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https://www.readbyqxmd.com/read/29123562/the-role-of-occupational-and-physiotherapy-in-multi-modal-approach-to-tackling-delirium-in-the-intensive-care
#1
REVIEW
Jenny Rains, Nigel Chee
The presence of delirium within critical care remains a long-standing challenge for patients and clinicians alike. A myriad of pre-disposing and precipitating factors lead to this patient cohort being high risk for developing delirium during their critical care stay. Until now, non-pharmacological management of these patients usually encompasses a 'bundle' of principles to reduce delirium days. These bundles have limited focus on the entire multi-disciplinary team (including occupational therapists and physiotherapists) who could assist with the reduction of delirium...
November 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29111342/the-use-of-repetitive-transcranial-magnetic-stimulation-for-stroke-rehabilitation-a-systematic-review
#2
REVIEW
Ana Dionísio, Isabel Catarina Duarte, Miguel Patrício, Miguel Castelo-Branco
OBJECTIVES: Stroke is a leading cause of disability. Alternative and more effective techniques for stroke rehabilitation have been sought to overcome limitations of conventional therapies. Repetitive transcranial magnetic stimulation (rTMS) arises as a promising tool in this context. This systematic review aims to provide a state of the art on the application of rTMS in stroke patients and to assess its effectiveness in clinical rehabilitation of motor function. METHODS: Studies included in this review were identified by searching PubMed and ISI Web of Science...
October 27, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28956721/examining-a-participation-focused-stroke-self-management-intervention-in-a-day-rehabilitation-setting-a-quasi-experimental-pilot-study
#3
Danbi Lee, Heidi Fischer, Sarah Zera, Rosetta Robertson, Joy Hammel
Background People with stroke often find discharge from rehabilitation distressing because they do not feel prepared to participate in life roles as they want. A self-management approach can facilitate improvement in confidence and ability to manage post-stroke community living and participation after transitioning into the community. Objective To evaluate the feasibility and effectiveness of the Improving Participation After Stroke Self-management program - Rehab version (IPASS-R) in a day rehabilitation setting...
September 28, 2017: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/28946996/motion-rehab-ave-3d-a-vr-based-exergame-for-post-stroke-rehabilitation
#4
Mateus Trombetta, Patrícia Paula Bazzanello Henrique, Manoela Rogofski Brum, Eliane Lucia Colussi, Ana Carolina Bertoletti De Marchi, Rafael Rieder
BACKGROUND AND OBJECTIVE: Recent researches about games for post-stroke rehabilitation have been increasing, focusing in upper limb, lower limb and balance situations, and showing good experiences and results. With this in mind, this paper presents Motion Rehab AVE 3D, a serious game for post-stroke rehabilitation of patients with mild stroke. The aim is offer a new technology in order to assist the traditional therapy and motivate the patient to execute his/her rehabilitation program, under health professional supervision...
November 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28892716/neuroscience-step-down-unit-admission-criteria-for-patients-with-intracerebral-hemorrhage
#5
Ayham M Alkhachroum, Oladi Bentho, Neel Chari, Ashish Kulhari, Wei Xiong
OBJECTIVES: The goal of our study is to determine optimal criteria which can be used to avoid admission to neuroscience intensive care units for patients with intracerebral hemorrhage (ICH). PATIENTS AND METHODS: This is a retrospective cohort study of 431 patients with primary ICH from January 2013 to the end of December 2015 and reviewed multiple admitting characteristics. Based on these needs, we tested the following step-down unit admission criteria: Supratentorial ICH, ICH volume <20 cc, no Intraventricular hemorrhage (IVH), systolic BP <200mmHg, no respiratory failure, GCS≥12...
November 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28768347/-trajectory-analysis-of-participation-in-a-sample-of-stroke-patients-in-german-neurological-outpatient-rehabilitation-centres
#6
Judit Marheineke, Ruth Deck, Paul Reuther, Dominik Pöppl
Objective We used a trajectory analysis to evaluate the course of participation in a sample of stroke patients in German neurological outpatient rehabilitation centres. Among other benefits, the method of trajectory analysis enables exploration of variables that influence the course of rehabilitation. Method In a multicentric observational study, patients at 17 outpatient neurorehabilitation centres were asked to fill in a questionnaire four times: at the time of admission to the rehabilitation center, on discharge and on month 4 and 12 post rehab...
July 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28696373/rehabilitation-plus-onabotulinumtoxina-improves-motor-function-over-onabotulinumtoxina-alone-in-post-stroke-upper-limb-spasticity-a-single-blind-randomized-trial
#7
Deidre Devier, JoAnn Harnar, Leandro Lopez, Allison Brashear, Glenn Graham
BACKGROUND: OnabotulinumtoxinA (BoNT-A) can temporarily decrease spasticity following stroke, but whether there is an associated improvement in upper limb function is less clear. This study measured the benefit of adding weekly rehabilitation to a background of BoNT-A treatments for chronic upper limb spasticity following stroke. METHODS: This was a multi-center clinical trial. Thirty-one patients with post-stroke upper limb spasticity were treated with BoNT-A. They were then randomly assigned to 24 weeks of weekly upper limb rehabilitation or no rehabilitation...
