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Stroke, rehabilitation

Nina Lefeber, Eva Swinnen, Eric Kerckhofs
PURPOSE: The integration of sufficient cardiovascular stress into robot-assisted gait (RAG) training could combine the benefits of both RAG and aerobic training. The aim was to summarize literature data on the immediate effects of RAG compared to walking without robot-assistance on metabolic-, cardiorespiratory- and fatigue-related parameters. METHODS: PubMed and Web of Science were searched for eligible articles till February 2016. Means, SDs and significance values were extracted...
October 20, 2016: Disability and Rehabilitation. Assistive Technology
Khader A Almhdawi, Virgil G Mathiowetz, Matthew White, Robert C delMas
There is a need for more effective rehabilitation methods for individuals post-stroke. Occupational Therapy Task-Oriented (TO) approach has not been evaluated in a randomized clinical trial. The purpose of this study was to evaluate functional and impairment efficacies of TO approach on the more-affected Upper Extremity (UE) of persons post-stroke. A randomized single-blinded cross-over trial recruited 20 participants post-stroke (mean chronicity = 62 months) who demonstrated at least 10° active more-affected shoulder flexion and abduction and elbow flexion-extension...
October 20, 2016: Occupational Therapy International
Victor E Ezeugwu, Neera Garga, Patricia J Manns
PURPOSE: Understanding the determinants of sedentary behaviour (sitting or lying with low energy expenditure) in stroke survivors can enhance the development of successful behaviour change strategies. This qualitative study explored the perceptions of stroke survivors about sedentary behaviour and ways in which it can be changed. METHODS: An interpretative qualitative inquiry was used with thematic analysis of interview data. Interviews were conducted using a semi-structured guide with 13 stroke survivors...
October 19, 2016: Disability and Rehabilitation
Agathe Gerwina Elena Pollmann, Marianne Frederiksen, Eva Prescott
PURPOSE: Evidence of the effect of cardiac rehabilitation (CR) after heart valve surgery is scarce, but nevertheless CR is recommended for this group of patients. Therefore, this study assessed the effect of CR on exercise capacity, cardiovascular risk factors, and long-term mortality and morbidity, as well as predictors for enrolment in or failing to complete CR. METHODS: A review of medical records identified 250 patients who underwent heart valve surgery between January 2009 and August 2013...
October 14, 2016: Journal of Cardiopulmonary Rehabilitation and Prevention
Natália de Almeida Carvalho Duarte, Luanda André Collange Grecco, Nelci Zanon, Manuela Galli, Felipe Fregni, Claudia Santos Oliveira
A review of the literature was performed to answer the following questions: Does motor cortex excitability correlate with motor function? Do motor cortex excitability and cortex activation change after a rehabilitation program that results in improvements in motor outcomes? Can the 10-20 electroencephalography (EEG) system be used to locate the primary motor cortex when employing transcranial direct current stimulation? Is there a bihemispheric imbalance in individuals with cerebral palsy similar to what is observed in stroke survivors? the authors found there is an adaptation in the geometry of motor areas and the cortical representation of movement is variable following a brain lesion...
October 18, 2016: Journal of Motor Behavior
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
Antonello Baldassarre, Lenny E Ramsey, Joshua S Siegel, Gordon L Shulman, Maurizio Corbetta
PURPOSE OF REVIEW: An important challenge in neurology is identifying the neural mechanisms underlying behavioral deficits after brain injury. Here, we review recent advances in understanding the effects of focal brain lesions on brain networks and behavior. RECENT FINDINGS: Neuroimaging studies indicate that the human brain is organized in large-scale resting state networks (RSNs) defined via functional connectivity, that is the temporal correlation of spontaneous activity between different areas...
October 5, 2016: Current Opinion in Neurology
Yee Sien Ng, Kristin Hx Tan, Cynthia Chen, Gilmore C Senolos, Effie Chew, Gerald Ch Koh
INTRODUCTION: The poststroke acute and rehabilitation length of stay (LOS) are key markers of stroke care efficiency. This study aimed to describe the characteristics and identify the predictors of poststroke acute, rehabilitation and total LOS. This study also defined a subgroup of patients as "short" LOS and compared its complication rates and functional outcomes in rehabilitation with a "long" acute LOS group. MATERIALS AND METHODS: A prospective cohort study (n = 1277) was conducted in a dedicated rehabilitation unit within a tertiary academic acute hospital over a 5-year period between 2004 and 2009...
