Stroke Special Interest Group Podcast

In this episode, host Marissa Moran, PT, DPT is joined by authors Dr. Anjali Sivaramakrishnan and Dr. Sandeep Subramanian to discuss their recent article published in the Neurorehabilitation and Neural Repair titled “A Systematic Review on the Effects of Acute Aerobic Exercise on Neurophysiological, Molecular, and Behavioral Measures in Chronic Stroke”. The authors share their research, which is a systematic review aimed at examining the effects of a single bout of aerobic exercise on neuroplasticity measures. They discuss aerobic priming and considerations for the clinic to promote improved motor learning for individuals with chronic stroke. The information in this podcast is meant for the benefit of physical therapists. It is not meant for personal medical diagnosis and/or treatment. Individuals should always consult an appropriate medical practitioner with questions. This is for informational and educational purposes only. It does not constitute and should not be used as a substitute for medical advice, diagnosis, rehabilitation, or treatment. Patients and other members of the general public should always seek the advice of a qualified healthcare professional regarding personal health and medical conditions. The Academy of Neurologic Physical Therapy and its collaborators disclaim any liability to any party for any loss or damage by errors or omissions in this publication. The views or opinions expressed are those of the individual creators and do not necessarily represent the position of the Academy of Neurologic Physical Therapy. Please send comments or questions on this podcast to the Stroke SIG at strokesig@gmail.com. The Stroke Special Interest Group is part of the Academy of Neurologic Physical Therapy – www.neuropt.com.

In this episode, host Marissa Moran PT, DPT is joined by Pierce Boyne, PT, DPT, PhD, NCS, Sandra A. Billinger, PT, PhD, and Darcy S. Reisman, PT, PhD to discuss their recent article posted in JAMA Neurology titled “Optimal Intensity and Duration of Walking Rehabilitation in Patients with Chronic Stroke: A Randomized Control Trial.” The authors discuss their research that investigated the gains in walking capacity between two different training parameters (high intensity interval training and moderate intensity aerobic training) after 4, 8, and 12 weeks of training. The information in this podcast is meant for the benefit of physical therapists. It is not meant for personal medical diagnosis and/or treatment. Individuals should always consult an appropriate medical practitioner with questions. Please send comments or questions on this podcast to the Stroke SIG at strokesig@gmail.com. The Stroke Special Interest Group is part of the Academy of Neurologic Physical Therapy – www.neuropt.com.

In this episode, host Jackie Loeshelle, PT, DPT is joined by Michelle Sawtelle, PT, PhD. Dr. Sawtelle currently serves on the Stroke SIG leadership board. This interview discusses why the sit to stand task is an important clinical indicator in the stroke population, the findings of Dr. Sawtelle’s research, and how we can translate findings from this article into clinical practice. The article “Gluteus Maximus Muscle Activation During a Chair-Rise in Adults With Chronic Stroke” is featured in the October 2022 issue of the JNPT. The JNPT is a partner on this episode. The article can be found here: https://journals.lww.com/jnpt/Abstract/2022/10000/Gluteus_Maximus_Muscle_Activation_Characteristics.6.aspx. The information in this podcast is meant for the benefit of physical therapists. It is not meant for personal medical diagnosis and/or treatment. Individuals should always consult an appropriate medical practitioner with questions. Please send comments or questions on this podcast to the Stroke SIG at strokesig@gmail.com. The Stroke Special Interest Group is part of the Academy of Neurologic Physical Therapy – www.neuropt.com.

In this episode, host Jackie Loeshelle, PT, DPT is joined by Nancy Salbach, PT, PhD to discuss Dr. Salbach’s article, “Assessment of Walking Speed and Distance Post-Stroke Increases after Providing a Theory-Based Toolkit”, published in the JNPT. The JNPT is a partner on this episode. Resources on the measurement of gait speed and distance can be found here: 10 Meter Walk Test: https://www.neuropt.org/docs/default-source/cpgs/core-outcome-measures/core-measure-10-meter-walk-test-(10mwt)_final.pdf?sfvrsn=c5585243_2&sfvrsn=c5585243_2 6 Minute Walk Test: https://neuropt.org/docs/default-source/cpgs/core-outcome-measures/core-outcome-measures-documents-july-2018/6mwt_protocol.pdf?sfvrsn=fc325343_2&sfvrsn=fc325343_2 The information in this podcast is meant for the benefit of physical therapists. It is not meant for personal medical diagnosis and/or treatment. Individuals should always consult an appropriate medical practitioner with questions. Please send comments or questions on this podcast to the Stroke SIG at strokesig@gmail.com. The Stroke Special Interest Group is part of the Academy of Neurologic Physical Therapy – www.neuropt.org.

