| 1. |
- Luker, Julie, et al.
(author)
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Stroke Survivors Experiences of Physical Rehabilitation: A Systematic Review of Qualitative Studies
- 2015
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In: Archives of Physical Medicine and Rehabilitation. - : W B SAUNDERS CO-ELSEVIER INC. - 0003-9993 .- 1532-821X. ; 96:9, s. 1698-1708
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Research review (peer-reviewed)abstract
- Objective: To report and synthesize the perspectives, experiences, and preferences of stroke survivors undertaking inpatient physical rehabilitation through a systematic review of qualitative studies. Data Sources: MEDLINE, CINAHL, Embase, and PsycINFO were searched from database inception to February 2014. Reference lists of relevant publications were searched. All languages were included. Study Selection: Qualitative studies reporting stroke survivors experiences of inpatient stroke rehabilitation were selected independently by 2 reviewers. The search yielded 3039 records; 95 full-text publications were assessed for eligibility, and 32 documents (31 studies) were finally included. Comprehensiveness and explicit reporting were assessed independently by 2 reviewers using the consolidated criteria for reporting qualitative research framework. Discrepancies were resolved by consensus. Data Extraction: Data regarding characteristics of the included studies were extracted by 1 reviewer, tabled, and checked for accuracy by another reviewer. All text reported in studies results sections were entered into qualitative data management software for analysis. Data Synthesis: Extracted texts were inductively coded and analyzed in 3 phases using thematic synthesis. Nine interrelated analytical themes, with descriptive subthemes, were identified that related to issues of importance to stroke survivors: (1) physical activity is valued; (2) bored and alone; (3) patient-centered therapy; (4) recreation is also rehabilitation; (5) dependency and lack of control; (6) fostering autonomy; (7) power of communication and information; (8) motivation needs nurturing; and (9) fatigue can overwhelm. Conclusions: The thematic synthesis provides new insights into stroke survivors experiences of inpatient rehabilitation. Negative experiences were reported in all studies and include disempowerment, boredom, and frustration. Rehabilitation could be improved by increasing activity within formal therapy and in free time, fostering patients autonomy through genuinely patient-centered care, and more effective communication and information. Future stroke rehabilitation research should take into account the experiences and preferences of stroke survivors. (C) 2015 by the American Congress of Rehabilitation Medicine
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| 2. |
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- 2019
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Journal article (peer-reviewed)
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| 3. |
- Ali, M, et al.
(author)
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More outcomes than trials: a call for consistent data collection across stroke rehabilitation trials.
- 2013
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In: International journal of stroke : official journal of the International Stroke Society. - : SAGE Publications. - 1747-4949. ; 8:1, s. 18-24
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Research review (peer-reviewed)abstract
- Stroke survivors experience complex combinations of impairments, activity limitations, and participation restrictions. The essential components of stroke rehabilitation remain elusive. Determining efficacy in randomized controlled trials (RCTs) is challenging; there is no commonly agreed primary outcome measure for rehabilitation trials. Clinical guidelines depend on proof of efficacy in RCTs and meta-analyses. However, diverse trial aims, differing methods, inconsistent data collection, and use of multiple assessment tools hinder comparability across trials. Consistent data collection in acute stroke trials has facilitated meta-analyses to inform trial design and clinical practice. With few exceptions, inconsistent data collection has hindered similar progress in stroke rehabilitation research. There is an urgent need for the routine collection of a core dataset of common variables in rehabilitation trials. The European Stroke Organisation Outcomes Working Group, the National Institutes of Neurological Disorders and Stroke Common Data Elements project, and the Collaborative Stroke Audit and Research project have called for consistency in data collection in stroke trials. Standardizing data collection can decrease study start up times, facilitate data sharing, and inform clinical guidelines. Although achieving consensus on which outcome measures to use in stroke rehabilitation trials is a considerable task, perhaps a feasible starting point is to achieve consistency in the collection of data on demography, stroke severity, and stroke onset to inclusion times. Longer term goals could include the development of a consensus process to establish the core dataset. This should be endorsed by researchers, funders, and journal editors in order to facilitate sustainable change.
