Effect of home exercise on post-stroke sensorimotor dysfunction during the long-term COVID-19 epidemic lockdown: a retrospective single-center cohort study

doi:10.21203/rs.3.rs-2112644/v1

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Research Article

Effect of home exercise on post-stroke sensorimotor dysfunction during the long-term COVID-19 epidemic lockdown: a retrospective single-center cohort study

https://doi.org/10.21203/rs.3.rs-2112644/v1

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Background:During the unpredictable and long-term COVID-19 epidemic lockdown (Shanghai, April 2022 to May 2022), a large number of patients with post-stroke dysfunction exercised at home, without going to specialized rehabilitation institutions for systematic rehabilitation treatment. To date, there are few relevant studies on the effect of home exercise in patients with post-stroke dysfunction in the case of long-term COVID-19 epidemic lockdown.

Methods: First, we collected the factors that might affect the post-stroke sensorimotor dysfunction during the long-term lockdown. The evaluation indicators of post-stroke sensorimotor dysfunction before and after the long-term lockdown were recorded. Second, we analyzed the recovery effect of sensorimotor dysfunction in post-stroke patients who can only rely on home exercise during the long-term lockdown. Third, we sequentially performed univariate and multivariate Logistic regression analyses to see which factors might influence post-stroke sensorimotor dysfunction during the long-term lockdown.

Results: We report the results of a retrospective single-center cohort study of 104 post-stroke sensorimotor dysfunction patients. For post-stroke sensory dysfunction, patients with shorter disease courses or personalized home exercise programs recovered better. For post-stroke motor dysfunction, patients with younger age, shorter disease courses, or personalized home exercise programs recovered better. For post-stroke balance dysfunction and ADL dysfunction, patients with shorter disease courses recovered better.

Conclusion:During the unpredictable and long-term COVID-19 epidemic lockdown, patients with post-stroke sensorimotor dysfunction who had personalized home exercise programs had better recovery of sensorimotor dysfunction than those who did not have personalized home exercise programs.

Trial registration: This trial was prospectively registered at ClinicalTrials.gov (ChiCTR2200063781; 16 September, 2022).

COVID-19

stroke

sensorimotor dysfunction

home exercise

a retrospective study

Stroke is an acute cerebrovascular disease caused by sudden occlusion or rupture of blood vessels in the brain. Currently, stroke has become one of the leading causes of death and disability in adults worldwide [1]. There are many kinds of dysfunction in stroke [2], including motor dysfunction, sensory dysfunction, cognitive dysfunction, emotional disturbance, speech disturbance, etc. For post-stroke dysfunction, patients usually choose to go to a specialized rehabilitation institution or the rehabilitation department of a general hospital for systematic rehabilitation treatment. The current rehabilitation treatment methods include temperature and tactile stimulation [3], muscle strength training [4], joint range of motion training [5], balance training [6], gait training [7], cognitive training [4], speech training [8], acupuncture and massage [9], central regulation technology [10], rehabilitation engineering [11], etc. However, during the unpredictable and long-term COVID-19 epidemic lockdown (Shanghai, April 2022 to May 2022), a large number of patients with post-stroke dysfunction exercised at home, without going to specialized rehabilitation institutions or rehabilitation departments of general hospitals for systematic rehabilitation treatment.

Home exercise is an important supplementary rehabilitation method for patients with post-stroke dysfunction, which can effectively help patients gradually recover their functions and improve their quality of life. Facing the unpredictable and long-term COVID-19 epidemic lockdown, a large number of patients with post-stroke dysfunction cannot come to the hospital for systematic rehabilitation treatment. With this in mind, doctors or therapists have designed personalized home exercise programs for patients with post-stroke dysfunction. Home exercises include sleeping position training, turn over training, sit and stand training, hip bridge training, assisted walking training, corner standing and squat training, Bobath shake hands, grasp sticks, pick up beans, turn over cards, etc. In recent years, studies have shown that home exercise can improve the functional status of patients with post-stroke dysfunction to a certain extent [12–14], but there are few relevant studies on the effect of home exercise in patients with post-stroke dysfunction in the case of long-term lockdown.

