cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.27899277
title: Backward walking training is as effective as or better than forward walking training for improving walking speed after stroke: a systematic review with meta-analysis

description: In people who have had stroke, are the effects of backward walking comparable with forward walking for improving walking (i.e. speed, cadence, and stride length)? Does the addition of backward walking to forward walking help improve the benefits of forward walking? Are any benefits maintained beyond intervention? A systematic review of randomized trials, with adults following stroke, was developed. The intervention of interest was backward walking training, delivered either as a solo intervention or in combination with forward walking training. The outcome measures of interest were walking speed, cadence, and stride length. The effect of backward walking training is similar as or better than that of forward walking training for improving walking speed (MD 0.16 m/s, 95% CI 0.06 to 0.27), but results for cadence and stride length were very imprecise. The addition of backward walking training to forward walking training provided negligible effects on walking speed (MD 0.03 m/s, 95% CI 0.01 to 0.04), cadence (MD 5 steps/min, 95% CI 1 to 10), and stride length (MD 0.04 m, 95% CI −0.01 to 0.09). Maintenance of effects beyond the intervention period remains uncertain. This review provided moderate-quality evidence that backward walking training is slightly better than forward walking training for improving walking speed after stroke, but not when it is additional to forward walking training. Large and well-designed trials are warranted to strengthen the evidence regarding backward walking training, especially in the subacute phase after stroke.
DOI: 10.6084/m9.figshare.27899277.v1
title: Backward walking training is as effective as or better than forward walking training for improving walking speed after stroke: a systematic review with meta-analysis

description: In people who have had stroke, are the effects of backward walking comparable with forward walking for improving walking (i.e. speed, cadence, and stride length)? Does the addition of backward walking to forward walking help improve the benefits of forward walking? Are any benefits maintained beyond intervention? A systematic review of randomized trials, with adults following stroke, was developed. The intervention of interest was backward walking training, delivered either as a solo intervention or in combination with forward walking training. The outcome measures of interest were walking speed, cadence, and stride length. The effect of backward walking training is similar as or better than that of forward walking training for improving walking speed (MD 0.16 m/s, 95% CI 0.06 to 0.27), but results for cadence and stride length were very imprecise. The addition of backward walking training to forward walking training provided negligible effects on walking speed (MD 0.03 m/s, 95% CI 0.01 to 0.04), cadence (MD 5 steps/min, 95% CI 1 to 10), and stride length (MD 0.04 m, 95% CI −0.01 to 0.09). Maintenance of effects beyond the intervention period remains uncertain. This review provided moderate-quality evidence that backward walking training is slightly better than forward walking training for improving walking speed after stroke, but not when it is additional to forward walking training. Large and well-designed trials are warranted to strengthen the evidence regarding backward walking training, especially in the subacute phase after stroke.
DOI: 10.6084/m9.figshare.28444075
title: The impact of social determinants of health on stroke rehabilitation service utilization measured during acute stroke hospitalization

description: Rehabilitation is the primary method of promoting functional recovery post-stroke. Identification of patients for rehabilitation services during the acute stroke hospitalization is essential to delivery of rehabilitation services. Social determinants of health (SDOH) impact health care and health outcomes in a myriad of ways, but it is unknown whether SDOH affects rehabilitation services utilization. This study elucidates the relationship of, and additional explanatory value of, county-level metrics of SDOH on rehabilitation services utilization during acute inpatient hospitalization for stroke. Using the American Heart Association Get with the Guidelines®-Stroke registry and the Institute for Health Metrics and Evaluation data, we investigated the impact of SDOH on rehabilitation services utilization over the years ranging from 2010 to 2019 in hospitalized ischemic stroke or intracerebral hemorrhage stroke patients. Analyses focused on determining which county-level SDOH metrics influenced rehabilitation services utilization using generalized linear mixed models. Akaike Information Criterion was used for model selection. County-level SDOH improved the predictive ability of the models to determine who would be transferred to a rehabilitation facility and who would be referred for rehabilitation after discharge. We found indicators that county-level metrics of high school education (<i>p</i> = 0.0003), being foreign-born (<i>p</i> &lt; 0.001), and rurality of the hospital (<i>p</i> = 0.004) influenced rehabilitation services utilization. SDOH impact rehabilitation utilization after acute stroke hospitalization. Future studies should focus on both individual- and county-level metrics of SDOH and their impact on access to rehabilitation. This information should be used to develop interventions to improve the equity of rehabilitation utilization after stroke.
DOI: 10.6084/m9.figshare.27278155
title: Body mass index is associated with disability at discharge as indicated by the modified Rankin Scale in patients with ischemic stroke: a JROAD-DPC study