July 11, 2017: Toxins
https://www.readbyqxmd.com/read/28616033/exercise-induced-muscle-fatigue-in-the-unaffected-knee-joint-and-its-influence-on-postural-control-and-lower-limb-kinematics-in-stroke-patients
#8
Sun Wook Park, Sung Min Son, Na Kyung Lee
This study aimed to investigate the effects of exercise-induced muscle fatigue in the unaffected knee joint on postural control and kinematic changes in stroke patients. Forty participants (20 stroke patients, 20 age-matched healthy participants) were recruited. To induce fatigue, maximum voluntary isometric contractions were performed in the unaffected knee joint in a Leg Extension Rehab exercise machine using the pneumatic resistance. We measured static and dynamic balance and lower-limb kinematics during gait...
May 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28482696/are-unstable-support-surfaces-superior-to-stable-support-surfaces-during-trunk-rehabilitation-after-stroke-a-systematic-review
#9
Tamaya Van Criekinge, Wim Saeys, Luc Vereeck, Willem De Hertogh, Steven Truijen
OBJECTIVE: To investigate the effect of trunk rehabilitation using unstable support surfaces compared to stable support surfaces, on static and dynamic balance after stroke. MATERIALS AND METHODS: A systematic review was conducted to identify relevant articles from the following databases: Medline (PubMed), Web of Science, PEDro, REHAB+, Rehabdata, Science Direct, CIRRIE, and Cochrane library. Studies were included when they involved adult stroke patients; were controlled clinical trials; assessed static and dynamic balance; and incorporated trunk exercises on stable or unstable support surfaces...
May 9, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28414666/just-a-puff-of-smoke
#10
A Leonard
CASE: A 44 year old woman with a history of stroke s/p aneurysm clipping, seizure, and substance abuse was brought to the hospital after a family member received a call from her friend saying she was acting unusual and may have had a seizure while hanging out on the street. At her baseline, she needed modest assistance in daily activities after her CVA and conversed without issue. Her mother died of a stroke. On exam the patient was afebrile, normotensive with mild tachycardia to 110...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28111008/primary-intraventricular-hemorrhage-clinical-characteristics-and-outcomes
#11
Rachel Weinstein, Kathryn Ess, Bilaal Sirdar, Sarah Song, Shawna Cutting
BACKGROUND: Primary intraventricular hemorrhage (IVH) in adults is a rare neurologic disorder. The typical course, etiology, complications, and outcomes have not been well established. MATERIALS AND METHODS: Consecutive patient records with a diagnosis of intracerebral hemorrhage admitted between May 2009 and June 2014 at a tertiary care center were retrospectively reviewed. Subjects were included in the study cohort if all neurologists and the radiology report agreed that the subject had an isolated IVH...
January 19, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28086871/the-integrated-care-pathway-for-post-stroke-patients-icapps-a-shared-care-approach-between-stakeholders-in-areas-with-limited-access-to-specialist-stroke-care-services
#12
Aznida Firzah Abdul Aziz, Nor Azlin Mohd Nordin, Mohd Fairuz Ali, Noor Azah Abd Aziz, Saperi Sulong, Syed Mohamed Aljunid
BACKGROUND: Lack of intersectoral collaboration within public health sectors compound efforts to promote effective multidisciplinary post stroke care after discharge following acute phase. A coordinated, primary care-led care pathway to manage post stroke patients residing at home in the community was designed by an expert panel of specialist stroke care providers to help overcome fragmented post stroke care in areas where access is limited or lacking. METHODS: Expert panel discussions comprising Family Medicine Specialists, Neurologists, Rehabilitation Physicians and Therapists, and Nurse Managers from Ministry of Health and acadaemia were conducted...
January 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/27930356/impact-of-insurance-status-on-outcomes-and-use-of-rehabilitation-services-in-acute-ischemic-stroke-findings-from-get-with-the-guidelines-stroke
#13
Laura N Medford-Davis, Gregg C Fonarow, Deepak L Bhatt, Haolin Xu, Eric E Smith, Robert Suter, Eric D Peterson, Ying Xian, Roland A Matsouaka, Lee H Schwamm
BACKGROUND: Insurance status affects access to care, which may affect health outcomes. The objective was to determine whether patients without insurance or with government-sponsored insurance had worse quality of care or in-hospital outcomes in acute ischemic stroke. METHODS AND RESULTS: Multivariable logistic regressions with generalized estimating equations stratified by age under or at least 65 years were adjusted for patient demographics and comorbidities, presenting factors, and hospital characteristics to determine differences in in-hospital mortality and postdischarge destination...
