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CVA AND Physical therapy

Prakrity Urja, Eric H Nippoldt, Virginia Barak, Carrie Valenta
Value-based care emphasizes achieving the greatest overall health benefit for every dollar spent. We present an interesting case of stroke, which made us consider how frequently health care providers are utilizing value-based care. A 73-year-old Caucasian, who was initially admitted for a hypertensive emergency, was transferred to our facility for worsening slurring of speech and left-sided weakness. The patient had an extensive chronic cerebrovascular disease, including multiple embolic type strokes, mainly in the distribution of the right temporal-occipital cerebral artery and transient ischemic attacks (TIAs)...
August 1, 2017: Curēus
Priya Karakkattil, Elaine Trudelle-Jackson, Heather Hilliard Brown, Patrick Hammontree, Mary Okolo
BACKGROUND: There is evidence that Botulinum Toxin-A (BTX-A) reduces focal spasticity associated with equinovarus to improve gait in patients poststroke. However, there is little research examining whether gait improvements are maintained after the effectiveness period of BTX-A injections. The purpose of this observational study was to determine whether there was a difference in gait parameters in three patients before BTX-A injection versus four and ten weeks after. CASE SERIES: Three women, ages 63, 60, and 42 postischemic stroke with hemiparesis and equinovarus underwent measurements for: plantar flexor spasticity, ankle dorsiflexion ROM, temporal-spatial gait parameters, and gait endurance...
May 2017: Physiotherapy Theory and Practice
Eglė Lendraitienė, Agnė Tamošauskaitė, Daiva Petruševičienė, Raimondas Savickas
A stroke (cerebrovascular accident - CVA) is a significant social-economic issue. Approximately 15-30% of all patients develop life-long disability, 20% require over 3 months of specialized care in healthcare institutions, and the majority of the patients never recover the ability to maintain a proper vertical position. Such CVA sequelae as balance disturbances not only negatively affect patients' daily physical activity, but also result in social isolation. A number of standardized clinical scales, tests, and instrumental examination techniques have been proposed for evaluating not only post-CVA balance function, but also any changes in this function following various interventions...
January 2017: Neurologia i Neurochirurgia Polska
Nicole E Tuong, Adam P Klausner, Lance J Hampton
INTRODUCTION: Cerebrovascular accidents, or strokes, are a common cause of morbidity and mortality in the United States. Urinary incontinence is a prevalent morbidity experienced by post-stroke patients that is associated with long term disability and institutionalization effects on these patients. MATERIALS AND METHODS: An extensive literature review was conducted using multiple academic search engines using the keywords: 'stroke,' 'CVA,' 'urinary incontinence,' 'urodynamics,' 'pharmacologic treatments,' and 'conservative treatments...
June 2016: Canadian Journal of Urology
Noriyuki Ohkura, Johsuke Hara, Tamami Sakai, Akihito Okazaki, Miki Abo, Kazuo Kasahara, Masaki Fujimura
BACKGROUND: Atopic cough (AC) and cough variant asthma (CVA) were identified as major causes of chronic non-productive cough in a Japanese study. A characteristic feature of CVA is the presence of a heightened cough response to bronchoconstriction. On the other hand, the cough response to bronchoconstriction in AC remains unclear. METHODS: Methacholine (Mch)-induced cough in AC was measured and compared with that in CVA. Diagnoses of AC and CVA were made based on patient history, physical examination, response to bronchodilator therapy, cough reflex sensitivity to capsaicin, spirometry, and airway responsiveness to methacholine...
June 2016: Experimental Lung Research
A DeWitt, C Patel, R Kuapati, K Reddy
A 56-year-old man with a history of uncontrolled type 2 diabetes mellitus, benign prostatic hypertrophy and history of recent knee and elbow abscess presented to the emergency department with nausea, vomiting, and fevers. Two days prior, he presented to the ER and was diagnosed with acute presumed prostatitis and urinary retention. He was discharged on ciprofloxacin and an indwelling Foley catheter with urology follow-up. After being unable to tolerate oral medications, he presented again to the emergency department, at which time, he was febrile and tachycardic...