description: Body mass index (BMI) of patients with ischemic stroke (IS) has been associated with prognosis and disability in studies in the United States. Although the Asian population is leaner, the optimal BMI for stroke-related disability remains unknown. To clarify the association between BMI and disability in patients with IS from a national database in Japan. The present study included 522,421 patients with IS identified in the JROAD-DPC database from April 2016 to March 2020. We used the WHO classification of BMI, which divides Asia-Pacific patients into five groups, to categorize BMI and the modified Rankin Scale (mRS) to assess stroke-related disability at admission and discharge. After multiple imputation for missing values, we conducted a multiple mixed-effect logistic regression analysis for poor mRS score (&gt;2) in September 2023. In addition, we created a restricted cubic spline model between the odds ratio (OR) for poor mRS and BMI. The mRS score worsened during hospitalization in 60.1% of the patients with IS, and 45.7% had a poor mRS score at discharge. Overweight patients had the lowest OR of having a poor mRS score (OR: 0.898, 95% confidence interval: 0.895–0.902). The spline curve for the OR for poor mRS score was U-shaped with a BMI of 24.7 kg/m<sup>2</sup>as the apex value. The present study revealed a U-shaped relationship between BMI and stroke-related disability, with overweight patients having the lowest OR for disability at discharge.
DOI: 10.6084/m9.figshare.27278155.v1
title: Body mass index is associated with disability at discharge as indicated by the modified Rankin Scale in patients with ischemic stroke: a JROAD-DPC study

description: Body mass index (BMI) of patients with ischemic stroke (IS) has been associated with prognosis and disability in studies in the United States. Although the Asian population is leaner, the optimal BMI for stroke-related disability remains unknown. To clarify the association between BMI and disability in patients with IS from a national database in Japan. The present study included 522,421 patients with IS identified in the JROAD-DPC database from April 2016 to March 2020. We used the WHO classification of BMI, which divides Asia-Pacific patients into five groups, to categorize BMI and the modified Rankin Scale (mRS) to assess stroke-related disability at admission and discharge. After multiple imputation for missing values, we conducted a multiple mixed-effect logistic regression analysis for poor mRS score (&gt;2) in September 2023. In addition, we created a restricted cubic spline model between the odds ratio (OR) for poor mRS and BMI. The mRS score worsened during hospitalization in 60.1% of the patients with IS, and 45.7% had a poor mRS score at discharge. Overweight patients had the lowest OR of having a poor mRS score (OR: 0.898, 95% confidence interval: 0.895–0.902). The spline curve for the OR for poor mRS score was U-shaped with a BMI of 24.7 kg/m<sup>2</sup>as the apex value. The present study revealed a U-shaped relationship between BMI and stroke-related disability, with overweight patients having the lowest OR for disability at discharge.
DOI: 10.6084/m9.figshare.28444075.v1
title: The impact of social determinents of health on stroke rehabilitation service utilization measured during acute stroke hospitalization

