StrokeEd

This is well worth listening to - fantastic messages from Janice Eng

A Neuro Physio podcast https://podcasts.apple.com/au/podcast/a-neuro-physio-podcast/id1493324068
is excited to be releasing new episodes.
If you’re not familiar with our podcast, Matt Wingfield and I interview expert clinicians, researchers, educators, thought-leaders and more. We talk about their area of expertise & their career pathway. The result is clinically relevant education, cutting-edge knowledge to directly apply to clinical practice, plus info on the range of career paths open to physiotherapists, and importantly, how to embark on them.

Upcoming we’ve got episodes about Movement Disorders and Upper Limb rehab. In the meantime we’re posting our past episodes.

First up, from earlier this year:
Prof Janice Eng University of British Columbia and UBC Department of Physical Therapy

https://podcasts.apple.com/au/podcast/a-neuro-physio-podcast/id1493324068?i=1000767181355

https://neurorehab.med.ubc.ca/our-people/dr-eng/

You can find us on all the usual podcast platforms.

Can 5 minutes of mental rehearsal improve stroke rehabilitation?
Evidence spotlight: systematic review on priming interventions and their effect on activity and motor impairment outcomes after stroke.

Why does priming matter?
Task specific practice is already an effective stroke rehabilitation intervention. The authors wanted to know, can we “prime” the brain beforehand so the practice that follows becomes even more effective?
This is based on the theory that priming temporarily increases corticomotor excitability and promotes neuroplasticity (Stoykov & Madhaven, 2015)

A systematic review of 24 randomised controlled trials involving 803 people after stroke. They found that motor imagery performed before task-specific practice improved both motor impairment and activity outcomes after stroke. Evidence for action observation was limited, and movement-based or aerobic exercise priming showed no clear additional benefit.

Clinically, motor imagery (in the form of mental practice) is a great tool to utilise as it is inexpensive, requires no equipment, easy to implement and is feasible in most clinical settings.

Take home messages:
- Task specific practice remains the cornerstone of stroke rehabilitation
- Motor imagery before task specific practice can enhance the results of task specific practice and improve activity and motor impairment outcomes after stroke
- Action observation priming has limited evidence to support its effect on activity after stroke
- Movement-based or aerobic-based priming has no evidence to support its effect on activity after stroke

To read the full paper, published in Journal of Physiotherapy visit https://www.sciencedirect.com/science/article/pii/S1836955324000833?via%3Dihub

This exercise targets inner range knee control to avoid knee hyperextension in stance phase. Knee hyperextension is a common impairment after stroke. It can be due to reduced strength, coordination or proprioception. Here’s how you can set up a stroke survivor for this exercise:

Safety and effectiveness: wall behind, table next to intact side, intact leg on block to increase weight-bearing on affected leg

Cues: polysterene cup to touch without knee hyper-extension, ball on clamp to indicate end of knee flexion

Feedback: number of successful reps = light touch to polysterene cup to not squash it, light touch to ball to not move it

Decreasing difficulty: foot on wedge to put ankle into plantarflexion - makes it easier to avoid knee hyper-extension

Increasing difficulty: increase weightbearing on affected leg

To learn more about training the lower limbs after stroke, read about our upcoming lower limb workshop in November held in Sydney: https://strokeed.com/event/evidence-based-retraining-of-lower-limb-skills-after-stroke-arc-sydney/

Paulette van Vliet and colleagues have published a task specific training manual for rehabilitation of the arm and hand after stroke. This is a fantastic resource that was developed as part of a feasibility randomised controlled trial of home-based reach-to-grasp training for people after stroke.

The manual contains 142 upper limb activities divided into sections based on the kinematic features of the task.
Within each section the activities are broadly structured in order of difficulty (eg. gravity-assisted -> gravity-neutral -> against gravity) but progression of activities should always be individualised.
The manual provides practical guidance for therapists on implementation.

Congratulations to Paulette and the team, and we are thrilled to share to this free resource.

To download a PDF copy of the manual, visit the StrokeEd website’s media library, or follow the link:https://strokeed.com/wp-content/uploads/2026/07/RTG_TreatmentManual.pdf

Time - often our big barrier to discussing/ planning implementation - listen to a very thoughtful experienced clinician and manager discuss this issue

🎙️New PEDroCast episode out now!

We're taking a break from PEDro's top trials in this episode to talk about how we can overcome lack of time in physiotherapy.

Lack of time is the most common barrier to evidence-based practice in physiotherapy. Factors contributing to this include high workload, lack of resources, competing priorities, and sense of feeling overwhelemed with the amount of evidence to stay on top of.

In this episode Dr Daniel Treacy, a physiotherapy from Australia, sits down with Dr Anne Moseley to discuss some of the time barriers Daniel and his team have experienced and some of the strategies they use to overcome them.

🎧 Listen to the episode now: https://open.spotify.com/show/63FQIl1zWMm1WB10E6GrIe?si=ytSfgV3LR_Kr2T20uZmAuA&nd=1&dlsi=5f22e3551bed431c