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Post stroke pain

Antonia F Ten Brink, Tibor R S Hajos, Coen van Bennekom, Janneke Nachtegaal, Henk E J Meulenbelt, Judith F M Fleuren, Mirjam Kouwenhoven, Marscha M Luijkx, Markus P Wijffels, Marcel W M Post
The aim of this study was to identify predictors, available at admission, of physical independence at discharge from inpatient rehabilitation. Secondary aims were to identify predictors of functional gain and length of stay (LOS). We included 1310 adult stroke patients who were admitted for inpatient rehabilitation in five Dutch rehabilitation centres. Data on the Utrecht Scale for Evaluation of Clinical Rehabilitation at admission and discharge (physical and cognitive independence, mood, pain and fatigue), age, sex and in a subsample stroke characteristics as well were collected...
September 30, 2016: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
Donald Nuss, Robert J Obermeyer, Robert E Kelly
Repair of pectus excavatum began at the beginning of the 20(th) century before endotracheal intubation was standard practice. Surgeons therefore developed techniques that corrected the deformity using an open procedure via the anterior chest wall. Initial techniques were unsatisfactory, but by the 1930s the partial rib resection and sternal osteotomy technique had been developed and was used in combination with external traction post-operatively to prevent the sternum from sinking back into the chest. In 1949, Ravitch recommended complete resection of the costal cartilages and complete mobilization of the sternum without external traction, and in 1961 Adkins and Blades introduced the concept of a substernal strut for sternal support...
September 2016: Annals of Cardiothoracic Surgery
Maud Pétrault, Sophie Gautier, Vincent Bérézowski, Thavarak Ouk, Michèle Bastide, Olivier Pétrault, Régis Bordet
Analgesics such as opioid agonists are usually not given during the post-operative phase of experimental stroke because they are susceptible to interfere with the evaluation of neuroprotective therapies. Here we investigate the potential of acetaminophen and nefopam, two non-opioid analgesic drugs, to exert an analgesic effect without inducing neuroprotection in a murine model of ischemic stroke. We demonstrate that acetaminophen (200 mg/kg, PO) induces a significant decrease in the infarct volume, particularly in the cortex (VEHICLE: 200...
September 30, 2016: Fundamental & Clinical Pharmacology
Cheng Chung Wang, Hsi-Chien Shih, Bai Chuang Shyu, Andrew Chih Wei Huang
Hemorrhagic stroke has many symptoms, including central pain, learning and memory impairments, motor deficits, language problems, emotional disturbances, and social maladjustment. Lesions of the ventral basal complex (VBC) of the thalamus elicit thermal and mechanical hyperalgesia, forming an animal model of central post-stroke pain (CPSP). However, no research has yet examined the involvement of learning and memory in CPSP using an animal model. The present study examined whether VBC lesions affect motor function, conditioned place preference (CPP; implicit memory), and spatial learning (explicit memory) in the acquisition and retrieval phases...
September 25, 2016: Behavioural Brain Research
Flavia Coroian, Jérôme Froger, H-Y Bonnin Koang, Claire Jourdan, Karima Bakhti, Marc Julia, Audrey Jaussent, Christian Hérisson, Isabelle Laffont
OBJECTIVE: The sensori-motor impairment of upper limb (UL) affects more than 50% of patients after stroke. The objective of this work was to study the efficiency of isokinetic muscle strengthening (IMS) in the chronic phase of stroke in this population. MATERIAL/PATIENTS AND METHODS: The patients underwent 6 weeks of outpatient rehabilitation, 3 days per week, combining physiotherapy (twice/day) and occupational therapy every day. The program was completed by 30 minutes elbow and wrist concentric slow speed IMS of flexor and extensor muscles, in the study group versus 30 minutes passive mobilisation of the joints carried out by the same isokinetic dynamometer in the control group...
September 2016: Annals of Physical and Rehabilitation Medicine
Mounir Beldjerd, Marie Belle, Claire Baradat, Magali Pradié, Claire Villepinte, Sylvie Hidalgo, Emilie Catella, Baptiste Gentilhomme, Thierry Cornier, David Gasq, Evelyne Castel-Lacanal, Philippe Marque, Xavier de Boissezon
OBJECTIVE: The shoulder is painful in 70% of post-stroke patients. Sling and shoulder orthosis are important for medical care. However, series slings have not proved efficiency to improve upper limb function. We realize (with OCTO31 company) a custom-made shoulder orthosis prototype (EO31) to set the upper limb in a posture with an elbow flexion, a forearm supination and, by the way, a finger extension. The objective is to facilitate the upper limb function and to decrease shoulder pain...
