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A majority of stroke patients have persisting upper extremity impairments, with a large number of individuals who do not regain the ability to reach and manipulate everyday objects despite receivin...

To design and test the feasibility of context-specific activities for improving physical activity (PA) levels among Indian adults with stroke. Context-specific activities were developed after a tho...

Purpose: To estimate the levels of physical activity (PA) in community-dwelling adults with stroke and to correlate it with the quality of life (QoL). Methods: In a cross-sectional study, adults with chronic stroke were assessed for PA using Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) and an accelerometer (Actigraph GT3X).QoL was assessed using Stroke Specific Quality of Life (SSQoL).Results: PA levels of our participants (n¼33; mean age 58.4 ± 12.1 years; mean FMA score 165.7 ± 31.1) were low with the mean activity of 252.9 ± 149.2 kilo counts per day and median energy expenditure of 77(44.6, 117.7) kilocalories per day. Median step count was 1635 (1084.9, 2434.3) steps per day. Mean time spent in sedentary and light activities were 504.1 ± 139 and 149.8 ± 68.3minutes per day, respectively. Median time spent in moderate and vigorous activities were 1.6(1, 4.4) and 0(0,0) minutes per day, respectively. Median PASIPD score was 12.3(6.1, 25.8) MET. Hours/day. SSQoL was found to have a positive correlation with average kilo counts/day, kilo calories/day, steps/day and PASIPD (r¼0.48, p¼.06; r¼0.46, p¼.009; r¼0.44, p¼.016; and r¼0.61, p�.001 respectively). Conclusions: PA levels of adults with stroke living in the semi-urban region of India are low and do not meet the recommended guidelines

Objective To evaluate and summarize the level of evidence for the immediate, short-term, and long-term effects of game-based rehabilitation on upper limb function in adults within the first six months following stroke. Introduction A game-based intervention is a valuable therapeutic tool for incorporating principles of motor learning and neuroplasticity in the rehabilitation of upper limb function post-stroke. Most of the existing reviews on game-based rehabilitation are focused on the chronic phase of stroke. However, as maximum upper limb motor recovery occurs in the first six months after stroke, further exploration of the effects of game-based rehabilitation in this phase is necessary. Inclusion criteria We will include randomized clinical trials assessing the immediate, short-term, and long-term effects of game-based rehabilitation on upper limb function in adults within the first six months following stroke. Methods The systematic review will follow the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) checklist and JBI methodology for systematic reviews of effectiveness. A database-specific search strategy will be used in CINAHL, PubMed, Scopus, Web of Science, ProQuest, PEDro, OT Seeker, and Ovid MEDLINE to identify studies in the English language with no date limit. Two reviewers will independently screen, extract data, and assess risk of bias of the eligible studies. Meta-analysis and publication bias evaluation will be done when adequate data are available. If a meta-analysis is precluded, then a narrative synthesis will be done. The Grading of Recommendations Assessment Development and Evaluation (GRADE) criteria will be used to assess the certainty of evidence for the outcome measures of interest. Systematic review registration number PROSPERO CRD42020190100.

Stroke survivors often face difficulty in community ambulation though they attain steady-state walking in clinical setups. Compliance and unpredictability of the environment may alter the muscle activity and challenge the individual's gait. Successful reintegration into the community requires gait assessment and training in a real-life challenging environment. Little is known about the assessment and training of gait in the community environment under challenging mobility dimensions. Hence, we aimed to study the changes that real-life environmental dimensions have on the activity of selected muscles in hemiparetic lower limb and gait velocity in stroke survivors.An observational cross-sectional study was conducted on 16 ambulatory stroke survivors to assess the hemiparetic lower limb muscle activity during walking in real-life environmental dimensions. Participants were made to walk in the community on a walkway consisting of even surface, ramp, stairs, uneven terrain and obstacles. They were also made to manoeuvre through traffic and pick a load while walking for a distance in the walkway. Muscle activity of Rectus Femoris, Biceps Femoris, Gastrocnemius Medialis and Tibialis Anterior of the paretic lower limb were continuously recorded while walking using wireless surface electromyography. Gait velocity for the entire walkway and level of perceived difficulty while walking in different dimensions were also measured. Paired t-test was used to compare the percentage Maximum Voluntary Contraction (%MVC) of lower limb muscles between even surface and real-life environment dimensions while walking. One sample t-test was used to compare the gait velocity in real-life dimensions versus gait velocity in even surface measured in an earlier study.There was a significant reduction (p 0.01) in the activity of all four hemiparetic lower limb muscles while walking under the influence of real-life environmental dimensions compared to even surface. Gait velocity (0.33 ± 0.17 m/s) was significantly lower than that is essential to be a community ambulator. The level of perceived difficulty across all dimensions was reported qualitatively with the highest difficulty reported during stair and obstacle clearance.Real-life environmental dimensions lead to the reduction of paretic lower limb muscle activities and gait velocity during walking in community-dwelling stroke survivors. Stroke survivors perceived more difficulty while walking in real-life environment dimensions particularly while negotiating stairs and obstacles.Knowledge about the influence of real-life environmental dimensions will help the clinicians to target rehabilitation methods to improve walking adaptability.

Introduction Game-based rehabilitation is an emerging therapeutic intervention that allows intensive, repetitive, task-based training to improve upper limb (UL) function following stroke, based on the principles of neuro-plasticity and motor (re)learning. Rehabilitation using commercial gaming system will be motivating, enjoyable, challenging and affordable. Therefore, the present study aims at assessing the effectiveness of an intensive, functional, gamified rehabilitation program using the ArmAble™ device in improving UL motor function in people with stroke. Method In this single-blinded, multi-centric, randomized clinical trial, 120 adults with acute/sub-acute unilateral stroke will be randomized to receive an intensive, functional, gamified training program using the ArmAble™ or task-based training along with a conventional therapy for 2 h/day, 6 days/week for 2 weeks, followed by a home-based, functional rehabilitation program for another 4 weeks (~30 min/day, 6 days/week). Primary outcomes evaluated by a blinded assessor at the baseline, 2 weeks and 6 weeks' post-intervention will include the Fugl-Meyer assessment – upper extremity and the action research arm test. A linear mixed effect regression model or relevant non-parametric tests will be used to analyze the data for all outcomes. An intention-to-treat analysis will be used with missing data handled by multiple imputation. Discussion Rehabilitation provided with the ArmAble™ device, if found effective, can be used from the early stages post-stroke to provide intensive, repetitive, gamified training to improve UL motor function. Trial registration number: CTRI/2020/09/027651.

Reason for withdrawal from publication Authors have made no progress with this protocol in 7 years. The Cochrane Review Group was unable to maintain contact with the contact author. The co-authors are unable to take over this protocol. The topic will be included in another protocol: Continuous exercise training, resistance exercise training and mixed training interventions for arterial hypertension in adults.

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To investigate the evidence for the efficacy of physical fitness training in the rehabilitation of spinal cord injury when compared to no training or usual care.