Performance In Stroke Patients Research Articles

Dynamic Reorganization Patterns of Brain Modules after Stroke Reflecting Motor Function.

Advancements in neuroimaging technologies have significantly deepened our understanding of the neural physiopathology associated with stroke. Nevertheless, the majority of studies ignored the characteristics of dynamic changes in brain networks. The relationship between dynamic changes in brain networks and the severity of motor dysfunction after stroke needs further investigation. From the perspective of multilayer network module reconstruction, we aimed to explore the dynamic reorganization of the brain and its relationship with motor function in subcortical stroke patients. We recruited 35 healthy individuals and 50 stroke patients with unilateral limb motor dysfunction (further divided into mild-moderate group and severe group). Using dynamic multilayer network modularity analysis, we investigated changes in the dynamic modular reconfiguration of brain networks. Additionally, we assessed longitudinal clinical scale changes in stroke patients. Correlation and regression analyses were employed to explore the relationship between characteristic dynamic indicators and impairment and recovery of motor function, respectively. We observed increased temporal flexibility in the Default Mode Network (DMN) and decreased recruitment of module reconfiguration in the Attention Network (AN), Sensorimotor Network (SMN), and DMN after stroke. We also observed reduced module loyalty following stroke. Additionally, correlation analysis showed that hyper-flexibility of the DMN was associated with better lower limb motor function performance in stroke patients with mild-to-moderate impairment. Regression analysis indicated that increased flexibility within the DMN and decreased recruitment coefficient within the AN may predict good lower limb function prognosis in patients with mild to moderate motor impairment. Our study revealed more frequent modular reconfiguration and hyperactive interaction of brain networks after stroke. Notably, dynamic modular remodeling was closely related to the impairment and recovery of motor function. Understanding the temporal module reconfiguration patterns in multilayer networks after stroke can provide valuable information for more targeted treatments.

Interactive Virtual Ankle Movement Controlled by Wrist sEMG Improves Motor Imagery: An Exploratory Study.

Virtual reality (VR) techniques can significantly enhance motor imagery training by creating a strong illusion of action for central sensory stimulation. In this article, we establish a precedent by using surface electromyography (sEMG) of contralateral wrist movement to trigger virtual ankle movement through an improved data-driven approach with a continuous sEMG signal for fast and accurate intention recognition. Our developed VR interactive system can provide feedback training for stroke patients in the early stages, even if there is no active ankle movement. Our objectives are to evaluate: 1) the effects of VR immersion mode on body illusion, kinesthetic illusion, and motor imagery performance in stroke patients; 2) the effects of motivation and attention when utilizing wrist sEMG as a trigger signal for virtual ankle motion; 3) the acute effects on motor function in stroke patients. Through a series of well-designed experiments, we have found that, compared to the 2D condition, VR significantly increases the degree of kinesthetic illusion and body ownership of the patients, and improves their motor imagery performance and motor memory. When compared to conditions without feedback, using contralateral wrist sEMG signals as trigger signals for virtual ankle movement enhances patients' sustained attention and motivation during repetitive tasks. Furthermore, the combination of VR and feedback has an acute impact on motor function. Our exploratory study suggests that the sEMG-based immersive virtual interactive feedback provides an effective option for active rehabilitation training for severe hemiplegia patients in the early stages, with great potential for clinical application.

Effects of Traditional Malay Massage on Muscle Tone, Muscle Function and Physical Performance in Patients with Stroke

Traditional Malay Massage (TMM), although is not the standard of care in the Malaysia Stroke Clinical Practice Guidelines, is common among stroke patients. This is despite the availability of clear evidence on the benefits of TMM in this population. The present study aims to investigate the effects of TMM on muscle tone, muscle function and physical performance in stroke patients. We found that as short as two weeks of TMM improved motor function and physical performance in subacute stroke patients. No change was observed on muscle tone. Future larger scale study is warranted to validate this finding.

