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Stroke AND return to driving

Peter Tanuseputro, Amy Hsu, Kerry Kuluski, Mathieu Chalifoux, Melissa Donskov, Sarah Beach, Peter Walker
OBJECTIVES: To describe the level of need and divertibility of newly admitted nursing home residents, describe the factors that drive need, and describe the outcomes of residents across different levels of need. DESIGN: Retrospective cohort study. SETTING: A total of 640 publicly funded nursing homes (also known as long-term care facilities) in Ontario, Canada. PARTICIPANTS: All newly admitted residents between January 1, 2010 and March 1, 2012...
April 1, 2017: Journal of the American Medical Directors Association
Trip Gabriel
In this vivid first-person case history, political reporter Trip Gabriel describes experiencing a classic episode of transient global amnesia. He was near the average target age of 61. Although no cause has been established for the syndrome, as with many other patients his episode appears to have been triggered by contact with water: He was racing a sailboat. While remaining alert and handling complex sailing maneuvers, he suddenly developed amnesia that left him with no recollection of finishing two races, returning to shore, drinking a beer with his friends, needing help finding his car, and not knowing where he was or where he lived...
March 2017: Cognitive and Behavioral Neurology: Official Journal of the Society for Behavioral and Cognitive Neurology
Janet Frith, Helen Warren-Forward, Isobel Hubbard, Carole James
BACKGROUND/AIM: In Australia, all stroke survivors should not drive for four weeks and transient ischaemic attack (TIA) survivors should not drive for two weeks. This study investigates the provision of return-to-driving education in the acute hospital setting and the use of this education by a cohort of Australian patients who have experienced a mild stroke or TIA and who are discharged directly home from their acute hospital admission. METHODS: A medical record audit was conducted of stroke patients discharged home from a regional hospital in Australia...
February 16, 2017: Australian Occupational Therapy Journal
Jaap Jan Vos, A F Kalmar, H G D Hendriks, J Bakker, T W L Scheeren
To assess the significance of an analogue of the mean systemic filling pressure (Pmsa) and its derived variables, in providing a physiology based discrimination between responders and non-responders to fluid resuscitation during liver surgery. A post-hoc analysis of data from 30 patients undergoing major hepatic surgery was performed. Patients received 15 ml kg(-1) fluid in 30 min. Fluid responsiveness (FR) was defined as an increase of 20% or greater in cardiac index, measured by FloTrac-Vigileo(®). Dynamic preload variables (pulse pressure variation and stroke volume variation: PPV, SVV) were recorded additionally...
February 16, 2017: Journal of Clinical Monitoring and Computing
Kerry Louise Hanna, Lauren Rachel Hepworth, Fiona Rowe
PURPOSE: To provide a systematic overview of the various tools available to screen for post-stroke visual impairment. METHODS: A review of the literature was conducted including randomised controlled trials, controlled trials, cohort studies, observational studies, systematic reviews and retrospective medical note reviews. All languages were included and translation was obtained. Participants included adults ≥18 years old diagnosed with a visual impairment as a direct cause of a stroke...
September 26, 2016: Disability and Rehabilitation
Sungwook Yu, Janani Muhunthan, Richard Lindley, Nick Glozier, Stephen Jan, Craig Anderson, Qiang Li, Maree L Hackett
BACKGROUND: There is limited information regarding return to driving after stroke. AIMS: To determine the frequency and predictors of return to driving within 1 month of acute stroke in younger (age 18-65 years) adults. METHODS: POISE (Psychosocial Outcomes In StrokE) was a cohort study conducted in Australia between October 2008 and June 2010. Consecutive patients (age 18-65 years) with a recent (≤28 days) acute stroke were recruited. Validated demographic, clinical, mental health, cognitive, and disability measures including return to driving were obtained...
