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Clinical Perspectives in Stroke Rehabilitation
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Clinical Perspectives in Stroke Rehabilitation

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Rehabilitation".

Deadline for manuscript submissions: 25 September 2025 | Viewed by 2819

Special Issue Editors

Prof. Dr. Krystyna Jaracz

E-Mail Website
Guest Editor
Department of Neurological Nursing, Poznan University of Medical Sciences, Rokietnicka 2A, 60-806 Poznań, Poland
Interests: neuropsychological; stroke; bipolar disorder
Dr. Karolina Filipska-Blejder

E-Mail Website
Co-Guest Editor
Neurological and Neurosurgical Nursing Department, Faculty of Health Science, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-821 Bydgoszcz, Poland
Interests: stroke; neurological diseases; stroke thrombolysis; older adults neurological deficits
Prof. Dr. Robert Ślusarz

E-Mail Website
Guest Editor Assistant
Neurological and Neurosurgical Nursing Department, Faculty of Health Science, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-821 Bydgoszcz, Poland
Interests: neurosurgery; traumatic brain injury; traumatic brain hemorrhage; neuro-oncology; glasgow coma scale; intervertebral disc; clinical nursing

Special Issue Information

Dear Colleagues,

Stroke is a serious medical and social problem due to its frequency of occurrence. The consequences of a stroke in the form of various types of deficits significantly limit everyday functioning and make independence difficult. Depending on the degree of brain damage, there is a risk of paresis, paralysis, balance disorders, sensory disorders, dysphagia, aphasia, and memory disorders. Thus, rehabilitation is so important for patients following a stroke. One of the key elements of successful rehabilitation after a stroke is how quickly it begins. It should be implemented as soon as possible, within the first few days of hospitalization. It can significantly improve the patient's condition and restore the ability to function independently. Furthermore, rehabilitation can limit the negative effects of stroke and reduce the risk of thromboembolic complications that can occur shortly after a stroke. Rehabilitation after a stroke is long-term and is influenced by many factors, including the patient’s age, cooperation from the patient, the time of commencement of rehabilitation, the number and type of comorbidities, the therapeutic methods used, the degree of brain damage, and others. Due to the seriousness of the topic, the aim of this Special Issue is to present, in a broad sense, clinical perspectives concerning rehabilitation after stroke.

Prof. Dr. Krystyna Jaracz
Dr. Karolina Filipska-Blejder
Guest Editors

Prof. Dr. Robert Ślusarz
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • stroke
  • clinical perspectives
  • therapy
  • functional outcome predictors
  • rehabilitation
  • quality of life

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Published Papers (5 papers)

