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https://www.readbyqxmd.com/read/28741720/alteplase-for-acute-ischemic-stroke-after-heparin-reversal-with-protamine-a-case-report-and-review
#1
Gabriel V Fontaine, Shawn M Smith
BACKGROUND: Few patients presenting with acute ischemic stroke (AIS) are eligible for alteplase, especially those receiving ongoing anticoagulation. We describe the first reported case of a patient receiving full-dose intravenous (IV) alteplase for AIS after heparin reversal with protamine. CASE: A 73-year-old male presented with AIS. He was treated with IV heparin, tirofiban, loading-dose prasugrel, and aspirin prior to percutaneous coronary intervention (PCI) for placement of a right coronary artery stent...
July 25, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28741278/italian-intersociety-consensus-on-prevention-diagnosis-and-treatment-of-delirium-in-hospitalized-older-persons
#2
Giuseppe Bellelli, Alessandro Morandi, Marco Trabucchi, Guido Caironi, Daniele Coen, Carlo Fraticelli, Ciro Paolillo, Carolina Prevaldi, Angela Riccardi, Gianfranco Cervellin, Corrado Carabellese, Salvatore Putignano, Stefania Maggi, Antonio Cherubini, Paola Gnerre, Andrea Fontanella, Nicola Latronico, Concezione Tommasino, Antonio Corcione, Giovanni Ricevuti, Nicola Ferrara, Francesco De Filippi, Alberto Ferrari, Mario Guarino, Maria Pia Ruggieri, Pietro Amedeo Modesti, Carlo Locatelli, Patrizia Hrelia, Marco Otto Toscano, Emi Bondi, Antonio Tarasconi, Luca Ansaloni, Francesco Perticone
Delirium is a severe neuropsychiatric syndrome characterized by inattention and global cognitive dysfunction in the setting of an acute medical illness, medical complication, drug intoxication, or drug withdrawal. The most important risk factors are advanced age and dementia, whereas pain, dehydration, infections, stroke, metabolic disturbances, and surgery are the most common triggering factors. Although delirium is a common clinical syndrome in different settings of care (acute care hospitals, inpatient rehabilitation facilities, nursing homes, and hospices), it often remains under-recognized, poorly understood, and inadequately managed...
July 24, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28739346/a-method-of-calculating-functional-independence-measure-at-discharge-from-functional-independence-measure-effectiveness-predicted-by-multiple-regression-analysis-has-a-high-degree-of-predictive-accuracy
#3
Makoto Tokunaga, Susumu Watanabe, Shigeru Sonoda
BACKGROUND: Multiple linear regression analysis is often used to predict the outcome of stroke rehabilitation. However, the predictive accuracy may not be satisfactory. The objective of this study was to elucidate the predictive accuracy of a method of calculating motor Functional Independence Measure (mFIM) at discharge from mFIM effectiveness predicted by multiple regression analysis. METHODS: The subjects were 505 patients with stroke who were hospitalized in a convalescent rehabilitation hospital...
July 21, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28738735/clinician-perspectives-on-cross-education-in-stroke-rehabilitation
#4
William Russell, Lesley Pritchard-Wiart, Patricia J Manns
PURPOSE: Cross-education is a neural phenomenon where strength of an untrained muscle improves after unilateral training of the opposite homologous muscle. It has been extensively studied in healthy populations and shows promise for post-stroke rehabilitation. The purpose of this study is to understand current post-stroke upper extremity rehabilitation practice; clinician's perspectives on cross-education and; facilitators and barriers to implementation of a cross-education intervention...
July 24, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28736792/double-injected-human-stem-cells-enhance-rehabilitation-in-tbi-mice-via-modulation-of-survival-and-inflammation
#5
Chul Kim, Ji-Min Park, TaeHo Kong, Seungmin Lee, Ki-Weon Seo, Yuri Choi, Young Sook Song, Jisook Moon
Traumatic brain injury (TBI), a complicated form of brain damage, is a major cause of mortality in adults. Following mechanical and structural primary insults, a battery of secondary insults, including neurotransmitter-mediated cytotoxicity, dysregulation of calcium and macromolecule homeostasis, and increased oxidative stress, exacerbate brain injury and functional deficits. Although stem cell therapy is considered to be an alternative treatment for brain injuries, such as TBI and stroke, many obstacles remain...
