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Background: The effects of mobile applications on upper limb impairments after stroke was not investigated. Aim: To examine the effects of mobile applications for improving upper limb after stroke. Methods: A systematic review of randomized trials was performed. Searches were conducted on MEDLINE/PUBMED, CINAHL, EMBASE, SCOPUS, Web of Science and PEDro databases. Participants were adults after stroke. The experimental intervention was upper limb rehabilitation using mobile applications compared with no/placebo, or rehabilitation without mobile applications. Outcome data related to upper limb outcomes were combined in meta-analyses. The quality of trials was assessed by the PEDro scores. Results: Seven trials (PEDro score 5; n=193; age = 28 to 85 years old) were included. Mobile applications may have a positive effect on upper limb motor impairment (MD 12 points out of 66; 95% CI -6 to 31) but unclear on capacity (MD 2 points out of 32; 95% CI -1.5 to 5.7), strength (MD 0.4 points out of 5; 95% CI -0.3 to 1.2), and dexterity (MD 2 points; 95% CI -2 to 6). Mobile applications may have similar effects of rehabilitation without mobile applications on upper limb motor impairment 18 (SMD 0.4; 95% CI -0.3 to 1.2), capacity (SMD 0.1; 95% CI -0.4 to 0.6), and strength (MD 0 19 Kg; 95% CI -4.3 to 4.3). Conclusion: Mobile applications may improve upper limb motor impairment, but the effects appear to be similar to rehabilitation without mobile applications. [ABSTRACT FROM AUTHOR]

Background: No studies examined the measurements properties of the 6-minute step test in people after stroke. Aim: To analyze the feasibility of a study aimed to check the reliability and validity of the 6-minute step test in people after stroke. Methods: Methodological, feasibility study. Participants were ambulatory adults with stroke, who could step up and down a bench with 20cm height, and provided written consent. The 6-minute step test, the 6-minute walk test, and other questionnaires were applied aimed to characterize the participants. Feasibility was analyzed in terms of recruitment (% of included participants/participants contacted) and retention (% of included participants who completed all evolutions). Preliminary results regarding test-retest reliability, inter-rater reliability, and validity of the 6-minute step test were examined by Intraclass Correlation Coefficients, and Persons's correlation. Ethical approval: 59441422.3.0000.5060. Results: Thirty-six individuals were contacted: 14 accepted to participate and 13 completed all tests. Recruitment was 39% and retention was 93%. Test-retest reliability (ICC 0.98; 95% CI 0.91 to 0.99, n=14), inter-rater reliability (ICC 0.96; 95% CI 0.87 to 0.99, n=13), and validity (r = 0.87; 95% CI 0.61 to 0.96) was considered high. Conclusions: The continuity of the methodological study is feasible and measurement properties of the 6-minute step test should be confirmed in a larger sample. [ABSTRACT FROM AUTHOR]

Background: The abilities to sit down and stand up are typically impaired after stroke.1 Aim: To examine the factors associated with the sit-to-stand performance after stroke. Methods: A cross-sectional study was performed. Participants were ambulatory adults with chronic stroke, who provided written consent prior to data collection. The outcome of interest was sit-to-stand performance (i.e., 5-repetition sit-to-stand test). The potential explanators were personal factors (i.e., age, sex, and time since stroke) and impairments (i.e., tonus - Modified Ashworth Scale, muscle strength - HandHeld dynamometry, motor coordination - LEMOCOT, and dynamic balance - 4-step square test). Significant explanators (p<0.05) were added into a regression analysis. Ethical approval: CAAE06609312.0.0000.5149. Results: A total of 102 individuals with chronic stroke (44 men), and a mean age of 66 (SD 13) years were included. Sit-to-stand performance was significantly correlated with dynamic balance (r=0.61; p<0.01), motor coordination (r=-0.41; p<0.01), and strength of hip extensors (r=-0.28; p=0.02), knee extensors (r=-0.32; p<0.01), and plantar flexors (r=-0.33; p<0.01). Dynamic balance alone explained 37% (t=6.68; p<0.01) of the variance in sit-to-stand performance. When strength of hip extensors was included in the model, the explained variance increased to 41% (t=-2,54; p=0.01). Conclusion: Dynamic balance and strength of the paretic hip extensors best explained sit-to-stand performance after stroke. [ABSTRACT FROM AUTHOR]

Background: Less than 50% of stroke survivors return to work.1 No studies examined the loss of work productivity among those who returned to work. Aim: To analyze the feasibility of applying the Work Limitation Questionnaire (WLQ) after stroke. Methods: Methodological, feasibility study. Participants were adults, who returned to work after stroke and provided written consent. The WLQ was applied twice in-person and once by telephone. Feasibility was analyzed in terms of recruitment (% of included participants/participants contacted) and retention (% of included participants who answered the WLQ three times). Preliminary results regarding test-retest reliability and validity of the telephone application were examined by mean differences and Intraclass Correlation Coefficients. Ethical approval: 61611022.00000.5060. Results: Twenty-seven individuals were contacted: 12 accepted to participate and answered the WLQ three times. Recruitment was 44% and retention was 100%. The 12 participants (6 women) reported 68% (SD 38) of work productivity loss. Test-retest reliability was high (ICC 0.99; 95% CI 0.98 to 0.99) with no differences between in-person applications (MD 2%; 95% CI -3 to 9). Reliability of the telephone application was high (ICC 0.90; 95% CI 66 to 0.97) with no differences with in-person application (MD 4%; 95% CI -20 to 11). Conclusions: The continuity of the methodological study is feasible and measurement properties of the WLQ should be confirmed in a larger sample. [ABSTRACT FROM AUTHOR]

