To review the evidence around self-management interventions used to improve mobility post-stroke.An integrative review was carried out. Eight databases were searched from 1992 to July 2021 using ke...

Objective: To explore experiences, needs and rehabilitation priorities of patients who had their stroke and the experiences of therapists managing stroke patients during the COVID-19 pandemic. Design: Exploratory qualitative study. Setting: Acute, sub-acute and community stroke facilities. Subjects: Twenty-two participants. Twelve therapists (all female, mean age 38.5 years) and ten patients (9 female, mean age 51.1 years) who were involved in stroke rehabilitation during the pandemic were interviewed. Methods: Individual semi-structured interviews were conducted. Interviews were recorded and transcribed before being analysed using a reflexive thematic analysis approach. Results: Four main themes demonstrate the modifications in the care system as a result of COVID-19, impact on the stroke patients at different stage, needs and priorities of stroke rehabilitation, and management strategies that have been used in stroke rehabilitation. Remote rehabilitation and self-management strategies were recommended to deliver care for stroke patients. However, therapists seemed unsatisfied with the quality of care delivered and patients suggested face to face delivery of care with proper personal protection equipment to better address their physical and mental health needs. Conclusion: The findings of this study explored the impact of the pandemic on stroke care from the perspective of the patients and therapists and provides suggestions for improved delivery of care in similar situations. Future research is warranted to examine the long-term effects on people who had inadequate post-stroke rehabilitation during covid pandemic and urgent measures taken to reduce the impact the pandemic has had on the physical and mental issues for these patients.

Objective: To evaluate the feasibility of implementing a self-management intervention to improve mobility in the community for stroke survivors. Methods: A two-phase sequential mixed methods design was used (a pilot randomised controlled trial and focus groups). Participants were adult stroke survivors within six months post discharge from hospital with functional and cognitive capacity for self-management. The intervention included education sessions, goal setting and action planning, group sessions, self-monitoring and follow up. The control group received usual care and both groups enrolled for 3 months in the study. Feasibility outcomes (recruitment and retention rates, randomisation and blinding, adherence to the intervention, collection of outcome measures, and the fidelity and acceptability of the intervention). Participants assessed at baseline, 3 months and 6 months for functional mobility and walking, self-efficacy, goal attainment, cognitive ability, and general health. A descriptive analysis was done for quantitative data and content analysis for the qualitative data. Findings of quantitative and qualitative data were integrated to present the final results of the study. Results: Twenty-four participants were recruited and randomised into two groups (12 each). It was feasible to recruit from hospital and community and to deliver the intervention remotely. Randomisation and blinding were successful. Participants were retained (83%) at 3 months and (79.2%) at 6 months assessments. Adherence to the intervention varied due to multiple factors. Focus groups discussed participants’ motivations for joining the programme, their perspectives on the intervention (fidelity and acceptability) and methodology, perceived improvements in mobility, facilitators and challenges for self-management, and suggestions for improvement. Conclusion: The self-management intervention seems feasible for implementation for stroke survivors in the community. Participants appreciated the support provided and perceived improvement in their mobility. The study was not powered enough to draw a conclusion about the efficacy of the program and a future full-scale study is warranted.

Background and Objectives: Research examining the difference between the effects of deep and superficial dry needling on myofascial trigger points (MTrPs) in the upper trapezius muscle is limited. Thus, this systematic review was conducted to compare the effects of these two dry needling techniques on pain and functional disability in adults with neck pain who demonstrated MTrPs. Materials and Methods: Randomised clinical trials (RCTs) were identified through an electronic search in PubMed, Scopus, Web of Science, Embase, Google Scholar, Dimensions and OpenAlex from inception until 22 September 2024. Only English-language studies were considered. Best-evidence synthesis was utilised to interpret the results of the included RCTs. Results: Of the 192 records obtained, 8 RCTs were included (2 with a low risk of bias, 4 with some risk-of-bias concerns and 2 with a high risk of bias). Overall, both deep and superficial dry needling provided short-term alleviation of pain and functional disability. No clinically meaningful differences were found between the two dry needling techniques. Conclusions: Deep and superficial dry needling seem to have similar positive effects on pain and functional disability in patients with neck pain exhibiting MTrPs.

Parents provide most of the support needed for children with cerebral palsy (CP) to increase the child’s participation and independence. Understanding the experiences of parents caring for children with CP is essential for developing effective family programs and services. The current knowledge about parents’ experiences in CP is based on studies in Western countries, with little known about this phenomenon in Arab countries like Saudi Arabia. This study aimed to understand the unique experiences and support needs of Saudi parents caring for children with CP from a social-ecological perspective. We conducted a qualitative, exploratory, descriptive study involving 12 semi-structured interviews with mothers and fathers of children with different types of CP. We analyzed the data using a reflexive thematic approach, following six distinct phases. Participants’ narratives revealed a complex caregiving journey marked by both challenges and rewards. Support from Saudi nuclear and extended family members was considered important; however, many parents expressed a need for additional physical and financial assistance from their families. Parents reported feeling stressed and experiencing challenges in accessing and navigating educational and healthcare services. Our findings highlight that Islamic values play a crucial role in the experiences of Saudi parents. These values foster a sense of collectivism, highlighting the importance of family support and community involvement, which can affect the Saudi caregiving environment. Parents remain an essential yet often invisible part of the Saudi caregiving system. Without adequate support, parents are at risk of experiencing social, financial, academic, physical, and mental health challenges, which may affect their overall family well-being. Future work may need to consider spiritual and gender roles when developing programs or services to support Saudi parents of children with CP.

Background and Study Aim. To choose the ideal training or performance times, it is crucial to assess VO2 max performance across different time-of-day particular chronotypes. This study aimed to investigate the differences in VO2 max between the chronotype of university students during the morning and evening time of the day. Material and Methods. Fifty-two university students (26 morning type and 26 evening type) with mean age 23.05± 2.07 years, weight 66.71±4.31Kg and height of 170.90±5.18 cm and BMI of 22.75±1.91kg/m2 were recruited based on the results of the Horne-Ostberg Morningness- Eveningness Questionnaire (MEQs) participated in this Cross-over study. VO2 max was measured directly by gas collected using mouth tube breath to breath through the use of the gas analyzer the AD instrument (model-ML206) with an incremental graded maximal exercise test done on the treadmill. Results. The morning type group's VO2 max was significantly better in the morning hour than it was in the evening (p=.013), and when the VO2 max of the evening type group was measured in the morning and evening hours and compared, there was a statistically significant difference in favour of the evening hours (p=.004). Additionally, there is no discernible difference between the VO2 max of the morning type and the evening type group either in the morning hours or the evening hours, but trends indicate that the morning type group has a higher VO2max in the morning hour and the same is true for the evening type group in the evening hour. Conclusion. The findings of this study showed an interaction between chronotype and time of the day in VO2 max. For endurance training, trainers should consider the individual's chronotype and time of the day for exercise prescription.