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Healthcare
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Stroke and Ageing
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Stroke and Ageing

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: closed (29 February 2024) | Viewed by 7103

Special Issue Editors

Prof. Dr. Dominique A. Cadilhac

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Guest Editor
School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC 3168, Australia
Interests: stroke; cerebrovascular disease; program evaluation; improvement science; economic evaluation
Special Issues, Collections and Topics in MDPI journals
Dr. Olivia Brancatisano

E-Mail Website
Guest Editor
Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3168, Australia
Interests: stroke; ageing; neurological disorders; community rehabilitation; lifestyle interventions; secondary prevention
Dr. Tharshanah Thayabaranathan

E-Mail Website
Guest Editor
School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC 3168, Australia
Interests: stroke; cerebrovascular disease; cardiovascular disease; disease prevention; lifestyle interventions; disease epidemiology

Special Issue Information

Dear Colleagues,

Globally, stroke continues to be a leading cause of death and long-term disability. Annually, stroke affects approximately 15 million people; 75% of strokes occur in adults aged 65 years or older. Due to the greater prevalence of comorbid conditions in the older population, the consequences of stroke in those cases are more severe. Although the overall incidence of stroke is declining in many high-income countries, the absolute number of strokes continues to increase because of the ageing population in high-income and low- as well as middle-income countries, in addition to improved survival. Primary and secondary prevention, or recovery-focused interventions in the community, may reduce the impact of stroke and improve the quality of life in older adults, but evidence is often limited to solutions trialed in high-income countries. The use of technology is also expanding the ability to reach more people in providing support following care in hospitals after stroke.

This Special Issue seeks empirical and review papers related to any of these themes, and is not intended to exclude other topics that may be relevant to stroke and ageing. Early phase or pilot projects for prevention, education, or rehabilitation after stroke in older adults, as well as projects highlighting technology-based interventions to support people in the community after stroke or those focused on consumer involvement, will also be considered.

Prof. Dr. Dominique A. Cadilhac
Dr. Olivia Brancatisano
Dr. Tharshanah Thayabaranathan
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Stroke
  • Prevention
  • Quality of life
  • Care transitions
  • Self-management

Published Papers (5 papers)