July 24, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28736326/tone-inhibiting-insoles-enhance-the-reciprocal-inhibition-of-ankle-plantarflexors-of-post-stroke-hemiparetic-subjects-an-electromyographic-study
#6
Nobushige Takahashi, Hidetoshi Takahashi, Osamu Takahashi, Ryosuke Ushijima, Rie Umebayashi, Junji Nishikawa, Yasutomo Okajima
BACKGROUND: Spasticity is a common sequela of upper motor neuron pathology, such as cerebrovascular diseases and cerebral palsy. Intervention for spasticity of the ankle plantarflexors in physical therapy may include tone-inhibiting casting and/or orthoses for the ankle and foot. However, the physiological mechanism of tone reduction by such orthoses remains unclarified. OBJECTIVE: To investigate the electrophysiologic effects of tone-inhibiting insoles in stroke subjects with hemiparesis by measuring changes in reciprocal Ia inhibition (RI) in the ankle plantarflexor...
July 20, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28734936/rehabilitation-interventions-for-upper-limb-function-in-the-first-four-weeks-following-stroke-a-systematic-review-and-meta-analysis-of-the-evidence
#7
REVIEW
Kimberley A Wattchow, Michelle N McDonnell, Susan L Hillier
OBJECTIVE: To investigate the therapeutic interventions reported in the research literature, and synthesize their effectiveness in improving upper limb (UL) function in the first four weeks post-stroke. DATA SOURCES: Electronic databases, trial registries and hand searching was conducted, from inception until June 2016. STUDY SELECTION: Randomised controlled trials (RCTs), controlled trials and interventional studies with pre/post-test design were included for adults within four weeks of any type of stroke with UL impairment...
July 19, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28729058/impacts-of-sensation-perception-and-motor-abilities-of-the-ipsilesional-upper-limb-on-hand-functions-in-unilateral-stroke-quantifications-from-biomechanical-and-functional-perspectives
#8
Hsiu-Yun Hsu, Chia-Wen Ke, Ta-Shen Kuan, Hsiu-Ching Yang, Ching-Liang Tsai, Li-Chieh Kuo
BACKGROUND: The presence of subtle losses in hand dexterity after stroke impacts the regaining of independence with regard to activities of daily living. Therefore, awareness of ipsilesional upper extremity (UE) function may be of importance when drafting a comprehensive rehabilitation program. However, current hand function tests seem to be unable to identify asymptomatic UE impairments. OBJECTIVES: To assess the motor coordination as well as the sensory-perception of an ipsilesional UE using biomechanical analysis of performance-oriented tasks and conducting a Manual Tactile Test (MTT)...
July 17, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28728602/robot-assisted-training-for-the-upper-limb-after-stroke-ratuls-study-protocol-for-a-randomised-controlled-trial
#9
Helen Rodgers, Lisa Shaw, Helen Bosomworth, Lydia Aird, Natasha Alvarado, Sreeman Andole, David L Cohen, Jesse Dawson, Janet Eyre, Tracy Finch, Gary A Ford, Jennifer Hislop, Steven Hogg, Denise Howel, Niall Hughes, Hermano Igo Krebs, Christopher Price, Lynn Rochester, Elaine Stamp, Laura Ternent, Duncan Turner, Luke Vale, Elizabeth Warburton, Frederike van Wijck, Scott Wilkes
BACKGROUND: Loss of arm function is a common and distressing consequence of stroke. We describe the protocol for a pragmatic, multicentre randomised controlled trial to determine whether robot-assisted training improves upper limb function following stroke. METHODS/DESIGN: Study design: a pragmatic, three-arm, multicentre randomised controlled trial, economic analysis and process evaluation. SETTING: NHS stroke services. PARTICIPANTS: adults with acute or chronic first-ever stroke (1 week to 5 years post stroke) causing moderate to severe upper limb functional limitation...
July 20, 2017: Trials
https://www.readbyqxmd.com/read/28727727/a-comparative-study-of-patients-activities-and-interactions-in-a-stroke-unit-before-and-after-reconstruction-the-significance-of-the-built-environment
#10
Anna Anåker, Lena von Koch, Christina Sjöstrand, Julie Bernhardt, Marie Elf
Early mobilization and rehabilitation, multidisciplinary stroke expertise and comprehensive therapies are fundamental in a stroke unit. To achieve effective and safe stroke care, the physical environment in modern stroke units should facilitate the delivery of evidence-based care. Therefore, the purpose of this study was to explore patients' activities and interactions in a stroke unit before the reconstruction of the physical environment, while in a temporary location and after reconstruction. This case study examined a stroke unit as an integrated whole...