Rehabilitative effects of electrical stimulation on gait performance in stroke patients: A systematic review with meta-analysis.

Electrical stimulation techniques are widely utilized for rehabilitation management in individuals with stroke patients. This review aims to summarize the rehabilitative effects of electrical stimulation therapy on gait performance in stroke patients. This review included randomized controlled trials (RCT) investigating the therapeutic effects of electrical stimulation in stroke patients throughout five databases. This review qualitatively synthesized 20 studies and quantitatively analyzed 11 RCTs. Functional electrical stimulation (FES) was the most commonly used electrical stimulation type to improve postural stability and gait performance in stroke patients. The clinical measurement tools commonly used in the three studies to assess the therapeutic effects of FES were Berg balance scale (BBS), 10-meter walk test (10MWT), 6-minute walk test (6mWT), and gait velocity. The BBS score and gait velocity had positive effects in the FES group compared with the control group, but the 10MWT and 6mWT showed the same effects between the two groups. The heterogeneity of BBS scores was also high. The results of this review suggest that electrical stimulation shows little evidence of postural stability and gait performance in stroke patients, although some electrical stimulations showed positive effects on postural stability and gait performance.

Processing Speed and Attentional Shift/Mental Flexibility in Patients with Stroke: A Comprehensive Review on the Trail Making Test in Stroke Studies.

The Trail Making Test (TMT) is one of the most commonly administered tests in clinical and research neuropsychological settings. The two parts of the test (part A (TMT-A) and part B (TMT-B)) enable the evaluation of visuoperceptual tracking and processing speed (TMT-A), as well as divided attention, set-shifting and cognitive flexibility (TMT-B). The main cognitive processes that are assessed using TMT, i.e., processing speed, divided attention, and cognitive flexibility, are often affected in patients with stroke. Considering the wide use of TMT in research and clinical settings since its introduction in neuropsychological practice, the purpose of our review was to provide a comprehensive overview of the use of TMT in stroke patients. We present the most representative studies assessing processing speed and attentional shift/mental flexibility in stroke settings using TMT and applying scoring methods relying on conventional TMT scores (e.g., time-to-complete part A and part B), as well as derived measures (e.g., TMT-(B-A) difference score, TMT-(B/A) ratio score, errors in part A and part B). We summarize the cognitive processes commonly associated with TMT performance in stroke patients (e.g., executive functions), lesion characteristics and neuroanatomical underpinning of TMT performance post-stroke, the association between TMT performance and patients' instrumental activities of daily living, motor difficulties, speech difficulties, and mood statue, as well as their driving ability. We also highlight how TMT can serve as an objective marker of post-stroke cognitive recovery following the implementation of interventions. Our comprehensive review underscores that the TMT stands as an invaluable asset in the stroke assessment toolkit, contributing nuanced insights into diverse cognitive, functional, and emotional dimensions. As research progresses, continued exploration of the TMT potential across these domains is encouraged, fostering a deeper comprehension of post-stroke dynamics and enhancing patient-centered care across hospitals, rehabilitation centers, research institutions, and community health settings. Its integration into both research and clinical practice reaffirms TMT status as an indispensable instrument in stroke-related evaluations, enabling holistic insights that extend beyond traditional neurological assessments.

Cortical activity in patients with high-functioning ischemic stroke during the Purdue Pegboard Test: insights into bimanual coordinated fine motor skills with functional near-infrared spectroscopy.