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14 pages, 1149 KiB  
Article
Co-Designed Cardiac Rehabilitation for the Secondary Prevention of Stroke (CARESS): A Pilot Program Evaluation
by Sabah Rehman, Seamus Barker, Kim Jose, Michele Callisaya, Helen Castley, Martin G. Schultz, Myles N. Moore, Dawn B. Simpson, Gregory M. Peterson and Seana Gall
Healthcare 2024, 12(7), 776; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12070776 - 3 Apr 2024
Viewed by 695
Abstract
Structured health system-based programs, such as cardiac rehabilitation, may reduce the risk of recurrent stroke. This study aimed to co-design and evaluate a structured program of rehabilitation, developed based on insights from focus groups involving stroke survivors and health professionals. Conducted in Tasmania, [...] Read more.
Structured health system-based programs, such as cardiac rehabilitation, may reduce the risk of recurrent stroke. This study aimed to co-design and evaluate a structured program of rehabilitation, developed based on insights from focus groups involving stroke survivors and health professionals. Conducted in Tasmania, Australia in 2019, the 7-week program comprised one hour of group exercise and one hour of education each week. Functional capacity (6 min walk test), fatigue, symptoms of depression (Patient Health Questionnaire), and lifestyle were assessed pre- and post-program, with a historical control group for comparison. Propensity score matching determined the average treatment effect (ATE) of the program. Key themes from the co-design focus groups included the need for coordinated care, improved psychosocial management, and including carers and peers in programs. Of the 23 people approached, 10 participants (70% men, mean age 67.4 ± 8.6 years) completed the program without adverse events. ATE analysis revealed improvements in functional capacity (139 m, 95% CI 44, 234) and fatigue (−5 units, 95% CI −9, −1), with a small improvement in symptoms of depression (−0.8 units, 95% CI −1.8, 0.2) compared to controls. The co-designed program demonstrated feasibility, acceptability, and positive outcomes, suggesting its potential to support stroke survivors. Full article
(This article belongs to the Special Issue Stroke and Ageing)
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15 pages, 251 KiB  
Article
Aphasia Depression and Psychological Therapy (ADaPT): Perspectives of People with Post-Stroke Aphasia on Participating in a Modified Cognitive Behavioral Therapy
by Caroline Baker, Sonia Thomas, Priscilla Tjokrowijoto, Brooke Ryan, Ian Kneebone and Renerus Stolwyk
Healthcare 2024, 12(7), 771; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12070771 - 2 Apr 2024
Viewed by 805
Abstract
Aphasia, a communication disability commonly caused by stroke, can profoundly affect a person’s mood and identity. We explored the experiences of stroke survivors with aphasia and depression who received a modified cognitive behavioral therapy (CBT)-based psychological intervention. The therapy is manualized with a [...] Read more.
Aphasia, a communication disability commonly caused by stroke, can profoundly affect a person’s mood and identity. We explored the experiences of stroke survivors with aphasia and depression who received a modified cognitive behavioral therapy (CBT)-based psychological intervention. The therapy is manualized with a flexible treatment protocol, including 10 individually based therapy sessions (+2 booster sessions) either via telehealth or in person. Six participants with chronic aphasia (60% of the total sample) participated in in-depth interviews that were analyzed using reflexive thematic analysis. Two core themes were derived from the data: the first theme, helpful elements of therapy—doing enjoyable activities, new ways of thinking, problem solving, working with the experienced therapist, and using telehealth; and the second theme, making progress—mood, communication, acceptance of the ‘new me’, and improving relationships. All participants found the therapy to be helpful in managing mood problems with various elements being beneficial depending on the individual, highlighting the importance of tailoring the intervention. Therefore, delivering modified CBT to individuals with aphasia is likely to be acceptable both in person and through telehealth. Further evaluation of the intervention and its impact on mood would be beneficial. Full article
(This article belongs to the Special Issue Stroke and Ageing)
12 pages, 611 KiB  
Article
Evaluating Feasibility of a Secondary Stroke Prevention Program
by Stephanie Hunter, Kimberley Vogel, Shane O’Leary and Jannette Maree Blennerhassett
Healthcare 2023, 11(19), 2673; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare11192673 - 2 Oct 2023
Viewed by 1302
Abstract
Healthy lifestyles including exercise and diet can reduce stroke risk, but stroke survivors often lack guidance to modify their lifestyles after hospital discharge. We evaluated the implementation of a new, secondary stroke prevention program involving supervised exercise, multidisciplinary education and coaching to address [...] Read more.
Healthy lifestyles including exercise and diet can reduce stroke risk, but stroke survivors often lack guidance to modify their lifestyles after hospital discharge. We evaluated the implementation of a new, secondary stroke prevention program involving supervised exercise, multidisciplinary education and coaching to address modifiable risk factors. The group-based program involved face-to-face and telehealth sessions. The primary outcomes were feasibility, examined via service information (referrals, uptake, participant demographics and costs), and participant acceptability (satisfaction and attendance). Secondary outcomes examined self-reported changes in lifestyle factors and pre–post scores on standardized clinical tests (e.g., waist circumference and 6-Minute Walk (6MWT)). We ran seven programs in 12 months, and 37 people participated. Attendance for education sessions was 79%, and 30/37 participants completed the full program. No adverse events occurred. Participant satisfaction was high for ‘relevance’ (100%), ‘felt safe to exercise’ (96%) and ‘intend to continue’ (96%). Most participants (88%) changed (on average) 2.5 lifestyle factors (diet, exercise, smoking and alcohol). Changes in clinical outcomes seemed promising, with some being statistically significant, e.g., 6MWT (MD 59 m, 95% CI 38 m to 80,159 m, p < 0.001) and waist circumference (MD −2.1 cm, 95%CI −3.9 cm to −1.4 cm, p < 0.001). The program was feasible to deliver, acceptable to participants and seemed beneficial for health. Access to similar programs may assist in secondary stroke prevention. Full article
