12 weeks, were equally distributed into an IFT electro-massage group or a control group. All participants underwent a two-week intervention (three times per week). The control group received usual care (thermotherapy, therapeutic exercise, manual therapy, and ultrasound). For participants in the IFT electro-massage group, a 15-min IFT electro-massage was added to usual care in every session. Shoulder pain intensity was assessed with a 100-mm visual analogue scale. Secondary measures included upper limb functionality (Constant-Murley score), and pain-free passive range of movement. A blinded evaluator collected outcomes at baseline and after the last treatment session. The ANOVA revealed a significant group effect, for those who received IFT electro-massage, for improvements in pain intensity, upper limb function, and shoulder flexion, abduction, internal and external rotation (all, p < 0.01). There were no between-group differences for shoulder extension (p = 0.531) and adduction (p = 0.340). Adding IFT electro-massage to usual care, including manual therapy and exercises, revealed greater positive effects on pain, upper limb function, and mobility in adults with SAPS after acromioplasty.

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Providing culturally safe cancer survivorship care with Indigenous communities: study protocol for an integrated knowledge translation study

Pilot and Feasibility Studies ◽

10.1186/s40814-019-0422-9 ◽

2019 ◽

Vol 5 (1) ◽

Cited By ~ 3

Author(s):

Wendy Gifford ◽

Roanne Thomas ◽

Gwen Barton ◽

Ian D. Graham

Keyword(s):

Knowledge Translation ◽

Cancer Survivorship ◽

Study Protocol ◽

Indigenous Communities ◽

Integrated Knowledge Translation ◽

Survivorship Care ◽

Translation Study ◽

Integrated Knowledge

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Changing practice in the assessment and treatment of somatosensory loss in stroke survivors: protocol for a knowledge translation study

BMC Health Services Research ◽

10.1186/s12913-018-2829-z ◽

2018 ◽

Vol 18 (1) ◽

Author(s):

Liana S. Cahill ◽

Natasha A. Lannin ◽

Yvonne Y. K. Mak-Yuen ◽

Megan L. Turville ◽

Leeanne M. Carey

Keyword(s):

Knowledge Translation ◽

Stroke Survivors ◽

Changing Practice ◽

Translation Study ◽

Assessment And Treatment

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Botulinum Toxin to Treat Upper-Limb Spasticity in Hemiparetic Patients: Grasp Strategies and Kinematics of Reach-to-Grasp Movements

Neurorehabilitation and Neural Repair ◽

10.1177/1545968309347683 ◽

2009 ◽

Vol 24 (2) ◽

pp. 141-151 ◽

Cited By ~ 22

Author(s):

Djamel Bensmail ◽

Johanna Robertson ◽

Christophe Fermanian ◽

Agnès Roby-Brami

Keyword(s):

Botulinum Toxin ◽

Upper Limb ◽

Motor Command ◽

Sensory Loss ◽

Functional Improvement ◽

Hand Position ◽

Reach To Grasp ◽

Upper Limb Function ◽

Position And Orientation ◽

Post Hoc

Background. Poor control of grasping in spastic, hemiparetic patients could be because of a combination of poor individuation of joints, weakness, spasticity, and sensory loss. Objective. To investigate the effect of botulinum toxin injections (BTIs) on grasping objects of different shapes and to assess the effect on upper-limb function, reach-to-grasp kinematics, and hand position and orientation at the time of grasp. Methods. We included 15 patients with spastic hemiparesis and 9 healthy controls in this open labeled study, in which the patients were assessed before (M0), 1 month after a first (M1), and 1 month after a second BTI (M4, at 4 months). A motion capture system recorded movements. Kinematic variables were computed as well as hand position and orientation at the time of grasping, and finger configurations were coded from video recordings. Results. In contrast with healthy participants, hemiparetic patients rarely used multipulpar grasps but used specific strategies combined with various directions of approach to the object. BTIs did not alter finger configuration but improved the final direction of the approach and the hand posture during the grasp. No significant changes in kinematic parameters were found using post hoc analysis, although a session effect was found for peak hand velocity. Individual analysis showed that the patients with the best potential for functional improvement are those with good proximal and moderate distal motor command. Conclusions. BTIs can modify hand kinematics as well as the approach and posture of reach-to-grasp movements. Function and grasping strategies are probably more dependent on motor recovery.

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