After stroke, even high-functioning individuals may experience compromised bimanual coordination and fine motor dexterity, leading to reduced functional independence. Bilateral arm training has been proposed as a promising intervention to address these deficits. However, the neural basis of the impairment of functional fine motor skills and their relationship to bimanual coordination performance in stroke patients remains unclear, limiting the development of more targeted interventions. To address this gap, our study employed functional near-infrared spectroscopy to investigate cortical responses in patients after stroke as they perform functional tasks that engage fine motor control and coordination. Twenty-four high-functioning patients with ischemic stroke (7 women, 17 men; mean age 64.75 ± 10.84 years) participated in this cross-sectional observational study and completed four subtasks from the Purdue Pegboard Test, which measures unimanual and bimanual finger and hand dexterity. We found significant bilateral activation of the sensorimotor cortices during all Purdue Pegboard Test subtasks, with bimanual tasks inducing higher cortical activation than the assembly subtask. Importantly, patients with better bimanual coordination exhibited lower cortical activation during the other three Purdue Pegboard Test subtasks. Notably, the observed neural response patterns varied depending on the specific subtask. In the unaffected hand task, the differences were primarily observed in the ipsilesional hemisphere. In contrast, the bilateral sensorimotor cortices and the contralesional hemisphere played a more prominent role in the bimanual task and assembly task, respectively. While significant correlations were found between cortical activation and unimanual tasks, no significant correlations were observed with bimanual tasks. This study provides insights into the neural basis of bimanual coordination and fine motor skills in high-functioning patients after stroke, highlighting task-dependent neural responses. The findings also suggest that patients who exhibit better bimanual performance demonstrate more efficient cortical activation. Therefore, incorporating bilateral arm training in post-stroke rehabilitation is important for better outcomes. The combination of functional near-infrared spectroscopy with functional motor paradigms is valuable for assessing skills and developing targeted interventions in stroke rehabilitation.

Effect of the cognitive strategy training protocol on task mastery and cognitive performance during the instrumental activity of daily living in stroke patients

Background: Stroke leads to decrease in physical, emotional, social function, and activities in daily living. Cognitive functions, either basic or higher-level, are fundamental factors in performing tasks and functional activities in daily life. Therefore, cognitive training to enhance functions in stroke patients is necessary. This study developed a cognitive strategy training protocol using the Perceive, Recall, Plan & Perform (PRPP) System of Intervention and the Multicontext Approach to improve cognitive function during performance in instrumental activities of daily living (IADL) tasks. Objectives: This study aimed to examine the task mastery of stroke patients during the performance of IADL tasks and to examine the effects of the cognitive strategy training protocol on cognitive performance in stroke patients. Materials and methods: The study was a quasi-experimental, one-group, pretestposttest research design. Eight stroke patients with cognitive impairment aged between 18-70 years old participated in the study. The intervention called “cognitive strategy training protocol” included 12 sessions, 3 times a week across 4 consecutive weeks. Each session took approximately 60 minutes. An outcome measure was the PRPP System of Task Analysis-Thai version. Descriptive data obtained from Stage One of the PRPP System-Thai version were analyzed to determine for task mastery, and pre-and post-scores of Stage Two of the PRPP System-Thai version were computed using the Wilcoxon signed-rank test. Results: After the cognitive strategy training protocol, all participants had higher percentage scores obtained from Stage One of the PRPP System-Thai version for at least 1 activity. Five out of eight participants showed higher percentage scores in both activities. Comparing the pre- and post-test scores from Stage Two of the PRPP System-Thai version using the Wilcoxon signed-rank test revealed no significant difference in all activities (p>0.05). However, the descriptive results of the posttest percentage scores of Stage Two of the PRPP System-Thai version showed that 4 out of 8 participants had higher scores for at least 1 activity and 2 participants showed higher scores in both activities. Conclusion: The cognitive strategy training protocol was likely to be possible to improve task mastery and cognitive performance during the IADLs tasks in the participants despite no statistically significant difference.

Assistive Technology Involving Postural Control and Gait Performance for Adults with Stroke: A Systematic Review and Meta-Analysis.