Background: People after stroke typically experience limitations in climbing stairs.1,2 Aim: To examine the effect of exercises for improving stair climbing after stroke. Methods: A systematic review of randomized trials was performed. Searches were conducted on MEDLINE, EMBASE, Cochrane Library, AMED, and PEDro databases. Participants were ambulatory adults, who have had a stroke. The experimental intervention was physical exercises for the paretic lower limb compared with no intervention/placebo. Outcome data related to stair climbing performance were combined in meta-analyses. The quality of trials was assessed by the PEDro scores and the quality of evidence was determined according to GRADE. Results: Nine trials (PEDro 5), involving 314 participants were included. The mean age of participants ranged from 50 to 68 years old. The examined interventions were strength training, task-oriented training, or a combination of strength training with aerobic or task-oriented training. Very-low quality evidence indicated that exercises improve stair climbing performance by SMD 0.4 (95% CI 0 to 0.8), and the time to ascent/descent stairs by MD 3.4 seconds (95% CI 0.4 to 6.5). Conclusion: This systematic review provided evidence that six weeks of planned, structured, and repetitive exercises (50 min, 4 times per week) improve stair climbing performance of moderately disabled individuals with chronic stroke. [ABSTRACT FROM AUTHOR]

Background: Backward walking training has gained popularity as an alternate type of training for improving walking and cardiorespiratory fitness.1 Aim: To examine the effects of backward walking training in comparison with forward walking training for improving walking after stroke. Methods: A systematic review of randomized trials was performed. Searches were conducted on AMED, Cochrane Library, EMBASE, LILACS, MEDLINE, Scielo and PEDro databases. Participants were ambulatory adults after stroke. The experimental intervention was backward walking training. Outcome data related to walking speed, cadence and stride length were combined in meta-analyses. The quality of trials was assessed by the PEDro scores, and the quality of evidence was determined according to the GRADE system. Results: Six trials (PEDro score 6), involving 156 participants, were included. The mean age of participants ranged from 50 to 69 years old. Moderate-quality evidence suggested that backward walking training is as effective or better than forward walking training for improving walking speed (MD 0.16 m/s, 95% CI 0.06 to 0.27). Effects on cadence (MD 3 steps/min, 95% CI -2 to 6) and stride length (MD 0.03 m, 95% CI -0.02 to 0.09) were very similar between interventions. Conclusion: This review provided evidence that the effect of backward walking training is similar to or better than the effect of forward walking training for improving walking speed after stroke. [ABSTRACT FROM AUTHOR]

Background: People with Parkinson's disease have reduced walking ability. Aim: To examine the effect of the addition of auditory cueing to walking training on walking, mobility, fear of falling, and balance. Methods: A systematic review of randomized trials was performed. Searches were conducted on MEDLINE, EMBASE, and PEDro databases. Participants were ambulatory adults with Parkinson's disease. The experimental intervention was auditory cueing in addition to walking training. Outcome data were combined in meta-analyses. The quality of trials was assessed by the PEDro scores, and the quality of evidence was determined according to GRADE. Results: Nine trials (PEDro 5), involving 289 participants (mean age: 57 to 74 years old; Hoehn and Yahr: I to IV), were included. Low-quality evidence suggested that the addition of auditory cueing improves walking speed (MD 0.09 m/s; 95% CI 0.02 to 0.15). Auditory cueing may also improve stride length (MD 5 cm); however, the estimate was imprecise (95% CI -2 to 11). Low to moderate-quality evidence suggested no or negligible effects on cadence (2 steps/min; 95% CI -12 to 16), mobility (-0.2 sec; 95% CI -1 to 0.6), fear of falling (MD -3 out of 100; 95% CI -8 to 2), and balance (1 point out of 56; 95% CI -3 to 6). Conclusion: The addition of auditory cueing to walking training (30 min, 3 times per week, 6 weeks) improved walking speed in Parkinson's disease more than walking training alone. [ABSTRACT FROM AUTHOR]

Background: Reduced ankle range of motion is related to walking limitations after stroke.1,2 Aim: To examine the effects of mobilization with movement for improving ankle range of motion and walking after stroke. Methods: A systematic review of randomized trials was performed. Searches were conducted on MEDLINE, CINAHL, EMBASE and PEDro databases. Participants were ambulatory adults after stroke. The experimental intervention was mobilization with movement compared with no/placebo/minimal intervention. Outcome data related to ankle range of motion, and walking spatiotemporal parameters were combined in metaanalyses. The quality of trials was assessed by the PEDro scores, and the quality of evidence was determined according to the GRADE system. Results: Eight trials (PEDro score 6), involving 218 participants, were included. The mean age of participants ranged from 46 to 62 years old. Low-quality evidence suggested that mobilization with movement improves ankle range of motion (MD 3.5º; 95% CI 2 to 5). Moderate-quality evidence suggested improvements on walking speed (MD 0.08 m/s; 95% CI 0.05 to 0.10), cadence (MD 10 steps/min; 95% CI 7 to 12), and step length (MD 4 cm; 95% CI 2 to 6). Conclusion: This systematic review indicated that 5 sets of 10 repetitions of mobilization with movement, applied 3 times a week, for 4 weeks, in association with walking training, improve ankle range of motion and walking after stroke. Review Registration: PROSPERO (CRD42023405130). [ABSTRACT FROM AUTHOR]