scholarly journals Are stroke survivors with delirium at higher risk of post-stroke dementia? Current evidence and future directions

2016 ◽  
Vol 31 (12) ◽  
pp. 1289-1294 ◽  
Author(s):  
Akin Ojagbemi ◽  
Dominic H. Ffytche
Keyword(s):  
Current Evidence ◽  
Stroke Survivors ◽  
Future Directions ◽  
Post Stroke

scholarly journals Rewiring the Lesioned Brain: Electrical Stimulation for Post-Stroke Motor Restoration

2020 ◽  
Vol 22 (1) ◽  
pp. 47-63 ◽  
Author(s):  
Shi-chun Bao ◽  
Ahsan Khan ◽  
Rong Song ◽  
Raymond Kai-yu Tong
Keyword(s):  
Electrical Stimulation ◽  
Functional Improvement ◽  
Stroke Survivors ◽  
Noninvasive Brain Stimulation ◽  
Future Directions ◽  
Post Stroke ◽  
Neuromotor Control ◽  
Peripheral Electrical Stimulation ◽  
Therapeutic Mechanisms ◽  
Multiple Levels

Electrical stimulation has been extensively applied in post-stroke motor restoration, but its treatment mechanisms are not fully understood. Stimulation of neuromotor control system at multiple levels manipulates the corresponding neuronal circuits and results in neuroplasticity changes of stroke survivors. This rewires the lesioned brain and advances functional improvement. This review addresses the therapeutic mechanisms of different stimulation modalities, such as noninvasive brain stimulation, peripheral electrical stimulation, and other emerging techniques. The existing applications, the latest progress, and future directions are discussed. The use of electrical stimulation to facilitate post-stroke motor recovery presents great opportunities in terms of targeted intervention and easy applicability. Further technical improvements and clinical studies are required to reveal the neuromodulatory mechanisms and to enhance rehabilitation therapy efficiency in stroke survivors and people with other movement disorders.

Levosimendan to facilitate weaning from cardiorespiratory support in critically ill patients: current evidence and future directions

2020 ◽  
Vol 86 (6) ◽  
Author(s):  
Fabio Sangalli ◽  
Giacomo Bellani ◽  
Alessandro Affronti ◽  
Francesca Volpi ◽  
Marco Feri ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Current Evidence ◽  
Future Directions

scholarly journals Post-stroke fatigue: an exploratory study with patients and health professionals to develop a patient-reported outcome measure

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Ingrid Johansen Skogestad ◽  
Marit Kirkevold ◽  
Petra Larsson ◽  
Christine Råheim Borge ◽  
Bent Indredavik ◽  
...  
Keyword(s):  
Future Development ◽  
Health Professionals ◽  
Outcome Measure ◽  
Patient Reported Outcome ◽  
Stroke Survivors ◽  
Structured Interviews ◽  
Post Stroke ◽  
Patient Reported Outcome Measure ◽  
Patient Reported ◽  
Initial Hospital

Abstract Background Post-stroke fatigue (PSF) is commonly reported and described as disabling by patients recovering from stroke. However, a major challenge is how to accurately diagnose and assess PSF. Therefore, the aim of this study was to explore PSF as it is experienced by stroke survivors and described by health professionals to guide future development of a PSF-specific PROM. Methods Individual semi-structured interviews were conducted with stroke survivors experiencing PSF (n = 9) and three focus groups were conducted with health professionals (n = 16). Data were analyzed through inductive content analysis. Results The analysis revealed four themes illustrating the experience and descriptions of PSF: 1) PSF characteristics, 2) interfering and aggravating factors, 3) management, and 4) PSF awareness, which refers to stroke survivors first becoming aware of PSF after their initial hospital admission. Conclusion This study highlights the complexity and multidimensionality of PSF. The results from this study will guide future development of a PSF-PROM and support its content validity.

scholarly journals Effect of robotic-assisted gait training on objective biomechanical measures of gait in persons post-stroke: a systematic review and meta-analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Heidi Nedergård ◽  
Ashokan Arumugam ◽  
Marlene Sandlund ◽  
Anna Bråndal ◽  
Charlotte K. Häger
Keyword(s):  
Kinetic Parameters ◽  
Step Length ◽  
Gait Training ◽  
Risk Of Bias ◽  
Current Evidence ◽  
Temporal Asymmetry ◽  
Robotic Assisted ◽  
Post Stroke ◽  
Gait Biomechanics ◽  
Affected Side

Abstract Background Robotic-Assisted Gait Training (RAGT) may enable high-intensive and task-specific gait training post-stroke. The effect of RAGT on gait movement patterns has however not been comprehensively reviewed. The purpose of this review was to summarize the evidence for potentially superior effects of RAGT on biomechanical measures of gait post-stroke when compared with non-robotic gait training alone. Methods Nine databases were searched using database-specific search terms from their inception until January 2021. We included randomized controlled trials investigating the effects of RAGT (e.g., using exoskeletons or end-effectors) on spatiotemporal, kinematic and kinetic parameters among adults suffering from any stage of stroke. Screening, data extraction and judgement of risk of bias (using the Cochrane Risk of bias 2 tool) were performed by 2–3 independent reviewers. The Grading of Recommendations Assessment Development and Evaluation (GRADE) criteria were used to evaluate the certainty of evidence for the biomechanical gait measures of interest. Results Thirteen studies including a total of 412 individuals (mean age: 52–69 years; 264 males) met eligibility criteria and were included. RAGT was employed either as monotherapy or in combination with other therapies in a subacute or chronic phase post-stroke. The included studies showed a high risk of bias (n = 6), some concerns (n = 6) or a low risk of bias (n = 1). Meta-analyses using a random-effects model for gait speed, cadence, step length (non-affected side) and spatial asymmetry revealed no significant differences between the RAGT and comparator groups, while stride length (mean difference [MD] 2.86 cm), step length (affected side; MD 2.67 cm) and temporal asymmetry calculated in ratio-values (MD 0.09) improved slightly more in the RAGT groups. There were serious weaknesses with almost all GRADE domains (risk of bias, consistency, directness, or precision of the findings) for the included outcome measures (spatiotemporal and kinematic gait parameters). Kinetic parameters were not reported at all. Conclusion There were few relevant studies and the review synthesis revealed a very low certainty in current evidence for employing RAGT to improve gait biomechanics post-stroke. Further high-quality, robust clinical trials on RAGT that complement clinical data with biomechanical data are thus warranted to disentangle the potential effects of such interventions on gait biomechanics post-stroke.

scholarly journals ‘Somebody stuck me in a bag of sand’: Lived experiences of the altered and uncomfortable body after stroke

2021 ◽  
pp. 026921552110007
Author(s):  
Hannah Stott ◽  
Mary Cramp ◽  
Stuart McClean ◽  
Ailie Turton
Keyword(s):  
Support Groups ◽  
Phenomenological Study ◽  
Community Support ◽  
Phenomenological Approach ◽  
The Body ◽  
Stroke Survivors ◽  
Post Stroke ◽  
Personal Perceptions ◽  
Psychological Sense ◽  
Qualitative Phenomenological

Objective: This study explored stroke survivors’ experiences of altered body perception, whether these perceptions cause discomfort, and the need for clinical interventions to improve comfort. Design: A qualitative phenomenological study. Setting: Participants’ homes. Participants: A purposive sample of 16 stroke survivors were recruited from community support groups. Participants (median: age 59; time post stroke >2 years), were at least six-months post-stroke, experiencing motor or sensory impairments and able to communicate verbally. Interventions: Semi-structured, face-to-face interviews were analysed using an interpretive phenomenological approach and presented thematically. Results: Four themes or experiences were identified: Participants described (1) a body that did not exist; (2) a body hindered by strange sensations and distorted perceptions; (3) an uncontrollable body; and (4) a body isolated from social and clinical support. Discomfort was apparent in a physical and psychological sense and body experiences were difficult to comprehend and communicate to healthcare staff. Participants wished for interventions to improve their comfort but were doubtful that such treatments existed. Conclusion: Indications are that altered body perceptions cause multifaceted physical and psychosocial discomfort for stroke survivors. Discussions with patients about their personal perceptions and experiences of the body may facilitate better understanding and management to improve comfort after stroke.

Aquatic Therapy for improving Lower Limbs Function in Post-stroke Survivors: A Systematic Review with Meta-Analysis

2021 ◽  
pp. 1-17
Author(s):  
Mahboubeh Ghayour Najafabadi ◽  
Ardalan Shariat ◽  
Jan Dommerholt ◽  
Azadeh Hakakzadeh ◽  
Amin Nakhostin-Ansari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Lower Limbs ◽  
Stroke Survivors ◽  
Aquatic Therapy ◽  
Post Stroke

scholarly journals Role of caregiver factors in outpatient medical follow-up post-stroke: observational study in Singapore

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shilpa Tyagi ◽  
Gerald Choon-Huat Koh ◽  
Nan Luo ◽  
Kelvin Bryan Tan ◽  
Helen Hoenig ◽  
...  
Keyword(s):  
Observational Study ◽  
Management Strategies ◽  
Stroke Survivor ◽  
Stroke Survivors ◽  
Post Stroke ◽  
Memory Problems ◽  
Healthcare Needs ◽  
Stroke Study

Abstract Background Outpatient medical follow-up post-stroke is not only crucial for secondary prevention but is also associated with a reduced risk of rehospitalization. However, being voluntary and non-urgent, it is potentially determined by both healthcare needs and the socio-demographic context of stroke survivor-caregiver dyads. Therefore, we aimed to examine the role of caregiver factors in outpatient medical follow-up (primary care (PC) and specialist outpatient care (SOC)) post-stroke. Method Stroke survivors and caregivers from the Singapore Stroke Study, a prospective, yearlong, observational study, contributed to the study sample. Participants were interviewed 3-monthly for data collection. Counts of PC and SOC visits were extracted from the National Claims Database. Poisson modelling was used to explore the association of caregiver (and patient) factors with PC/SOC visits over 0–3 months (early) and 4–12 months (late) post-stroke. Results For the current analysis, 256 stroke survivors and caregivers were included. While caregiver-reported memory problems of a stroke survivor (IRR: 0.954; 95% CI: 0.919, 0.990) and caregiver burden (IRR: 0.976; 95% CI: 0.959, 0.993) were significantly associated with lower early post-stroke PC visits, co-residing caregiver (IRR: 1.576; 95% CI: 1.040, 2.389) and negative care management strategies (IRR: 1.033; 95% CI: 1.005, 1.061) were significantly associated with higher late post-stroke SOC visits. Conclusion We demonstrated that the association of caregiver factors with outpatient medical follow-up varied by the type of service (i.e., PC versus SOC) and temporally. Our results support family-centred care provision by family physicians viewing caregivers not only as facilitators of care in the community but also as active members of the care team and as clients requiring care and regular assessments.

Rehabilitation of Post Stroke Sensory Dysfunction—A Scoping Review

2021 ◽  
pp. 251660852098429
Author(s):  
Dorcas B. C. Gandhi ◽  
Ivy Anne Sebastian ◽  
Komal Bhanot
Keyword(s):  
Motor Behavior ◽  
Sensory Modality ◽  
Sensory System ◽  
Sensory Stimulation ