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Stroke and Rehabilitation

Hanne Pallesen, Lena Aadal, Siri Moe, Cathrine Arntzen
Objectives: The recovery process is reported by stroke survivors to be a change process fraught with crises and hazard. Interaction with health professionals and others may play a central role in establishing renewed control over life. Research Questions: (1) How do patients handle and overcome experienced changes after stroke? (2) How do they experience the support to handle these changes during the first year after stroke? (3) How do the similarities and differences transpire in Danish and Norwegian contexts? Methodology ...
2019: Rehabilitation Research and Practice
Chung-Chieh Yu, Chih-Yu Huang, Wei-Ke Kuo, Chung-Yao Chen
Objectives: To assess the effect of continuous positive airway pressure (CPAP) on nocturia in ischemic stroke patients with obstructive sleep apnea (OSA). Methods: This was a prospective and non-randomized controlled study in which ischemic stroke patients with OSA being treated in a rehabilitation ward were enrolled. The participants who tolerated CPAP were classified as the CPAP group, while those who refused or could not tolerate CPAP were classified as the control group...
2019: Clinical Interventions in Aging
JuHyung Park
[Purpose] The purpose of this study was to examine the effects of time-use intervention on the quality of life of outpatients with chronic stroke. [Participants and Methods] This study randomly allocated 31 chronic stroke outpatients into an experimental group (n=16) and a control group (n=15). The experiment group was given general rehabilitative therapy three times per week for eight weeks, and time-use intervention through counselling once per week for eight weeks. The control group was given general rehabilitative therapy only for three times per week for eight weeks...
January 2019: Journal of Physical Therapy Science
Ying Yuan, Xiang-Hong Cai, Feng Chen, Dong-Xiao Chen, Ying Gao, Zi-Zhen Liu, Meng-Xin Ling, Ping Xu
OBJECTIVE: To observe the effect of deep acupuncture of Tiantu (CV22), etc. in combination with rehabilitation training on swallowing function of patients with post-stroke dysphasia. METHODS: A total of 70 patients suffering from post-stroke dysphagia were randomly divided into control group (conventional acupuncture+ swallowing rehabilitation training) and treatment group (deep acupuncture of CV22 + rehabilitation training, n = 35 cases in each group). The swallowing rehabilitation procedure was conducted 30 min every time, twice daily, 5 times a week for 3 weeks...
January 25, 2019: Zhen Ci Yan Jiu, Acupuncture Research
Chantal Viscogliosi, Johanne Desrosiers, Sylvie Belleville
ABSTRACTThis longitudinal mixed-method study examined the types of help provided by caregivers to optimize participation of older adults with cognitive deficits post-stroke (care recipients), and how these types of help varied with caregiver's burden. Twelve family caregivers of care recipients post-stroke completed a burden questionnaire and semi-structured interviews one month, three months, and six months following care recipient's discharge home from acute care, rehabilitation, or day hospital. Care recipients completed cognitive tests and a social participation questionnaire...
February 18, 2019: Canadian Journal on Aging, la Revue Canadienne du Vieillissement
Jessica L Kelleher, Paul Weiss, Amy D Rodriguez, Joe R Nocera, Monica C Serra
BACKGROUND: Little is known about the body weight goals and trends of stroke survivors, despite evidence that overweight and obesity can negatively influence poststroke rehabilitation outcomes. Thus, the purpose of this study was to identify self-reported body weight trends over time in stroke survivors and nonstroke controls (>50 years old) and describe the methods used to attempt to achieve body weight goals. METHODS: Self-reported body weight 1) at age 25 years, 2) 10 years prior to the current assessment, 3) 1 year prior to the current assessment, 4) current weight, and 5) age of heaviest body weight were collected from adults self-reporting a stroke in the 2011-2012 and 2013-2014 National Health and Nutrition Examination Surveys (stroke: N = 387 and nonstroke: N = 5085)...
February 13, 2019: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Nick S Ward, Fran Brander, Kate Kelly
OBJECTIVE: Persistent difficulty in using the upper limb remains a major contributor to physical disability post-stroke. There is a nihilistic view about what clinically relevant changes are possible after the early post-stroke phase. The Queen Square Upper Limb Neurorehabilitation programme delivers high-quality, high-dose, high-intensity upper limb neurorehabilitation during a 3-week (90 hours) programme. Here, we report clinical changes made by the chronic stroke patients treated on the programme, factors that might predict responsiveness to therapy and the relationship between changes in impairment and activity...
