Title:
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Sleep and daytime functioning in chronic stroke patients with hemiparesis
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Sleep is a critical modulator for daytime functioning, health and wellbeing and has a
pivotal role in motor memory consolidation. It is for these reasons that sleep is a
potentially important part of stroke care. However, this idea is severely under
researched. It is necessary to explore sleep behaviour in stroke patients and the
importance of healthy sleep for recovery and neurorehabilitation. More specifically,
investigate the extent to which sleep may be a key modulator for motor
neurorehabilitation success. It is the central aim of this thesis to contribute to the
understanding of the sleep behaviour and daytime functioning in patients with
chronic physical deficits after stroke and to explore the potential role of sleep for
neurorehabilitation. Furthermore, this is the first known study to monitor sleep
behaviour during a motor neurorehabilitation trial and assess outcome within this
context. The research aimed to: 1) make a substantial contribution to the under
researched field of post stroke sleep, 2) address some of the limitations imposed on
previous studies, 3) focus on a specific cohort, 4) examine sleep in the context of a
neurorehabilitation programme. The patient cohort employed in this research
comprised chronic stroke patients (>'12 months) with upper limb hemiparesis. It was
found that sleep and daytime functioning disturbances were prevalent in
approximately one third of patients. Interestingly, patients were not generally aware
of the severity of their daytime functioning deficits. Sleep and daytime functioning
were mildly related to motor recovery and neurorehabilitation. In conclusion, sleep
clearly has a role in stroke patient quality of life, recovery and neurorehabilitation
outcome, however further research using alternative assessments of sleep are
necessary. The findings of this thesis have implications for post stroke management
including increasing medical knowledge and adjustments in rehabilitation protocols
that favour sleep.
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