October 2016: International Journal of Stroke: Official Journal of the International Stroke Society
Henriette A Seichter, Felix Blumenthal, Carmen R Smarandache-Wellmann
Here we demonstrate the dissection of the crayfish abdominal nerve cord. The preparation comprises the last two thoracic ganglia (T4, T5) and the chain of abdominal ganglia (A1 to A6). This chain of ganglia includes the part of the central nervous system (CNS) that drives coordinated locomotion of the pleopods (swimmerets): the swimmeret system. It is known for over five decades that in crayfish each swimmeret is driven by its own independent pattern generating kernel that generates rhythmic alternating activity ...
2014: Journal of Visualized Experiments: JoVE
Mary Elizabeth Walsh, Rose Galvin, Cliona Loughnane, Chris Macey, N Frances Horgan
PURPOSE: Acute stroke care continues to improve but the later stroke recovery phase remains less well understood. The aim of this study was to document self-reported need in relation to stroke recovery and community re-integration among community-dwelling persons up to five years post-stroke. METHODS: A national survey was carried out in Ireland. Participants were recruited through stroke advocacy organisations and health professionals. Existing validated questionnaires were adapted with permission...
2015: Disability and Rehabilitation
Mary E Walsh, Rose Galvin, Cliona Loughnane, Chris Macey, N Frances Horgan
PURPOSE: Although acute stroke care has improved survival, many individuals report dissatisfaction with community reintegration after stroke. The aim of this qualitative meta-synthesis was to examine the barriers and facilitators of community reintegration in the first year after stroke from the perspective of people with stroke. METHODS: A systematic literature search was conducted. Papers that used qualitative methods to explore the experiences of individuals with stroke around community reintegration in the first year after stroke were included...
2015: Disability and Rehabilitation
Markus Butz, Ines D Steenbuck, Arjen van Ooyen
After brain lesions caused by tumors or stroke, or after lasting loss of input (deafferentation), inter- and intra-regional brain networks respond with complex changes in topology. Not only areas directly affected by the lesion but also regions remote from the lesion may alter their connectivity-a phenomenon known as diaschisis. Changes in network topology after brain lesions can lead to cognitive decline and increasing functional disability. However, the principles governing changes in network topology are poorly understood...
2014: Frontiers in Neuroanatomy
Kelsey Thompson, Katherine Read, Steven Anderson, Matthew Rizzo
Many patients with circumscribed brain injuries, such as those caused by stroke or focal trauma, return to driving after a period of acute recovery. These persons often have chronic residual cognitive deficits that may impact on driving safety, but little is known about their driving behavior in the real world. Extant studies tend to rely on driving simulators or controlled on-road drives. These methods of observation are not able to capture the complexities of the typical driving environment, and may not accurately represent a driver's usual behavior on the road...
2011: Proceedings of the ... International Driving Symposium on Human Factors in Driver Assessment, Training, and Vehicle Design
Dean Papaliodis, Nicholas Richardson, Jason Tartaglione, Timothy Roberts, Richard Whipple, George Zanaros
OBJECTIVE: Golf is a widely popular sport in the United States with 29 million Americans participating in the game. With an aging population and increased incidence of glenohumeral degenerative arthritis, the number of active golfers requiring total shoulder replacement is on the rise. This study aims to evaluate the effect of total shoulder replacement on golfing activity. DESIGN: Retrospective; questionnaire. SETTING: Survey. PARTICIPANTS: Three hundred sixty-seven patients were identified based on Current Procedural Terminology codes who underwent total shoulder arthroplasty (TSA) between January 2004 and January 2013...
July 2015: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Annabel McNamara, Ruth Walker, Julie Ratcliffe, Stacey George
PURPOSE: Returning to driving post-stroke is a step towards independence. On return to driving following stroke, confidence is related to performance in on-road assessment and self-regulation of driving behaviours occurs. The aim of this study was to examine the relationship between driver's confidence and driving habits post-stroke. METHOD: Structured telephone surveys were completed with 40 stroke survivors (62% men), of mean age 65 years SD 12.17 who returned to driving post-stroke within the previous 3 years...
