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Rehabilitation of stroke

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
Christine Graven, Kim Brock, Keith D Hill, Sue Cotton, Lynette Joubert
BACKGROUND AND PURPOSE: Depression is a common issue after stroke. A focus on assisting people to achieve their personal participation goals may reduce levels of depression. The aim of this study was to investigate the effectiveness of a person-centered, integrated approach on facilitating goal achievement in the first year poststroke on depressive symptoms. METHODS: This study was a randomized controlled trial that addressed ways to enhance participation in patient-valued activities and intermittently screen for adverse sequelae postdischarge from rehabilitation...
October 13, 2016: Stroke; a Journal of Cerebral Circulation
V A Bronnikov, V B Smychek, Yu A Mavlikaeva, Yu I Kravtsov, K A Sklyannaya, O A Plotnikova, A V Vil'deman
AIM: To compare the efficacy of complex rehabilitation in patients receiving robotic kinesiotherapy and conventional physical therapy. MATERIAL AND METHODS: In total 68 patients were examined, including 37 patients receiving traditional kinesiotherapy and sessions on the robotic complex 'Locomat' and 31 patients of the control group who received conventional physical therapy. RESULTS AND CONCLUSION: There were statistical between-group differences in the indices of mobility, physical capabilities, strength and muscle tone in paretic extremities as well as the overall improvement of daily activity...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
I O Shchederkina, N N Zavadenko, I E Koltunov
AIM: To optimize a system of medical care, introduction of treatment and diagnostic guidelines, including secondary stroke prevention and rehabilitation measures, by implementation of pediatric stroke registry. MATERIAL AND METHODS: Fifty-seven patients, aged from 1 year to 17 years 11 months, included into the Moscow city registry of pediatric stroke were examined. Forty-two patients suffered ischemic stroke and 15 hemorrhagic stroke. RESULTS AND CONCLUSION: The diagnostic search for the causes of pediatric stroke is difficult due to the wide variety of etiologic factors and high frequency of their combinations...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Michał Starosta, Justyna Redlicka, Michał Brzeziański, Marta Niwald, Elżbieta Miller
Diseases of the central nervous system are the most common cause of mobility and cognitive impairment. Stroke is the leading cause of hospitalization in the Neurological Rehabilitation Departments. Age increases the risk of stroke, therefore monitoring basic medical parameters, including blood pressure especially under age of 65, is a very important part of preventive healthcare. According to data from the National Association of Stroke, in 10% of patients after brain stroke, recovery of motor functions and mental state is almost complete, in 25% impairment is minimal, in 40% the functional and cognitive disability is moderated or significant therefore requires rehabilitation, in 10% in view of impossibility of active rehabilitation patients requires comprehensive nursing care service at home or in special long term care centers...
July 29, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Volker Ressel, Ruth O'Gorman Tuura, Ianina Scheer, Hubertus J A van Hedel
BACKGROUND: Rehabilitation in children with acquired brain injury is a challenging endeavour. There is a large variability in motor recovery between patients, and a need to optimize therapies by exploiting cerebral plasticity and recovery mechanisms. This retrospective study aims to identify tract-based markers that could serve as predictors of functional outcome following rehabilitation. METHODS: Twenty-nine children with traumatic brain injury (n = 14) or stroke (n = 15) underwent a 3 T Magnetic Resonance Imaging (MRI) measurement, including Diffusion Tensor Imaging (DTI) between admission to the Hospital and onset of rehabilitation therapy at the Rehabilitation Centre...
October 12, 2016: Brain Imaging and Behavior
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