User profile of people contacting a stroke helpline (StrokeLine) in Australia: a retrospective cohort study

Background: StrokeLine is a specialised telephone helpline led by health professionals in Australia. Aims: (i) To describe the profile of StrokeLine callers; (ii) to understand the reasons people engage with the service and (iii) how StrokeLine responded to the caller\u27s needs. Methods: Routine call data were obtained from the StrokeLine between November 2019 and November 2020. Data were extracted and descriptive analyses performed. De-identified free-text data were obtained separately for November 2019 and June 2020 and analysed using qualitative content analysis. Results: Of the 1429 calls most were from carers, family and friends (38%) or the stroke survivor themselves (34%). Most calls were made by women (64%) and the average age of the stroke survivor was ≥65 years (33%) with the time since the stroke occurred \u3c1 year. The main reason for calling was to manage stroke-related impairments (40%). Providing information, support and advice was the most common action provided by StrokeLine staff (25%). Content analysis of 225 calls revealed most stroke survivors called for emotional support, while carers sought more practical guidance. StrokeLine provided information for referral to relevant services and guidance on what to do next. Conclusions: Most calls were received from family and carers, as well as stroke survivors. They contacted StrokeLine for information and advice, practical solutions, emotional support, and referral advice to other services

Bridging the gap between goal intentions and actions: a systematic review in patient populations

Purpose: To evaluate the evidence for the effectiveness of if-then implementation intentions (if-then plans) in adult patient populations. Outcomes of interest included adherence, goal pursuit and physical health outcomes. Methods: Keywords were used to search electronic databases without date or language restrictions (up to 30 April 2014). Studies were included if they (1) concerned a patient population; (2) used if-then plans as a sole intervention or as part of treatment, therapy or rehabilitation; (3) if they were randomised controlled trials. The PEDro scale was used to evaluate study quality. Guidance as set out by the Cochrane Collaboration was used. Two reviewers independently extracted data, discrepancies were discussed and if required referred to a third reviewer. Results: In total, 18 of the 2141 articles were identified as potentially relevant and four studies of people with epilepsy, chronic back pain, stroke and obesity met the inclusion criteria. People who form if-then plans achieved better outcomes on epilepsy and stroke medication adherence and physical capacity than controls. Conclusions: Of the four studies that used an if-then plan, only one (people with epilepsy) looked at the intervention as a stand-alone strategy. Further research needs to explore if this simple approach improves rehabilitation outcomes and is a helpful and feasible strategy for people experiencing disabilities. Implications for Rehabilitation Steps involved in achieving goals, such as doing exercises or completing other goal related tasks, can be compromised for people with chronic health conditions particularly resulting from difficulties in self-regulating behaviour. If-then plans are implementation intention tools aimed at supporting people to deal more effectively with self-regulatory problems that might undermine goal striving and goal attainment, and have been found to be effective in health promotion and health behaviour change. This systematic literature review identified four studies completed with patient populations, with three demonstrating effectiveness. If-then plans provide an opportunity for clinicians to develop better ways of implementing rehabilitation. Bridging the gap between goal intentions and actions

Neurophysiological effects after active-passive movement priming.

<p>Black bars are group averages from the mirror symmetric (MIR) session; white bars are group averages from the alternating (ALT) session. <b>A.</b> Corticomotor excitability increased after MIR but not ALT. There was a main effect of Pattern for non-conditioned ECR and FCR MEP area (Exp 1). Bars represent average ECR and FCR MEP area from 13 participants collapsed across all three post time points expressed as a percentage of baseline (100%). One-sample t-tests indicated significant MEP facilitation in both muscles after mirror symmetric but not parallel movement. <b>B.</b> Long interval intracortical inhibition (LICI) was modulated by Pattern (Exp 1). There was a main effect of Pattern for ΔLICI. Bars represent average change in LICI from ECR and FCR MEPs of 8 participants at each Post time point relative to baseline (0%). Relative to baseline, there was a non-significant trend for reduced LICI after the mirror session (<i>P</i>&lt;0.1) and a trend for increased LICI in the alternating session (<i>P</i>&lt;0.06). <b>C.</b> Interhemispheric inhibition (IHI) was modulated by Pattern and Time reduced after the MIR, but not PAR, session (Exp 2) indicated by a Pattern×Time interaction for ΔIHI. Bars represent average change in IHI from FCR MEPs of 13 participants at each Post time point relative to baseline (0%). At Post₁₅, ΔIHI was less in the MIR session compared to the ALT session, but did not differ at other time points. One-sample t-tests indicated a significant reduction of IHI at Post₁₅ relative to baseline after MIR only.</p

Participant details, design, and summary of main results for each experiment.

<p>Exp = Experiment; N = number of participants; EH = Edinburgh Handedness (−100 = left-handed; +100 = right-handed) MIR = mirror-symmetric; ALT = alternating; CME = corticomotor excitability of the passive M1; SAI = short afferent inhibition; LICI = long interval intracortical inhibition; IHI = Interhemispheric inhibition; SICI = short interval intracortical inhibition; H amp = H-reflex amplitude; PMF = pre-movement facilitation; ↑ Increase; ↓ Decrease; ←→ No change. All MIR effects are relative to baseline, except * = relative to ALT.</p

The active-passive movement protocol.

<p>Average left (active) and right (passive) FCR EMG traces from a single participant (1 s of data, average of 60 traces). For clarity EMG is shown from a mirror symmetric condition only. The marked difference in EMG activity can be seen between the active FCR (grey trace) and passive FCR (black trace) during the movement. A schematic of passive (black trace) and active wrist angle from mirror symmetric and alternating session of Exp 1 is shown.</p