Stroke

Stroke

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stoke-isig_brochurejan13_cover_sThe mission of the Stroke ISIG is to (1) promote opportunities for ACRM members to network with colleagues interested in promoting evidence-based rehabilitation for people with stroke and (2) serve as a vehicle for rehabilitation professionals of all disciplines to work together for the expressed mission of advancing the field of stroke rehabilitation.

The work of the Stroke ISIG is done through its task forces and the ACRM Annual Conference events. An executive committee provides leadership.

Participation in our four very active task forces is open to all members of the Stroke ISIG and new members are welcome. We invite all ACRM members and others thinking about joining the Stroke ISIG for the first time to contact any of the executive committee members or task force chairs to become part of a very exciting venture in ACRM. Our membership is growing – don’t be left behind!

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Executive Committee

Chair: Stephen Page, PhD, OTR/L FAHA, FACRM
Chair-Elect:  Pam Roberts, PhD, OTR/L, SCFES, FAOTA, CPHQ
Past Chair: Phil Morse, PhD, FACRM
Secretary: Kristen L. Mauk, PhD, DNP, RN, CRRN, GCNS-BC, GNP-BC, FAAN
Membership Officer (and Canadian Representative): Jocelyn Harris, PhD, OTR/L
Communications Officer: Sarah Wallace, PhD, CCC-SLP
Early Career Chair: Valerie Hill, PhD MS OTR/L
Member-at-Large: Richard Zorowitz, MD
Member-At-Large: Elaine L. Miller, PhD, RN, CRRN, FAAN, FAHA
International  Networking Liaison (Ex-Officio): Prathap Raghavan, MD
ACRM Staff Liaison: Terri Compos


Stroke-ISIG ONLY Membership Application

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Congratulations to Stroke Poster Award Winners

The Stroke-ISIG recognized the work of three poster presenters during the ACRM 2013 Annual Conference Business Meeting in Orlando. Congratulations to the following Stroke Outstanding Poster Award winners.

  • Alexandra Borstad, PhD
    1st Place Poster Award
  • Kristine Miller, PT, PhD
    2nd Place Poster Award
  • Grace Kim, MS, OTR/L
    3rd Place Poster Award

STROKE MATTERS

This semi-annual newsletter of the ACRM Stroke-ISIG, reports the news, updates, progress, and opportunities that spring from the group’s many task forces and dedicated members.

Read it now.


Task Forces

The work of the Stroke-ISIG is carried out by its various task forces:

  • Cognition
  • Living Life After Young Stroke
  • Movement Interventions
  • Vision

Collaboration among task force members is accomplished throughout the year with regular conference calls and two face-to-face meetings per year. These are held during the ACRM Mid-Year Meeting in the spring and the ACRM Annual Conference in the fall. All of the task forces have made impressive strides in the past two years in preparing and publishing papers. Read on to learn about the specific projects undertaken by each group.

COGNITION TASK FORCE

CHAIR:  Sarah Wallace, PhD, CCC-SLP

The Cognition Task Force is comprised of rehabilitation practitioners and researchers invested in promoting activity-based strategies for assessing and treating cognitive impairment after stroke. Anywhere from 1 in 2 to 1 in 3 individuals demonstrate cognitive impairment within the first 3 months after stroke, and these impairments are associated with significant long-term disability. The Cognition Task Force activities are focused on developing resources to: (1) address the impact of cognitive impairment on rehabilitation and recovery, (2) promote effective and contextually relevant rehabilitation strategies to address cognitive impairment after stroke.

The Task Force completed a review paper that is currently under review in the Archives of Physical Medicine and Rehabilitation. The purpose of the paper was to provide a framework for categorizing patterns of cognitive-motor interference (CMI). Additionally, the authors sought to highlight specific patterns of CMI reported in published studies comparing single-task and dual-task performance of cognitive and motor tasks during gait and balance activities after stroke. In 2012, the cognition task force developed two workgroups based on the findings from this review paper and discussion of limitations in these and related studies. To become involved contact chair Sarah Wallace, PhD, CCC-SLP.

Cognitive Motor Interference Work Group

CO-CHAIRS:
Prudence Plummer-D’Amato, PT, PhD 
Michael Fraas, PhD, CCC-SLP

This workgroup is currently developing a multi-site investigation that will examine CMI between cohorts of adults with left and right CVA. The methodology for this investigation includes the use of verbal and non-verbal cognitive tasks and a gait task that will be examined in both single and dual-task conditions. If anyone is interested in collaborating on this investigation please contact Dr. Plummer-D’Amato or Dr. Fraas for more information.


Assessment of Cognition in Aphasia Work Group

CO-CHAIRS:
Lisa Connor, PhD, MSOT
Sarah Wallace, PhD, CCC-SLP

This workgroup is made up of various rehabilitation professionals. We are beginning to develop a group of review papers detailing the available evidence for assessment of cognition in people with aphasia. We hope to make recommendations for future research and clinical practice based on our results. If anyone is interested in contributing to this project, please contact Dr. Connor or Dr. Wallace.

LIVING LIFE AFTER YOUNG STROKE TASK FORCE

CHAIR: Kathy Kniepman, OTD, MPH, OTR/L
CO-CHAIR: Tamara Bushnik, PhD, FACRM

There is a dramatic shifting in the demographic of people who experience stroke. While it is true that the majority is still near or in retirement at the time of the stroke, there is a growing percentage of individuals who experience stroke while they are in their work- and family-building stage of life. Whether this is due to the growing obesity problem in the United States or to other factors that have not been well identified, the Living Life After Young Stroke Task Force believes that this younger group of survivors of stroke face unique challenges and needs for rehabilitation and post-acute rehabilitation, education, and support.

The group is currently discussing goals and objectives for a future project. Please contact Kathy Kniepman or Tamara Bushnik if you are interested in participating.

MOVEMENT INTERVENTIONS TASK FORCE

CO-CHAIRS:
Marsha Neville Smith, PhD, OT
Pam Bosch, PT, DPT, PhD

The Movement Interventions Task Force is a dynamic group of neurorehabilitation researchers and clinicians representing a variety of disciplines from across the United States and Canada. A common interest among all members, and the theme of this task force, is movement after stroke.

Movement-related deficits are the most common impairments exhibited after stroke, and in many cases, the most disabling. Yet, there remain few therapies that effectively target stroke motor impairments. Moreover, the therapeutic ingredients that most impact motor changes after stroke, and the ways in which movement-related variables change after stroke (i.e. speed, precision, strength, pacing), each remain poorly understood. We are a product-oriented group focusing on developing new knowledge about movement after stroke through development of presentations, papers, and other educational materials for patients, care partners, and professionals.

RECENT PRODUCTS

  • A recent publication suggesting appropriate operational definitions for intensity, duration, and frequency of stroke rehabilitation (Arch Phys Med Rehabil, 2012;93:1395-9).
  • Another manuscript is being drafted to provide clinicians with current evidence and guidelines for use of neuroprosthetic walking devices.
  • The group is preparing a conference symposium for the 2013 ACRM Annual Conference that will emphasize the importance of using standardized clinical assessments and assist clinicians in putting such tools to use in their settings.
  • Other planned products include fact sheets on post-stroke complementary and alternative medicine and secondary stroke prevention.

Through the creation of these products, our goals are to improve stroke clinical practice, increase (and in some cases, establish) evidence related to motor impairment reduction after stroke, and influence public policy. For more information about the Movement Interventions Task Force contact Arlene Schmid orPamela Bosch.


VISION TASK FORCE

CO-CHAIRS:

JR Rizzo, MD
Kimberly Hreha, MS OTR/L OT, edD(c)

The visual system is one of our most important senses. It enables us to gather and process information and determines how we will interact with our dynamic environment. Neurological diseases or insults can leave patients with some degree of visual, perceptual, and/or cognitive dysfunction. A neglected component in therapies to improve function is a clear understanding of eye-hand coordination even though harmonization between eye and hand movement is required for all functional activities.

The mission of this task force is to understand how vision, visual motor, and visual perceptual training can be generalized to limb training to improve coordination and functional performance and develop the field of functional vision rehabilitation. Further, our task force will investigate the role of eye movements in eye-hand coordination and in the recovery of motor control in patients with stroke. We hope to stimulate research that will build a logical foundation to integrate the principles of eye-hand coordination into clinical practice to improve functional ability.

The Vision Task Force is a group comprised of clinicians and researchers who are dedicated to elucidating these serious concerns. Aside from the development of functional vision rehabilitation for ocular ailments, our secondary goals involve promulgating information regarding the importance of visual deficits and the clinical situations where they may be prevalent, in addition to advocating for public policy to take a stronger stance on assisting those with vision impediments and allocating healthcare resources appropriately.

PROJECTS

One of the first projects that the Vision Task Force has focused on is developing a conceptual framework for vision. Colenbrander (2009) distinguishes between visual function and functional vision. The task force has taken these two concepts and built a conceptual framework for vision-centric healthcare. As our field progresses within the domains of ophthalmology, optometry, rehabilitation medicine, neurology, and neurosurgery, it behooves us to combine this burgeoning field of evidence-based medicine into reliable and valid diagnostic and treatment algorithms that can be utilized across clinical specialties.


GOALS OF THE STROKE-ISIG

  • Development of products within the task forces
  • Grow the Stroke-ISIG in number, depth and breadth, including links to other professional groups interested in stroke rehabilitation

DEVELOPING STROKE-RELATED PROGRAM CONTENT

A major focus of the Stroke ISIG is to promote more stroke-related content in the ACRM annual conference program. The 2012 Vancouver conference was a tremendous success in this area. We began the meeting with two great half-day pre-conference instructional courses, Innovations in Stroke Rehabilitation – Part 1 (Catherine Lang, Arlene Schmid, Robert Teasell, Lara Boyd) and Part 2 (Sarah Wallace, Deirdre Dawson, Pamela Roberts, Richard Riggs JR Rizzo).

We also sponsored the inaugural Stroke Special Topics Session titled, “Translating Research into Clinical Practice,” featuring Janice Eng and colleagues discussing their GRASP program. This symposium is now an annual event dedicated to the presentation and discussion of integrated efforts to implementing research findings in real-world clinical practice.

An extra bonus for the Stroke ISIG  during the Vancouver conference was the Deborah L. Wilkerson Early Career Award Winner presentation by Elizabeth Skidmore (“Closing the Gap: Early Intervention for Cognitive Disability after Stroke”).

To learn more about membership and activities of the Stroke-ISIG, contact the chair, Phil Morse, PhD, FACRM.


STROKE-ISIG RESOURCES

  • The Member Guide to Product Development describes ACRM products, e.g., fact sheets, journal articles, manuals, and the procedure used by ACRM groups and committees to develop them. Includes a Product Development Worksheet and how to request a Product Review.

HOW DO I JOIN OTHER ACRM GROUPS?

ACRM membership includes affiliation with any ACRM community forum. Members may participate in any group, including Brain Injury, Spinal Cord Injury, and Stroke Interdisciplinary Special Interest Groups; Early Career, Healthcare Policy, International, and Outcomes Measurement Networking Groups; as well as groups now forming for Geriatric Rehabilitation, Pain, Neurodegenerative Diseases, and Pediatric Rehabilitation. Nonmembers are welcome and encouraged to participate in any networking or  forming group. Please contact Terri Compos, ACRM Community Relations Manager, for details.