May 2015: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Ou Bai, Dandan Huang, Ding-Yu Fei, Richard Kunz
BACKGROUND: Mental practice using motor imagery of limb movement may facilitate motor recovery in persons who have experienced cerebrovascular accident (CVA). However, the lack of a feedback mechanism that can monitor the quality of the motor imagery affects patients' engagement and motivation to participate in the mental practice training program. OBJECTIVE: This study investigates the effect of novel real-time motor imagery-associated cortical activity feedback on motor imagery-based mental practice training...
2014: NeuroRehabilitation
Barbara M Doucet, Jill Seale
Healthcare students are often challenged in understanding the complexities associated with the diagnosis of cerebrovascular accident (CVA, stroke). Due to the diversity of clinical presentations following stroke and the intractable nature of some stroke sequelae, learning to effectively manage persons with stroke cannot always be translated solely through didactic methods. This paper describes a free post-stroke clinic, organized as part of the occupational therapy (OT) and physical therapy (PT) curricula, that offered hands-on learning with actual patients with stroke, provided a needed service to the community, and established a pathway for university stroke research...
2012: Journal of Allied Health
Ebru Alemdaroğlu, Halil Uçan, Aslı Mete Topçuoğlu, Filiz Sivas
OBJECTIVE: To determine predictors of falls in stroke patients in the first 6 months after a baseline evaluation before their discharge from inpatient rehabilitation. DESIGN: Prospective cohort study. SETTING: Rehabilitation hospital, then home. PARTICIPANTS: Consecutive stroke patients (N=66) were followed at home after discharge from the rehabilitation hospital. INTERVENTIONS: Not applicable...
December 2012: Archives of Physical Medicine and Rehabilitation
James F Malec, Jacob Kean, Irwin M Altman, Shannon Swick
OBJECTIVES: (1) To evaluate the measurement reliability and construct validity of the Mayo-Portland Adaptability Inventory, 4th revision (MPAI-4) in a sample consisting exclusively of patients with cerebrovascular accident (CVA) using single parameter (Rasch) item-response methods; (2) to examine the differential item functioning (DIF) by sex within the CVA population; and (3) to examine DIF and differential test functioning (DTF) across traumatic brain injury (TBI) and CVA samples. DESIGN: Retrospective psychometric analysis of rating scale data...
December 2012: Archives of Physical Medicine and Rehabilitation
Juan Yang, En-mei Liu, Jin-feng Wei, Kun-hua Chen, Zheng-xiu Luo, Jian Luo, Zhou Fu, Li-jia Wang, Quan Lu
OBJECTIVE: To investigate the proportion of incidence of children with non-specific chronic cough in Chongqing and analyze the characteristics of etiology during the follow-up. METHOD: Diagnostic criteria were defined for children with non-specific chronic cough according to the Guidelines of diagnosis and therapy for children with chronic cough that were formulated by the Subspecialty Group, Society of Pediatrics, Chinese Medical Association and Chinese Journal of Pediatrics in 2008...
June 2010: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Rita Sleimen-Malkoun, Jean Jacques Temprado, Viktor K Jirsa, Eric Berton
In the present paper, we review the main concepts of the dynamical systems approach to bimanual coordination and propose applications to therapeutic intervention for functional recovery of coordinated movements in stroke. Further, we describe the behavioral alterations of discrete bimanual coordination resulting from cerebral vascular accident (CVA) lesions and speculate on the possibility of mimicking the mechanisms of CVA lesions via symmetry breaking in dynamic systems.
October 2010: Nonlinear Dynamics, Psychology, and Life Sciences
Guo-liang Lu, Jiang-tao Lin
OBJECTIVE: To explore the spectrum and clinical features of causes for chronic cough. METHODS: A total of 103 patients with at least 8 weeks of chronic cough and normal chest radiographs were recruited from the outpatient clinic of China-Japan Friendship Hospital Department of Respiratory Diseases between Oct 2005 to Feb 2009. The causes were investigated using a well established protocol according to The Chinese Respiratory Society guidelines for management of cough...