2017: PloS One
https://www.readbyqxmd.com/read/28727668/comprehensive-cardiac-rehabilitation-for-secondary-prevention-after-transient-ischemic-attack-or-mild-stroke-psychological-profile-and-outcomes
#11
Peter L Prior, Vladimir Hachinski, Richard Chan, Karen Unsworth, Sharon Mytka, Michael Harnadek, Christina OʼCallaghan, Neville Suskin
PURPOSE: Having previously reported that comprehensive cardiac rehabilitation (CCR) is effective for secondary prevention post-transient ischemic attack (TIA)/mild nondisabling stroke (MNDS), we present psychometric findings for the same sample that elucidate subacute TIA/MNDS psychological outcomes and test whether CCR would be independently associated with psychological improvements. METHODS: In this prospective cohort trial patients with ≥1 risk factor, recruited from a stroke prevention clinic within 12 months (mean = 11...
July 19, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28727485/the-longitudinal-relationship-between-acceptance-and-anxiety-and-depression-in-people-who-have-had-a-stroke
#12
Dominic Crowley, Leanne Andrews
OBJECTIVES: The role that acceptance may play in anxiety and depression has received little attention in stroke, unlike other chronic conditions. This study aimed to clarify whether acceptance of a stroke is related to anxiety and depression post-stroke when controlling for social support. DESIGN: A longitudinal design was employed with 35 participants completing measures at two time points: three-month and nine-month post-stroke. METHODS: Forty-one stroke patients, who were three-month post-stroke, were recruited from a stroke service register...
July 20, 2017: Aging & Mental Health
https://www.readbyqxmd.com/read/28724575/a-multidirectional-gravity-assist-algorithm-that-enhances-locomotor-control-in-patients-with-stroke-or-spinal-cord-injury
#13
Jean-Baptiste Mignardot, Camille G Le Goff, Rubia van den Brand, Marco Capogrosso, Nicolas Fumeaux, Heike Vallery, Selin Anil, Jessica Lanini, Isabelle Fodor, Grégoire Eberle, Auke Ijspeert, Brigitte Schurch, Armin Curt, Stefano Carda, Jocelyne Bloch, Joachim von Zitzewitz, Grégoire Courtine
Gait recovery after neurological disorders requires remastering the interplay between body mechanics and gravitational forces. Despite the importance of gravity-dependent gait interactions and active participation for promoting this learning, these essential components of gait rehabilitation have received comparatively little attention. To address these issues, we developed an adaptive algorithm that personalizes multidirectional forces applied to the trunk based on patient-specific motor deficits. Implementation of this algorithm in a robotic interface reestablished gait dynamics during highly participative locomotion within a large and safe environment...
July 19, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28724317/who-among-patients-with-acquired-brain-injury-returned-to-work-after-occupational-rehabilitation-the-rapid-return-to-work-cohort-study
#14
Randi Wågø Aas, Lise Aasen Haveraaen, Evelien P M Brouwers, Lisebet Skeie Skarpaas
BACKGROUND: Acquired brain injury (ABI) is known to be severely disabling. On average, 40% of employees return to work (RTW) within two years after injury. There is, however, limited research on what might contribute to successful RTW. AIM: To examine factors that might impact the time-to first RTW for patients with ABI, participating in a RTW-program. METHODS: The study was designed as a cohort study of patients on sick leave due to mild or moderate ABI (n = 137)...
July 20, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28722777/nurses-and-nurse-assistants-beliefs-attitudes-and-actions-related-to-role-and-function-in-an-inpatient-stroke-rehabilitation-unit-a-qualitative-study
#15
Mia Ingerslev Loft, Ingrid Poulsen, Bente Appel Esbensen, Helle Klingenberg Iversen, Lone Lunbak Mathiesen, Bente Martinsen
AIMS AND OBJECTIVE: To explore nurses' and nurse assistants' beliefs, attitudes, and actions related to their function in an inpatient stroke rehabilitation unit. BACKGROUND: Several attempts have been made to describe nurses' roles and functions in inpatient neurorehabilitation. However, current understandings of the contributions that nurses and nurse assistants make to neurorehabilitation remain sparse. DESIGN: Descriptive, interpretive qualitative study...
