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Rehabilitation of stroke

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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
#1
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/28081026/the-effect-of-nebulized-glycopyrrolate-on-posterior-drooling-in-patients-with-brain-injury-two-cases-of-different-brain-lesions
#2
Zee-Ihn Lee, Kwang Jae Yu, Dae Hee Lee, Seong Kyung Hong, Seung Beom Woo, Jong Min Kim, Donghwi Park
Posterior drooling, which can lead to substantial respiratory morbidity, including unexplained lung diseases and recurrent pneumonia, is an important issue in the rehabilitation unit. There are various treatment options for posterior drooling, including pharmacologic therapy, oral motor or behavioral therapy, biofeedback, local glandular injection of botulinum toxin, irradiation, and surgery. Among them, nebulized glycopyrrolate has the following advantages: It is noninvasive and is relatively free of central adverse effects because it does not cross the blood-brain barrier unlike other anticholinergics...
January 9, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28079400/dysphagia-therapy-post-stroke-an-exploration-of-the-practices-and-clinical-decision-making-of-speech-language-pathologists-in-australia
#3
Olivia Jones, Jade Cartwright, Anne Whitworth, Naomi Cocks
PURPOSE: A variety of dysphagia management options are available for the treatment of dysphagia following a stroke, however, it is unknown which of these approaches are most commonly utilised by Australian speech-language pathologists (SLPs) and whether particular factors influence decision-making. METHOD: The aim of this study was to investigate, through an online survey, the treatment practices of SLPs in Australia for the treatment of dysphagia post-stroke and identify the factors influencing treatment decisions...
January 12, 2017: International Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/28077661/characterizing-differential-post-stroke-corticomotor-drive-to-the-dorsi-and-plantarflexor-muscles-during-resting-and-volitional-muscle-activation
#4
Jacqueline Ann Palmer, Ryan Zarzycki, Susanne M Morton, Trisha M Kesar, Stuart A Binder-Macleod
Imbalance of corticomotor excitability between the paretic and nonparetic limbs has been associated with the extent of upper extremity motor recovery post-stroke, is greatly influenced by specific testing conditions such as the presence or absence of volitional muscle activation, and may vary across muscle groups. However, despite its clinical importance, post-stroke corticomotor drive to lower extremity muscles has not been thoroughly investigated. Additionally, while conventional gait rehabilitation strategies for stroke survivors focus on paretic limb foot drop and dorsiflexion impairments, most contemporary literature has indicated that paretic limb propulsion and plantarflexion impairments are the most significant limiters to post-stroke walking function...
January 11, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28075495/oral-tactile-sensitivity-and-masticatory-performance-are-impaired-in-stroke-patients
#5
Martin Schimmel, Garance Voegeli, Elena Duvernay, Beatrice Leemann, Frauke Müller
BACKGROUND: Orofacial impairment following stroke frequently involves reduced chewing performance, i.e., oral phase dysphagia. OBJECTIVE: To investigate the sensitivity of oral tissues following stroke and its potential impact on masticatory function. METHODS: Hospitalized post-stroke patients were recruited and compared to healthy controls. Outcome measures comprised masticatory performance employing a colour-mixing ability-, i.e. bolus-kneading test, maximum lip and bite force, and the one-point and two-point tactile thresholds...
January 11, 2017: Journal of Oral Rehabilitation
https://www.readbyqxmd.com/read/28074998/-prognostic-factors-of-functional-recovery-from-a-stroke-at-one-year
#6
J A Moreno-Palacios, I Moreno-Martinez, A Bartolome-Nogues, E Lopez-Blanco, R Juarez-Fernandez, I Garcia-Delgado
INTRODUCTION: Recovery of the ability to walk and independence is fundamental for any patient who suffers a stroke, and it can be influenced by a number of factors. AIM: To determine what variables are more important to achieve a good functional recovery at one year after the stroke. PATIENTS AND METHODS: An observational, longitudinal prospective study was conducted with 231 patients diagnosed with a stroke in the year 2013. An analysis was performed of the clinical characteristics, socio-demographic data, neurological situation at the time of hospitalisation -National Institute of Health Stroke Scale (NIHSS)-, functional situation (Rankin Scale and Barthel Index) and ability to walk, both on hospitalisation and on discharge from rehabilitation and at one year...
January 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28073355/factors-associated-with-improvement-or-decline-in-cognitive-function-after-an-ischemic-stroke-in-korea-the-korean-stroke-cohort-for-functioning-and-rehabilitation-kosco-study
#7
Jin A Yoon, Deog Young Kim, Min Kyun Sohn, Jongmin Lee, Sam-Gyu Lee, Yang-Soo Lee, Eun Young Han, Min Cheol Joo, Gyung-Jae Oh, Junhee Han, Minsu Park, Kyung Pil Park, Kyung-Ha Noh, Won Hyuk Chang, Yong-Il Shin, Yun-Hee Kim
BACKGROUND: We conducted a prospective cohort study to investigate prevalence of poststroke cognitive impairment at 3 and 12 months after stroke onset and identify clinical and demographic factors associated with improvement or decline in cognitive function between 3 months and 12 months. METHODS: We analyzed the cognitive assessments of total patients and patients older than 65 years separately. All patients with an ischemic stroke were divided into normal cognitive group (NCG) and impaired cognition group (ICG) by using a cutoff score on the Korean Mini-Mental State Examination (K-MMSE)...
