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rehabilitation in stroke

Bea Essers, Sarah Meyer, Nele De Bruyn, Annick Van Gils, Leonardo Boccuni, Lisa Tedesco Triccas, André Peeters, Vincent Thijs, Hilde Feys, Geert Verheyden
PURPOSE: To investigate the relation between observed and perceived upper limb motor function in patients with chronic stroke. MATERIAL AND METHODS: We investigated 32 patients at six months after stroke with the Fugl-Meyer Assessment (observed function) and hand subscale of the Stroke Impact Scale (perceived function). Spearman correlation was calculated to relate observed and perceived function. Through cut-off scores, we divided our sample in low (Fugl-Meyer Assessment <31/66) and good observed function, and low (hand subscale of Stroke Impact Scale <61/100) and good perceived function...
March 22, 2018: Disability and Rehabilitation
Hung-Ju Chen, Yu-Ting Deng, Yu-Lin Chang, Yi-Chen Kuo, Yu-Li Lin
BACKGROUND & PROBLEMS: Acute stroke patients should receive a rehabilitation assessment within 24-48 hours of hospitalization. Initial ambulation is known to reduce the occurrence of complications, improve the ability to perform activities of daily living, and reduce the risk of long-term disability. PURPOSE: To raise the initial ambulation willingness of acute stroke patients and to increase the willingness of these patients to receive rehabilitation treatment as soon as possible in order to reduce the long-term physical damage of the stroke incident...
April 2018: Hu Li za Zhi the Journal of Nursing
Sharon Israely, Gerry Leisman, Eli Carmeli
The purpose of this study was to investigate whether adaptive responses to error-augmentation force fields, would decrease the trajectory errors in hand-reaching movements in multiple directions in healthy individuals. The study was conducted, as a randomized controlled trial, in 41 healthy subjects. The study group trained on a 3D robotic system, applying error-augmenting forces on the hand during the execution of tasks. The control group carried out the same protocol in null-field conditions. A mixed-model ANOVA was implemented to investigate the interaction between groups and time, and changes in outcome measures within groups...
March 22, 2018: Advances in Experimental Medicine and Biology
Michael P Kilgard, Robert L Rennaker, Jen Alexander, Jesse Dawson
BACKGROUND: Recent studies indicate that vagus nerve stimulation (VNS) paired with rehabilitation can enhance neural plasticity in the primary sensory and motor cortices, improve forelimb function after stroke in animal models and improve motor function in patients with arm weakness after stroke. OBJECTIVE: To gain "first-in-man" experience of VNS paired with tactile training in a patient with severe sensory impairment after stroke. METHODS: During the long-term follow-up phase of a clinical trial of VNS paired with motor rehabilitation, a 71-year-old man who had made good motor recovery had ongoing severe sensory loss in his left hand and arm...
2018: NeuroRehabilitation
Bo-Ram Kim, Yejin Lee, Soo Jin Kim, Hyuntae Kim, Jong Won Lee, Seunghwan Lee, Jongmin Lee
Palatal myoclonus (PM) is a rare disease that may induce dysphagia. Since dysphagia related to PM is unique and is characterized by myoclonic movements of the involved muscles, specific treatments are needed for rehabilitation. However, no study has investigated the treatment effectiveness for this condition. Therefore, the aim of this case report was to describe the benefit of combining behavioral treatment with valproic acid administration in patients with dysphagia triggered by PM. The two cases were treated with combined treatment...
February 2018: Annals of Rehabilitation Medicine
Kristina Griffin, Michael O'Hearn, Carla C Franck, Carol A Courtney
STUDY DESIGN: Case Report. PURPOSE: Stroke is the most common cause of long-term disability. Dysesthesia, an unpleasant sensory disturbance, is common following thalamic stroke and evidence-based interventions for this impairment are limited. The purpose of this case report was to describe a decrease in dysesthesia following manual therapy intervention in a patient with history of right lacunar thalamic stroke. CASE DESCRIPTION: A 66-year-old female presented with tingling and dysesthesia in left hemisensory distribution including left trunk and upper/lower extremities, limiting function...
March 20, 2018: Disability and Rehabilitation
Uros Marusic, Sidney Grosprêtre
Normal and pathological ageing are associated with several motor impairments that reduce quality of life and represent a general challenge for public healthcare systems. Consequently, over the past decades, many scientists and physiotherapists dedicated their research to the development and improvement of safe and costless methods to counteract the progressive decline of motor functions with age. The urgency of finding new and easy to implement methods is even more paramount in case of acute pathologies (e...