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| 4. |
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| 5. |
- Bernhardt, Julie, et al.
(author)
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Why hospital design matters : A narrative review of built environments research relevant to stroke care
- 2022
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In: International Journal of Stroke. - : SAGE Publications. - 1747-4930 .- 1747-4949. ; 17:4
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Journal article (peer-reviewed)abstract
- Healthcare facilities are among the most expensive buildings to construct, maintain, and operate. How building design can best support healthcare services, staff, and patients is important to consider. In this narrative review we outline why the healthcare environment matters and describe areas of research focus and current built environment evidence that supports health care in general and stroke care in particular. Ward configuration, corridor design, and staff station placements can all impact care provision, staff and patient behaviour. Contrary to many new ward design approaches, single bed rooms are neither uniformly favoured, nor strongly evidence-based, for people with stroke. Green spaces are important both for staff (helping to reduce stress and errors), patients and relatives, although access to, and awareness of, these and other communal spaces is often poor. Built environment research specific to stroke is limited but increasing and we highlight emerging collaborative multi-stakeholder partnerships (Living Labs) contributing to this evidence base. We believe that involving engaged and informed clinicians in design and research will help shape better hospitals of the future.
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| 6. |
- Cumming, Toby B, et al.
(author)
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Hemispatial neglect and rehabilitation in acute stroke.
- 2009
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In: Archives of physical medicine and rehabilitation. - : Elsevier BV. - 1532-821X .- 0003-9993. ; 90:11, s. 1931-6
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To compare 2 methods for determining neglect in patients within 2 days of stroke, and to investigate whether early neglect was related to rehabilitation practice, and whether this relationship was affected by an early, intensive mobilization intervention. DESIGN: Data were collected from patients participating in a phase II randomized controlled trial of early rehabilitation after stroke. SETTING: Acute hospital stroke unit. PARTICIPANTS: Stroke patients (N=71). INTERVENTION: The 2 arms of the trial were very early mobilization (VEM) and standard care (SC). MAIN OUTCOME MEASURES: Neglect was assessed using the Star Cancellation Test and the National Institutes of Health Stroke Scale (NIHSS) inattention item within 48 hours of stroke onset, and therapy details were recorded during the hospital stay. RESULTS: Assessing neglect so acutely after stroke was difficult: 29 of the 71 patients were unable to complete the Star Cancellation Test, and agreement between this test and the NIHSS measure was only .42. Presence of neglect did not preclude early mobilization. SC group patients with neglect had longer hospital stays (median, 11d) than those without neglect (median, 4d); there was no difference in length of stay between patients with and without neglect in the VEM group (median, 6d in both). CONCLUSION: Early mobilization of patients with neglect was feasible and may contribute to a shorter acute hospital stay.
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| 7. |
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| 8. |
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| 9. |
- Elf, Marie, 1962-, et al.
(author)
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A Systematic Review of Research Gaps in the Built Environment of Inpatient Healthcare Settings
- 2024
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In: Health Environments Research & Design Journal. - 1937-5867 .- 2167-5112.
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Research review (peer-reviewed)abstract
- OBJECTIVE: This study utilized the evidence-gap map method and critically examined the scope, methodologies, and focus of the studies that investigated the influence of the built environment on inpatient healthcare settings over a decade (2010-2021).METHODS: We conducted a systematic review per the preferred reporting items for systematic reviews and meta-analyses guidelines and surveyed 406 articles, primarily from North America and Europe.RESULTS: Our findings revealed a dominant focus on architectural features (73%), such as room design and ward layout. Comparatively, there was less emphasis on interior-, ambient-, social-, and nature-related features. Most previous studies explored multiple environmental features, which indicated the intricacy of this field. Research outcomes were diverse, with person-centered care (PCC) being the most frequently investigated, followed by safe care, emotional well-being, activity, and behavior. Furthermore, research methods varied considerably based on the study's outcomes and features. Clinical outcomes and safe care favored quantitative methods, activity and behavior favored mixed methods, and PCC favored qualitative research.CONCLUSION: This review provides an in-depth overview of the existing studies on healthcare design research and sheds light on the current trends and methodological choices. The insights garnered can guide future research, policy-making, and the development of healthcare facilities.