This study used a retrospective cohort study method to collect data on patients with post-stroke sensorimotor dysfunction before and after the long-term lockdown, and then analyzed the recovery effect of sensorimotor dysfunction after home exercise in patients with post-stroke dysfunction, and then use Logistic regression analysis to screen out the factors that may affect the effect of home exercise during the long-term lockdown, especially personalized home exercise programs, so as to provide important medical data for doctors and patients in the face of the long-term lockdown, and provide a certain basis for the medical systems and medical policy makers to make medical policies [15].

Study design

This study was a retrospective cohort study. Before and after the unpredictable and long-term COVID-19 epidemic lockdown (Shanghai, April 2022 to May 2022) [16], all patients received rehabilitation assessments in Yueyang Hospital of Integrated Traditional Chinese and Western Medicine. Before the long-term lockdown, as many patients as possible were educated by doctors or therapists about the content of home exercise, and a personalized home exercise programs was tailored for each post-stroke patient based on their dysfunction. This study was approved by the Ethics Committee of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine. Since this study was a retrospective cohort study, informed consent was not applicable.

First, we collected the factors that might affect the post-stroke sensorimotor dysfunction during the long-term lockdown. The evaluation indicators of post-stroke sensorimotor dysfunction before and after the long-term lockdown were recorded. Second, we analyzed the recovery effect of sensorimotor dysfunction in post-stroke patients who can only rely on home exercise during the long-term lockdown. Third, we sequentially performed univariate and multivariate Logistic regression analyses to see which factors might influence post-stroke sensorimotor dysfunction during the long-term lockdown.

Patients and Data Collection

All patients were from Yueyang Hospital of Integrated Traditional Chinese and Western Medicine and were diagnosed as stroke based on clinical assessment and neuroimaging. The onset time of all patients was more than 1 month, and patients’ disease was in a stable phase. All patients were between 30 and 70 years old. All patients had sensorimotor dysfunction after stroke (Fugl-Meyer motor score༜100 and Fugl-Meyer sensory score༜24). Of the 115 registered cases, 104 (90.4%) were considered eligible and 11 (9.6%) were excluded from the analysis. Specifically, 6 patients could not be followed up, 2 patients had recurrent stroke, and 3 patients had loss of important data (Fig. 1).

We collected all data related with factors that might affect post-stroke sensorimotor dysfunction during the long-term lockdown, including: age (years), sex, education, Body Mass Index (BMI), the course of disease (month), the condition of personalized home exercise programs, and the condition of home-based rehabilitation equipment.

Data Grouping

Age (years) was categorized into three groups [17]: ༜45 years old = 1, 45–60 years old = 2 and ༞60 years old = 3; gender was categorized into two groups: female = 0 and male = 1; education was categorized into two groups: primary school - middle School = 0 and junior college or above = 1; BMI of the Asian population was categorized into three groups [18]: ༜18.5 = 1, 18.5–24 = 2 and ༞24 = 3; the course of disease (months) was categorized into two groups [19]: 1–6 months = 0 and ༞6 months = 1; the condition of personalized home exercise programs: no = 0 and yes = 1; the condition of home-based rehabilitation equipment: almost no = 0 and partially satisfied = 1.

Evaluation indicators of post-stroke sensorimotor dysfunction

The change of Fugl–Meyer Assessment (FMA)-sensory score (No change in score or score change below 0 = 0; Score change above 0 = 1); The change of Fugl–Meyer Assessment (FMA)-motor score (No change in score or score change below 0 = 0; Score change above 0 = 1); The change of Berg Balance Scale (BBS) score (No change in score or score change below 0 = 0; Score change above 0 = 1); The change of Ability of Daily Living (ADL) score (No change in score or score change below 0 = 0; Score change above 0 = 1).

FMA is widely used in the assessment of sensorimotor function and can reflect the level of sensorimotor function in stroke patients [20]. FMA includes nine areas of sensorimotor function (A: shoulder; B: wrist; C: hand/finger; D: coordination of upper limb; E: hip/knee/ankle; F: coordination and balance of lower limbs; H: sensory; J: ROM/pain). Among them, the total score of FMA-sensory is 24 points (light touch 8, proprioception 16), and lower scores indicate worse sensory function; the total score of FMA-motor is 100 points (upper extremity 66, lower extremity 34), and lower scores indicate worse movement function. The FMA has excellent reliability and validity and is sufficiently sensitive to clinical and research practice [21].