March 20, 2018: European Journal of Sport Science
Rebecca Lewthwaite, Carolee J Winstein, Christianne J Lane, Sarah Blanton, Burl R Wagenheim, Monica A Nelsen, Alexander W Dromerick, Steven L Wolf
BACKGROUND: Task-oriented therapies have been developed to address significant upper extremity disability that persists after stroke. Yet, the extent of and approach to rehabilitation and recovery remains unsatisfactory to many. OBJECTIVE: To compare a skill-directed investigational intervention with usual care treatment for body functions and structures, activities, participation, and quality of life outcomes. METHODS: On average, 46 days poststroke, 361 patients were randomized to 1 of 3 outpatient therapy groups: a patient-centered Accelerated Skill Acquisition Program (ASAP), dose-equivalent usual occupational therapy (DEUCC), or usual therapy (UCC)...
February 2018: Neurorehabilitation and Neural Repair
Wudan Yan
After suffering a stroke-perhaps a blood clot gets lodged in the brain or a blood vessel near the brain bursts-a person may suddenly not be able to hear, talk, or see. He or she might have trouble walking or exhibit a speech impediment. In fact, one of the greatest challenges of treating patients affected by stroke is that it's a heterogeneous condition, says Joel Stein, a physiatrist specializing in physical medicine and rehabilitation at Columbia University and Weill Cornell Medical College in New York City (Figure 1)...
March 2018: IEEE Pulse
Natasha A Lannin, Louise Ada, Coralie English, Julie Ratcliffe, Maria Crotty
Rationale Although clinical practice guidelines recommend that management of moderate to severe spasticity include the use of botulinum toxin-A in conjunction with therapy, there is currently no evidence to support the addition of therapy. Aims To determine the effect and cost-benefit of adding evidence-based movement training to botulinum toxin-A. Sample size estimate A total of 136 participants will be recruited in order to be able to detect a between-group difference of seven points on the Goal Attainment Scale T-score with 80% power at a two-tailed significance level of 0...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Emily A Kringle, Lauren Terhorst, Meryl A Butters, Elizabeth R Skidmore
OBJECTIVES: The purpose of this exploratory study was to identify clinical predictors that could distinguish clients' level of engagement in inpatient rehabilitation following stroke. METHODS: This is a secondary analysis of pooled data from three randomized controlled trials that examined the effects of a behavioral intervention. The sample (n=208) consisted of clients with stroke who had cognitive deficits (Quick-EXIT≥3) and were admitted to inpatient rehabilitation facilities associated with a university medical center...
March 19, 2018: Journal of the International Neuropsychological Society: JINS
Suman Lahiry, Christopher Levi, Joosup Kim, Dominique A Cadilhac, Andrew Searles
Background: In regional and rural Australia, patients experiencing ischemic stroke do not have equitable access to an intravenous recombinant tissue plasminogen activator (tPA). Although thrombolysis with tPA is a clinically proven and cost-effective treatment for eligible stroke patients, there are few economic evaluations on pre-hospital triage interventions to improve access to tPA. Aim: To describe the potential cost-effectiveness of the pre-hospital acute stroke triage (PAST) protocol implemented to provide priority transfer of appropriate patients from smaller hospitals to a primary stroke center (PSC) in regional New South Wales, Australia...
2018: Frontiers in Public Health
Katarzyna Świder, Jacek Matys
After a stroke, patients frequently show compromised swallowing, mastication, and speech, as well as unfavorable motion and deviation of the tongue and mandible. The dentist can improve the oral rehabilitation of a patient with deteriorated facial and oral muscles after a stroke by incorporating orofacial myofunctional therapy. This report describes a method for tongue exercises and correction of mandible deviation in an edentulous patient after a stroke by using a pearl on a wire in the anteriomedian palatal part of the maxillary denture...
March 15, 2018: Journal of Prosthetic Dentistry
Joseph T Patterson, Kyle Tillinghast, Derek Ward
BACKGROUND: Limited data describe risks and perioperative resource needs of total joint arthroplasty (TJA) in dialysis-dependent patients. METHODS: Retrospective multiple cohort analysis of dialysis-dependent American College of Surgeons National Surgical Quality Improvement Program patients undergoing primary elective total hip and knee arthroplasty compared to non-dialysis-dependent controls from 2005 to 2015. Relative risks (RRs) of 30-day adverse events were determined by multivariate regression adjusting for baseline differences...