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Research

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11 pages, 825 KiB  
Article
Cognitive and Psychomotor Performance of Patients After Ischemic Stroke Undergoing Early and Late Rehabilitation
by Aleksander Korchut, Danuta Sternal, Sylwia Krzemińska, Ewa Marcisz-Dyla and Ewelina Bąk
J. Clin. Med. 2025, 14(6), 2122; https://doi.org/10.3390/jcm14062122 - 20 Mar 2025
Viewed by 248
Abstract
Objectives: The aim of this study was to determine the performance of cognitive and psychomotor functions in patients after ischemic stroke, taking into account the effectiveness of early and late rehabilitation. Methods: The study included 86 patients with ischemic stroke hospitalized in the [...] Read more.
Objectives: The aim of this study was to determine the performance of cognitive and psychomotor functions in patients after ischemic stroke, taking into account the effectiveness of early and late rehabilitation. Methods: The study included 86 patients with ischemic stroke hospitalized in the Neurological Rehabilitation Unit. The patients were divided into two groups according to the timing of rehabilitation, considering early rehabilitation which started within 30 days of hospital discharge (56 patients), and late rehabilitation which started after 30 days of hospital discharge (30 patients). Cognitive and psychomotor functions were measured in all the study patients using the Integrated System for the Measurement of Psychophysiological Variables called Polypsychograph, including tests assessing memory, attention, eye–hand coordination, and reaction speed. The measurements were repeated after 21 days of post-stroke rehabilitation. Results: Early rehabilitation led to significant improvements in most of the parameters studied, including memory, attention, speed of thinking, and precision of movement. Late rehabilitation was followed by an improvement in the results of the indicators studied to a lesser extent than the early rehabilitation. Improvements in temporal and qualitative parameters were observed in both groups of patients undergoing early and late rehabilitation. Conclusions: In patients after ischemic stroke, early rehabilitation improved cognitive and psychomotor performance to a greater extent than late rehabilitation. Full article
(This article belongs to the Special Issue Clinical Perspectives in Stroke Rehabilitation)
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17 pages, 268 KiB  
Article
Effect of Transcranial Direct Current Stimulation on Memory and Emotional Recovery in Patients with Stroke and Traumatic Brain Injury: A Prospective, Multicenter, Interventional Pilot Study
by Marta Szczepańska, Zofia Twardochleb, Maciej Miś, Marcin Miś, Adam Druszcz, Małgorzata Paprocka-Borowicz and Joanna Rosińczuk
J. Clin. Med. 2025, 14(6), 2083; https://doi.org/10.3390/jcm14062083 - 19 Mar 2025
Viewed by 266
Abstract
Background/Objectives: Emotional and cognitive impairments are prevalent in patients with acute ischemic stroke (AIS) and traumatic brain injury (TBI), significantly affecting their quality of life and recovery potential. Transcranial direct current stimulation (tDCS) has emerged as a promising non-invasive method to enhance neurorehabilitation [...] Read more.
Background/Objectives: Emotional and cognitive impairments are prevalent in patients with acute ischemic stroke (AIS) and traumatic brain injury (TBI), significantly affecting their quality of life and recovery potential. Transcranial direct current stimulation (tDCS) has emerged as a promising non-invasive method to enhance neurorehabilitation outcomes by modulating neural activity. Methods: This prospective, open-label, multicenter interventional study included 100 participants (50 AIS, 50 TBI) who underwent 10 sessions of tDCS. Emotional states, depression levels, and memory and learning outcomes were assessed pre- and post-intervention using the UWIST Mood Adjective Checklist (UMACL), Depression Measurement Questionnaire (DMQ), Benton Visual Retention Test (BVRT), and Brain Damage Diagnostic Test (BDDT). Results: Significant improvements in emotional states were observed post-tDCS. Hedonic tone increased (AIS: 2.5 to 5 stens; TBI: 1.5 to 4 stens), while tension arousal decreased (AIS: 8 to 6 stens; TBI: 8 to 6 stens; all p < 0.001). Depression levels dropped significantly, with the overall depression index decreasing from 131 to 100 points in AIS and from 126 to 104 points in TBI (both p < 0.001). Memory and learning scores improved significantly, evidenced by increased correct responses and reduced errors in BVRT and BDDT tests (all p < 0.001). Conclusions: tDCS effectively improved emotional states, reduced depression levels, and enhanced cognitive functions in AIS and TBI patients. These findings support the integration of tDCS into neurorehabilitation protocols, with further research needed to explore long-term benefits and individualized treatment strategies. Full article
(This article belongs to the Special Issue Clinical Perspectives in Stroke Rehabilitation)
13 pages, 754 KiB  
Article
Assessment of the Psychometric Properties of the Tampa Scale of Kinesiophobia (TSK) Questionnaire in Poland Based on Patients with Type 2 Diabetes Complicated by Stroke
by Ewelina Bąk, Wojciech Kustrzycki, Robert Skalik and Sylwia Krzemińska
J. Clin. Med. 2025, 14(5), 1751; https://doi.org/10.3390/jcm14051751 - 5 Mar 2025
Viewed by 276
Abstract
Background/Objectives: Kinesiophobia, or the fear of movement, is a significant problem in the rehabilitation of patients after a stroke, especially in individuals with diabetes, who have an increased risk of health complications. The aim of the study was to validate the Tampa Scale [...] Read more.
Background/Objectives: Kinesiophobia, or the fear of movement, is a significant problem in the rehabilitation of patients after a stroke, especially in individuals with diabetes, who have an increased risk of health complications. The aim of the study was to validate the Tampa Scale for Kinesiophobia (TSK) for assessing kinesiophobia in the context of patients with diabetes complicated by stroke to ensure its adequacy and reliability in this specific group of patients. Methods: After considering exclusion criteria, 166 patients with type 2 diabetes after ischemic stroke, hospitalized in the neurological rehabilitation ward, were included in the analysis. A survey using the TSK was conducted in the study group. A reliability analysis of the questionnaire was conducted, and then exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to disclose the number of factors that characterize the study group. Results: The Cronbach’s alpha value for the entire scale is 0.875. The value for all the questions on the scale was also above 0.86, so they are considered reliable. Removing any question does not increase the value of Cronbach’s alpha or Guttman index. Based on the scree plot, two factors were identified. The first factor includes 12 items and forms a physical factor, while the second factor includes 5 items and forms a psychological factor. The fit of the two-factor model was checked using confirmatory factor analysis. The final two-factor model has an acceptable fit. All the factor loadings are statistically significant. The factor loadings range from 0.262 to 0.729 for the physical factor and from 0.543 to 0.822 for the psychological factor. Conclusions: The TSK is a reliable and valid tool for assessing the level of kinesiophobia in a group of patients with type 2 diabetes complicated by stroke. The results of the study using this tool may contribute to the development of more effective therapeutic strategies that take into account the specific physical and psychological needs of this group of patients. Full article
(This article belongs to the Special Issue Clinical Perspectives in Stroke Rehabilitation)
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12 pages, 1315 KiB  
Article
Analyzing the Impact of Rehabilitation Utilizing Neurofunctional Exercises on the Functional Status of Stroke Patients
by Rafał Studnicki, Karolina Studzińska, Tomasz Adamczewski, Rita Hansdorfer-Korzon and Maciek Krawczyk
J. Clin. Med. 2024, 13(20), 6271; https://doi.org/10.3390/jcm13206271 - 21 Oct 2024
Viewed by 1166
Abstract
Background/Objectives: Physical rehabilitation based on neurofunctional exercises can have a positive impact on restoring functionality and enhancing the quality of life of these individuals. Therefore, the purpose of this study is to analyze the effects of rehabilitation, including neurofunctional exercises, on the [...] Read more.
Background/Objectives: Physical rehabilitation based on neurofunctional exercises can have a positive impact on restoring functionality and enhancing the quality of life of these individuals. Therefore, the purpose of this study is to analyze the effects of rehabilitation, including neurofunctional exercises, on the functional status of stroke patients. Methods: The cohort study design included 102 male and female participants: 51 patients underwent physiotherapy rehabilitation including neurofunctional exercises (SG), while the other 51 did not follow a rehabilitation program based on neurofunctional exercises (CG). The participants were assessed twice: once during their stay in the early neurology department after the first stroke, and again six months later. The assessments were conducted using the Barthel Scale (BS), the Rankin Scale (RS), and the National Institutes of Health Stroke Scale (NIHSS). Results: Baseline comparisons revealed significantly greater BS (p = 0.001) in the CG compared to the SG. Conversely, the SG had a significantly higher NIHSS than the CG at baseline (p = 0.001), as well as higher RS (p < 0.001). Within the SG, there were significant increases in BS (p < 0.001), while no significant differences were found between baseline and post 6 months in RS (p = 0.537) and NIHSS (p = 0.475). Regarding the CG, significant increases were observed in BS (p = 0.005) and NIHSS (p < 0.001), while no significant differences were found in RS (p = 0.335). Conclusions: In conclusion, this study reveals that incorporating neurofunctional exercises does not appear to play a significant role in the patients’ progress. The controlled group, engaged in home-based activities, showed greater improvements in their condition. Full article
(This article belongs to the Special Issue Clinical Perspectives in Stroke Rehabilitation)
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Review