February 15, 2019: Journal of Neurology, Neurosurgery, and Psychiatry
Giovanni Morone, Marco Iosa, Teresa Paolucci, Luca Muzzioli, Stefano Paolucci
OBJECTIVE: To investigate the association between body mass index (BMI) and rehabilitation outcome in hemiparetic patients with stroke in subacute phase. DESIGN: This was a prospective study testing the correlation between BMI and the effectiveness of rehabilitation, measured using Barthel Index (BI) scores. We enrolled patients with subacute stroke (n=664, age 68±14 years, length of hospital stay 84±34 days). We assessed the BMI and BI both at admission and discharge...
February 12, 2019: American Journal of Physical Medicine & Rehabilitation
Lazar I Jovanovic, Naaz Kapadia, Lorna Lo, Vera Zivanovic, Milos R Popovic, Cesar Marquez-Chin
Functional electrical stimulation therapy (FEST) is a state-of-the-art treatment for retraining motor function following neurological injuries. Recent literature suggests that FEST can be further improved with brain-computer interface (BCI) technology. In this case study, we assessed the feasibility of using BCI-triggered FEST (BCI-FEST) to restore upper-limb function in a 57-year old male with severe left hemiplegia resulting from a stroke six years prior to enrollment in the study. The intervention consisted of two blocks of 40 one-hour BCI-FEST sessions (total of 80 sessions) for the left upper limb, with three sessions delivered weekly...
February 13, 2019: American Journal of Physical Medicine & Rehabilitation
Adela Desowska, Duncan L Turner
Recovery from a stroke is a dynamic time-dependent process, in which the central nervous system reorganises to accommodate for the impact of the injury. The purpose of this paper is to review recent longitudinal studies of changes in brain connectivity after stroke. A systematic review of research papers reporting functional or effective connectivity at two or more time points in stroke patients was conducted. Stroke leads to an early reduction of connectivity in the motor network. With recovery time, the connectivity increases and can reach the same levels as in healthy participants...
February 15, 2019: Reviews in the Neurosciences
Alexander Lilja-Cyron, Morten Andresen, Jesper Kelsen, Trine Hjorslev Andreasen, Kåre Fugleholm, Marianne Juhler
BACKGROUND: Decompressive craniectomy (DC) is used in cases of severe intracranial hypertension or impending intracranial herniation. DC effectively lowers intracranial pressure (ICP) but carries a risk of severe complications related to abnormal ICP and/or cerebrospinal fluid (CSF) circulation, eg, hygroma formation, hydrocephalus, and "syndrome of the trephined." OBJECTIVE: To study the long-term effect of DC on ICP, postural ICP regulation, and intracranial pulse wave amplitude (PWA)...
February 15, 2019: Neurosurgery
Shirley Handelzalts, Michal Kenner-Furman, Ganit Gray, Nachum Soroker, Guy Shani, Itshak Melzer
BACKGROUND: Reactive balance responses are critical for fall prevention. Perturbation-based balance training (PBBT) has shown a positive effect in reducing the risk of falls among older adults and persons with Parkinson's disease. OBJECTIVE: To explore the effect of a short-term PBBT on reactive balance responses, performance-based measures of balance and gait and balance confidence. METHODS: Thirty-four moderate-high functioning, subacute persons with stroke (PwS) (lower extremity Fugl-Meyer score 29...
February 15, 2019: Neurorehabilitation and Neural Repair
Marialuisa Gandolfi, Nicola Valè, Eleonora Kirilova Dimitrova, Stefano Mazzoleni, Elena Battini, Mirko Filippetti, Alessandro Picelli, Andrea Santamato, Michele Gravina, Leopold Saltuari, Nicola Smania
Background: The combined use of Robot-assisted UL training and Botulinum toxin (BoNT) appear to be a promising therapeutic synergism to improve UL function in chronic stroke patients. Objective: To evaluate the effects of Robot-assisted UL training on UL spasticity, function, muscle strength and the electromyographic UL muscles activity in chronic stroke patients treated with Botulinum toxin. Methods: This single-blind, randomized, controlled trial involved 32 chronic stroke outpatients with UL spastic hemiparesis...
2019: Frontiers in Neurology
Sarah Prior, Nicole Reeves, Gregory Peterson, Linda Jaffray, Steven Campbell
Sexual dysfunction is common but often under-recognised or neglected after stroke. This study sought to identify the existing methods for providing information and discussion on post-stroke sexual activity, and perceived gaps from the patient perspective. A sample of 1265 participants who had been admitted to any of the four major public hospitals in Tasmania, Australia, with stroke (International Classification of Diseases (ICD-10) group B70) were mailed a survey assessing their experiences with, and opinions about, receipt of post-stroke sexual activity education...