BBS is a widely used balance scale in clinical practice, which can well reflect the balance function level of stroke patients [22]. BBS has 14 items with a full score of 56. This total score ultimately reflects the overall balance function. The higher the score, the better the balance function. Berg balance scale has good reliability, validity and sensitivity for clinical and research practice.

ADL is assessed by using the Modified Barthel index (BI), including the patient’s stool, urination, grooming, toileting, eating, transfer, walking, dressing, going up and down stairs, and bathing [23]. The total score of ADL is 100, representing self-care ability; The total score of ADL is 0, representing complete dependence. ADL can be classified as mild (61–99 points), moderate (41–60 points), and severe (1–40 points).

Statistical Analysis

The data was analyzed by SPSS25.0 software. First, we analyzed baseline characteristics of all patients to obtain an overview of the data distribution. The chi-square test was used to determine statistical differences between proportions in each group. Second, we performed univariate logistic regression analysis to assess the impacts of factors that might affect sensorimotor dysfunction after stroke during the long-term lockdown, including variables with odds ratios (ORs) with 95% confidence indexes (CIs). Third, multivariate logistic regression analyses were performed. For multivariate Logistic regression analyses, the optimal regression equation established by the Enter method has the best effect for estimation and prediction, and is applicable when the number of independent variables is small [24]. All the meaningful factors were included. P values less than 0.05 were considered statistically significant.

3.1 Baseline Characteristics

A total of 104 post-stroke sensorimotor dysfunction patients were included in this study. They were grouped according to the recovery of sensorimotor dysfunction. See Table 1 for details. For FMA-sensory score, there were no statistically significant differences in age, gender, education, BMI, or home-based rehabilitation equipment between two groups (P > 0.05). However, the results showed that patients with shorter course of the disease (1–6 months) or personalized home exercise program had better recovery of sensory dysfunction (P < 0.05). For FMA-motor score, there were no statistically significant differences in age (< 45 years and 45–60 years, < 45 years and > 60 years), gender, education, or BMI between two groups (P > 0.05). However, the results showed that patients with 45–60 years (Relative to > 60 years), shorter course of the disease (1–6 months), personalized home exercise program, or more home-based rehabilitation equipment had better recovery of sensory dysfunction (P < 0.05). For Berg Balance score, there were no statistically significant differences in age (< 45 years and 45–60 years, 45–60 years and > 60 years), gender, education, or BMI between two groups (P > 0.05). However, the results showed that patients with < 45 years (Relative to > 60 years), shorter course of the disease (1–6 months), personalized home exercise program, or more home-based rehabilitation equipment had better recovery of sensory dysfunction (P < 0.05). For ADL score, there were no statistically significant differences in age (< 45 years and 45–60 years, 45–60 years and > 60 years), gender, education, or BMI between two groups (P > 0.05). However, the results showed that patients with < 45 years (Relative to > 60 years), shorter course of the disease (1–6 months), personalized home exercise program, or more home-based rehabilitation equipment had better recovery of sensory dysfunction (P < 0.05). We also found that patients with personalized home exercise program had better recovery of post-stroke sensorimotor (P < 0.05).

Table 1

Baseline characteristics of participants
	FMA-sensory score		P value	FMA-motor score		P value	Berg Balance score		P value	ADL score		P value
	Improvement	No	P value	Improvement	No	P value	Improvement	No	P value	Improvement	No	P value
Age(years)			0.085			0.013			0.020			0.017
༜45	7	10		4	13		9	8		9	8
45–60	6	31		18	19		10	27		9	28
༞60	9	41		10	40		9	41		9	41
Gender			0.116			0.278			0.365			0.223
Female	5	32		12	25		8	29		7	30
Male	18	49		29	38		20	47		20	47
Education			0.575			0.183			0.576			0.777
Primary school-middle school	13	51		22	42		16	48		16	48
Junior college or above	10	30		19	21		12	28		11	29
BMI			0.695			0.321			0.381			0.912
< 18.5	2	12		3	11		3	11		3	11
18.5–24	14	49		26	37		20	43		17	46
༞24	7	20		12	15		5	22		7	20
The course of the disease(months)			< 0.001			< 0.001			< 0.001			< 0.001
1–6 months	14	13		20	7		17	10		19	8
༞6 months	9	68		21	56		11	66		8	69
Personalized home exercise programs			0.007			< 0.001			0.006			0.033
No	6	47		11	42		8	45		9	44
Yes	17	34		30	21		20	31		18	33
Home-based rehabilitation equipments			0.126			< 0.001			< 0.001
Almost no	11	53		14	50		9	55		11	53	0.010
Partially satisfied	12	28		27	13		19	21		16	24

3.2 FMA-sensory

FMA-sensory for a Univariate Logistic Regression Analysis

The results of FMA-sensory univariate analysis are shown in Table 2-FMA-sensory score. Age, sex, education, BMI, and the condition of home-based rehabilitation equipment were not associated with the recovery of post-stroke sensory dysfunction during the long-term lockdown. Again, patients with shorter course of the disease and personalized home exercise programs likely contributed to the recovery of post-stroke sensory dysfunction during the long-term lockdown (P < 0.05).

Table 2

Univariate logistic regression analysis was performed for FMA-sensory, FMA-motor, Berg Balance Scale, ADL scale
	FMA-sensory score		FMA-motor score		Berg Balance score		ADL score
	Hazard Ratio(95%CI)	P value	Hazard Ratio(95%CI)	P value	Hazard Ratio(95%CI)	P value	Hazard Ratio(95%CI)	P value
Age(years)
༜45	Reference		Reference		Reference		Reference
45–60	0.276(0.075–1.017)	0.053	0.291(0.080–1.062)	0.062	0.329(0.099–1.090)	0.069	0.286(0.085–0.961)	0.043
༞60	0.357(0.109–1.172)	0.090	0.077(0.021–0.287)	< 0.001	0.195(0.059–0.644)	0.007	0.195(0.059–0.644)	0.007
Gender
Female	Reference		Reference		Reference		Reference
Male	2.351(0.793–6.967)	0.123	1.590(0.686–3.687)	0.280	1.543(0.602–3.955)	0.367	1.824(0.688–4.835)	0.227
Education
Primary school-middle school	Reference		Reference		Reference		Reference
Junior college or above	1.308(0.511–3.347)	0.576	1.727(0.771–3.871)	0.184	1.286(0.532–3.105)	0.576	1.138(0.465–2.786)	0.777
BMI
< 18.5	Reference		Reference		Reference		Reference
18.5–24	1.714(0.343–8.580)	0.512	2.577(0.654–10.156)	0.176	1.705(0.428–6.795)	0.449	1.355(0.337–5.454)	0.669
༞24	2.100(0.374–11.807)	0.400	2.933(0.664–12.954)	0.156	0.833(0.168–4.144)	0.824	1.283(0.275–5.984)	0.751
The course of the disease(months)
1–6 months	Reference		Reference		Reference		Reference
༞6 months	0.123(0.044–0.343)	< 0.001	0.131(0.048–0.355)	< 0.001	0.098(0.036–0.269)	< 0.001	0.049(0.016–0.147)	< 0.001
Personalized home exercise programs
No	Reference		Reference		Reference		Reference
Yes	3.917(1.398–10.971)	0.009	5.455(2.292–12.980)	< 0.001	3.629(1.419–9.280)	0.007	2.667(1.064–6.683)	0.036
Home-based rehabilitation equipment
Almost no	Reference		Reference		Reference		Reference
Partially satisfied	2.065(0.809–5.273)	0.130	7.418(3.051–18.031)	< 0.001	5.529(2.162–14.141)	< 0.001	3.212(1.297–7.953)	0.012

FMA-sensory for Multivariate Logistic Regression Analysis

The results of FMA-sensory multivariate analysis are shown in Fig. 2. The course of the disease and personalized home exercise programs were included. The results showed that shorter course of the disease (OR 0.125, P < 0.001) and personalized home exercise programs (OR 3.826, P = 0.019) were significant protective factors for the recovery of post-stroke sensory dysfunction during the long-term lockdown.

3.3 FMA-motor

FMA-motor for a Univariate Logistic Regression Analysis

The results of FMA-motor univariate analysis are shown in Table 2-FMA-motor score. Sex, education, and BMI were not associated with the recovery of post-stroke motor dysfunction during the long-term lockdown. Again, age, the course of disease, personalized home exercise programs, and the condition of home-based rehabilitation equipment likely contributed to the recovery of post-stroke motor dysfunction during the long-term lockdown (P < 0.050).