description: Rehabilitation is the primary method of promoting functional recovery post-stroke. Identification of patients for rehabilitation services during the acute stroke hospitalization is essential to delivery of rehabilitation services. Social determinants of health (SDOH) impact health care and health outcomes in a myriad of ways, but it is unknown whether SDOH affects rehabilitation services utilization. This study elucidates the relationship of, and additional explanatory value of, county-level metrics of SDOH on rehabilitation services utilization during acute inpatient hospitalization for stroke. Using the American Heart Association Get with the Guidelines®-Stroke registry and the Institute for Health Metrics and Evaluation data, we investigated the impact of SDOH on rehabilitation services utilization over the years ranging from 2010 to 2019 in hospitalized ischemic stroke or intracerebral hemorrhage stroke patients. Analyses focused on determining which county-level SDOH metrics influenced rehabilitation services utilization using generalized linear mixed models. Akaike Information Criterion was used for model selection. County-level SDOH improved the predictive ability of the models to determine who would be transferred to a rehabilitation facility and who would be referred for rehabilitation after discharge. We found indicators that county-level metrics of high school education (<i>p</i> = 0.0003), being foreign-born (<i>p</i> &lt; 0.001), and rurality of the hospital (<i>p</i> = 0.004) influenced rehabilitation services utilization. SDOH impact rehabilitation utilization after acute stroke hospitalization. Future studies should focus on both individual- and county-level metrics of SDOH and their impact on access to rehabilitation. This information should be used to develop interventions to improve the equity of rehabilitation utilization after stroke.
DOI: 10.6084/m9.figshare.28444075.v2
title: The impact of social determinants of health on stroke rehabilitation service utilization measured during acute stroke hospitalization

description: Rehabilitation is the primary method of promoting functional recovery post-stroke. Identification of patients for rehabilitation services during the acute stroke hospitalization is essential to delivery of rehabilitation services. Social determinants of health (SDOH) impact health care and health outcomes in a myriad of ways, but it is unknown whether SDOH affects rehabilitation services utilization. This study elucidates the relationship of, and additional explanatory value of, county-level metrics of SDOH on rehabilitation services utilization during acute inpatient hospitalization for stroke. Using the American Heart Association Get with the Guidelines®-Stroke registry and the Institute for Health Metrics and Evaluation data, we investigated the impact of SDOH on rehabilitation services utilization over the years ranging from 2010 to 2019 in hospitalized ischemic stroke or intracerebral hemorrhage stroke patients. Analyses focused on determining which county-level SDOH metrics influenced rehabilitation services utilization using generalized linear mixed models. Akaike Information Criterion was used for model selection. County-level SDOH improved the predictive ability of the models to determine who would be transferred to a rehabilitation facility and who would be referred for rehabilitation after discharge. We found indicators that county-level metrics of high school education (<i>p</i> = 0.0003), being foreign-born (<i>p</i> &lt; 0.001), and rurality of the hospital (<i>p</i> = 0.004) influenced rehabilitation services utilization. SDOH impact rehabilitation utilization after acute stroke hospitalization. Future studies should focus on both individual- and county-level metrics of SDOH and their impact on access to rehabilitation. This information should be used to develop interventions to improve the equity of rehabilitation utilization after stroke.
DOI: 10.6084/m9.figshare.27278156
title: Validity and stability of the international physical activity questionnaire short-form for stroke survivors with preserved walking ability

description: Stroke survivors usually present sedentary lifestyles and fail to comply with the World Health Organization physical activity recommendations. Reliable, low-cost, and fast tools are needed to monitor physical activity levels in this population. This study aimed to evaluate the content and face validity, construct validity, and test-retest stability of the International Physical Activity Questionnaire Short-Form (IPAQ-SF) in stroke survivors. One hundred and twenty stroke survivors able to walk independently and preserved comprehension and communication abilities (61 ± 12 years, 35% female) were involved in this psychometric study. Participants completed the interview form of the IPAQ-SF via standardized videoconference twice, one week apart, under identical conditions, to evaluate test-retest stability. Correlations between IPAQ-SF and the caloric expenditure during the minutes of activity registered with the Fitbit Inspire 2 activity tracker wristband and 6-Metre Timed Walk (6MTW) were explored to assess construct validity. The IPAQ-SF showed good content and face validity. “Moderate” to ”strong” correlations were found with the Fitbit Inspire 2 (rho: 0.40 to 0.63), while “weak” to “moderate” correlations were found with the 6MTW (rho: 0.35 to 0.50). Test-retest stability was “moderate” to “excellent” (κ: 0.844 to 0.881; ICC: 0.533 to 0.917). The IPAQ-SF demonstrated satisfactory content and construct validity, and stability in stroke survivors, supporting its clinical and research utility when the data collection is conducted by trained evaluators using a standardized interview protocol in large samples.
DOI: 10.6084/m9.figshare.27278156.v2
title: Validity and stability of the international physical activity questionnaire short-form for stroke survivors with preserved walking ability