Host Jackie Loeshelle, PT, DPT is joined by Jennith Bernstein, PT, DPT, ATP/SMS of the Assistive Technology/Seated and Wheeled Mobility SIG to discuss wheelchair prescription for the neurologic population and the important role physical therapists have in this process. Disclosure: Dr. Bernstein is a Clinical Affairs Manager for Permobil. Resources on this topic are listed below: Sample seating and mobility evaluation: Seating/Mobility Evaluation (methodistonline.org) Permobil LMN generator: LMN Login (permobillmn.com) RESNA position papers: RESNA > Resources > Position Papers and Service Provision Guidelines Textbook: Seating and Wheeled Mobility textbook by Lange & Minkel: Seating and Wheeled Mobility: A Clinical Resource Guide (healio.com) Continuing education, CEUs:  Through APTA 10-course series for beginners, free for members and non-members, provided through Clinician Task Force and APTA AT/SWM SIG  Academy of Neurologic Physical Therapy Education Center: Interactive Courses (anpteducationcenter.org) Continuing education previously recorded webinars from International Seating Symposium: RSTCE: On-Demand Webinars (pitt.edu) The information in this podcast is meant for the benefits of physical therapists. It is not meant for personal medical diagnosis and or treatment. Individuals should always consult an appropriate medical practitioner with questions. Please send comments or questions on this podcast to the Stroke SIG at strokesig@gmail.com The Stroke Special Interest Group and Assistive Technology/Seating and Wheeled Mobility Special Interest Group are part of the Academy of Neurologic Physical Therapy – www.neuropt.org.

In this episode, physical therapist and clinician, Jonathan Kinzinger, shares his story of finding evidence that he could apply to practice. Resources such as the Clinical Practice Guidelines for the core outcome measures and locomotor training inspired him to change practice. He is now embarking on systematic change.   For more information on the Academy of Neurologic Physical Therapy and the Evidence Elevates campaign visit www.neuropt.org.

Host Dr. Jackie Loeshelle is joined by Dr. Evan Cohen and Dr. Mark Manago to discuss blood flow restriction training for patients with neurologic deficits. During the interview, Drs. Cohen and Manago discuss how blood flow restriction works physiologically and evidence on using this intervention for individuals with a variety of neurologic diagnoses. They discuss how fatigue is often a limiting factor of exercise (for both strengthening and aerobic training) with patient with neurologic conditions, and that the addition of blood flow restriction may allow patients to be able to work at a higher intensity when fatigue is a barrier. Listen to learn more! Please send comments or questions on this podcast to strokesig@gmail.com The Stroke Special Interest Group is part of the Academy of Neurologic Physical Therapy – www.neuropt.org.

In this episode, host Jackie Loeshelle is joined by Dr. Catherine Siengsukon, PT, PhD to discuss her article “Association Between Sleep Duration and Functional Disability in Inpatient Rehabilitation: A Pilot Observational Study”. This interview highlights the important role of sleep in stroke recovery and how physical therapists should aim to assist patients in optimizing sleep. Listen to this episode to Read the article here: https://reader.elsevier.com/reader/sd/pii/S2590109521000604?token=516D52AD07267F4E394E1A7B92C9D6841D50AD10BE81C03508EF07AEE3195F7D13DC70B9A582D683D6D192C206BD0FA6&originRegion=us-east-1&originCreation=20220221035258 Please send comments or questions this podcast to strokesig@gmail.com The Stroke Special Interest Group is part of the Academy of Neurologic Physical Therapy – www.neuropt.org.