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| 10. |
- Ha, Jason, 1985, et al.
(author)
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Bed rest or mobilization after rt-PA? A case-crossover study of factors influencing clinical decision making in stroke services
- 2013
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In: International journal of stroke. - : SAGE Publications. - 1747-4949 .- 1747-4930. ; 8:3, s. 172-179
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Journal article (peer-reviewed)abstract
- Background Acute stroke management is a dynamic field. Treatment with recombinant tissue plasminogen activator is standard care in Australia, but there are no evidence-based practice guidelines about first out of bed activity (mobilization) after recombinant tissue plasminogen activator. Aims To identify factors influencing clinicians' decisions to delay or allow mobilization. Methods Case-crossover design. Using hypothetical case vignettes, we explored the factors that clinicians consider when deciding to first mobilize a patient after recombinant tissue plasminogen activator. Acute stroke physicians and nurses from Australian hospitals known to treat with recombinant tissue plasminogen activator participated. Information about hospital recombinant tissue plasminogen activator protocols and perceived benefits and harms of mobilization after recombinant tissue plasminogen activator were also captured. Results Fifty-four clinicians, 52% senior nurses, and 48% senior physicians from all states of Australia participated. Of the factors influencing decisions about mobilization after recombinant tissue plasminogen activator, neurological decline (0·29; confidence interval 0·12, 0·46; P=0·001), neurological decline with symptomatic intracerebral hemorrhage (0·41; confidence interval 0·24, 0·59; P<0·0001), infection of uncertain cause (0·32; confidence interval 0·14, 0·50; P=0·0010), severe chest infection (0·35; confidence interval 0·16, 0·53; P=0·0004), severe stroke (0·29; confidence interval 0·12, 0·46; P=0·0010), drowsiness (0·47; confidence interval 0·29, 0·63; P<0·0001), and confusion (0·31; confidence interval 0·15, 0·47; P=0·0001) significantly influenced decisions. Falls risk was a common concern (85%). Conclusion Growing interest in development of clear protocols that guide first mobilization after recombinant tissue plasminogen activator prompted this study. We have identified factors that may influence decisions about when to allow patients to mobilize after recombinant tissue plasminogen activator. These, combined with emerging evidence of risks and benefits of early mobilization, should help protocol development in the future.
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| 11. |
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| 12. |
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| 13. |
- Kattge, Jens, et al.
(author)
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TRY plant trait database - enhanced coverage and open access
- 2020
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In: Global Change Biology. - : Wiley-Blackwell. - 1354-1013 .- 1365-2486. ; 26:1, s. 119-188
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Journal article (peer-reviewed)abstract
- Plant traits-the morphological, anatomical, physiological, biochemical and phenological characteristics of plants-determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait-based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits-almost complete coverage for 'plant growth form'. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait-environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives.
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| 14. |
- Kylén, Maya, et al.