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15 pages, 482 KiB  
Review
Efficacy and Safety of Early Mobilization and Factors Associated with Rehabilitation After Stroke—Review
by Karolina Filipska-Blejder, Krystyna Jaracz and Robert Ślusarz
J. Clin. Med. 2025, 14(5), 1585; https://doi.org/10.3390/jcm14051585 - 26 Feb 2025
Viewed by 387
Abstract
Background/Objectives: Knowledge about the safety and effectiveness of early post-stroke mobilization and its correlation with various factors is necessary to select an appropriate rehabilitation program and reduce the time of convalescence. Understanding the above processes will help to effectively lower the economic burden. [...] Read more.
Background/Objectives: Knowledge about the safety and effectiveness of early post-stroke mobilization and its correlation with various factors is necessary to select an appropriate rehabilitation program and reduce the time of convalescence. Understanding the above processes will help to effectively lower the economic burden. Thus, we conducted a review to assess the safety and effectiveness of early post-stroke rehabilitation and the impact of various factors on the course of therapy. Methods: The analysis included publications meeting the inclusion criteria published in the years 2015–2024 in Web of Science, Scopus, Embase, and PubMed. Finally, 12 studies were qualified for the review. The study group ranged from 37 to 2325 people. Results: The results of studies on early stroke mobilization indicate possible benefits, including reduced time of hospitalization and faster achievement of higher functional scores. It has been shown that the important factors correlating with the effectiveness of therapy include: rehabilitation intensity, age, functional status before the stroke, depression, social support, lesion location, lower extremity deep vein thrombosis, cognitive disorder, dysphagia, and lower limb spasticity. Conclusions: There is a strong need for research into post-stroke rehabilitation to speed up recovery times and reduce the economic burden on the country. Current research findings on the efficacy and safety of early rehabilitation are inconsistent. There is a strong need for international guidelines. Full article
(This article belongs to the Special Issue Clinical Perspectives in Stroke Rehabilitation)
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