June 2009: Chinese Journal of Tuberculosis and Respiratory Diseases
V Alvarez, P Dussoix, J-M Gaspoz
The incidence of facial palsy is about 50/100000/year, i.e. 210 cases/year in Geneva. Clinicians can be puzzled by it, because it encompasses aetiologies with very diverse prognoses. Most patients suffer from Bell palsy that evolves favourably. Some, however, suffer from diseases such as meningitis, HIV infection, Lyme's disease, CVA, that require fast identification because of their severity and of the need for specific treatments. This article proposes an algorithm for pragmatic and evidence-based management of facial palsy...
January 28, 2009: Revue Médicale Suisse
Zhi-hong Wang, Jiang-tao Lin, Yong Li, Jie Gao, Jia-jia Zhu
OBJECTIVE: To analyze the etiological diagnosis and efficacy of specific therapy of chronic cough. METHODS: Totally 106 patients with chronic cough were diagnosed using a diagnostic protocol based on the Guideline on Diagnosis and Treatment of Chronic Cough established by China Medical Association, which included history inquiry, physical examination, pulmonary function tests, X-ray or CT of paranasal sinuses or chest, 24-hour esophageal pH monitoring, and sputum cell differentials...
October 2007: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
F J Aidar, A J Silva, V M Reis, A Carneiro, S Carneiro-Cotta
INTRODUCTION: Cerebrovascular accidents (CVA) are the third most common cause of death and are the main cause of permanent disability in the western world, where they also rank first as regards the loss of years of disability-adapted independent life. Ischaemic CVAs tend to present irreversible sequelae, which reduces the patient's quality of life. AIM: To analyse the effect of a series of exercises carried out in water on the quality of life of patients who have had an ischaemic CVA...
November 1, 2007: Revista de Neurologia
Amole Khadilkar, Karin Phillips, Nathalie Jean, Catherine Lamothe, Sarah Milne, Joanna Sarnecka
BACKGROUND AND PURPOSE: The purpose of this project was to create guidelines for 13 types of physical rehabilitation interventions used in the management of adult patients (>18 years of age) presenting with hemiplegia or hemiparesis following a single clinically identifiable ischemic or hemorrhagic cerebrovascular accident (CVA). METHOD: Using Cochrane Collaboration methods, the Ottawa Methods Group identified and synthesized evidence from comparative controlled trials...
2006: Topics in Stroke Rehabilitation
Peter V Dicpinigaitis
BACKGROUND: Asthma is among the most common causes of chronic cough in adult nonsmokers. Although cough usually accompanies dyspnea and wheezing, it may present in isolation as a precursor of typical asthmatic symptoms, or it may remain the predominant or sole symptom of asthma. The latter condition is known as cough-variant asthma (CVA). METHODS: Data for this review were obtained from a National Library of Medicine (PubMed) search, performed in April 2004, of the English language literature from 1975 to 2004, limited to human studies, using the search terms "cough" and "asthma...
January 2006: Chest
Craig J Newsam, Lucinda L Baker
OBJECTIVE: To compare maximum voluntary isometric torque (MVIT) and motor unit recruitment of the quadriceps after an electric stimulation facilitation program in persons affected by cerebrovascular accident (CVA). DESIGN: Three-week, randomized controlled trial with an electric stimulation facilitation program added to standard care. SETTING: Inpatient rehabilitation center. PARTICIPANTS: Twenty patients receiving rehabilitation for first-time CVA (51...
December 2004: Archives of Physical Medicine and Rehabilitation
Stephen J Page, David R Gater, Paul Bach-Y-Rita
Termination of motor rehabilitation is often recommended as patients with cerebrovascular accident (CVA) become more chronic and/or when they fail to respond positively to motor rehabilitation (commonly termed a "plateau"). Managed-care programs frequently reinforce this practice by restricting care to patients responding to therapy and/or to the most acute patients. When neuromuscular adaptation occurs in exercise, rather than terminating the current regimen, a variety of techniques (eg, modifying intensity, attempting different modalities) are used to facilitate neuromuscular adaptations...
August 2004: Archives of Physical Medicine and Rehabilitation
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