description: Stroke survivors usually present sedentary lifestyles and fail to comply with the World Health Organization physical activity recommendations. Reliable, low-cost, and fast tools are needed to monitor physical activity levels in this population. This study aimed to evaluate the content and face validity, construct validity, and test-retest stability of the International Physical Activity Questionnaire Short-Form (IPAQ-SF) in stroke survivors. One hundred and twenty stroke survivors able to walk independently and preserved comprehension and communication abilities (61 ± 12 years, 35% female) were involved in this psychometric study. Participants completed the interview form of the IPAQ-SF via standardized videoconference twice, one week apart, under identical conditions, to evaluate test-retest stability. Correlations between IPAQ-SF and the caloric expenditure during the minutes of activity registered with the Fitbit Inspire 2 activity tracker wristband and 6-Metre Timed Walk (6MTW) were explored to assess construct validity. The IPAQ-SF showed good content and face validity. “Moderate” to ”strong” correlations were found with the Fitbit Inspire 2 (rho: 0.40 to 0.63), while “weak” to “moderate” correlations were found with the 6MTW (rho: 0.35 to 0.50). Test-retest stability was “moderate” to “excellent” (κ: 0.844 to 0.881; ICC: 0.533 to 0.917). The IPAQ-SF demonstrated satisfactory content and construct validity, and stability in stroke survivors, supporting its clinical and research utility when the data collection is conducted by trained evaluators using a standardized interview protocol in large samples.
DOI: 10.6084/m9.figshare.28121200
title: The effectiveness of core stability exercises on functional outcomes in early subacute stroke recovery: a randomized controlled trial

description: The core is important in providing local strength and balance and is central to almost all kinetic chains of daily activities. This study aimed to assess the effectiveness of additional Core Stability Exercises (CSE) to conventional physiotherapy (CP) versus CP alone to improve dynamic sitting balance, coordination, trunk function, and stepping (gait) as a primary outcome and functional sitting balance, postural control, standing balance and fall risk, lower limb spasticity, activities of daily living, degree of disability, and quality of life for early subacute stroke recovery. A multicentre parallel, randomized, controlled, assessor-blinded trial was conducted. Eighty-seven early stroke survivors initiated (≤30 days) were divided into two groups. Experimental group (EG) performed CSE in addition to CP and the control group (CG) performed CP alone for 5-day/week for 5-week. Outcomes were assessed at the beginning and end of the intervention (5-week) and follow-up (12-week). Quality of life was assessed at 5-week and 12- week. Variables were analyzed using a repeated-measures analysis of variance (ANOVA), with Bonferroni’s post-hoc test. All statistical tests were performed for 0.05 significance level and 95% confidence interval. Eighty-three individuals were analyzed 40 in the EG and 43 in the CG. Differences between groups were shown favoring EG regarding dynamic sitting balance, trunk coordination/function (Spanish-Trunk Impairment Scale), lower limb spasticity (modified-Ashworth Scale) and balance (Spanish-Postural Assessment Scale). No differences were observed for the other outcomes. CSE in addition to CP improves dynamic sitting balance, trunk coordination/function, lower-limb spasticity, and balance in early recovery post-stroke.
DOI: 10.6084/m9.figshare.28121200.v1
title: The effectiveness of core stability exercises on functional outcomes in early subacute stroke recovery: a randomized controlled trial

