ORCID Profile
0000-0002-0291-4610
Current Organisations
CHU Tengandogo
,
Université Joseph Ki-Zerbo
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Publications
The influence of communal spaces on patient activity in rehabilitation: a mixed methods study
Publisher: Informa UK Limited
Date: 2023
Accelerometer and Global Positioning System Measurement of Recovery of Community Ambulation Across the First 6 Months After Stroke: An Exploratory Prospective Study
Publisher: Elsevier BV
Date: 09-2016
DOI: 10.1016/J.APMR.2016.04.013
Abstract: To characterize community ambulation and determine if it changes across the first 6 months after discharge from hospital after stroke. Prospective, observational study. Community setting. Subacute stroke survivors with no cognitive impairment or conditions limiting mobility prior to stroke (N=34). Not applicable. Community ambulation was measured by an accelerometer, Global Positioning System, and activity diary. Measures included the following: volume (step count time spent in the community, lying/sitting, standing, and walking), frequency (number of community trips number of and time in short-, medium-, long-duration bouts), intensity (number of and time at low-, moderate-, high-intensity bouts), and trip type at 1, 3, and 6 months after hospital discharge. At 1 month participants took on average 1 trip per day in the community, lasting 137±113 minutes. Overall, most community ambulation was spread across long-duration bouts (>300 steps) lasting 11.3 to 14.1min/d and moderate-intensity bouts (30-80 steps per minute). There was no change in community ambulation trip type (P<.302) or ambulation characteristics over time except for a greater number of and time spent in long ambulation bouts at 6 months only (P<.027). Total volume and intensity of community ambulation did not change over the first 6 months postdischarge after stroke. However, at 6 months, survivors spent more time in long-duration ambulation bouts. Review of stroke survivors at 6 months after hospital discharge is suggested because this is when changes in community ambulation may first be observed.
Which impairments, activity limitations and personal factors at hospital discharge predict walking activity across the first 6 months poststroke?
Publisher: Informa UK Limited
Date: 06-02-2019
People with mild Parkinson's disease have impaired force production in upper limb muscles: A cross‐sectional study
Publisher: Wiley
Date: 20-10-2022
DOI: 10.1002/PRI.1976
Abstract: There has been little examination of force production of the upper limb in people with Parkinson's disease (PD), despite its impact on activities of daily living and clear evidence that force production is significantly reduced in lower limb muscle groups. The aim of this study was to determine the force production of the major muscle groups of the upper limb in people with PD during the “on” phase after medication, compared with aged‐matched neurologically‐normal controls. A cross‐sectional study was carried out. Thirty people with mild PD (Hoehn Yahr mean 1.1) and 24 age‐matched neurologically‐normal controls. Maximum isometric force production of the shoulder flexors, extensors, abductors, adductors, internal rotators and external rotators, elbow flexors and extensors, wrist flexors and extensors and hand grip using dynamometry. There was a significant impairment in force production in all upper limb muscle groups, compared with control participants, except in the wrist flexors. On average the deficit in force production was 22%, despite people with PD having mild disease, being physically active and being measured during the “on” phase of medication. The most severely affected muscle groups were the upper limb extensors. People with PD have a significant deficit in force production of the upper limb muscle groups compared with age‐matched neurologically normal controls. Regular assessment of strength of the upper limb should be considered by clinicians and strengthening interventions could be implemented if a deficit is identified.
Are Accelerometers and GPS Devices Valid, Reliable and Feasible Tools for Measurement of Community Ambulation After Stroke?
Publisher: Cambridge University Press (CUP)
Date: 08-06-2016
Abstract: Purpose: To determine validity, reliability and feasibility of accelerometers (ActivPAL ™ , Sensewear Pro 2 Armband) and portable global positioning systems (GPS) (Garmin Forerunner 405CX) for community ambulation measurement after stroke. Methods: Fifteen community-dwelling stroke survivors attended two sessions completing a 6-minute walk, treadmill walking, and 200-m outdoor circuit. Feasibility was determined by wearing devices over four days. Measures collected included step count, time spent walking, distance, energy expenditure and location. Intra-class correlation coefficients (ICC), Bland–Altman plots and absolute percentage of error (APE) were used to determine validity and reliability. Results: ActivPAL ™ had excellent validity and reliability for most measures (ICC: 0.821–0.999, APE: 0%–11.1%), except for good-excellent findings at speeds 0.42 m/s (ICC: 0.659–0.894, APE: 1.6%–11.1%). Sensewear had missing values for 23% of recordings and high error for all measures. GPS demonstrated excellent validity and reliability for time spent walking and step count (ICC: 0.805–0.999, APE: 0.9%–10%), and 100% accuracy for location. However, it was not valid or reliable for distance (ICC = −0.139, APE = 23.8%). All devices appeared feasible for community ambulation measurement with assistance for setup and data analysis. Conclusions: ActivPAL ™ and Garmin GPS appear valid, reliable and feasible tools for community ambulation measurement after stroke, except for distance. Sensewear demonstrated poor validity and reliability when worn on the paretic arm.
