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Stroke rehab

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
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
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
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
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
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...
2016: BMC Medical Informatics and Decision Making
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
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]
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)
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
S Ponte, S Gabrielli, J Jonsdottir, M Morando, S Dellepiane
This paper describes the biomedical, remote monitoring infrastructure developed and currently tested in the EU REHAB@HOME project to support home rehabilitation of the upper extremity of persons post-stroke and in persons with other neurological disorders, such as Multiple Sclerosis patients, in order to track their progress over therapy and improve their Quality of Life. The paper will specifically focus on describing the initial testing of the tele-rehabilitation system's components for patients' biomedical monitoring over therapy, which support the delivery and monitoring of more personalized, engaging plans of care by rehabilitation centers and services...
2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Breda Cullen, Jaycee Pownall, Joanne Cummings, Satu Baylan, Niall Broomfield, Caroline Haig, Denyse Kersel, Heather Murray, Jonathan J Evans
Psychological distress is common following acquired brain injury (ABI), but the evidence base for psychotherapeutic interventions is small and equivocal. Positive psychotherapy aims to foster well-being by increasing experiences of pleasure, engagement and meaning. In this pilot trial, we investigated the feasibility and acceptability of brief positive psychotherapy in adults with ABI and emotional distress. Participants were randomised to brief positive psychotherapy plus usual treatment, or usual treatment only...
January 4, 2016: Neuropsychological Rehabilitation
Navid Khodaparast, Michael P Kilgard, Reema Casavant, Andrea Ruiz, Iqra Qureshi, Patrick D Ganzer, Robert L Rennaker, Seth A Hays
BACKGROUND AND OBJECTIVE: Stroke is a leading cause of long-term disability. Currently, there are no consistently effective rehabilitative treatments for chronic stroke patients. Our recent studies demonstrate that vagus nerve stimulation (VNS) paired with rehabilitative training improves recovery of function in multiple models of stroke. Here, we evaluated the ability of VNS paired with rehabilitative training to improve recovery of forelimb strength when initiated many weeks after a cortical and subcortical ischemic lesion in subjects with stable, chronic motor deficits...
August 2016: Neurorehabilitation and Neural Repair
Tim Pauley, Chetan P Phadke, Adam Kassam, Farooq Ismail, Chris Boulias, Michael Devlin
OBJECTIVE: To determine the impact of cognitive interference on foot pedal reaction time among stroke survivors with right- (RH) or left-hemiplegia (LH). DESIGN: Cross-sectional comparison without randomization. SUBJECTS/PATIENTS: 10 patients post-stroke with RH, 10 with LH; 10 age-matched controls. METHODS: Foot pedal response times were measured using three different reaction time (RT) paradigms: simple RT, dual-task RT (counting backward by serial 3 seconds), and choice RT (correct response contingent on stimuli to eliminate pre-programing)...
October 2015: Topics in Stroke Rehabilitation
Chiu Yuen To, Sina Rajamand, Ratnesh Mehra, Stephanie Falatko, Yaser Badr, Boyd Richards, Omar Qahwash, Richard D Fessler
BACKGROUND: Although initial studies of neuroendovascular intervention did not review benefit over intravenous thrombolytics (iv r-tPA), recent studies have suggested otherwise. Elderly patients (age ≥80 years) are typically excluded from clinical trials. PURPOSE: To examine the utility of mechanical thrombectomy based on patient outcomes. MATERIAL AND METHODS: All stroke-alert activations at our health system from January 2011 to June 2014 were examined...
September 2015: Acta Radiologica Open
Emad B Basalious, Rehab N Shamma
Subarachnoid hemorrhage (SAH) is a major cause of death in patients suffering from stroke. Nimodipine (NM) is the only FDA-approved drug for treating SAH-induced vasospasm. However, NM suffers from poor oral bioavailability (5-13%) due to its low aqueous solubility, extensive first pass metabolism and short elimination half-life (1-2h). The objective of this study was to develop NM-loaded Pluronic/phosphatidylcholine/polysorbate 80 mixed micelles (PPPMM) that can solubilize NM in aqueous media even after dilution, prolong its circulation time, improve its bioavailability and eventually help in targeting it to the brain tissue...
September 30, 2015: International Journal of Pharmaceutics
Hsin-Ta Li, Jheng-Jie Huang, Chien-Wen Pan, Heng-I Chi, Min-Chun Pan
In clinical settings, traditional stroke rehabilitation evaluation methods are subjectively scored by occupational therapists, and the assessment results vary individually. To address this issue, this study aims to develop a stroke rehabilitation assessment system by using inertial measurement units. The inertial signals from the upper extremities were acquired, from which three quantitative indicators were extracted to reflect rehabilitation performance during stroke patients' movement examination, i.e., shoulder flexion...
July 6, 2015: Sensors
Debbie Rand, Gabi Zeilig, Rachel Kizony
BACKGROUND: Impaired dexterity of the weaker upper extremity is common post stroke and it is recommended that these individuals practice many repetitions of movement to regain function. However, stroke rehabilitation methods do not achieve the required intensity to be effective. Touchscreen tablet technology may be used as a motivating tool for self-training impaired dexterity of the weaker upper extremity post stroke. METHODS/DESIGN: Rehab-let is a self-training protocol utilizing game apps on a touchscreen for practicing movement of the weaker upper extremity...
June 18, 2015: Trials
Harald Jagos, Veronika David, Michael Haller, Stefan Kotzian, Manuela Hofmann, Stefan Schlossarek, Karoline Eichholzer, Manfred Winkler, Matthias Frohner, Martin Reichel, Winfried Mayr, Dietmar Rafolt
BACKGROUND: Preservation of mobility in conjunction with an independent life style is one of the major goals of rehabilitation after stroke. OBJECTIVES: The Rehab@Home framework shall support the continuation of rehabilitation in the domestic area. METHODS: The framework consists of instrumented insoles, connected wirelessly to a 3G ready tablet PC, a server and a web-interface for medical experts. The rehabilitation progress is estimated via automated analysis of movement data from standardized assessment tests which are executed via the tablet PC application designed according to the needs of stroke patients...
2015: Studies in Health Technology and Informatics
David T Pruitt, Ariel N Schmid, Lily J Kim, Caroline M Abe, Jenny L Trieu, Connie Choua, Seth A Hays, Michael P Kilgard, Robert L Rennaker
Traumatic Brain Injury (TBI) is one of the largest health problems in the United States, and affects nearly 2 million people every year. The effects of TBI, including weakness and loss of coordination, can be debilitating and last years after the initial injury. Recovery of motor function is often incomplete. We have developed a method using electrical stimulation of the vagus nerve paired with forelimb use by which we have demonstrated enhanced recovery from ischemic and hemorrhagic stroke. Here we have tested the hypothesis that vagus nerve stimulation (VNS) paired with physical rehabilitation could enhance functional recovery after TBI...
May 1, 2016: Journal of Neurotrauma
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