FMA-motor for Multivariate Logistic Regression Analysis

The results of FMA-motor multivariate analysis are shown in Fig. 3. Age, the course of disease, personalized home exercise programs, and the condition of home-based rehabilitation equipment were included. The results showed that there was no statistically significant difference in the condition of home-based rehabilitation equipment. Patients with < 45 years (Relative to > 60 years) (OR 0.185, P = 0.039), shorter course of the disease (OR 0.138, P = 0.001), personalized home exercise program (OR 3.698, P = 0.027) were significant protective factors for the recovery of post-stroke motor dysfunction during the long-term lockdown.

3.4 Berg Balance Scale (BBS)

BBS for a Univariate Logistic Regression Analysis

The results of BBS univariate analysis are shown in Table 2-Berg balance score. Sex, education, and BMI were not associated with the recovery of post-stroke balance dysfunction during the long-term lockdown. Again, age, the course of disease, personalized home exercise programs, and the condition of home-based rehabilitation equipment likely contributed to the recovery of post-stroke balance dysfunction during the long-term lockdown (P < 0.050).

BBS for Multivariate Logistic Regression Analysis

The results of BBS multivariate analysis are shown in Fig. 4. Age, the course of disease, personalized home exercise programs, and the condition of home-based rehabilitation equipment were included. The results showed that there was no statistically significant difference in age, personalized home exercise programs, and the condition of home-based rehabilitation equipment. Patients with shorter course of the disease (OR 0.101, P < 0.001) was a significant protective factor for the recovery of post-stroke balance dysfunction during the long-term lockdown.

3.5 Ability of Daily Living (ADL) scale

ADL scale for a Univariate Logistic Regression Analysis

The results of ADL scale univariate analysis are shown in Table 2-ADL score. Sex, education, and BMI were not associated with the recovery of post-stroke ADL dysfunction during the long-term lockdown. Again, age, the course of disease, personalized home exercise programs, and the condition of home-based rehabilitation equipment likely contributed to the recovery of post-stroke ADL dysfunction during the long-term lockdown (P < 0.050).

ADL Scale for Multivariate Logistic Regression Analysis

The results of ADL scale multivariate analysis are shown in Fig. 5. Age, the course of disease, personalized home exercise programs, and the condition of home-based rehabilitation equipment were included. The results showed that there was no statistically significant difference in age, personalized home exercise programs, and the condition of home-based rehabilitation equipment. Patients with shorter course of the disease (OR 0.043 P < 0.001) was a significant protective factor for the recovery of post-stroke ADL dysfunction during the long-term lockdown.

Stroke is one of the leading causes of disability worldwide [25]. Rehabilitation is mainly based on hospital system treatment and supplemented by home exercise, which is an important rehabilitation model for patients with post-stroke dysfunction [12, 26]. During the long-term COVID-19 epidemic lockdown, patients with post-stroke dysfunction can only perform home exercise. Some studies have proved that home exercise is effective for the recovery of post-stroke sensorimotor dysfunction [12–14]. There are many factors that affect the effectiveness of home exercise for post-stroke sensorimotor dysfunction, such as home-based rehabilitation equipment [27], home exercise programs [28], weight [29], and more. But do these factors have a similar impact in the case of the long-term lockdown? We conducted a retrospective cohort study on this question, and the results were somewhat different from previous studies.

For sensory dysfunction, the course of disease and personalized home exercise programs likely contributed to the recovery of post-stroke sensory dysfunction during the long-term lockdown. Previous studies have shown that sensory training is expected to improve post-stroke sensory dysfunction [30, 31]. In our study, personalized home exercise programs also promoted the recovery of post-stroke sensory dysfunction. In the face of a possible long-term lockdown, it is suggested to strengthen the systematic sensory training guidance and personal training management of patients with post-stroke sensory dysfunction through remote network.