This study aimed to comprehensively summarize assistive technology devices for postural control and gait performance in stroke patients. In the study, we searched for randomized controlled trials (RCTs) published until 31 December 2022 in four electrical databases. The most frequently applied assistive technology devices involving postural stability and gait function for stroke patients were robot-assistive technology devices. Out of 1065 initially retrieved citations that met the inclusion criteria, 30 RCTs (12 studies for subacute patients and 18 studies for chronic patients) were included in this review based on eligibility criteria. The meta-analysis included ten RCTs (five studies for subacute patients and five for chronic patients) based on the inclusion criteria of the data analysis. After analyzing, the variables, only two parameters, the Berg balance scale (BBS) and the functional ambulation category (FAC), which had relevant data from at least three studies measuring postural control and gait function, were selected for the meta-analysis. The meta-analysis revealed significant differences in the experimental group compared to the control group for BBS in both subacute and chronic stroke patients and for the FAC in chronic stroke patients. Robot-assistive training was found to be superior to regular therapy in improving postural stability for subacute and chronic stroke patients but not gait function. This review suggests that robot-assistive technology devices should be considered in rehabilitative approaches for postural stability and gait function for subacute and chronic stroke patients.

Comparison between healthcare quality in primary stroke centers and comprehensive stroke centers for acute stroke patients: evidence from the Chinese Stroke Center Alliance

To improve stroke care quality, the guidelines for stroke center construction in China recommended establishing primary stroke centers (PSCs) and comprehensive stroke centers (CSCs). We aimed to compare stroke care quality between the two types of centers. Data were collected from acute stroke patients admitted to PSCs or CSCs in the China Stroke Center Alliance program. Twenty-one individual guideline-recommended performance measures and two summary measures were compared between the two groups. Multivariable logistic regression models were used to examine the association between stroke center status (CSC vs. PSC) and healthcare quality. Data from 750,594 stroke patients from 1474 stroke centers (252 CSCs and 1222PSCs) were analyzed. For many components of healthcare performance in stroke patients, comparable levels of performance were observed between CSCs and PCSs. Nonetheless, CSCs outperformed PSCs in the areas of administering intravenous recombinant tissue plasminogen activator within 4.5h (aOR=1.31 [95% CI: 1.07-1.60]), rehabilitation for acute ischaemic stroke (AIS) (aOR=1.19 [95% CI: 1.01-1.40]), and the provision of hypoglycemic medication and statin therapy upon discharge for AIS (aOR=1.26 [95% CI: 1.00-1.59] and aOR=1.28 [95% CI: 1.04-1.59], respectively). More patients with intracerebral haemorrhage and subarachnoid haemorrhage received neurosurgery in CSCs (14.4% vs. 10.6% and 51.0% vs. 33.9%, respectively). Additionally, CSCs had higher in-hospital mortality than PSCs (aOR=1.33 [95% CI: 1.01-1.73]). Overall PSCs provided equivalent care for many quality measures to CSCs in China with the exception of thrombolysis, rehabilitation access, and medication at discharge for AIS, whereby improvements should be directed. Nevertheless, PSCs have demonstrated lower risk-adjusted in-hospital mortality rates. The National Key Research and Development Projects of China.

Performance of stroke patients using a brain-computer interface during motor imagery: a systematic review

Performance of stroke patients using a brain-computer interface during motor imagery: a systematic review

Effectiveness of vestibular exercises on balance impairment in patients affected with stroke - A systematic review

Introduction and Aim: The patients who have been suffered with stroke have severe balance problems, it is difficult to tell with certainty how balance performance in stroke patients is impacted by vestibular impairment. The study's purpose was to determine if oculomotor and gaze stability exercises may help post-stroke individuals improve their balance. Materials and Methods: This study includes all articles of various databases from 2000 to 2020 was included for study selection. The google scholar, research gate databases were comprehensively studied. 100 articles were searched and out of which 60 articles were selected to be assessed for eligibility in full text. Finally, 9 articles were chosen for inclusion and for analysis, although 7 of them did not match our proposed inclusion criteria. Results: Exercises for the vestibular system have been demonstrated to be effective for stroke patients whose balance has been compromised. Conclusion: The study finds that more high -quality experimental research on vestibular exercises and balance impairment after stroke is necessary because there is very little evidence from earlier experimental studies to draw firm conclusions about their effects.