July 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28720980/efficacy-of-cognitive-rehabilitation-therapy-on-poststroke-depression-among-survivors-of-first-stroke-attack-in-ibadan-nigeria
#16
Olugbemi Olukolade, Helen O Osinowo
BACKGROUND AND PURPOSE: Poststroke depression (PSD) is a common complication after stroke. There is no adequate treatment for PSD. This study examined efficacy of cognitive rehabilitation therapy (CRT) in the treatment of PSD among stroke survivors. METHODS: An experimental design, 30 participants with poststroke depression were randomly assigned into 3 groups of cognitive rehabilitation therapy (CRT), psychoeducation (PE), and the control group (CG). CRT consisted of nine sessions with three-phased sessions focusing on activity stimulation, negative thoughts, and people contacts, PE consisted of nine sessions focusing on knowledge on stroke and poststroke depression, and the CG group was on the waiting list...
2017: Behavioural Neurology
https://www.readbyqxmd.com/read/28719996/efficacy-of-short-term-robot-assisted-rehabilitation-in-patients-with-hand-paralysis-after-stroke-a-randomized-clinical-trial
#17
Jorge H Villafañe, Giovanni Taveggia, Silvia Galeri, Luciano Bissolotti, Chiara Mullè, Grace Imperio, Kristin Valdes, Alberto Borboni, Stefano Negrini
BACKGROUND: We evaluated the effectiveness of robot-assisted motion and activity in additional to physiotherapy (PT) and occupational therapy (OT) on stroke patients with hand paralysis. METHODS: A randomized controlled trial was conducted. Thirty-two patients, 34.4% female (mean ± SD age: 68.9 ± 11.6 years), with hand paralysis after stroke participated. The experimental group received 30 minutes of passive mobilization of the hand through the robotic device Gloreha (Brescia, Italy), and the control group received an additional 30 minutes of PT and OT for 3 consecutive weeks (3 d/wk) in addition to traditional rehabilitation...
February 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28719977/the-efficacy-of-interactive-motion-capture-based-rehabilitation-on-functional-outcomes-in-an-inpatient-stroke-population-a-randomized-controlled-trial
#18
John Cannell, Emelyn Jovic, Amy Rathjen, Kylie Lane, Anna M Tyson, Michele L Callisaya, Stuart T Smith, Kiran Dk Ahuja, Marie-Louise Bird
OBJECTIVE: To compare the efficacy of novel interactive, motion capture-rehabilitation software to usual care stroke rehabilitation on physical function. DESIGN: Randomized controlled clinical trial. SETTING: Two subacute hospital rehabilitation units in Australia. PARTICIPANTS: In all, 73 people less than six months after stroke with reduced mobility and clinician determined capacity to improve. INTERVENTIONS: Both groups received functional retraining and individualized programs for up to an hour, on weekdays for 8-40 sessions (dose matched)...
July 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28719572/neuroimaging-correlates-of-post-stroke-aphasia-rehabilitation-in-a-pilot-randomized-trial-of-constraint-induced-aphasia-therapy
#19
Rodolphe Nenert, Jane B Allendorfer, Amber M Martin, Christi Banks, Angel Ball, Jennifer Vannest, Aimee R Dietz, Jerzy P Szaflarski
BACKGROUND Recovery from post-stroke aphasia is a long and complex process with an uncertain outcome. Various interventions have been proposed to augment the recovery, including constraint-induced aphasia therapy (CIAT). CIAT has been applied to patients suffering from post-stroke aphasia in several unblinded studies to show mild-to-moderate linguistic gains. The aim of the present study was to evaluate the neuroimaging correlates of CIAT in patients with chronic aphasia related to left middle cerebral artery stroke...
July 18, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28716014/the-comprehensive-post-acute-stroke-services-compass-study-design-and-methods-for-a-cluster-randomized-pragmatic-trial
#20
Pamela W Duncan, Cheryl D Bushnell, Wayne D Rosamond, Sara B Jones Berkeley, Sabina B Gesell, Ralph B D'Agostino, Walter T Ambrosius, Blair Barton-Percival, Janet Prvu Bettger, Sylvia W Coleman, Doyle M Cummings, Janet K Freburger, Jacqueline Halladay, Anna M Johnson, Anna M Kucharska-Newton, Gladys Lundy-Lamm, Barbara J Lutz, Laurie H Mettam, Amy M Pastva, Mysha E Sissine, Betsy Vetter
BACKGROUND: Patients discharged home after stroke face significant challenges managing residual neurological deficits, secondary prevention, and pre-existing chronic conditions. Post-discharge care is often fragmented leading to increased healthcare costs, readmissions, and sub-optimal utilization of rehabilitation and community services. The COMprehensive Post-Acute Stroke Services (COMPASS) Study is an ongoing cluster-randomized pragmatic trial to assess the effectiveness of a comprehensive, evidence-based, post-acute care model on patient-centered outcomes...
July 17, 2017: BMC Neurology
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