February 5, 2019: Healthcare (Basel, Switzerland)
Katrine M L Sauvé-Schenk, Mary Y Egan, Claire-Jehanne Dubouloz-Wilner, Elizabeth Kristjansson
PURPOSE: Low income is known to influence participation post stroke, but the process by which this occurs is poorly understood. METHODS: A qualitative multiple case study approach, focusing on the experience of returning to participation in personal projects among eight low-income francophone stroke survivors living in eastern Ontario (Canada). Data included semi-structured interviews with the stroke survivors and with their care partners, participant observations, assessment measures, and chart reviews...
February 14, 2019: Disability and Rehabilitation
Chuanxin M Niu, Yong Bao, Cheng Zhuang, Si Li, Tong Wang, Lijun Cui, Qing Xie, Ning Lan
Functional electrical stimulation (FES) is capable of activating muscles that are under-recruited in neurological diseases, such as stroke. Therefore, FES provides a promising technology for assisting upper-limb motor functions in rehabilitation following stroke. However, the full benefits of FES may be limited due to lack of a systematic approach to formulate the pattern of stimulation. Our preliminary work demonstrated that it is feasible to use muscle synergy to guide the generation of FES patterns.In this paper, we present a methodology of formulating FES patterns based on muscle synergies of a normal subject using a programmable multi-channel FES device...
February 2019: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Arzu Güçlü Gündüz, Gökhan Yazıcı, Çağla Özkul, Hamit Küçük, Hale Zeynep Batur Çağlayan, Bijen Nazlıel
Background/aim: Following stroke, damage to the central nervous system and adaptive changes in muscle tissue are factors responsible for the loss of muscle strength. Even though it is suggested that early physiotherapy and mobilization prevent structural adaptive changes in muscle tissue, studies regarding this issue are insufficient. The aim of this study is to investigate the effects of early physiotherapy and mobilization on quadriceps muscle thickness (QMT) in stroke patients. Materials and methods: Twelve stroke patients who were admitted to the neurology intensive care unit and 13 healthy controls were included in the study...
February 11, 2019: Turkish Journal of Medical Sciences
Julinda Mehilli, Jaya Chandrasekhar, Samantha Sartori, Alaide Chieffo, Anna S Petronio, Thierry Lefèvre, Patrizia Presbitero, Piera Capranzano, Didier Tchetche, Alessandro Iadanza, Gennaro Sardella, Nicolas M Van Mieghem, Emanuela Meliga, Nicolas Dumonteil, Chiara Fraccaro, Daniela Trabattoni, David Jochheim, Magda Zadrozny, Ghada W Mikhail, Samin Sharma, Maria C Ferrer, Christoph Naber, Peter Kievit, Kamilia Moalem, Usman Baber, Clayton Snyder, Madhav Sharma, Marie C Morice, Roxana Mehran
BACKGROUND: Several clinical and procedural factors determine outcomes after transcatheter aortic valve replacement (TAVR), but data are scarce on the impact of post-TAVR discharge disposition on long-term outcomes. We sought to analyse whether discharge location after TAVR is associated with 1-year outcomes in women undergoing contemporary TAVR. METHODS: The Women's INternational Transcatheter Aortic Valve Implantation (WIN-TAVI) registry is the first all-female TAVR registry to study the safety and performance of contemporary TAVR in women (n = 1019)...
February 2019: Canadian Journal of Cardiology
Deanna Anderlini, Guy Wallis, Welber Marinovic
Stroke is the third leading cause of death in the developed world and the primary cause of adult disability. The most common site of stroke is the middle cerebral artery (MCA), an artery that supplies a range of areas involved in both language and motor function. As a consequence, many stroke patients experience a combination of language and motor deficits. Indeed, those suffering from Broca's aphasia have an 80% chance of also suffering hemiplegia. Despite the prevalence of multifaceted disability in patients, the current trend in both clinical trials and clinical practice is toward compartmentalization of dysfunction...
February 13, 2019: Neurorehabilitation and Neural Repair
Gulcihan Arkan, Ayse Beser, Meryem Ozturk Haney, Vesile Ozturk
BACKGROUND: When stroke survivors return to their lives in society, they often face issues such as physical or cognitive impairment, dependence on others, social isolation, and reduced self-esteem, which may lead to disastrous consequences in patients' self-perceived self-efficacy and self-confidence in everyday life. Self-efficacy plays an important role in the well-being of stroke patients. Accurate assessment of the stroke patients' self-efficacy by health professionals is critical to obtaining data regarding their functioning levels...
February 8, 2019: Journal of Nursing Research: JNR
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