description: The core is important in providing local strength and balance and is central to almost all kinetic chains of daily activities. This study aimed to assess the effectiveness of additional Core Stability Exercises (CSE) to conventional physiotherapy (CP) versus CP alone to improve dynamic sitting balance, coordination, trunk function, and stepping (gait) as a primary outcome and functional sitting balance, postural control, standing balance and fall risk, lower limb spasticity, activities of daily living, degree of disability, and quality of life for early subacute stroke recovery. A multicentre parallel, randomized, controlled, assessor-blinded trial was conducted. Eighty-seven early stroke survivors initiated (≤30 days) were divided into two groups. Experimental group (EG) performed CSE in addition to CP and the control group (CG) performed CP alone for 5-day/week for 5-week. Outcomes were assessed at the beginning and end of the intervention (5-week) and follow-up (12-week). Quality of life was assessed at 5-week and 12- week. Variables were analyzed using a repeated-measures analysis of variance (ANOVA), with Bonferroni’s post-hoc test. All statistical tests were performed for 0.05 significance level and 95% confidence interval. Eighty-three individuals were analyzed 40 in the EG and 43 in the CG. Differences between groups were shown favoring EG regarding dynamic sitting balance, trunk coordination/function (Spanish-Trunk Impairment Scale), lower limb spasticity (modified-Ashworth Scale) and balance (Spanish-Postural Assessment Scale). No differences were observed for the other outcomes. CSE in addition to CP improves dynamic sitting balance, trunk coordination/function, lower-limb spasticity, and balance in early recovery post-stroke.
DOI: 10.6084/m9.figshare.27278112
title: Effects of cardiorespiratory physiotherapy on lung function in stroke: a network meta-analysis

description: The efficacy of various physiotherapy interventions for improving lung function has not been compared. To evaluate cardiorespiratory physiotherapy interventions on lung function in patients with stroke, prioritize intervention types, and establish hierarchy. Twelve randomized controlled trials published during 2000–2022 in PubMed, EMBASE, Cochrane Library, and Web of Science were selected. Interventions included aerobic training (AT), combined inspiratory and expiratory training (CIET), inspiratory training (IT), combined aerobic and breadth training (CABT), and conventional training (CT). Outcome variables were forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC. CIET and IT were more effective than CT for FEV1 and FVC. CIET and IT showed larger effect sizes compared to AT for FEV1. The intervention rankings were as follows: IT (86.62%), CIET (63.31%), CABT (50.79%), AT (28.72%), and CT (20.55%) for FEV1; IT (93.89%), CIET (75.06%), CT (42.38%), CABT (37.73%), and AT (0.94%) for FVC; and IT (78.30%), CT (54.14%), CABT (42.62%), CIET (41.65%), and AT (33.29%) for FEV1/FVC. CIET and IT were more effective than CT for FVC in patients with stroke aged ≥60 years. Besides FEV1/FVC, IT and CIET inhalation exercises improved lung function more effectively than other therapies, with IT or CIET being more effective than AT or CT. CIET and IT were more effective than CT for FVC in patients with stroke aged ≥60 years than in those &lt;60 years. These findings highlight the significance of breathing training for patients with stroke and support clinical decision-making.
DOI: 10.6084/m9.figshare.27278112.v1
title: Effects of cardiorespiratory physiotherapy on lung function in stroke: a network meta-analysis

description: The efficacy of various physiotherapy interventions for improving lung function has not been compared. To evaluate cardiorespiratory physiotherapy interventions on lung function in patients with stroke, prioritize intervention types, and establish hierarchy. Twelve randomized controlled trials published during 2000–2022 in PubMed, EMBASE, Cochrane Library, and Web of Science were selected. Interventions included aerobic training (AT), combined inspiratory and expiratory training (CIET), inspiratory training (IT), combined aerobic and breadth training (CABT), and conventional training (CT). Outcome variables were forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC. CIET and IT were more effective than CT for FEV1 and FVC. CIET and IT showed larger effect sizes compared to AT for FEV1. The intervention rankings were as follows: IT (86.62%), CIET (63.31%), CABT (50.79%), AT (28.72%), and CT (20.55%) for FEV1; IT (93.89%), CIET (75.06%), CT (42.38%), CABT (37.73%), and AT (0.94%) for FVC; and IT (78.30%), CT (54.14%), CABT (42.62%), CIET (41.65%), and AT (33.29%) for FEV1/FVC. CIET and IT were more effective than CT for FVC in patients with stroke aged ≥60 years. Besides FEV1/FVC, IT and CIET inhalation exercises improved lung function more effectively than other therapies, with IT or CIET being more effective than AT or CT. CIET and IT were more effective than CT for FVC in patients with stroke aged ≥60 years than in those &lt;60 years. These findings highlight the significance of breathing training for patients with stroke and support clinical decision-making.