September 2016: Annals of the Academy of Medicine, Singapore
T George Hornby, Jennifer L Moore, Linda Lovell, Elliot J Roth
PURPOSE OF REVIEW: Research findings from the fields of motor learning and exercise physiology suggest specific training parameters that can be manipulated during physical rehabilitation profoundly influence skilled task performance. This review details the rationale for some of these training variables and their application in selected intervention studies focused on improving walking function in patients poststroke. RECENT FINDINGS: Basic and applied studies have shown that the amount, intensity, and variability of specific task practice applied during rehabilitation interventions can affect recovery of walking poststroke...
September 28, 2016: Current Opinion in Neurology
Joachim Liepert
PURPOSE OF REVIEW: This article evaluates whether specific drugs are able to facilitate motor recovery after stroke or improve the level of consciousness, cognitive, or behavioral symptoms after traumatic brain injury. RECENT FINDINGS: After stroke, serotonin reuptake inhibitors can enhance restitution of motor functions in depressed as well as in nondepressed patients. Erythropoietin and progesterone administered within hours after moderate to severe traumatic brain injury failed to improve the outcome...
September 28, 2016: Current Opinion in Neurology
Hani Raoul Khouzam
Trazodone is an antidepressant that is FDA-approved for the treatment of depression. It has been used by mental health and primary care providers for the treatment of multiple psychiatric and medical conditions .This review describes trazodone mechanism of action, formulation, dosage and adverse effects and then summarizes the beneficial effects of trazodone in the treatment of various psychiatric and medical conditions such as major depression, as well non-approved FDA indications such as insomnia,anxiety disorders, posttraumatic stress disorder, obsessive compulsive disorder, feeding and eating disorders, substance use disorders, behavioral disturbances associated with cognitive dysfunction, sexual dysfunction, certain pain conditions, and rehabilitation after acute ischemic stroke...
October 17, 2016: Postgraduate Medicine
Savita Katbamna, Lisa Manning, Amit Mistri, Mark Johnson, Thompson Robinson
OBJECTIVES: This paper presents the findings of a qualitative study exploring White and British Indian informal stroke carers' experiences of caring, factors contributing to their stress, and strategies used to overcome stress. DESIGN: A qualitative approach involving in-depth interviews was used to explore informal carers' experiences of caring for stroke survivors and the stress of caring at one and three to six months from the onset of stroke. Interviewers bilingual in English and Gujarati or Punjabi conducted interviews with carers...
October 15, 2016: Ethnicity & Health
Derya Memis, Erkan Kozanoglu, Bayram Kelle, Mustafa K Goncu
OBJECTIVE: To determine the effects of demographic and clinical characteristics on mobility, disability, and activities of daily life of patients with stroke. METHODS: This cross-sectional clinical study was performed in the Department of Physical Medicine and Rehabilitation in Cukurova University Faculty of Medicine in Adana, Turkey, between February 2011 and December 2011. The study included 126 patients with stroke. The Brunnstrom recovery scale (BRS), functional ambulation classification scale (FACS), modified Barthel index (MBI), modified Rankin scale (MRS), and Rivermead mobility index (RMI) were used in the evaluation of the functional status of stroke patients...
October 2016: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
Saad M Bindawas, Vishal S Vennu
Stroke is a major cause of death and other complications worldwide. In Saudi Arabia, stroke has become an emerging health issue leading to disability and death. However, stroke care including rehabilitation services, in Saudi Arabia lags behind developed countries. Stroke rehabilitation is an essential recovery option after stroke and should start as early as possible to avoid potential complications. The growing evidence on stroke rehabilitation effectiveness in different health care settings and outcome measures used widely are reviewed in this call to action paper...
