Date Presented 04/05/19 The purpose of the study was to develop and evaluate the feasibility of a culturally tailored, community-based life management intervention to improve quality of life and mitigate stroke risk factors in 10 individuals after experiencing a stroke. The intervention was feasible in this sample with positive outcomes for participant retention and attendance; engagement in meaningful activities; stroke-related quality of life; reintegration to normal living; and healthy behavior changes. Primary Author and Speaker: Valerie Hill Additional Authors and Speakers: Valerie Miller Contributing Authors: Amytis Towfighi

Date Presented 04/04/19 The purpose of the study was to develop and evaluate the feasibility of a community-based peer mentor program to prevent and manage pressure ulcers and identify untreated depression for 20 individuals with spinal-cord injury. Based on this sample, community-based peer mentoring was feasible with positive outcomes for PU prevention; management of PUs and depression; self-management of chronic conditions; and community reintegration. Primary Author and Speaker: Valerie Hill Additional Authors and Speakers: Shawn Phipps Contributing Authors: Christina Wolfe, David Ponce

Date Presented 4/20/2018 Stroke survivors frequently exhibit motor impairments in one upper extremity. The current study showed that 120-min daily sessions of occupational practice augmented by electrical stimulation significantly increased affected arm use and performance of valued occupations. Primary Author and Speaker: Stephen Page Additional Authors and Speakers: Valerie Hill Contributing Authors: Peter Levine, Kari Dunning, Lauren Wengard

Date Presented 4/16/2015 The purpose of this randomized controlled trial was to test the feasibility of an outpatient poststroke lifestyle intervention in a safety-net health care system to estimate and compare effect sizes for short-term changes in body mass index (BMI), diet, and physical activity.

Date Presented 4/18/2015 This study suggests that mental-practice-triggered stimulation markedly increases movement and dexterity in moderately impaired upper extremities following stroke. These changes caused increased ability to use the limb functionally for occupations such as opening a door and using a fishing rod.

OBJECTIVE. To determine the feasibility and impact of home-based, mental practice–triggered electrical stimulation among stroke survivors exhibiting moderate upper-extremity (UE) impairment. METHOD. Five participants with moderate, stable UE hemiparesis were administered the Fugl-Meyer Assessment, the Box and Block Test, and the Activities of Daily Living, Hand Function, and overall recovery domains of the Stroke Impact Scale (Version 3). They were then administered an 8-wk regimen consisting of 1 hr of mental practice–triggered electrical stimulation every weekday in their home. At the end of every 2 wk, participants attended supervised stimulation to progress therapeutic exercises and stimulation levels and monitor compliance. RESULTS. Six instances of device noncompliance were reported. Participants exhibited reduced UE motor impairment and increased UE dexterity and participation in valued activities. CONCLUSION. The regimen appears feasible and had a substantial impact on UE impairment, dexterity, and participation in valued activities as well as perceptions of recovery.

OBJECTIVE. We examined the efficacy of a remotely based arm rehabilitation regimen. A 62-year-old man participated in occupation-based, task-specific practice of activities of daily living (ADLs) >3 years after stroke. The entire regimen was administered over the Internet using personal computer–based cameras and free network meeting software. METHOD. Fugl-Meyer Assessment (FM), Action Research Arm Test (ARA), and Canadian Occupational Performance Measure (COPM) were administered before intervention. One week after treatment, FM, ARA, and COPM were readministered. RESULTS. The participant exhibited reduced impairment and reduced functional limitation. He also expressed enhanced satisfaction with his ability to perform ADLs and rated his ADL performance better after intervention. The participant could now drive using both hands, use eating utensils, and catch and throw a ball. CONCLUSION. Data suggest feasibility and efficacy of a remotely based, inexpensive approach using functional electrical stimulation for affected arm rehabilitation after stroke.

OBJECTIVE. We examined the efficacy of a clinically based regimen in which a woman 16 months’ post-stroke participated in daily practice sessions of valued activities of daily living (ADLs). A unique aspect of this intervention was that it was largely patient driven, with the patient practicing ADLs while wearing an electrical stimulation neuroprosthesis. METHOD. The Fugl-Meyer Assessment (FM), Action Research Arm Test (ARA), Arm Motor Activity Test (AMAT), and Canadian Occupational Performance Measure (COPM) were administered before intervention. Therapy consisted of 3-hr ADL training sessions every weekday during a 3-week period using a neuroprosthesis featuring functional electrical stimulation during treatment sessions. One week after the end of the treatment phase, the FM, ARA, AMAT, and COPM were again administered. RESULTS. The patient exhibited reduced impairment (FM score change from 31 to 35), decreased time needed to complete AMAT tasks (from 998 s to 558 s), and increased ARA score (from 27 to 31). CONCLUSION. Clinically meaningful changes were realized with distant or minimal therapist supervision, making this regimen a practical and efficacious alternative.

Modified constraint-induced movement therapy (mCIMT) is a reimbursable regimen that improves the use and function of more-affected arms in patients who have had a stroke. To participate in this regimen, however, patients must exhibit active extension of the more-affected wrists and fingers, which renders many people ineligible. This study determined the efficacy of a mental practice program that preceded mCIMT in improving more-affected arm function in 4 patients with a stroke. Patients received therapy emphasizing activities of daily living (ADLs), followed by sessions of mental practice of the ADL. One week after completing mental practice, patients participated in mCIMT. After mental practice, patients exhibited marked changes on assessments and increased active wrist and finger extension, which qualified them for mCIMT. After mCIMT, participants exhibited additional functional gains, sustained 3 months later. Data suggest that mental practice provides a pathway whereby patients can participate in mCIMT, realize additional gains, and again perform valued ADLs.