(author)
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Built Environments to Support Rehabilitation for People With Stroke From the Hospital to the Home (B-Sure) : Protocol for a Mixed Method Participatory Co-Design Study
- 2023
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In: JMIR Research Protocols. - 1929-0748. ; 12
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Journal article (peer-reviewed)abstract
- BACKGROUND: A global trend is to move rehabilitation closer to people's neighborhoods and homes. Still, little attention has been given to how the built environment outside the hospital setting might impact rehabilitation and recovery for stroke survivors.OBJECTIVE: The overarching objective of this project is to develop conceptual models of built environments that support stroke rehabilitation and recovery outside the hospital setting. Specifically, the project will explore factors and characteristics of the built environment that support people with stroke and their families and identify innovative built environments that can be designed for local health care. The project will examine facilitators and obstacles for implementing built environmental solutions and evaluate the potential benefits, feasibility, and acceptability.METHODS: The project uses a mixed methods design approach with 3 phases. In phase 1, factors and characteristics of the built environment for rehabilitation will be identified. Based on the results from phase 1, phase 2 will involve co-designing prototypes of environments to support the rehabilitation process for people with stroke. Finally, the prototypes will be evaluated in phase 3. Qualitative and quantitative methods will include a literature review, a concept mapping (CM) study, stakeholder interviews, prototype development, and testing. The project will use multidimensional scaling, hierarchical cluster analysis, descriptive statistics for quantitative data, and content analysis for qualitative data. Location analysis will rely on the location-allocation model for network problems, and the rule-based analysis will be based on geographic information systems data.RESULTS: As of the submission of this protocol, ethical approval for the CM study and the interview study has been obtained. Data collection is planned to start in September 2023 and the workshops later in the same year. The scoping review is ongoing from January 2023. The CM study is ongoing and will be finalized in the spring of 2024. We expect to finish the data analysis in the second half of 2024. The project is a 3-year project and will continue until December 2025.CONCLUSIONS: We aim to determine how new environments could better support a person's control over their day, environment, goals, and ultimately control over their recovery and rehabilitation activities. This "taking charge" approach would have the greatest chance of transferring the care closer to the patient's home. By co-designing with multiple stakeholders, we aim to create solutions with the potential for rapid implementation. The project's outcomes may target other people with frail health after a hospital stay or older persons in Sweden and anywhere else. The impact and social benefits include collaboration between important stakeholders to explore how new environments can support the transition to local health care, co-design, and test of new conceptual models of environments that can promote health and well-being for people post stroke.INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/52489.
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| 15. |
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| 16. |
- Salinas, Joel, et al.
(author)
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An International Standard Set of Patient-Centered Outcome Measures After Stroke.
- 2016
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In: Stroke: a journal of cerebral circulation. - 1524-4628. ; 47:1, s. 180-186
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Journal article (peer-reviewed)abstract
- Value-based health care aims to bring together patients and health systems to maximize the ratio of quality over cost. To enable assessment of healthcare value in stroke management, an international standard set of patient-centered stroke outcome measures was defined for use in a variety of healthcare settings.
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| 17. |
- Shannon, Michelle, et al.
(author)
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Bringing the single versus multi-patient room debate to vulnerable patient populations : a systematic review of the impact of room types on hospitalized older people and people with neurological disorders
- 2020
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In: Intelligent Buildings International. - : Informa UK Limited. - 1750-8975 .- 1756-6932. ; 12:3, s. 180-198
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Journal article (peer-reviewed)abstract
- Single-patient rooms are commonly recommended in acute hospital environments. People with neurological disorders, and those who are older, have complex clinical presentations requiring support and recovery for physical, cognitive, and social consequences of their brain injury, and/or chronic health problems. It is currently unknown what type of patient room, or what physical characteristics in such rooms, might be most desirable for the recovery of such people. We explored how hospital single-patient rooms are similar to or different from multi-bed rooms, and how the impact of room type has been measured in this group of people. A systematic mixed studies review was conducted to interrogate these questions. We identified 182 studies (mostly quantitative in design), 19 of which proceeded to formal data extraction. The findings show lack of clarity of salient physical characteristics in either room type for our review population. Importantly, apart from some signal of infection control benefits, our findings do not show evidence to support the use of single-patient rooms with older people and people with neurological disorders for other important outcomes. More investigation of the under-recognized potential of the patient room environment for shaping patient physical, cognitive, and social well-being in specific hospitalized populations is required.
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| 18. |
- Shannon, Michelle M, et al.