September 2016: Annals of Physical and Rehabilitation Medicine
Flavia Coroian, Bertrand Coulet, Claire Jourdan, Olivier Choquet, Isabelle Laffont
OBJECTIVE: The musculotendinous retractions are common complications of central neurological damage with consequences for comfort and function. Treatment of uncomfortable retractions is often surgical, mainly based on tendon gestures. The objective of this study was to evaluate the efficiency of percutaneous needle tenotomy in these indications. MATERIAL/PATIENTS AND METHODS: The indication was accepted at a medical-surgical consultation. Tenotomy was performed using an 18 Gauge needle...
September 2016: Annals of Physical and Rehabilitation Medicine
Timothy J Fuller, Christopher M Paprzycki, Muhammad H Zubair, Lala R Hussain, Brian A Kuhn, Matthew H Recht, Patrick E Muck
BACKGROUND: Interventional strategies for massive and submassive Pulmonary Embolism (smPE) have historically included either systematic intravenous thrombolytic alteplase (IV TPA) or surgical embolectomy, both of which are associated with significant morbidity and mortality. However, with the advent of endovascular techniques, recent studies have suggested that an endovascular approach to the treatment of acute smPE may be both safe and effective with excellent outcomes. The purpose of this study was to evaluate the outcomes of patients who have undergone catheter directed thrombolysis (CDT) for smPE at our institution in an effort to determine the safety of the procedure...
September 22, 2016: Annals of Vascular Surgery
N Charfi, S Trabelsi, M Turki, M Mâalej Bouali, L Zouari, M Dammak, J Ben Thabet, C Mhiri, M Mâalej
INTRODUCTION: The physical and/or psycho-cognitive changes after stroke may lead to a decline in the quality of life (QOL) of patients. The aims of our study were to evaluate the QOL of stroke survivors and to investigate its relationships with the physical disability degree and the emotional disorders (anxiety and depression). METHODS: We conducted a cross-sectional study, which included 147 patients, followed for stroke that had occurred over the past year, in the outpatient neurology department at the university hospital Habib Bourguiba of Sfax (Tunisia)...
September 20, 2016: L'Encéphale
R Garreta-Figuera, A Torrequebrada-Gimenez, En Representacion Del Grupo de Estudio 5e En Representacion Del Grupo de Estudio 5e
INTRODUCTION: Although spasticity is a disabling complication of high incidence, there is a lack of either regional or national epidemiological studies in Spain evaluating its management. AIM: To evaluate the management of spasticity in Spain. PATIENTS AND METHODS: An epidemiological, observational, multicenter, and retrospective study involving 49 rehabilitation services of public and private hospitals was designed. RESULTS: Two hundred and thirty-five patients from 49 centers, with evidence of upper (UL) or lower limb (LL) spasticity with one valid baseline visit and at least one follow-up visit, were included...
October 1, 2016: Revista de Neurologia
Hyun-Ju Jeon, Sangjoon An, Jinwoo Yoo, No-Hyun Park, Kyu Hoon Lee
[Purpose] A simple rehabilitation device system for strengthening upper limb muscles in hemiplegic patients was developed. This system, which stimulates active exercise while accounting for intensity, time, and frequency, was examined in the present pilot study. [Subjects and Methods] Patients had shoulder pain and limited shoulder movement. Changes in range of motion (ROM) and scores of a visual analog scale (VAS) for pain were evaluated in the experimental and control groups every four weeks for twelve weeks...
August 2016: Journal of Physical Therapy Science
Alexandre Heeren, Charlotte Coussement, Élisabeth Colon
Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that has undergone intensive research over the past decade with promising results. tDCS is based on the application of weak, direct current over the scalp, leading to cortical hypo- or hyperpolarization according to the specified parameters. Recent studies have shown that tDCS is able to induce potent changes in cortical excitability as well as to elicit long-lasting modifications in brain activity. Over the last decade, tDCS physiological mechanisms of action have been intensively investigated...
August 2016: Médecine Sciences: M/S
Antoine Chevalier, Kelly Armstrong, C Norwood-Williams, Raman Gokal
Introduction: This case study offers a detailed comparative analysis of the effects of direct-current electroacupuncture (DC-EA) on the autonomic nervous system (ANS), when DC-EA was applied to the cranial sutures and scars of a patient with a history of ischemic stroke and postconcussion syndrome (PCS) pain. Case: A 56-year-old female suffering from severe tremors and debilitating headaches requested acupuncture after conventional biomedicines failed to relieve her symptoms. Evaluations were performed to check the status of 27 ANS functions...