(This article belongs to the Special Issue Stroke and Ageing)
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17 pages, 573 KiB  
Article
Improving Practice for Urinary Continence Care on Adult Acute Medical and Rehabilitation Wards: A Multi-Site, Co-Created Implementation Study
by Dianne Lesley Marsden, Kerry Boyle, Jaclyn Birnie, Amanda Buzio, Joshua Dizon, Judith Dunne, Sandra Greensill, Kelvin Hill, Sandra Lever, Fiona Minett, Sally Ormond, Jodi Shipp, Jennifer Steel, Amanda Styles, John Wiggers, Dominique Ann-Michele Cadilhac and Jed Duff
Healthcare 2023, 11(9), 1241; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare11091241 - 26 Apr 2023
Viewed by 1601
Abstract
Many adult inpatients experience urinary continence issues; however, we lack evidence on effective interventions for inpatient continence care. We conducted a before and after implementation study. We implemented our guideline-based intervention using strategies targeting identified barriers and evaluated the impact on urinary continence [...] Read more.
Many adult inpatients experience urinary continence issues; however, we lack evidence on effective interventions for inpatient continence care. We conducted a before and after implementation study. We implemented our guideline-based intervention using strategies targeting identified barriers and evaluated the impact on urinary continence care provided by inpatient clinicians. Fifteen wards (acute = 3, rehabilitation = 7, acute and rehabilitation = 5) at 12 hospitals (metropolitan = 4, regional = 8) participated. We screened 2298 consecutive adult medical records for evidence of urinary continence symptoms over three 3-month periods: before implementation (T0: n = 849), after the 6-month implementation period (T1: n = 740), and after a 6-month maintenance period (T2: n = 709). The records of symptomatic inpatients were audited for continence assessment, diagnosis, and management plans. All wards contributed data at T0, and 11/15 wards contributed at T1 and T2 (dropouts due to COVID-19). Approximately 26% of stroke, 33% acute medical, and 50% of rehabilitation inpatients were symptomatic. The proportions of symptomatic patients (T0: n = 283, T1: n = 241, T2: n = 256) receiving recommended care were: assessment T0 = 38%, T1 = 63%, T2 = 68%; diagnosis T0 = 30%, T1 = 70%, T2 = 71%; management plan T0 = 7%, T1 = 24%, T2 = 24%. Overall, there were 4-fold increased odds for receiving assessments and management plans and 6-fold greater odds for diagnosis. These improvements were sustained at T2. This intervention has improved inpatient continence care. Full article
(This article belongs to the Special Issue Stroke and Ageing)
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16 pages, 1039 KiB  
Protocol
A Network of Sites and Upskilled Therapists to Deliver Best-Practice Stroke Rehabilitation of the Arm: Protocol for a Knowledge Translation Study
by Leeanne M. Carey, Liana S. Cahill, Jannette M. Blennerhassett, Michael Nilsson, Natasha A. Lannin, Vincent Thijs, Susan Hillier, Dominique A. Cadilhac, Geoffrey A. Donnan, Meg E. Morris, Leonid Churilov, Marion Walker, Shanthi Ramanathan, Michael Pollack, Esther May, Geoffrey C. Cloud, Sharon McGowan, Tissa Wijeratne, Marc Budge, Fiona McKinnon, John Olver, Toni Hogg, Michael Murray, Brendon Haslam, Irene Koukoulas, Brittni Nielsen, Yvonne Mak-Yuen, Megan Turville, Cheryl Neilson, Anna Butler, Joosup Kim and Thomas A. Matyasadd Show full author list remove Hide full author list
Healthcare 2023, 11(23), 3080; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare11233080 - 1 Dec 2023
Viewed by 1275
Abstract
Implementation of evidence-informed rehabilitation of the upper limb is variable, and outcomes for stroke survivors are often suboptimal. We established a national partnership of clinicians, survivors of stroke, researchers, healthcare organizations, and policy makers to facilitate change. The objectives of this study are [...] Read more.
Implementation of evidence-informed rehabilitation of the upper limb is variable, and outcomes for stroke survivors are often suboptimal. We established a national partnership of clinicians, survivors of stroke, researchers, healthcare organizations, and policy makers to facilitate change. The objectives of this study are to increase access to best-evidence rehabilitation of the upper limb and improve outcomes for stroke survivors. This prospective pragmatic, knowledge translation study involves four new specialist therapy centers to deliver best-evidence upper-limb sensory rehabilitation (known as SENSe therapy) for survivors of stroke in the community. A knowledge-transfer intervention will be used to upskill therapists and guide implementation. Specialist centers will deliver SENSe therapy, an effective and recommended therapy, to stroke survivors in the community. Outcomes include number of successful deliveries of SENSe therapy by credentialled therapists; improved somatosensory function for stroke survivors; improved performance in self-selected activities, arm use, and quality of life; treatment fidelity and confidence to deliver therapy; and for future implementation, expert therapist effect and cost-effectiveness. In summary, we will determine the effect of a national partnership to increase access to evidence-based upper-limb sensory rehabilitation following stroke. If effective, this knowledge-transfer intervention could be used to optimize the delivery of other complex, evidence-based rehabilitation interventions. Full article
(This article belongs to the Special Issue Stroke and Ageing)
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