(author)
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Re-Imagining Hospital Patient Room Design for People After stroke : A Randomized Controlled Study Using Virtual Reality
- 2024
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In: Stroke. - 0039-2499 .- 1524-4628. ; 55:7, s. 1895-1903
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Journal article (peer-reviewed)abstract
- BACKGROUND: The hospital's physical environment can impact health and well-being. Patients spend most of their time in their hospital rooms. However, little experimental evidence supports specific physical design variables in these rooms, particularly for people poststroke. The study aimed to explore the influence of patient room design variables modeled in virtual reality using a controlled experimental design.METHODS: Adults within 3 years of stroke who had spent >2 nights in hospital for stroke and were able to consent were included (Melbourne, Australia). Using a factorial design, we immersed participants in 16 different virtual hospital patient rooms in both daytime and nighttime conditions, systematically varying design attributes: patient room occupancy, social connectivity, room size (spaciousness), noise (nighttime), greenery outlook (daytime). While immersed, participants rated their affect (Pick-A-Mood Scale) and preference. Mixed-effect regression analyses were used to explore participant responses to design variables in both daytime and nighttime conditions. Feasibility and safety were monitored throughout. Australian New Zealand Clinical Trials Registry, Trial ID: ACTRN12620000375954.RESULTS: Forty-four adults (median age, 67 [interquartile range, 57.3-73.8] years, 61.4% male, and a third with stroke in the prior 3-6 months) completed the study in 2019-2020. We recorded and analyzed 701 observations of affective responses (Pick-A-Mood Scale) in the daytime (686 at night) and 698 observations of preference responses in the daytime (685 nighttime) while continuously immersed in the virtual reality scenarios. Although single rooms were most preferred overall (daytime and nighttime), the relationship between affective responses differed in response to different combinations of nighttime noise, social connectivity, and greenery outlook (daytime). The virtual reality scenario intervention was feasible and safe for stroke participants.CONCLUSIONS: Immediate affective responses can be influenced by exposure to physical design variables other than room occupancy alone. Virtual reality testing of how the physical environment influences patient responses and, ultimately, outcomes could inform how we design new interventions for people recovering after stroke.REGISTRATION: URL: https://anzctr.org.au; Unique identifier: ACTRN12620000375954.
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| 19. |
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| 20. |
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| 21. |
- Sjöholm, Anna, et al.
(author)
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Does evidence really matter? Professionals’ opinions on the practice of early mobilization after stroke
- 2011
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In: Journal of multidisciplinary health care. - 1178-2390. ; 2011:4, s. 367-376
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Journal article (peer-reviewed)abstract
- Introduction: Early mobilization after stroke may be important for a good outcome and it is currently recommended in a range of international guidelines. The evidence base, however, is limited and clear definitions of what constitutes early mobilization are lacking. Aims: To explore stroke care professionals’ opinions about (1) when after stroke, first mobilization should take place, (2) whether early mobilization may affect patients’ final outcome, and (3) what level of evidence they require to be convinced that early mobilization is beneficial. Methods: A nine-item questionnaire was used to interview stroke care professionals during a conference in Sydney, Australia. Results: Among 202 professionals interviewed, 40% were in favor of mobilizing both ischemic and hemorrhagic stroke patients within 24 hours of stroke onset. There was no clear agreement about the optimal time point beyond 24 hours. Most professionals thought that patients’ final motor outcome (76%), cognitive outcome (57%), and risk of depression (75%) depends on being mobilized early. Only 19% required a large randomized controlled trial or a systematic review to be convinced of benefit. Conclusion: The spread in opinion reflects the absence of clear guidelines and knowledge in this important area of stroke recovery and rehabilitation, which suggests further research is required.
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| 22. |
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| 23. |
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| 24. |
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| 25. |
- Skarin, Monica, et al.
(author)
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Acute stroke patient mobilisation practices and concerns. A survey of 202 stroke professionals
- 2009
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In: European Stroke Conference, Stockholm, Sweden, May.
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Conference paper (peer-reviewed)abstract
- Background Stroke unit care is proven to improve outcome for patients. One component responsible for this may be that patients are mobilised earlier and more intensively, but there is lack of unambiguous scientific evidence. Therefore current practices may be driven by historical precedent and/or clinical opinion, and varying approaches to mobilisation are likely. This study sought to determine different health professionals´ beliefs regarding early mobilisation (EM) in acute stroke. EM was defined as intensive out of bed activities within the first 24 hours after stroke onset. Methods A 9 item anonymous questionnaire on benefits and harms with early mobilisation after stroke was used to interview stroke care professionals during the integrated Stroke Society of Australasia (SSA) and Australasian Nursing and Allied Health Conference in Sydney in August 2008. Data were collected using personal digital assistants. Five point Likert scales sought levels of agreement with harm and benefit of EM. Results The survey was completed by 202 professionals, representing 38% of all conference attendees. 65% were females, 50% under 40 years old, 46% worked in an acute stroke unit and 31% in rehabilitation, 35% were nurses, 26% were medical doctors, 19% were physiotherapists and 12% were occupational therapists. Two thirds had less than 10 years experience in stroke care overall. Sixty percent of professionals had concerns about possible harm of early mobilisation and more so for hemorrhagic (59%) than ischemic (23%) stroke (p<0.001). Cardiovascular stability was the major concern (12% ischemic, 34% hemorrhagic). Conclusion Our results show that most professionals had concerns about early mobilisation of stroke patients and these concerns were stronger for hemorrhagic than for ischemic stroke patients. This is surprising given the lack of evidence to support such a dichotomy and the potential harms of bed-confining hemorrhagic stroke patients.