For motor dysfunction, age, the course of disease, and personalized home exercise programs likely contributed to the recovery of post-stroke motor dysfunction during the long-term lockdown. However, previous studies have shown that body-weight [29] and home-based rehabilitation equipment [12, 32] are expected to improve post-stroke motor dysfunction. A previous New England Journal of Medicine study suggested that the use of body-weight-supported treadmill improved walking speed and motor recovery [29]. Of course, the effect of body-weight-supported treadmills is more similar to BMI reduction. In addition, home-based rehabilitation equipment has a positive impact on recovery of post-stroke motor dysfunction [33, 34]. However, in this study, home-based rehabilitation equipment did not promote the recovery of post-stroke motor dysfunction. The reason may be that during the unpredictable and long-term COVID-19 epidemic lockdown, patients did not expect to be closed for so long at the beginning, so that the corresponding home-based exercise rehabilitation equipment was generally insufficiently prepared. In the face of a possible long-term lockdown, patients are advised to actively seek personalized rehabilitation programs, purchase more exercise home rehabilitation equipment if conditions permit, and appropriately control their weight within the normal BMI range.

For balance dysfunction, the course of disease likely contributed to the recovery of post-stroke balance dysfunction during the long-term lockdown. However, previous studies have shown that body-weight [29], balance training [35] and home-based rehabilitation equipment [36] are expected to improve post-stroke balance dysfunction. A previous New England Journal of Medicine study suggested that the use of body-weight-supported treadmill improved balance and functional status [29]. Weight loss within the normal range is beneficial to the improvement of balance dysfunction. Of course, home-based balance rehabilitation equipment is relatively rare and difficult to apply without the guidance of a professional therapist. At present, balance dysfunction is more difficult to recover than motor dysfunction, and requires more professional guidance and equipment, which is difficult to achieve during the long-term lockdown period. In the face of a possible the long-term lockdown, it is recommended to provide patients with remote balance function training guidance and appropriate weight control within the normal range of BMI.

For ADL dysfunction, the course of disease likely contributed to the recovery of post-stroke ADL dysfunction during the long-term lockdown. A systematic review from Cochrane suggested that there is some evidence that occupational therapy improves performance in post-stroke ADL dysfunction [37]. In the face of a possible the long-term lockdown, it is recommended to provide patients with remote ADL function training guidance.

In conclusion, we believe that in the face of the unpredictable and long-term COVID-19 epidemic lockdown, patients with post-stroke sensorimotor dysfunction should actively seek personalized rehabilitation programs and purchase corresponding home-based rehabilitation equipment. Doctors and therapists should actively provide remote rehabilitation guidance. The medical systems and medical policy makers should provide funding, technology and policies to build remote rehabilitation guidance platforms and provide home-based rehabilitation equipment.

BMI

Body Mass Index

FMA

Fugl–Meyer Assessment

BBS

Berg Balance Scale

ADL

Ability of Daily Living

Modified Barthel Index.

Acknowledgments

Thank all investigators for their efforts.

Authors’ contributions

JGX presented research questions and research designs. XYH and MXZ assisted JGX to improve the study design and the quality of the manuscript. DW and JJW sorted out the relevant materials for this study and specified statistical strategy. All authors read and approved the submitted version.

Funding

This study is funded by the National Key R&D Program of China (Grant No. 2018YFC2001600).

Availability of data and materials

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethics approval and consent to participate

This study was approved by the Ethics Committee of Yueyang Hospital of Traditional Chinese Medicine and Western Medicine. Since this study was a retrospective cohort study, informed consent was not applicable.

Consent for publication

Not applicable.

Competing interests

The authors have no conflict of interest to report.

Availability of data and materials

The datasets generated and/or analyzed after completing the current study will be available from the corresponding author by reasonable requests.

Author details

¹Shanghai University of Traditional Chinese Medicine, Shanghai, China. ²Shanghai University of Traditional Chinese Medicine Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai, China.