Recovery of ambulation activity across the first six months post-stroke
Publisher: Elsevier BV
Date: 09-2016
DOI: 10.1016/J.GAITPOST.2016.06.038
Abstract: Stroke survivors commonly adopt sedentary activity behaviours by the chronic phase of recovery. However, the change in activity behaviours from the subacute to chronic phase of stroke is variable. This study explored the recovery of ambulation activity (volume and bouts) at one, three and six months after hospital discharge post-stroke. A total of 42 stroke survivors were recruited at hospital discharge and followed up one, three and six months later. At follow-up, ambulation activity was measured over four days using the ActivPAL™ accelerometer. Measures included volume of activity and frequency and intensity of ambulation activity bouts per day. Linear mixed effects modelling was used to determine changes over time. There was wide variation in activity. Total step counts across all time points were below required levels for health benefits (mean 4592 SD 3411). Most activity was spread across short bouts. While most number of bouts was of low intensity, most time was spent in moderate intensity ambulation across all time points. Daily step count and time spent walking and sitting/lying increased from one month to three and six months. The number of and time spent in short and medium duration bouts increased from one to six months. Time in long duration bouts increased at three months only. Time spent in moderate intensity ambulation increased over time. No change was observed for any other measures. In future, it would be valuable to identify strategies to increase engagement in activity behaviours to improve health outcomes after stroke.
An exploration of sedentary behavior patterns in community dwelling people with stroke
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 14-03-2021
DOI: 10.1097/NPT.0000000000000357
Abstract: Long periods of daily sedentary time, particularly accumulated in long uninterrupted bouts, are a risk factor for cardiovascular disease. People with stroke are at high risk of recurrent events and prolonged sedentary time may increase this risk. We aimed to explore how people with stroke distribute their periods of sedentary behavior, which factors influence this distribution, and whether sedentary behavior clusters can be distinguished? This was a secondary analysis of original accelerometry data from adults with stroke living in the community. We conducted data-driven clustering analyses to identify unique accumulation patterns of sedentary time across participants, followed by multinomial logistical regression to determine the association between the clusters, and the total amount of sedentary time, age, gender, body mass index (BMI), walking speed, and wake time. Participants in the highest quartile of total sedentary time accumulated a significantly higher proportion of their sedentary time in prolonged bouts ( P 0.001). Six unique accumulation patterns were identified, all of which were characterized by high sedentary time. Total sedentary time, age, gender, BMI, and walking speed were significantly associated with the probability of a person being in a specific accumulation pattern cluster, P 0.001 – P = 0.002. Although unique accumulation patterns were identified, there is not just one accumulation pattern for high sedentary time. This suggests that interventions to reduce sedentary time must be in idually tailored. Video Abstract available for more insight from the authors (see the Video Supplemental Digital Content 1, available at: links.lww.com/JNPT/A343).
EPICE an emotion fuzzy vectorial space for time modeling in medical decision
Publisher: ACM
Date: 17-10-2017
Activity monitors for increasing physical activity in adult stroke survivors
Publisher: Wiley
Date: 09-02-2017
Perspectives of Stroke and Cardiac Clinicians on Cardiac Rehabilitation Post-TIA or Mild Stroke
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2022
How should we measure physical activity after stroke? An international consensus
Publisher: SAGE Publications
Date: 24-06-2023
DOI: 10.1177/17474930231184108
Abstract: Physical activity is important for secondary stroke prevention. Currently, there is inconsistency of outcomes and tools used to measure physical activity following stroke. To establish internationally agreed recommendations to enable consistent measurement of post-stroke physical activity. Stroke survivors and carers were surveyed online once regarding what is important in physical activity measurement. Three survey rounds with expert stroke researchers and clinicians were conducted using Keeney’s Value-Focused Thinking Methodology. Survey 1 identified physical activity tools, outcomes, and measurement considerations which were ranked in Survey 2. Consensus recommendations on tools were then formulated by the consensus group based on survey responses. In Survey 3, participants reviewed ranked results and evidence gathered to determine their support for consensus recommendations. Twenty-five stroke survivors, 5 carers, 18 researchers, and 17 clinicians from 16 countries participated. Time in moderate-vigorous physical activity and step count were identified as the most important outcomes to measure. Key measurement considerations included the ability to measure across frequency, intensity, duration domains in real-world settings user-friendliness, comfort, and ability to detect changes. Consensus recommendations included using the Actigraph, Actical, and Activ8 devices for physical activity intensity ActivPAL for duration and Step Activity Monitor for frequency and the IPAQ and PASE questionnaires. Survey 3 indicated 100% support for device and 96% for questionnaire recommendations. These consensus recommendations can guide selection of physical activity measurement tools and outcomes. Tool selection will depend on measurement purpose, user-knowledge, and resources. Comprehensive measurement requires the use of devices and questionnaires.