January 10, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28071808/structure-and-feasibility-of-extra-practice-during-stroke-rehabilitation-a-systematic-scoping-review
#8
REVIEW
Claire Stewart, Annie McCluskey, Louise Ada, Suzanne Kuys
BACKGROUND/AIM: Improved motor performance is related to the amount of practice completed after a stroke. Australian guidelines recommend that at least one hour of active practice should be completed per day. Yet active practice levels remain low. The aims of this scoping review were to describe how extra practice at the activity level is structured for stroke survivors, and explore the feasibility of participants completing extra practice. METHODS: A systematic search was conducted of five electronic databases up to August 2015...
January 10, 2017: Australian Occupational Therapy Journal
https://www.readbyqxmd.com/read/28069851/less-intense-postacute-care-better-outcomes-for-enrollees-in-medicare-advantage-than-those-in-fee-for-service
#9
Peter J Huckfeldt, José J Escarce, Brendan Rabideau, Pinar Karaca-Mandic, Neeraj Sood
Traditional fee-for-service (FFS) Medicare's prospective payment systems for postacute care provide little incentive to coordinate care or control costs. In contrast, Medicare Advantage plans pay for postacute care out of monthly capitated payments and thus have stronger incentives to use it efficiently. We compared the use of postacute care in skilled nursing and inpatient rehabilitation facilities by enrollees in Medicare Advantage and FFS Medicare after hospital discharge for three high-volume conditions: lower extremity joint replacement, stroke, and heart failure...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28061507/return-to-work-after-a-stroke-in-working-age-persons-a-six-year-follow-up
#10
Emma Westerlind, Hanna C Persson, Katharina S Sunnerhagen
OBJECTIVES: Stroke is one of the most common and resource intensive diseases for society. Stroke in the working age population is increasing in different parts of the world. An incomplete return to work (RTW) after sick leave post stroke entails negative consequences for the affected person and an economical burden for society. The aim of this study was to explore the RTW rate and factors associated with RTW in a six-year follow up post stroke. METHODS: Data from 174 persons 63 years or younger, with first ever stroke in 2009-2010 in Gothenburg were analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/28056920/huatuo-zaizao-pill-promotes-functional-recovery-and-neurogenesis-after-cerebral-ischemia-reperfusion-in-rats
#11
Sijin Duan, Tian Wang, Jianqiao Zhang, Minmin Li, Chengwen Lu, Lijie Wang, Yan Zou, Fenghua Fu
BACKGROUND: Ischemic stroke is the third leading cause of death in adults worldwide and is the first leading cause of long-term disability. Neurogenesis plays an important role in promoting behavioral recovery after stroke. Huatuo Zaizao pill (HT), a traditional Chinese medicine, has been used clinically in China to promote the rehabilitation after stroke, but the underlying mechanism of action was still unclear. This study is to investigate the effects of HT on the functional recovery in a rat model of cerebral ischemia-reperfusion (I/R) injury, and the potential molecular mechanisms...
January 5, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28055887/eeg-based-strategies-to-detect-motor-imagery-for-control-and-rehabilitation
#12
Kai Keng Ang, Cuntai Guan
Advances in Brain-Computer Interface (BCI) technology have facilitated the detection of Motor Imagery (MI) from electroencephalography (EEG). First, we present three strategies of using BCI to detect MI from EEG: operant conditioning that employed a fixed model, machine learning that employed a subject-specific model computed from calibration, and adaptive strategy that continuously compute the subjectspecific model. Second, we review prevailing works that employed the operant conditioning and machine learning strategies...
December 30, 2016: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28054834/long-term-restrictions-in-participation-in-stroke-survivors-under-and-over-70-years-of-age
#13
Joris A de Graaf, Maria L van Mierlo, Marcel W M Post, Wilco P Achterberg, L Jaap Kappelle, Johanna M A Visser-Meily
PURPOSE: This study aims to (1) assess differences in participation restrictions between stroke survivors aged under and over 70 years and (2) identify predictors associated with favorable and unfavorable long-term participation in both age groups. METHODS: Prospective cohort study in which 326 patients were assessed at stroke onset, two months and one year after stroke. The Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation) was used to measure participation restrictions one year after stroke...
January 5, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28052710/depression-after-stroke-at-12-month-follow-up-a-multicenter-study
#14
Patchara Limampai, Wanpen Wongsrithep, Vilai Kuptniratsaikul
PURPOSE: To study the prevalence of depression at 12 months after stroke and to analyze factors associated with depression. METHODS: This prospective cross-sectional study was conducted among 9 tertiary hospitals in Thailand. Stroke patients from the Thai Stroke Rehabilitation Registry (TSRR) who were admitted in inpatient rehabilitation wards were recruited for evaluation at the 12-month follow-up time point. Hospital Anxiety and Depression Score (HADS) was used to evaluate depression in stroke...