Song J, Jiang X, Cao Y, Juan J, Wu T, Hu Y. Interaction between an ATP-Binding Cassette A1 (ABCA1) Variant and Egg Consumption for the Risk of Ischemic Stroke and Carotid Atherosclerosis: a Family-Based Study in the Chinese Population. J Atheroscler Thromb. 2019;26(9):835–45.
Lyu D, Lyu X, Zhang Y, et al. Tai Chi for Stroke Rehabilitation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Physiol. 2018;9:983.
von Bornstädt D, Gertz K, Lagumersindez Denis N, Seners P, Baron JC, Endres M. Sensory stimulation in acute stroke therapy. J Cereb Blood Flow Metab. 2018;38(10):1682–9.
Koch S, Tiozzo E, Simonetto M, et al. Randomized Trial of Combined Aerobic, Resistance, and Cognitive Training to Improve Recovery From Stroke: Feasibility and Safety. J Am Heart Assoc. 2020;9(10):e015377.
Masakado Y, Abo M, Kondo K, et al. Efficacy and safety of incobotulinumtoxinA in post-stroke upper-limb spasticity in Japanese subjects: results from a randomized, double-blind, placebo-controlled study (J-PURE). J Neurol. 2020;267(7):2029–41.
Zouita S, Zouhal H, Ferchichi H, Paillard T, Dziri C, Hackney AC, et al. Effects of Combined Balance and Strength Training on Measures of Balance and Muscle Strength in Older Women With a History of Falls. Front Physiol. 2020 Dec;23:11:619016.
Koch G, Bonnì S, Casula EP, et al. Effect of Cerebellar Stimulation on Gait and Balance Recovery in Patients With Hemiparetic Stroke: A Randomized Clinical Trial. JAMA Neurol. 2019;76(2):170–8.
Sihvonen AJ, Leo V, Ripollés P, et al. Vocal music enhances memory and language recovery after stroke: pooled results from two RCTs. Ann Clin Transl Neurol. 2020;7(11):2272–87.
Li D, Chen QX, Zou W, Sun XW, Yu XP, Dai XH, et al. Acupuncture promotes functional recovery after cerebral hemorrhage by upregulating neurotrophic factor expression. Neural Regen Res. 2020 Aug;15(8):1510–7.
Du J, Yang F, Hu J, et al. Effects of high- and low-frequency repetitive transcranial magnetic stimulation on motor recovery in early stroke patients: Evidence from a randomized controlled trial with clinical, neurophysiological and functional imaging assessments. Neuroimage Clin. 2019;21:101620.
Miao Y, Chen S, Zhang X, et al. BCI-Based Rehabilitation on the Stroke in Sequela Stage. Neural Plast. 2020;2020:8882764.
Ji EK, Wang HH, Jung SJ, et al. Graded motor imagery training as a home exercise program for upper limb motor function in patients with chronic stroke: A randomized controlled trial. Med (Baltim). 2021;100(3):e24351.
Mahmood A, Nayak P, English C, et al. Adherence to home exercises and rehabilitation (ADHERE) after stroke in low-to-middle-income countries: A randomized controlled trial. Top Stroke Rehabil. 2022;29(6):438–48.
Godlove J, Anantha V, Advani M, Des Roches C, Kiran S. Comparison of Therapy Practice at Home and in the Clinic: A Retrospective Analysis of the Constant Therapy Platform Data Set. Front Neurol. 2019;10:140.
Cai J, Deng X, Yang J, et al. Modeling transmission of SARS-CoV-2 Omicron in China. Nat Med. 2022;28(7):1468–75.
Zhang X, Zhang W, Chen S. Shanghai’s life-saving efforts against the current omicron wave of the COVID-19 pandemic. Lancet. 2022;399(10340):2011–2.
Jin F, Vajdic CM, Law M, et al. Incidence and time trends of anal cancer among people living with HIV in Australia. AIDS. 2019;33(8):1361–8.
Nagamine Y, Kondo N, Yokobayashi K, et al. Socioeconomic Disparity in the Prevalence of Objectively Evaluated Diabetes Among Older Japanese Adults: JAGES Cross-Sectional Data in 2010. J Epidemiol. 2019;29(8):295–301.
Kim E, Yang J, Woo Park K, Cho S. Preventative, but not post-stroke, inhibition of CD36 attenuates brain swelling in hyperlipidemic stroke. J Cereb Blood Flow Metab. 2020;40(4):885–94.
Cao LM, Dong ZQ, Li Q, Chen X. Treadmill training improves neurological deficits and suppresses neuronal apoptosis in cerebral ischemic stroke rats. Neural Regen Res. 2019;14(8):1387–93.