November 14, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27688152/a-modelling-tool-for-capacity-planning-in-acute-and-community-stroke-services
#14
Thomas Monks, David Worthington, Michael Allen, Martin Pitt, Ken Stein, Martin A James
BACKGROUND: Mathematical capacity planning methods that can take account of variations in patient complexity, admission rates and delayed discharges have long been available, but their implementation in complex pathways such as stroke care remains limited. Instead simple average based estimates are commonplace. These methods often substantially underestimate capacity requirements. We analyse the capacity requirements for acute and community stroke services in a pathway with over 630 admissions per year...
September 29, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27268564/efficacy-of-inpatient-rehabilitation-after-left-ventricular-assist-device-implantation
#15
Gardner Yost, Laura Coyle, Kristen Milkevitch, Roy Adair, Antone Tatooles, Geetha Bhat
BACKGROUND: Left ventricular assist devices (LVADs) have become an increasingly popular and effective means for treating advanced heart failure. LVAD implantation requires extensive surgery and postoperative rehabilitation. The Functional Independence Measure (FIM) has been used to quantify functional gains in numerous patient populations, including those with stroke and spinal cord injury. This study investigated functional improvements in patients undergoing LVAD implantation using the FIM score...
June 4, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/27267889/post-discharge-stroke-patients-information-needs-as-input-to-proposing-patient-centred-ehealth-services
#16
Nadia Davoody, Sabine Koch, Ingvar Krakau, Maria Hägglund
BACKGROUND: Despite the potential of eHealth services to revolutionize the way healthcare and prevention is provided many applications developed for patients fail to deliver their promise. Therefore, the aim of this study is to use patient journey mapping to explore post-discharge stroke patients' information needs to propose eHealth services that meet their needs throughout their care and rehabilitation processes. METHODS: Three focus groups with younger (<65 years) and older (> = 65 years) stroke patients were performed...
June 7, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27163250/mobile-game-based-virtual-reality-rehabilitation-program-for-upper-limb-dysfunction-after-ischemic-stroke
#17
Yoon-Hee Choi, Jeonghun Ku, Hyunmi Lim, Yeo Hyung Kim, Nam-Jong Paik
BACKGROUND: Virtual reality (VR) has the potential to provide intensive, repetitive, and task-oriented training, and game-based therapy can enhance patients' motivation and enjoyment. OBJECTIVE: The objective of the present study was to develop a mobile game-based upper extremity VR program for patients who have experienced stroke, and to evaluate the feasibility and effectiveness of the program. METHODS: This randomized, double-blind, controlled trial included 24 patients with ischemic stroke...
May 2, 2016: Restorative Neurology and Neuroscience
https://www.readbyqxmd.com/read/27029647/virtual-reality-gaming-in-the-rehabilitation-of-the-upper-extremities-post-stroke
#18
Michael Yates, Arpad Kelemen, Cecilia Sik Lanyi
BACKGROUND: Occurrences of strokes often result in unilateral upper limb dysfunction. Dysfunctions of this nature frequently persist and can present chronic limitations to activities of daily living. METHODS: Research into applying virtual reality gaming systems to provide rehabilitation therapy have seen resurgence. Themes explored in stroke rehab for paretic limbs are action observation and imitation, versatility, intensity and repetition and preservation of gains...
2016: Brain Injury: [BI]
https://www.readbyqxmd.com/read/26986120/what-do-stroke-patients-look-for-in-game-based-rehabilitation-a-survey-study
#19
Ya-Xuan Hung, Pei-Chen Huang, Kuan-Ta Chen, Woei-Chyn Chu
Stroke is one of the most common causes of physical disability, and early, intensive, and repetitive rehabilitation exercises are crucial to the recovery of stroke survivors. Unfortunately, research shows that only one third of stroke patients actually perform recommended exercises at home, because of the repetitive and mundane nature of conventional rehabilitation exercises. Thus, to motivate stroke survivors to engage in monotonous rehabilitation is a significant issue in the therapy process. Game-based rehabilitation systems have the potential to encourage patients continuing rehabilitation exercises at home...
March 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26920909/systemic-inflammatory-response-syndrome-and-outcomes-in-intracerebral-hemorrhage
#20
Amelia K Boehme, Angela N Hays, Kimberly P Kicielinski, Kanika Arora, Niren Kapoor, Michael J Lyerly, Alissa Gadpaille, Harn Shiue, Karen Albright, David Miller, Mitchell S V Elkind, Mark R Harrigan
BACKGROUND: To identify the patients at greatest odds for systemic inflammatory response syndrome (SIRS) and examine the association between SIRS and outcomes in patients presenting with intracerebral hemorrhage (ICH). METHODS: We retrospectively reviewed consecutive patients presenting to a tertiary care center from 2008 to 2013 with ICH. SIRS was defined according to standard criteria as 2 or more of the following: (1) body temperature <36 or >38 °C, (2) heart rate >90 beats per minute, (3) respiratory rate >20, or (4) white blood cell count <4000/mm(3) or >12,000/mm(3) or >10 % polymorphonuclear leukocytes for >24 h in the absence of infection...
August 2016: Neurocritical Care
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