February 17, 2018: Journal of Arthroplasty
John R Best, Janice J Eng, Jennifer C Davis, Robin Hsiung, Peter A Hall, Laura E Middleton, Peter Graf, Charles H Goldsmith, Teresa Liu-Ambrose
INTRODUCTION: Cerebrovascular disease-such as stroke-is the second most common cause of dementia (ie, vascular dementia). Specifically, a stroke increases one's risk for dementia by a factor of two. Thus, stroke survivors represent a target population in need of intervention strategies to promote cognitive function and prevent dementia. The current standard of care in stroke rehabilitation does not adequately address the significant cognitive consequences of stroke, especially for those who are in the chronic phase (ie, >12 months since an index stroke)...
March 17, 2018: BMJ Open
Samman Shahpar, Alex W K Wong, Susan Keeshin, Sarah Eickmeyer, Patrick Semik, Masha Kocherginsky, Stacy McCarty
BACKGROUND: Malignant brain tumors cause significant impairments in function due to nature of the disease. Patients with malignant brain tumors can make functional gains equivalent to those with stroke and traumatic brain injury in the inpatient rehabilitation setting. However, the efficacy of outpatient rehabilitation in this population has received little study. OBJECTIVE: To determine if an interdisciplinary outpatient rehabilitation program will improve functional outcomes in patients with malignant brain tumors...
March 14, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
William J Meurer, Bradley Barth, Michael Abraham, Jerome Hoffman, Gary M Vilke, Gerard DeMers
BACKGROUND: Stroke treatment is a continuum that begins with the rapid identification of symptoms and treatment with transition to successful rehabilitation. Therapies for acute ischemic stroke (AIS) may vary based on anatomic location, interval from symptom onset, and coexisting health conditions. Successful therapy requires a seamless systematic approach with coordination from prehospital environment through acute management at medical facilities to disposition and long-term care of the patient...
March 12, 2018: Journal of Emergency Medicine
Conran Joseph, Björn Stömbäck, Maria Hagströmer, David Conradsson
OBJECTIVE: To investigate the feasibility of using accelerometers to monitor physical activity in persons with stroke admitted to inpatient rehabilitation. DESIGN: Longitudinal observational study. PARTICIPANTS: Persons with stroke admitted to a specialized rehabilitation centre for sub-acute rehabilitation were recruited between August and December 2016. METHODS: Volume and intensity of physical activity were assessed with accelerometers throughout the rehabilitation period...
March 15, 2018: Journal of Rehabilitation Medicine
Vinícius Viana Abreu Montanaro, Thiago Falcão Hora, Creuza Maria da Silva, Carla Verônica de Viana Santos, Maria Inacia Ruas Lima, Edson Marcio Negrão, Daniele Sebestyan Martins Ribeiro, Eleonora Maria de Jesus Oliveira, Gabriel R de Freitas
BACKGROUND: Chagas disease is related to ischemic stroke (IS), although few epidemiological studies have evaluated the associated mortality and recurrence. Our objective is to determine factors associated with mortality and recurrence of IS in patients with IS and Chagas disease. METHODS: We retrospectively studied data obtained from electronic medical records of patients admitted at SARAH Hospitals across Brazil between 2009 and 2013. Using Cox regression analysis for mortality and logistic regression for recurrence, we assessed primary population characteristics and statistical associations between risk factors and outcomes...
March 14, 2018: European Neurology
Jie Zhang, Xuehu Wei, Sangma Xie, Zhen Zhou, Desheng Shang, Renjie Ji, Yamei Yu, Fangping He, Yue Du, Xiangming Ye, Benyan Luo
In the dual-route language model, the dorsal pathway is known for sound-to-motor mapping, but the role of the ventral stream is controversial. With the goal of enhancing our understanding of language models, this study investigated the diffusion characteristics of candidate tracts in aphasic patients. We evaluated 14 subacute aphasic patients post-stroke and 11 healthy controls with language assessment and diffusion magnetic resonance imaging. Voxel-based lesion-symptom mapping found multiple linguistic associations for the ventral stream, while automated fiber quantification (AFQ) showed, via reduced fractional anisotropy (FA) and axial diffusivity with increased radial diffusivity (all corrected p  < 0...
2018: Frontiers in Neurology
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