August 1, 2016: Medical Acupuncture
Cosimo Costantino, Laura Galuppo, Davide Romiti
BACKGROUND: In recent years, local muscle vibration received considerable attention as a useful method for muscle stimulation in clinical therapy. Some studies described specific vibration training protocol, and few of them were conducted on post-stroke patients. Therefore there is a general uncertainty regarding the vibrations protocol. AIM: The aim of this study was to evaluate the effects of local muscle high frequency mechano-acoustic vibratory treatment on grip muscle strength, muscle tonus, disability and pain in post-stroke individuals with upper limb spasticity...
September 6, 2016: European Journal of Physical and Rehabilitation Medicine
F Gentile, G Lundberg, R Hultgren
OBJECTIVE/BACKGROUND: To describe the risk factor distribution and outcome for patients with critical limb ischemia (CLI) due to infrapopliteal arterial lesions treated by endovascular or open procedures, with special consideration of diabetic patients. METHODS: Data were collected from the Swedish Vascular Registry, Swedvasc, covering all procedures performed on 549 consecutive patients between May 2008 and January 2014 at the Karolinska University Hospital. Diagnosis of ischemic rest pain and/or tissue loss and treatment of infrapopliteal arterial occlusive disease were considered...
September 1, 2016: European Journal of Vascular and Endovascular Surgery
Ilknur Albayrak, Seza Apiliogullari, Ozkan Onal, Cengizhan Gungor, Ali Saltali, Funda Levendoglu
STUDY OBJECTIVE: Complex regional pain syndrome is a painful and disabling syndrome where the patient presents with neuropathic pain, edema, or vasomotor or pseudomotor abnormalities that are often refractory to treatment. Complex regional pain syndrome type 1 may occurs in stroke patients. Radiofrequency is a therapeutic modality that has been used for years for diseases associated with neuropathic pain. DESIGN: Case series report. SETTING: Selcuk University Hospital...
September 2016: Journal of Clinical Anesthesia
Cosmin Caraşca, Angela Borda, Alexandru Incze, Emilian Caraşca, Attila Frigy, HoraŢiu Suciu
We present the case of a 55-year-old male with mild hypertension and brief episodes of paroxysmal self-limiting atrial fibrillation (AF) since 2010. Despite a small cardioembolic risk score, CHA2DS2-Vasc=1 (Congestive heart failure, Hypertension, Age=75, Diabetes melitus, prior Stroke), the patient is effectively anticoagulated using acenocumarol. In December 2014, he showed signs of plantar transitory ischemia, for which he did not address the doctor. In early January 2015, he urgently presented at the hospital with left renal pain, caused by a renal infarction, diagnosed by computed tomography (CT) angiography...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Andrew Chih Wei Huang, Hsiang-Chin Lu, Bai Chuang Shyu
Approximately 8% of stroke patients present symptoms of central post-stroke pain (CPSP). CPSP is associated with allodynia and hypersensitivity to nociceptive stimuli. Although some studies have shown that neuropathic pain may involve the dorsolateral prefrontal cortex, rostral anterior cingulate cortex, amygdala, hippocampus, periaqueductal gray, rostral ventromedial medulla, and medial thalamus, the neural substrates and their connections that mediate CPSP remain unclear. [(14)C]-Iodoantipyrine (IAP) uptake can be measured to evaluate spontaneously active pain...
2016: Journal of Visualized Experiments: JoVE
Joanne O'Connor, Dorothy McCaughan, Catriona McDaid, Alison Booth, Debra Fayter, Roccio Rodriguez-Lopez, Roy Bowers, Lisa Dyson, Cynthia P Iglesias, Simon Lalor, Rory J O'Connor, Margaret Phillips, Gita Ramdharry
BACKGROUND: Patients who have knee instability that is associated with neuromuscular disease (NMD) and central nervous system (CNS) conditions can be treated using orthoses, such as knee-ankle-foot orthoses (KAFOs). OBJECTIVES: To assess existing evidence on the effectiveness of orthoses; patient perspectives; types of orthotic devices prescribed in the UK NHS; and associated costs. METHODS: Qualitative study of views of orthoses users - a qualitative in-depth interview study was undertaken...
July 2016: Health Technology Assessment: HTA
Stephanie Marrocco, Lucas D Crosby, Ian C Jones, Rebecca F Moyer, Trevor B Birmingham, Kara K Patterson
BACKGROUND: Post-stoke gait disorders could cause secondary musculoskeletal complications associated with excessive repetitive loading. The study objectives were to 1) determine the feasibility of measuring common proxies for dynamic medial knee joint loading during gait post-stroke with external knee adduction (KAM) and flexion moments (KFM) and 2) characterize knee loading and typical load-reducing compensations post-stroke. METHODS: Participants with stroke (n=9) and healthy individuals (n=17) underwent 3D gait analysis...
September 2016: Gait & Posture
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