January 5, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28050492/efficacy-of-modified-constraint-induced-movement-therapy-in-the-treatment-of-hemiparetic-upper-limb-in-stroke-patients-a-randomized-controlled-trial
#15
Raj Kumar Yadav, Rajendra Sharma, Diganta Borah, S Y Kothari
INTRODUCTION: Paretic upper limb in stroke patients has a significant impact on the quality of life. Modified Constraint Induced Movement Therapy (mCIMT) is one of the treatment options used for the improvement of the function of the paretic limb. AIM: To investigate the efficacy of four week duration mCIMT in the management of upper extremity weakness in hemiparetic patients due to stroke. MATERIALS AND METHODS: Prospective single blind, parallel randomized controlled trial in which 30 patients received conventional rehabilitation programme (control group) and 30 patients participated in a mCIMT programme in addition to the conventional rehabilitation programme (study group)...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28049565/adapting-the-concepts-of-brain-and-cognitive-reserve-to-post-stroke-cognitive-deficits-implications-for-understanding-neglect
#16
Roza M Umarova
Advanced lesion mapping and connectivity analyses are currently the main tools used to understand the mechanisms underlying post-stroke cognitive deficits. However, the factors contributing to pre-stroke architecture of cognitive networks are often ignored, even though they reportedly play a decisive role in the manifestation of cognitive impairment in neurodegeneration. The present review on post-stroke cognitive deficits therefore adopts the concept of brain and cognitive reserve, which was originally developed to account for the individual differences in the course of aging and neurodegenerative diseases...
December 16, 2016: Cortex; a Journal Devoted to the Study of the Nervous System and Behavior
https://www.readbyqxmd.com/read/28049003/cognitive-motor-interference-on-upper-extremity-motor-performance-in-a-robot-assisted-planar-reaching-task-among-patients-with-stroke
#17
Joon-Ho Shin, Gyulee Park, Duk Youn Cho
OBJECTIVE: To explore motor performance on two different cognitive tasks during robotic rehabilitation in which motor performance was longitudinally assessed. DESIGN: Prospective study SETTING: Rehabilitation hospital PARTICIPANTS: Patients with chronic stroke and upper extremity impairment (N=22) INTERVENTION: A total of 640 repetitions of robot-assisted planar reaching, five times a week for 4 weeks MAIN OUTCOME MEASURES: Longitudinal robotic evaluations regarding motor performance included smoothness, mean velocity, path error, and reach error by the type of cognitive task...
December 31, 2016: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28044315/the-electric-field-distributions-in-anatomical-head-models-during-transcranial-direct-current-stimulation-for-post-stroke-rehabilitation
#18
Zoi Manoli, Marta Parazzini, Paolo Ravazzani, Theodoros Samaras
PURPOSE: The lack of knowledge of the electric field distribution inside the brain of stroke patients receiving transcranial direct current stimulation (tDCS) calls for estimating it computationally. Moreover, the impact on this distribution of a novel clinical management approach which involves secondary motor areas (SMA) in stroke rehabilitation needs to be evaluated. Finally, the differences in the electric field distributions due to gender and age need to be investigated. METHODS: This work presents the development of two different anatomical models (young adult female and elderly male) with an ischemic stroke region of spherical volume 10 cm(3) or 50 cm(3) , using numerical models of the Virtual Population (ViP)...
November 21, 2016: Medical Physics
https://www.readbyqxmd.com/read/28043958/fluctuating-drowsiness-following-cardiac-catheterisation-artery-of-percheron-ischaemic-stroke-causing-bilateral-thalamic-infarcts
#19
Daniel Hammersley, Ankur Arora, Madhava Dissanayake, Nabarun Sengupta
An 81-year-old man underwent cardiac catheterisation to investigate breathlessness and left ventricular impairment of unknown cause. He had unobstructed coronary arteries. Immediately following the procedure, he became suddenly unresponsive with vertical gaze palsy, anisocoria and bilateral upgoing plantar responses. He made a rapid recovery to his premorbid state 25 min later with no residual focal neurological signs. He then had multiple unresponsive episodes, interspaced with complete resolution of symptoms and neurological signs...
January 2, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28041902/intervention-by-speech-therapists-to-promote-oral-intake-of-patients-with-acute-stroke-a-retrospective-cohort-study
#20
Tomoko Nakazora, Junko Maeda, Konosuke Iwamoto, Sayori Hanashiro, Yoshikazu Nakamura, Tetsuhito Kiyozuka, Kazuhisa Domen
OBJECTIVE: Early rehabilitation for acute stroke patients is widely recommended. We tested the hypothesis that daily intervention by speech therapists promotes safe oral intake of patients with acute stroke. METHODS: We analyzed hospitalized patients who experienced cerebral infarction and cerebral hemorrhage and who underwent rehabilitation between October 2010 and September 2014 at our hospital. In total, 936 patients were analyzed, and 452 patients underwent daily speech therapy...
December 29, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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