Intrarater and interrater reliability of the dynamic gait index in post stroke patients with eye movement disorders

BackgroundThe Dynamic Gait Index (DGI) is a useful tool that has been evaluated for its reliability in patients with vestibular disorders, elderly people and, in chronic stroke population. Present study was aimed to evaluate the intrarater and interrater reliability of the DGI to measure dynamic balance and gait performance in stroke patients with eye movement disorders. MethodsA sample of 30 stroke patients suffering from eye movement disorders were recruited. Two Physical therapists assessed the intrarater and interrater reliability of the DGI in two testing sessions three days apart. In the later session, two raters assessed the patients’ performance simultaneously on the DGI. The reliability was calculated using the intra-class correlation coefficient (ICC2, 1). Standard error of measurement (SEM) and minimal detectable change (MDC95) at 95% confidence interval were also calculated. A significance level was set at p-value <0.05. ResultsThe (ICC2, 1) for intrarater and interrater reliability of total DGI scores was 0.86 and 0.91 respectively. While (ICC2, 1) for intrarater and interrater reliability of individual items ranged from 0.73 to 0.91 to 0.73–0.93, respectively. The (SEM) and (MDC95) for intrarater reliability of total DGI scores were 0.76 and 2.10, respectively. Corresponding values for interrater reliability were 0.62 and 1.71, respectively. ConclusionsThe DGI is a reliable tool for evaluating the dynamic balance and gait performance in stroke patients with eye movement disorders. This tool showed good to excellent intrarater and interrater reliability of total DGI scores and moderate to good intrarater and interrater reliability of individual items of the DGI.

Cadence Feedback and Video-Based Engagement Improves Motivation and Performance during Pedalling in Stroke Patients

Video and music as a dissociative attention stimulus during exercise is known to distract from the discomfort of physical exertion and improve exercise adherence; however, the influence of video-based feedback and engagement during pedalling on the performance and motivation of pedalling in stroke patients is poorly understood. The aim of this study was to employ a novel video-based engagement paradigm for pedalling in stroke patients and evaluate its capacity to influence the cadence control, physiological output, and perceived motivation and enjoyment. Thirteen stroke patients were recruited with low-to-moderate lower-limb disability (mean age: 64.0 yrs.). A reference group of 18 healthy young adult subjects (mean age: 27.7 yrs.) was also recruited to assess the broad applicability of the techniques to a contrasting non-pathological cohort. The participants pedalled at a slow (60 RPM) and fast (100 RPM) target speed with constant resistance in 15 min pedalling bouts that included (i) baseline pedalling with real-time visual feedback of cadence deviation from the target provided only in the first 20 s (ii) real-time visual feedback of cadence data over the entire pedalling session, and (iii) real-time engagement to maintain the playback rate of a prerecorded video by pedalling at the target speed. During low speed pedalling, stroke patients demonstrated significantly smaller absolute cadence deviation during pedalling with feedback (mean difference: 1.8 RPM, p = 0.014) and video-based engagement (mean difference: 2.4 RPM, p = 0.006) compared to the baseline pedalling. For the healthy adults, feedback and video-based engagement reduced cadence deviation significantly at all speeds (p &lt; 0.05). All but one stroke patient either enjoyed or really enjoyed the video engagement during pedalling and felt motivated to undertake this form of exercise in therapy in the future. This proof-of-concept study showed that feedback and video-based engagement may improve the targeted pedalling performance in stroke patients, and by helping dissociate subjects from physical cues associated with fatigue, may ultimately improve exercise motivation and compliance.