In this episode, the Journal of Neurologic Physical Therapy (JNPT) partners with the ANPT Stroke Special Interest Group for an interview with Amanda DeMartino conducted by host Jackie Loeshelle. Dr. DeMartino is an author of a recently published article examining manual dexterity measures and their relationship to use of the paretic upper extremity in individuals with stroke. This article is included in the October 2021 issue of JNPT. Find more about this article here:  https://journals.lww.com/jnpt/Abstract/2021/10000/Manual_Dexterity_Is_Associated_With_Use_of_the.7.aspx Link for podcast transcript: https://www.neuropt.org/docs/default-source/stroke-sig/podcast_ep15.docx The Stroke Special Interest Group is part of the Academy of Neurologic Physical Therapy – www.neuropt.org

In this episode, the Journal of Neurologic Physical Therapy (JNPT) partners with the ANPT Stroke Special Interest Group for an interview with Dr. Therese Johnston and Dr. Lisa Brown conducted by host Jackie Loeshelle. Drs. Johnston and Brown are authors of a recently released clinical practice guideline examining the use of ankle foot orthoses and functional electrical stimulation for individuals post-stroke. Their article is included in the April 2021 issue of JNPT. Find more about the CPG here: https://www.neuropt.org/practice-resources/anpt-clinical-practice-guidelines/AFO_FES-post-stroke Link for podcast transcript: https://www.neuropt.org/docs/default-source/stroke-sig/podcast_ep14.docx

For this episode, host Jackie Loeshelle is joined by Dr. Dileep Yavagal, MD to discuss mechanical thrombectomy as a medical intervention for acute onset ischemic stroke. Dr. Yavagal discusses mechanical thrombectomy and its outcomes to allow us as therapists to better understand how it may impact our patients’ progress in rehabilitation. Please send comments or questions on this podcast to strokesig@gmail.com. The Stroke Special Interest Group is part of the Academy of Neurologic Physical Therapy.

This podcast is the fourth installation in the ANPT Stroke SIG’s podcast series about locomotor training.  In this episode, we talk with Dr. Jenni Moore, Dr. Chris Henderson, Dr. Lauren Lenca, and Dr. Elisabeth Bø and examine their project conducted called FIRST (Focused Intensity Repetitive Step Training). This project implemented the evidence-based, as per the recent locomotor CPG, and laboratory tested intervention of high intensity gait training in inpatient stroke rehabilitation facilities and compared its outcomes with traditional care interventions. At all the sites during this project, high intensity gait training was performed for the majority of the sessions as opposed to the traditional PT approach which involves performing multiple different interventions during sessions.  As researchers are aware of and as clinicians can imagine, there may be unforeseeable circumstances and variability in sessions that may affect the degree to which a research-based protocol can be followed with integrity in a clinic. The aim of this podcast will be to discuss the successes, facilitators, barriers, and challenges that different clinical sites had in implementing this evidence based intervention. Please see the following link for the clinical prediction rule paper that provides the evidence for the calculator on the Institute of Knowledge Translation’s website: https://authors.elsevier.com/c/1cDf9wCg4Gdk Please send comments or questions on this podcast to strokesig@gmail.com The Stroke Special Interest Group is part of the Academy of Neurologic Physical Therapy – www.neuropt.org.

Host Jackie Loeshelle is joined by members of the Locomotion – Chronic CPG Knowledge Translation Task Force for a Part III discussion on the Locomotor CPG. In this episode, Dr. Carey Holleran and Dr. Maghan Bretz discuss the Intensity Matters Campaign, which provides clinicians with guidance on how to focus on intensity when providing intervention for improving locomotor function in individuals with chronic neurologic conditions (CVA, iSCI, and TBI). The Task Force has created guidelines that can be found on the ANPT website. This podcast episode will provide clinically applicable knowledge to implement intense and task-specific gait training into your practice. Please send questions or comments to strokesig@gmail.com. Supporting links: Locomotor CPG Full Text: https://journals.lww.com/jnpt/fulltext/2020/01000/clinical_practice_guideline_to_improve_locomotor.8.aspx “Intensity Matters” webpage by the Locomotor CPG Knowledge Translation Task Force that includes helpful clinical resources/tools and supporting articles: https://www.neuropt.org/practice-resources/locomotor The Stroke Special Interest Group is part of the Academy of Neurologic Physical Therapy – www.neuropt.org.