Prediction of independent walking in people who are nonambulatory early after stroke
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2021
DOI: 10.1161/STROKEAHA.120.032345
Abstract: One systematic review has examined factors that predict walking outcome at one month in initially nonambulatory patients after stroke. The purpose of this systematic review was to examine, in nonambulatory people within a month of stroke, which factors predict independent walking at 3, 6, and 12 months. Prognostic factors: Any factors measured within one month after stroke with the aim of predicting independent walking. Outcome of interest: Independent walking defined as walking with or without an aid but with no human assistance. Fifteen studies comprising 2344 nonambulatory participants after stroke were included. Risk of bias was low in 7 studies and moderate in 8 studies. In idual meta-analyses of 2 to 4 studies were performed to calculate the pooled estimate of the odds ratio for 12 prognostic factors. Younger age (odds ratio [OR], 3.4, P .001), an intact corticospinal tract (OR, 8.3, P .001), good leg strength (OR, 5.0, P .001), no cognitive impairment (OR, 3.5, P .001), no neglect (OR, 2.4, P =0.006), continence (OR, 2.3, P .001), good sitting (OR, 7.9, P .001), and independence in activities of daily living (OR 10.5, P .001) predicted independent walking at 3 months. Younger age (OR, 2.1, P .001), continence (OR, 13.8, P .001), and good sitting (OR, 19.1, P .001) predicted independent walking at 6 months. There were insufficient data at 12 months. Younger age, an intact corticospinal tract, good leg strength, continence, no cognitive impairment, no neglect, good sitting, and independence in activities of daily living in patients who are nonambulatory early after stroke predict independent walking at 3 months. URL: www.crd.york.ac.uk rospero/ Unique identifier: CRD42018108794.
Identifying factors associated with sedentary time after stroke. Secondary analysis of pooled data from nine primary studies.
Publisher: Informa UK Limited
Date: 18-02-2019
Activity Monitors for Increasing Physical Activity in Adult Stroke Survivors
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2019
Perspectives of health professionals on physical activity and sedentary behaviour in hospitalised adults: A systematic review and thematic synthesis
Publisher: SAGE Publications
Date: 17-04-2023
DOI: 10.1177/02692155231170451
Abstract: To explore health professionals’ perspectives on physical activity and sedentary behaviour of hospitalised adults to understand factors that contribute to these behaviours in this environment. Five databases (PubMed, MEDLINE, Embase, PsycINFO and CINAHL) were searched in March 2023. Thematic synthesis. Included studies explored perspectives of health professionals on the physical activity and/or sedentary behaviour of hospitalised adults using qualitative methods. Study eligibility was assessed independently by two reviewers and results thematically analysed. Quality was assessed using the McMaster Critical Review Form and confidence in findings assessed using GRADE-CERQual. Findings from 40 studies explored perspectives of over 1408 health professionals from 12 health disciplines. The central theme identified was that physical activity is not a priority in this setting due to the complex interplay of multilevel influences present in the interdisciplinary inpatient landscape. Subthemes, the hospital is a place for rest, there are not enough resources to make movement a priority, everyone's job is no one's job and policy and leadership drives priorities, supported the central theme. Quality of included studies was variable critical appraisal scores ranged from 36% to 95% on a modified scoring system. Confidence in findings was moderate to high. Physical activity in the inpatient setting is not a priority, even in rehabilitation units where optimising function is the key. A shift in focus towards functional recovery and returning home may promote a positive movement culture that is supported by appropriate resources, leadership, policy, and the interdisciplinary team.
Activity monitors for increasing physical activity in adult stroke survivors
Publisher: Wiley
Date: 27-07-2018
Cardiac Rehabilitation: Are People With Stroke or Transient Ischaemic Attack Being Included? A Cross-Sectional Survey
Publisher: Elsevier BV
Date: 03-2020
DOI: 10.1016/J.HLC.2019.03.018
Abstract: Cardiac rehabilitation (CR) may be an effective secondary prevention program for people with stroke or transient ischaemic attack (TIA). The aims of this study were to determine whether people with stroke or TIA were attending CR in Australia and if there were any barriers to attendance. An invitation to participate in an online survey was distributed between January and April 2018, via email, to 411 phase 2 CR coordinators located across Australia. These coordinators were identified through a publicly available directory. The survey contained questions on the demographics of CR programs and attendance of people with stroke or TIA. A Likert scale was used to investigate perceived barriers to CR for people with stroke or TIA. Descriptive statistics were completed for all survey responses except those from open text questions, which were analysed via an inductive qualitative approach. In total, 149 CR coordinators responded who managed a total of 154 programs. The programs were primarily located in regional (40%) or metropolitan (31%) areas. Nearly 50% of programs were based in a public hospital-based gym/outpatient centre. Over 90% (n = 97/104) of coordinators reported that people with a primary diagnosis of stroke or TIA accounted for less than 2% of their patient population. Despite this, 52% of coordinators thought CR was an appropriate form of secondary prevention for people with stroke or TIA. The largest perceived barriers to attendance were safety (79%, n = 80/101), limited staff to patient ratio (76%, n = 77/101), integration difficulties (68%. n = 69/101) and a lack of referrals (66%, n = 67/101). Few people with a primary diagnosis of stroke or TIA attend CR in Australia, despite over half of CR coordinators believing that CR is appropriate for this group. Cardiac rehabilitation may be particularly suitable for people with mild-stroke or TIA. However, further research is required.
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No related grants have been discovered for Niruthikha Mahendran.