October 2016: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
Sami Ridwan, Horst Urbach, Susanne Greschus, Johanna von Hagen, Jonas Esche, Azize Boström
BACKGROUND: Given the young age of onset and the high probability of long-term disability after SAH, the financial impact is expected to be substantial. Primary objective was to highlight subsequent treatment costs after the acute in-hospital stay including rehabilitation and home care in comparison to ischemic stroke. METHODS: The study included 101 patients with aneurysmal SAH treated July 2007 through April 2009. In-hospital expenses were calculated using the German Diagnose Related Groups DRG...
October 12, 2016: World Neurosurgery
Hui-Chuan Huang, Chien-Hung Chang, Chaur-Jong Hu, Meei-Ling Shyu, Chin-I Chen, Chih-Shan Huang, Hsiu-Ting Tsai, Hsiu-Ju Chang
OBJECTIVE: To explore the temporal effects of psychological distress on the functional recovery among stroke survivors. DESIGN: A longitudinal follow-up study. All participants were interviewed at 5 days after stroke onset, and at 1, 2, 3, and 6 months after discharge from acute care hospitals. SETTING: Neurology inpatient and outpatient departments and rehabilitation clinics. PARTICIPANTS: First-time stroke participants (N=62) without cognitive impairment, psychiatric disorders, or cancer were recruited...
October 12, 2016: Archives of Physical Medicine and Rehabilitation
Takashi Shiromoto, Naohiko Okabe, Feng Lu, Emi Maruyama-Nakamura, Naoyuki Himi, Kazuhiko Narita, Yoshiki Yagita, Kazumi Kimura, Osamu Miyamoto
BACKGROUND AND OBJECTIVE: Endogenous neurogenesis is associated with functional recovery after stroke, but the roles it plays in such recovery processes are unknown. This study aims to clarify the roles of endogenous neurogenesis in functional recovery and motor map reorganization induced by rehabilitative therapy after stroke by using a rat model of cerebral ischemia (CI). METHODS: Ischemia was induced via photothrombosis in the caudal forelimb area of the rat cortex...
October 12, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Aizpea Aguirrezabal Juaristi, Montse Ferrer Fores, Ester Marco Navarro, Sergi Mojal García, Gemma Vilagut Saiz, Esther Duarte Oller
BACKGROUND AND OBJECTIVE: The Satisfaction Pound Scale is a specific questionnaire to evaluate satisfaction with the rehabilitation program after a stroke. The aim of this study was to adapt this scale to Spanish and to evaluate its metric characteristics. METHOD: The adaptation included translation and back-translation methods. Metric characteristics were evaluated in 74 patients, all of whom were administered the Satisfaction Pound Scale and the Short Form 36 (SF-36)...
October 13, 2016: Medicina Clínica
Eun Young Han, Sang Hee Im, Bo Ryun Kim, Min Ji Seo, Myeong Ok Kim
OBJECTIVE: Brachial-ankle pulse wave velocity (baPWV) evaluates arterial stiffness and also predicts early outcome in stroke patients. The objectives of this study were to investigate arterial stiffness of subacute nonfunctional ambulatory stroke patients and to compare the effects of robot-assisted gait therapy (RAGT) combined with rehabilitation therapy (RT) on arterial stiffness and functional recovery with those of RT alone. METHOD: The RAGT group (N = 30) received 30 minutes of robot-assisted gait therapy and 30 minutes of conventional RT, and the control group (N = 26) received 60 minutes of RT, 5 times a week for 4 weeks...
October 2016: Medicine (Baltimore)
Sangeetha Madhavan, James W Stinear, Neeta Kanekar
Objective. High intensity interval treadmill training (HIITT) has been gaining popularity for gait rehabilitation after stroke. In this study, we examined the changes in excitability of the lower limb motor cortical representation (M1) in chronic stroke survivors following a single session of HIITT. We also determined whether exercise-induced changes in excitability could be modulated by transcranial direct current stimulation (tDCS) enhanced with a paretic ankle skill acquisition task. Methods. Eleven individuals with chronic stroke participated in two 40-minute treadmill-training sessions: HIITT alone and HITT preceded by anodal tDCS enhanced with a skill acquisition task (e-tDCS+HIITT)...
2016: Neural Plasticity
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