Host Jackie Loeshelle is joined by Dr. George Hornby for a Part II discussion on the Locomotor CPG. The Locomotor CPG identifies the most optimal interventions for gait recovery based on current evidence for individuals with chronic stroke, incomplete spinal cord injury, and traumatic brain injury. This episode delves deeper into the background and design of the CPG, how the literature search occurred, and how the authors interpreted results to develop recommendations. Dr. Hornby also discusses implementation and audit strategies for high intensity gait training in the clinical setting. Read the full-text CPG here: https://journals.lww.com/jnpt/Fulltext/2020/01000/Clinical_Practice_Guideline_to_Improve_Locomotor.8.aspx Additional resources from the Locomotor Knowledge Translation Task Force: https://www.neuropt.org/practice-resources/locomotor/resourses The Stroke Special Interest Group is part of the Academy of Neurologic Physical Therapy – www.neuropt.org.

In this episode, Cory Hall has a conversation with Dr. George Hornby, Professor of Physical Medicine & Rehabilitation at Indiana University. He is the primary author of the 2020 Clinical Practice Guideline to Improve Locomotor Function Following Chronic Stroke, Incomplete Spinal Cord Injury, and Brain Injury. In this engaging conversation you will learn direct clinical tips and tricks to help you in your clinical practice to improve locomotor function. The full article can be found on the Journal of Neurologic Physical Therapy. Find additional resources at this website: http://www.neuropt.org/practice-resources/anpt-clinical-practice-guidelines/locomotor-training-cpg The Stroke Special Interest Group is part of the Academy of Neurologic Physical Therapy – www.neuropt.org.

Dr. Stephen Page OTR/L, PhD joins us to discuss constraint induced movement therapy (CIMT) after stroke. Listen as he discusses the benefits of CIMT and some of his research involving a modified CIMT program. The Spinal Cord Injury Special Interest Group is a part of the Academy of Neurologic Physical Therapy, www.neuropt.org.

Dr. Sandra Billinger, PT, PhD, FAHA Associate Professor at the University of Kansas joins us to talk about physical activity and exercise after stroke. She discusses physical activity levels after stroke, how to encourage patients to be more active, exercise dosage, and exercise testing, including the use of a recumbent stepper to conduct submaximal exercise testing. Dr. Billinger also talks about her current research examining cerebral blood flow during exercise. The Stroke Special Interest Group is part of the Academy of Neurologic Physical Therapy – www.neuropt.org.

Dr. Sandra Billinger, PT, PhD, FAHA joins us to talk about physical activity and exercise after stroke. She discusses physical activity levels after stroke, how to encourage patients to be more active, exercise dosage, and exercise testing, including the use of a recumbent stepper to conduct submaximal exercise testing. Dr. Billinger also talks about her current research examining cerebral blood flow during exercise.

Dr. Sarah Blanton PT, DPT, NCS Associate Professor of Rehabilitation Medicine at Emory University School of Medicine joins us to talk about caregiving after stroke. Listen as Dr. Blanton discusses how caregivers or care partners can be ill-prepared for their role, how to assess caregiver burden and ways we can address the needs of caregivers. The Stroke Special Interest Group is part of the Academy of Neurologic Physical Therapy – www.neuropt.org.

Heather Hayes, Stroke SIG chair, interviews professor Julie Bernhardt. Professor Berhnardt is a clinician researcher at University of Melbourne. She is a National Health and Medical Research Council established fellow and senior principal florey research fellow at the florey Institute of Neuroscience and Mental Health, Melbourne, Australia. Julie has been working with people with stroke for 30 years. She is Head of the Stroke Division at the Florey and leader of the AVERT Early Intervention Research Program. Working in a large multidisciplinary team of researchers, the focus of Julie’s group is the development and testing of new, exercise and rehabilitation interventions that aim to reduce the burden of stroke related disability. Julie is Australia’ leading stroke rehabilitation trialist, recently completing the largest, international trial of early mobility based rehabilitation ever conducted (AVERT) which included over 2000 patients from 5 countries. Listen as Julie discusses findings from her research, applications for clinicians, and here future research direction. The Stroke Special Interest Group is part of the Academy of Neurologic Physical Therapy – www.neuropt.org.