Effects of Dual-Task Training, Physiotherapy, and Combined Therapy on Balance Performance in Stroke Patients

Effects of Dual-Task Training, Physiotherapy, and Combined Therapy on Balance Performance in Stroke Patients

Effects of Dual-Task Training, Physiotherapy, and Combined Therapy on Balance Performance in Stroke Patients

Effects of Dual-Task Training, Physiotherapy, and Combined Therapy on Balance Performance in Stroke Patients

Projection of Damaged Visual and Language Regions on Low Trail Making Test Part-B Performance in Stroke Patients.

BackgroundThe Trail Making Test Part-B (TMT-B) is an attention functional test to investigate cognitive dysfunction. It requires the ability to recognize not only numbers but also letters. We analyzed the relationship between brain lesions in stroke patients and their TMT-B performance.MethodsFrom the TMT-B, two parameters (score and completion time) were obtained. The subjects were classified into several relevant groups by their scores and completion times through a data-driven analysis (k-means clustering). The score-classified groups were characterized by low (≤10), moderate (10 < score < 25), and high (25) scores. In terms of the completion time, the subjects were classified into four groups. The lesion degree in the brain was calculated for each of the 116 regions classified by automated anatomical labeling (AAL). For each group, brain sites with a significant difference (corrected p < 0.1) between each of the 116 regions were determined by a Wilcoxon Rank–Sum significant difference test.ResultsLesions at the cuneus and the superior occipital gyrus, which are mostly involved in visual processing, were significant (corrected p < 0.1) in the low-score group. Furthermore, the moderate-score group showed more-severe lesion degrees (corrected p < 0.05) in the regions responsible for the linguistic functions, such as the superior temporal gyrus and the supramarginal gyrus. As for the completion times, lesions in the calcarine, the cuneus, and related regions were significant (corrected p < 0.1) in the fastest group as compared to the slowest group. These regions are also involved in visual processing.ConclusionThe TMT-B results revealed that the subjects in the low-score group or the slowest- group mainly had damage in the visual area, whereas the subjects in the moderate-score group mainly had damage in the language area. These results suggest the potential utility of TMT-B performance in the lesion site.

Prediction of Communication Impairment in Children With Bilateral Cerebral Palsy Using Multivariate Lesion- and Connectome-Based Approaches: Protocol for a Multicenter Prospective Cohort Study.

BackgroundBilateral cerebral palsy (BCP) is the most common type of CP in children and is often accompanied by different degrees of communication impairment. Several studies have attempted to identify children at high risk for communication impairment. However, most prediction factors are qualitative and subjective and may be influenced by rater bias. Individualized objective diagnostic and/or prediction methods are still lacking, and an effective method is urgently needed to guide clinical diagnosis and treatment. The aim of this study is to develop and validate an objective, individual-based model for the prediction of communication impairment in children with BCP by the time they enter school.MethodsA multicenter prospective cohort study will be conducted in four Chinese hospitals. A total of 178 children with BCP will undergo advanced brain magnetic resonance imaging (MRI) at baseline (corrected age, before the age of 2 years). At school entry, communication performance will be assessed by a communication function classification system (CFCS). Three-quarters of children with BCP will be allocated as a training cohort, whereas the remaining children will be allocated as a test cohort. Multivariate lesion- and connectome-based approaches, which have shown good predictive ability of language performance in stroke patients, will be applied to extract features from MR images for each child with BCP. Multiple machine learning models using extracted features to predict communication impairment for each child with BCP will be constructed using data from the training cohort and externally validated using data from the test cohort. Prediction accuracy across models in the test cohort will be statistically compared.DiscussionThe findings of the study may lead to the development of several translational tools that can individually predict communication impairment in children newly diagnosed with BCP to ensure that these children receive early, targeted therapeutic intervention before they begin school.Trial registrationThe study has been registered with the Chinese Clinical Trial Registry (ChiCTR2100049497).