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| 26. |
- Skarin, Monica, et al.
(author)
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'Better wear out sheets than shoes': a survey of 202 stroke professionals' early mobilisation practices and concerns
- 2011
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In: International Journal of Stroke. - 1747-4949. ; 6:1, s. 10-15
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Journal article (peer-reviewed)abstract
- Background Stroke unit care improves the outcome for patients. One component responsible for this may be that patients are mobilised earlier and more intensively. An ongoing randomised controlled trial is investigating the potential benefits of early mobilisation, but currently there is limited evidence for the practice. Therefore, current practices may be driven by historical precedent and/or clinical opinion, and varying approaches to mobilisation are likely. This study aims to examine different health professionals' concerns regarding early mobilisation in acute stroke. In this study, early mobilisation was defined as frequent out of bed activities within the first 24 h after stroke onset. Methods A nine-item anonymous questionnaire exploring benefits and harms with early mobilisation after stroke was used during interviews of stroke care professionals attending the annual Australasian stroke conference in 2008. Results The survey was completed by 202 professionals, representing 38% of all conference attendees. Sixty-five per cent were females, 50% under 40-years old, 46% worked in acute stroke and 31% in rehabilitation. Thirty-five per cent were nurses, 26% medical doctors, 19% physiotherapists and 12% occupational therapists. Two-thirds had <10-years experience with stroke. Sixty per cent of the surveyed professionals had concerns about early mobilisation and there were significantly more professionals concerned about early mobilisation for haemorrhagic (59%) than ischaemic (23%) stroke patients. Conclusion Our study shows that most clinicians had concerns in relation to early mobilisation of stroke patients and more clinicians had concerns for haemorrhagic than for ischaemic stroke. The evidence underlying these concerns is shallow.
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| 27. |
- van Wijck, Frederike, et al.
(author)
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Improving life after stroke needs global efforts to implement evidence-based physical activity pathways.
- 2019
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In: International journal of stroke : official journal of the International Stroke Society. - : SAGE Publications. - 1747-4949. ; 14:5, s. 457-459
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Journal article (peer-reviewed)abstract
- There is an urgent need to improve life after stroke across the world-especially in low-income countries-through methods that are effective, equitable and sustainable. This paper highlights physical activity (PA) as a prime candidate for implementation. PA reduces modifiable risk factors for first and recurrent stroke and improves function and activity during rehabilitation and following discharge. Preliminary evidence also indicates PA is cost-effective. This compelling evidence urgently needs to be translated into seamless pathways to enable stroke survivors across the world to engage in a more active lifestyle. Although more quality research is needed-particularly on how to optimize uptake and maintenance of PA-this should not delay implementation of high-quality evidence already available. This paper shares examples of best practice service models from low-, middle-, and high-income countries around the world. The authors call for a concerted effort to implement high-quality PA services to improve life after stroke for all.
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| 28. |
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| 29. |
- Åstrand, Anna, et al.
(author)
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Poststroke Physical Activity Levels No Higher in Rehabilitation than in the Acute Hospital.
- 2016
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In: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. - : Elsevier BV. - 1532-8511. ; 25:4, s. 938-45
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Journal article (peer-reviewed)abstract
- Returning to physical activity is a common goal for stroke survivors undergoing rehabilitation, and higher levels of activity have been linked to better gait and greater independence in activities of daily living. Our aim was to determine if inpatient rehabilitation settings promoted higher levels of physical activity in stroke survivors than an acute stroke unit setting.
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