Xu M, Lin R, Luo J, et al. Using brain functional magnetic resonance imaging to evaluate the effectiveness of acupuncture combined with mirror therapy on upper limb function in patients with cerebral ischemic stroke: a study protocol for a randomized, controlled trial. Trials. 2021;22(1):53.
Elsner VR, Trevizol L, de Leon I, et al. Therapeutic effectiveness of a single exercise session combined with WalkAide functional electrical stimulation in post-stroke patients: a crossover design study. Neural Regen Res. 2020;16(5):805–12.
Gupta A, Shukla G, Afsar M, et al. Role of Positive Airway Pressure Therapy for Obstructive Sleep Apnea in Patients With Stroke: A Randomized Controlled Trial. J Clin Sleep Med. 2018;14(4):511–21.
Pasińska P, Wilk A, Kowalska K, Szyper-Maciejowska A, Klimkowicz-Mrowiec A. The long-term prognosis of patients with delirium in the acute phase of stroke: PRospective Observational POLIsh Study (PROPOLIS). J Neurol. 2019;266(11):2710–7.
Chia FS, Kuys S, Low Choy N. Sensory retraining of the leg after stroke: systematic review and meta-analysis. Clin Rehabil. 2019;33(6):964–79.
Serrada I, Hordacre B, Hillier SL. Does Sensory Retraining Improve Sensation and Sensorimotor Function Following Stroke: A Systematic Review and Meta-Analysis. Front Neurosci. 2019;13:402.
Yang K, Zeng L, Ge A, et al. The Effect of Hedysarum multijugum Maxim.-Chuanxiong rhizoma Compound on Ischemic Stroke: A Research Based on Network and Experimental Pharmacology. Oxid Med Cell Longev. 2020;2020:6072380.
Wu D, Ma J, Zhang L, Wang S, Tan B, Jia G. Effect and Safety of Transcutaneous Auricular Vagus Nerve Stimulation on Recovery of Upper Limb Motor Function in Subacute Ischemic Stroke Patients: A Randomized Pilot Study. Neural Plast. 2020;2020:8841752.
Emmerson KB, Harding KE, Lockwood KJ, Taylor NF. Home exercise programs supported by video and automated reminders for patients with stroke: A qualitative analysis. Aust Occup Ther J. 2018;65(3):187–97.
Mahmood A, Blaizy V, Verma A, et al. Acceptability and Attitude towards a Mobile-Based Home Exercise Program among Stroke Survivors and Caregivers: A Cross-Sectional Study. Int J Telemed Appl. 2019;2019:5903106.
Duncan PW, Sullivan KJ, Behrman AL, et al. Body-weight-supported treadmill rehabilitation after stroke. N Engl J Med. 2011;364(21):2026–36.
Chae SH, Kim Y, Lee KS, Park HS. Development and Clinical Evaluation of a Web-Based Upper Limb Home Rehabilitation System Using a Smartwatch and Machine Learning Model for Chronic Stroke Survivors: Prospective Comparative Study. JMIR Mhealth Uhealth. 2020;8(7):e17216.
Levy T, Killington M, Lannin N, Crotty M. Viability of using a computer tablet to monitor an upper limb home exercise program in stroke. Physiother Theory Pract. 2021;37(2):331–41.
Lee JI, Park J, Koo J, et al. Effects of the home-based exercise program with an augmented reality system on balance in patients with stroke: a randomized controlled trial. Disabil Rehabil Published online May. 2022;15:1–8.
Xie G, Rao T, Lin L, et al. Effects of Tai Chi Yunshou exercise on community-based stroke patients: a cluster randomized controlled trial. Eur Rev Aging Phys Act. 2018;15:17.
Tally Z, Boetefuer L, Kauk C, Perez G, Schrand L, Hoder J. The efficacy of treadmill training on balance dysfunction in individuals with chronic stroke: a systematic review. Top Stroke Rehabil. 2017;24(7):539–46.
Legg LA, Lewis SR, Schofield-Robinson OJ, Drummond A, Langhorne P. Occupational therapy for adults with problems in activities of daily living after stroke. Cochrane Database Syst Rev. 2017;7:CD003585.

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Effect of home exercise on post-stroke sensorimotor dysfunction during the long-term COVID-19 epidemic lockdown: a retrospective single-center cohort study

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Abstract

Figures

1. Introduction

2. Methods

3. Results

3.1 Baseline Characteristics

3.2 FMA-sensory

3.3 FMA-motor

3.4 Berg Balance Scale (BBS)

3.5 Ability of Daily Living (ADL) scale

4. Discussion

Abbreviations

Declarations

References

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