Stephen Ashford
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View article: Meta-Analysis of Goal Setting and Physical Treatment Categorisation for Focal Spasticity Following Stroke or Other Acquired Brain Injury
Meta-Analysis of Goal Setting and Physical Treatment Categorisation for Focal Spasticity Following Stroke or Other Acquired Brain Injury Open
Background: Setting goals and planning treatment to attain those goals is often integral to rehabilitation practice, particularly when managing spasticity following stroke or other brain injury. Optimal treatment planning and provision usi…
View article: Understanding development of contractures in people with stroke: formulation of a logic-model to inform care and prevention
Understanding development of contractures in people with stroke: formulation of a logic-model to inform care and prevention Open
The resulting Logic-Model of the problem will enable development of evidence-based pathways to prevent and treat contracture.
View article: Pain Reduction with Repeated Injections of Botulinum Toxin A in Upper Limb Spasticity: A Longitudinal Analysis from the ULIS-III Study
Pain Reduction with Repeated Injections of Botulinum Toxin A in Upper Limb Spasticity: A Longitudinal Analysis from the ULIS-III Study Open
Pain reduction is a common goal of the treatment of upper limb spasticity with botulinum toxin (BoNT-A). ULIS-III was a large international, observational, longitudinal study (N = 953) conducted in real-life clinical practice over two year…
View article: Muscle selection and dosing in patients undergoing treatment with abobotulinumtoxinA for lower limb spasticity in real-world practice
Muscle selection and dosing in patients undergoing treatment with abobotulinumtoxinA for lower limb spasticity in real-world practice Open
Objective: Describe abobotulinumtoxinA (aboBoNT-A) dosing parameters in the real-world management of lower limb spasticity (LLS). Methods: Prospective, observational study (NCT04050527) following ambulatory adults with unilateral LLS trea…
View article: A concise practical clinical guide to identifying spasticity in neurological shoulder dysfunction
A concise practical clinical guide to identifying spasticity in neurological shoulder dysfunction Open
Background Spasticity is a known complication to the hemiplegic shoulder following acquired brain injury. However, there is a current discrepancy between the diagnosis of arm spasticity and the subsequent assessment and treatment of spasti…
View article: Longitudinal Goal Attainment With Repeat Injections of AbobotulinumtoxinA in Adults With Lower Limb Spasticity: Results From a Prospective Observational Study
Longitudinal Goal Attainment With Repeat Injections of AbobotulinumtoxinA in Adults With Lower Limb Spasticity: Results From a Prospective Observational Study Open
Findings from this large, international study provide evidence for the benefit of repeated cycles of AboBoNT-A for LLS. Multivariate analyses indicated that goal attainment during the first cycle was better with those injected using inject…
View article: Predictors of real-world response in adults treated with botulinumtoxin-A for upper limb spasticity
Predictors of real-world response in adults treated with botulinumtoxin-A for upper limb spasticity Open
Background: To explore predictors of treatment response in adults receiving botulinumtoxin-A (BoNT-A) for upper limb spasticity (ULS) and to describe the association between response and concomitant medication, professional physical therap…
View article: Predictors of increasing disability in activities of daily living among people with advanced respiratory disease: a multi-site prospective cohort study, England UK
Predictors of increasing disability in activities of daily living among people with advanced respiratory disease: a multi-site prospective cohort study, England UK Open
Mobility limitation could be used as a simple referral criterion across people with advanced respiratory disease to ensure timely rehabilitation that targets independence in ADLs.
View article: Clinical presentation of patients with lower limb spasticity undergoing routine treatment with botulinum toxin: baseline findings from an international observational study
Clinical presentation of patients with lower limb spasticity undergoing routine treatment with botulinum toxin: baseline findings from an international observational study Open
Objective: Describe how people with lower limb spasticity present for treatment in routine clinical practice. Methods: Prospective, observational study (Clinicaltrials.gov: NCT04050527) of ambulatory adult patients (≥ 18 years) with unilat…
View article: Ultrasound image guided injection of botulinum toxin for the management of spasticity: A Delphi study to develop recommendations for a scope of practice, competency, and governance framework
Ultrasound image guided injection of botulinum toxin for the management of spasticity: A Delphi study to develop recommendations for a scope of practice, competency, and governance framework Open
View article: Patient research priority setting partnership in human T‐cell lymphotropic virus type I
Patient research priority setting partnership in human T‐cell lymphotropic virus type I Open
Introduction Human T‐cell lymphotropic virus type 1 (HTLV‐1) is a chronic infection affecting 5–10 million people worldwide. Ten percent develop HTLV‐1‐associated diseases, and 3%–5% develop HTLV‐1‐associated myelopathy (HAM)/tropical spas…
View article: Ankle contracture in people with acquired brain injury (ABI), intervention, and outcome following inpatient neurorehabilitation categorized by severity
Ankle contracture in people with acquired brain injury (ABI), intervention, and outcome following inpatient neurorehabilitation categorized by severity Open
Background: Acquired brain injury frequently causes difficulty with moving and walking, which if not actively managed, can lead to secondary contracture and deformity. Intervention to manage ankle contracture may include conservative metho…
View article: Predictors of increasing disability in activities of daily living among people with advanced respiratory disease: a multi-site prospective cohort study, England UK
Predictors of increasing disability in activities of daily living among people with advanced respiratory disease: a multi-site prospective cohort study, England UK Open
Disability in activities of daily living (ADL) is a common unmet need among people with advanced respiratory disease. Rehabilitation could help prolong independence, but indicators for timely intervention in this population are lacking. Th…
View article: Worldwide Survey of Clinician Practice on use of Adjunctive Therapies Following Botulinum Toxin Injection for Spasticity
Worldwide Survey of Clinician Practice on use of Adjunctive Therapies Following Botulinum Toxin Injection for Spasticity Open
Objective: Non-pharmacological adjunctive therapies can be used alongside botulinum toxin injection to enhance its efficacy. The objective of this global study was to determine the current practice and perception among clinicians of the us…
View article: The Impact of Spasticity and Contractures on Dependency and Outcomes from Rehabilitation
The Impact of Spasticity and Contractures on Dependency and Outcomes from Rehabilitation Open
Background: Acquired brain injury (ABI) can result in severe physical impairment causing difficulty with moving which, if not actively managed, can lead to contracture and deformity. Delayed access to rehabilitation may result in more cont…
View article: “I wanna live and not think about the future” what place for advance care planning for people living with severe multiple sclerosis and their families? A qualitative study
“I wanna live and not think about the future” what place for advance care planning for people living with severe multiple sclerosis and their families? A qualitative study Open
Background Little is known about how people with multiple sclerosis (MS) and their families comprehend advance care planning (ACP) and its relevance in their lives. Aim To explore under what situations, with whom, how, and why do people wi…
View article: “I wanna live and not think about the future” What place for advance care planning for people living with severe multiple sclerosis and their families? A qualitative study
“I wanna live and not think about the future” What place for advance care planning for people living with severe multiple sclerosis and their families? A qualitative study Open
Background Little is known about how people with multiple sclerosis and their families comprehend advance care planning (ACP) and its relevance in their lives. Aim To explore under what situations, with whom, how, and why do people with MS…
View article: Prolonged disorders of consciousness: identification using the UK FIM + FAM and cohort analysis of outcomes from a UK national clinical database
Prolonged disorders of consciousness: identification using the UK FIM + FAM and cohort analysis of outcomes from a UK national clinical database Open
In absence of a dedicated PDOC registry, FIM + FAM scores can identify patients in VS/MCS at population level. Identifying those who emerge and providing timely rehabilitation generates cost-savings well-exceeding the cost of the evaluatio…
View article: The spasticity-related quality of life 6-dimensions instrument in upper-limb spasticity: Development and responsiveness
The spasticity-related quality of life 6-dimensions instrument in upper-limb spasticity: Development and responsiveness Open
Objective: To describe the development of the Spasticity-related Quality of Life 6-Dimensions instrument (SQoL-6D) and its sensitivity to clinical change (responsiveness). Design: Multicentre, prospective, longitudinal cohort study at 8 UK…
View article: The spasticity-related quality of life 6-dimensions instrument in upper-limb spasticity: A first psychometric evaluation
The spasticity-related quality of life 6-dimensions instrument in upper-limb spasticity: A first psychometric evaluation Open
Objective: Psychometric evaluation of the Spasticity-related Quality of Life 6-Dimensions instrument (SQoL-6D). Design: A clinimetric evaluation conducted in a multicentre, prospective, longitudinal cohort study at 8 UK sites. Patients: Ad…
View article: Stratified management of hemiplegic shoulder pain using an integrated care pathway: an 18-year clinical cohort analysis
Stratified management of hemiplegic shoulder pain using an integrated care pathway: an 18-year clinical cohort analysis Open
These high pain-response rates compare favourably to the literature (14-27%), suggesting that this stratified and integrated approach to HSP guides more effective management in this heterogeneous clinical presentation.Implications for Reha…
View article: Investigating psychometric properties of the arm activity measure – Thai version (ArmA-TH) sub‐scales using the Rasch model
Investigating psychometric properties of the arm activity measure – Thai version (ArmA-TH) sub‐scales using the Rasch model Open
View article: Psychometric properties of measures of upper limb activity performance in adults with and without spasticity undergoing neurorehabilitation–A systematic review
Psychometric properties of measures of upper limb activity performance in adults with and without spasticity undergoing neurorehabilitation–A systematic review Open
Introduction This systematic review appraises the measurement quality of tools which assess activity and/or participation in adults with upper limb spasticity arising from neurological impairment, including methodological quality of the ps…
View article: Relationships between prolonged physical and social isolation during the COVID-19 pandemic, reduced physical activity and disability in activities of daily living among people with advanced respiratory disease
Relationships between prolonged physical and social isolation during the COVID-19 pandemic, reduced physical activity and disability in activities of daily living among people with advanced respiratory disease Open
In people with advanced respiratory disease, we examined (i) the impact of COVID-19–related physical and social isolation on physical activity and (ii) relationships between time spent in isolation and disability in activities of daily liv…
View article: Early Identification, Intervention and Management of Post-stroke Spasticity: Expert Consensus Recommendations
Early Identification, Intervention and Management of Post-stroke Spasticity: Expert Consensus Recommendations Open
Stroke patients with spasticity usually require long-lasting care and interventions but frequently report that outpatient and community treatment is limited, reflecting a significant unmet need in health and social care provision. Rehabili…
View article: Investigating Psychometric Properties of the Arm Activity Measure – Thai Version (ArmA-TH) Sub-Scales Using the Rasch Model
Investigating Psychometric Properties of the Arm Activity Measure – Thai Version (ArmA-TH) Sub-Scales Using the Rasch Model Open
Background: This study investigated the ArmA-TH measurement properties based on item response theory, using the Rasch model. Methods: Patients with upper limb hemiplegia resulting from cerebrovascular and other brain disorders were asked t…
View article: Investigating Psychometric Properties of the Arm Activity Measure – Thai Version (ArmA-TH) Sub-scales Using the Rasch Model
Investigating Psychometric Properties of the Arm Activity Measure – Thai Version (ArmA-TH) Sub-scales Using the Rasch Model Open
Background: This study investigated the ArmA-TH measurement properties based on item response theory, using the Rasch model. Methods: Patients with upper limb hemiplegia resulting from cerebrovascular and other brain disorders were asked t…
View article: Disability in Basic Activities of Daily Living Is Associated With Symptom Burden in Older People With Advanced Cancer or Chronic Obstructive Pulmonary Disease: A Secondary Data Analysis
Disability in Basic Activities of Daily Living Is Associated With Symptom Burden in Older People With Advanced Cancer or Chronic Obstructive Pulmonary Disease: A Secondary Data Analysis Open
View article: A realist review of advance care planning for people with multiple sclerosis and their families
A realist review of advance care planning for people with multiple sclerosis and their families Open
Although mechanisms are inhibited by the context of MS, health professionals can facilitate greater uptake of ACP among those people with MS who want it by developing their skills in communication, building trusting relationships, sharing …
View article: Psychometric evaluation of the leg activity measure (LegA) for outcome measurement in people with brain injury and spasticity
Psychometric evaluation of the leg activity measure (LegA) for outcome measurement in people with brain injury and spasticity Open
The study provides support for the Leg Activity measure being valid, reliable and responsive.Implications for rehabilitationThe Leg Activity measure is the only published self-report measure in the current literature that addresses passive…