Effect of Customized Insoles on Gait in Post-Stroke Hemiparetic Individuals: A Randomized Controlled Trial

Simple SummaryStroke patients commonly have different lower extremity biomechanical abnormalities that severely affect walking after damage to normal neural pathways, however, little attention has been paid to them, and current gait rehabilitation techniques have made limited efforts to provide patients with consistent, stable, and effective correction when walking. In the present study, we investigated whether customized insoles could improve gait performance in hemiplegic stroke patients, and the results showed that customized insoles could be a valid intervention that targets residual hemiplegic gait after stroke, thereby enhancing walking function and improving the quality of life of the patients.Background: Insoles have been widely applied to many diseases, but stroke involves complex problems and there is a paucity of research on the application of insoles in stroke patients. Aim: To evaluate the effect of customized insoles on gait in patients with hemiplegia. Design: A randomized controlled trial. Setting: Rehabilitation department of a hospital. Population: A total of 50 stroke patients were randomized into an experimental group (n = 25) or a control group (n = 25). Methods: Both groups received conventional gait training, which was conducted five times a week, every 40 min for four weeks and patients in the experimental group were required to wear customized insoles for at least 1 h per day for four weeks. The primary outcome measure was the Tinetti Gait Scale (TGS) and the secondary outcome measures were the plantar pressure test, 6-min walking test (6MWT), lower extremity Fugl–Meyer assessment (FMA-LE), Berg Balance Scale (BBS), and the modified Barthel index (MBI). Results: Compared to the control group, there were significant increases in the experimental group after four weeks (p = 0.014) and at the four week follow-up (p = 0.001) in the change in TGS, weight-bearing on the involved side (p = 0.012) or forefoot (p = 0.028) when standing, weight-bearing on the involved side (p = 0.01 6) or forefoot (p = 0.043) when walking, early stance phase (p = 0.023) and mid stance phase (p = 0.013) on the involved side, FMA-LE (p = 0.029), BBS (p = 0.005), and MBI (p = 0.009), but there were no differences in the late stance phase (p = 0.472) on the involved side when walking or in the 6MWT (p = 0.069). Conclusions: Customized insoles had great efficacy in enhancing gait performance in stroke patients.

Estimation of Upper Extremity Movement Performance in Stroke Patients with Artificial Learning Techniques

The main reason why people are directed to rehabilitation services after stroke-like neurological diseases are to bring individuals' daily abilities to a normal level. Measuring the activities of people in their daily lives ensures that these rehabilitation services progress more healthily. In our study, Brunnstrom Hemiplegia Recovery Staging, which is widely used by doctors to evaluate the movement function of stroke patients during rehabilitation, was examined. The study was specifically adapted to the upper extremity stage 4a movement of the Brunnstrom Staging. Daily movements of patients were evaluated with accelerometer sensors. With this methodology, sensor data was collected from 15 volunteer stroke patients and 80 healthy individuals. These sensor data were interpreted by the medical professional. Thus, consistency between movement data of healthy and sick individuals was analyzed. The data obtained as a result of the analysis process were examined with artificial learning methods and classified as healthy/unhealthy. The methodology of the study is suitable for research designed to increase upper / lower extremity performance in the daily life of individuals.

The link between self-efficacy and mobility performance in stroke patients

Stroke may cause extensive brain damage that can hamper a patient's mobility performance to carry out their daily activities. This study aimed to examine the links between mobility performance and the self-efficacy and characteristics of stroke patients. A cross-sectional survey was undertaken at a hospital in Bandung, Indonesia. A total of 106 respondents, recruited by using consecutive sampling, filled out the Stroke Self-Efficacy and Barthel Index, together with socio-demographic questionnaires. Stroke onset, stroke type, employment status, and education level were found to have significant relationships with mobility performance (p<0.05). A significant relationship was also identified between the level of self-efficacy and mobility performance (p<0.001). Self-efficacy is linked to the mobility performance of stroke patients. Nurses should pay more attention to the self-efficacy of these patients during their rehabilitation period.