Family-mediated exercise intervention (FAME): evaluation of a novel form of exercise delivery after stroke.

BACKGROUND AND PURPOSE: Additional exercise therapy has been shown to have a positive impact on function after acute stroke and research is now focusing on methods to increase the amount of therapy that is delivered. This randomized controlled trial examined the impact of additional family-mediated exercise (FAME) therapy on outcome after acute stroke. METHODS: Forty participants with acute stroke were randomly assigned to either a control group who received routine therapy with no formal input from their family members or a FAME group, who received routine therapy and additional lower limb FAME therapy for 8 weeks. The primary outcome measure used was the lower limb section of the Fugl-Meyer Assessment modified by Lindmark. Other measures of impairment, activity, and participation were completed at baseline, postintervention, and at a 3-month follow-up. RESULTS: Statistically significant differences in favor of the FAME group were noted on all measures of impairment and activity postintervention (P<0.05). These improvements persisted at the 3-month follow-up but only walking was statistically significant (P<0.05). Participants in the FAME group were also significantly more integrated into their community at follow-up (P<0.05). Family members in the FAME group reported a significant decrease in their levels of caregiver strain at the follow-up when compared with those in the control group (P<0.01). CONCLUSIONS: This evidence-based FAME intervention can serve to optimize patient recovery and family involvement after acute stroke at the same time as being mindful of available resources.

An investigation of the reliability of Rapid Upper Limb Assessment (RULA) as a method of assessment of children's computing posture.

Rapid Upper Limb Assessment (RULA) is a quick observation method of posture analysis. RULA has been used to assess children's computer-related posture, but the reliability of RULA on a paediatric population has not been established. The purpose of this study was to investigate the inter-rater and intra-rater reliability of the use of RULA with children. Video recordings of 24 school children were independently viewed by six trained raters who assessed their postures using RULA, on two separate occasions. RULA demonstrated higher intra-rater reliability than inter-rater reliability although both were moderate to good. RULA was more reliable when used for assessing the older children (8-12 years) than with the younger children (4-7 years). RULA may prove useful as part of an ergonomic assessment, but its level of reliability warrants caution for its sole use when assessing children, and in particular, younger children.