2015: Disability and Rehabilitation
Brian Mulloney, Carmen Smarandache-Wellmann, Cynthia Weller, Wendy M Hall, Ralph A DiCaprio
The system of modular neural circuits that controls crustacean swimmerets drives a metachronal sequence of power-stroke (PS, retraction) and return-stroke (RS, protraction) movements that propels the animal forward efficiently. These neural modules are synchronized by an intersegmental coordinating circuit that imposes characteristic phase differences between these modules. Using a semi-intact preparation that left one swimmeret attached to an otherwise isolated central nervous system (CNS) of the crayfish, Pacifastacus leniusculus, we investigated how the rhythmic activity of this system responded to imposed movements...
December 1, 2014: Journal of Neurophysiology
Brian Silver, Rachel Wulf Silver
There is no defined duration of therapy for stroke patients, who may continue to experience recovery for several months after the event. Physical, occupational, and speech therapy should be offered as long as benefit is experienced. Patients may benefit from self-directed therapy. Constraint-induced movement therapy, a rigorous program for upper extremity weakness, has been proven effective for improving arm function. Other areas of investigation include repetitive transcranial magnetic stimulation, cellular management, robotic therapy, and pharmacologic strategies to enhance recovery...
May 2014: FP Essentials
Annabel McNamara, Stacey George, Julie Ratcliffe, Ruth Walker
AIM: Little is known about how older people recovering from stroke perceive their return to driving, particularly in the early stages of recovery when they may receive driving information. METHODS: Semistructured interviews were conducted with 21 participants (52% female, mean age 74.5 years) within the first 16 weeks post-stroke, while inpatients in either acute or rehabilitation stroke wards. Interview data were analysed using content analysis. RESULTS: Three main themes emerged: 'driving as independence', 'emphasis on physical recovery', and 'limits on driving pre-stroke'...
March 2015: Australasian Journal on Ageing
Brenda H Vrkljan, Anita M Myers, Alexander M Crizzle, Robin A Blanchard, Shawn C Marshall
BACKGROUND: Assessing medical fitness to drive (FTD) can include both off- and on-road testing, although consistency of practice is unclear. PURPOSE: To examine actual practices being used to assess FTD at driver assessment centres (DACs) across Canada. METHOD: Surveys e-mailed to 90 DACs were returned by 47 assessors. FINDINGS: The majority of respondents (89%) were occupational therapists. Assessors reported doing an average of eight FTD assessments per month (range = I to 40) at an average cost of $366 (SD = $225; range = $40 to $985)...
December 2013: Canadian Journal of Occupational Therapy. Revue Canadienne D'ergothérapie
Antonio J Salazar, Ana S Silva, Claudia Silva, Carla M Borges, Miguel V Correia, Rubim S Santos, Joao P Vilas-Boas
BACKGROUND: An increasingly aging society and consequently rising number of patients with poststroke-related neurological dysfunctions are forcing the rehabilitation field to adapt to ever-growing demands. Although clinical reasoning within rehabilitation is dependent on patient movement performance analysis, current strategies for monitoring rehabilitation progress are based on subjective time-consuming assessment scales, not often applied. Therefore, a need exists for efficient nonsubjective monitoring methods...
January 2014: Topics in Stroke Rehabilitation
John Pearn, Rory J O'Connor
Around 150,000 people experience a stroke every year in the UK. Nearly one million people in England are living with the effects of a stroke; one third of whom are moderately to severely disabled. A quarter of stroke survivors are under the age of 65 meaning that many are in work and/or have responsibility for caring for children or elderly parents. With a comprehensive rehabilitation team, patients with more complex or severe disability can be rehabilitated in the community providing that the home environment can be suitably adapted...
September 2013: Practitioner
Annabel McNamara, Julie Ratcliffe, Stacey George
AIM: To determine whether self-perceived driving confidence levels are lower in the post-stroke driving population than their aged-matched non-stroke driving peers. A lack of driving confidence has been linked to self-limiting driving behaviours. METHOD: Adelaide Driving Self-Efficacy Scale (ADSES) scores were collected for a stroke population who returned to driving (N = 40, 25 men) with a mean age of 65 (SD = 12.17) years and an older non-stroke driver population (N = 114, 56 men) with a mean age of 72 (SD = 5...
September 2014: Australasian Journal on Ageing
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