CMIV Publications

Background Stroke now represents the condition with the highest need for physical rehabilitation worldwide, with only low or moderate-level evidence testing telerehabilitation compared to in-person care. We compared functional ambulation in subacute patients with stroke following telerehabilitation and matched in-person controls with no biopsychosocial differences at baseline.Methods We conducted a matched case-control study to compare functional ambulation between individuals with stroke following telerehabilitation and in-person rehabilitation, assessed using the Functional Ambulation Categories (FAC) and the Functional Independence Measure (TM) (FIM).Results The telerehabilitation group (n = 38) achieved significantly higher FAC gains (1.5 (1.3) vs 1.0 (1.0)) than the in-person rehabilitation group, with no differences in ambulation efficiency, in individuals: admitted to rehabilitation within 60 days after stroke onset; aged 49.8 (+/- 11.4) years at admission; 55.3% female sex; moderate stroke severity; 42.1% with 'good' motor FIM at baseline; mostly living with sentimental partner (73.7%); with 21.1% holding an university education degree.Conclusions The groups showed no significant differences in ambulation efficiency, though the telerehabilitation group achieved higher FAC gains. Our results suggest that home telerehabilitation can be considered a good alternative to in-person rehabilitation when addressing ambulation in patients with moderate stroke severity and whose home situation mostly includes a cohabiting partner.

Introduction: Little is known about the day-to-day variability of different skin microcirculation parameters, and how this variability is influenced by age and sex. The aim was to examine the day-to-day variability of microcirculatory parameters in relation to age and sex. Methods: The cutaneous microcirculation was measured using a fiber optic probe integrating laser Doppler flowmetry (LDF) and diffuse reflectance spectroscopy (DRS) to measure oxygen saturation, red blood cell (RBC) tissue fraction, speed-resolved and conventional perfusion. Measurements at two separate days were compared during baseline, a 5-min occlusion and during the following post-occlusive reactive hyperemia (PORH) period on the volar forearm and dorsal foot in totally 48 men and women aged 20-30 and 50-60 years, respectively. Variability was expressed as the coefficient of variation CV and repeatability as the intraclass correlation coefficient ICC. Results: Peak oxygen saturation during PORH had the lowest day-to-day variability for the forearm (CV = 2.1 %) and the foot (CV = 3.8 %) as well as an excellent repeatability (ICC = 0.80 and ICC = 0.82, respectively). Older women had a higher day-to-day variability in baseline conventional perfusion compared to younger women on the forearm (p = 0.007). On the foot, older women had a lower day-to-day variability than younger women for baseline oxygen saturation (p = 0.006) and peak RBC tissue concentration (p = 0.008). Older men had a lower day-to-day variability than younger men for baseline oxygen saturation (p = 0.012) but a higher variability for baseline and peak RBC tissue concentration (p = 0.008 and p = 0.002) on the foot. Conclusion: Peak oxygen saturation had the lowest day-to-day variability of the measured parameters. A lower value of peak oxygen saturation has previously been associated with increasing systematic coronary risk implying that this is a suitable parameter for measuring microcirculatory dysfunction. Sex and age only affected the day-to-day variability of very few parameters.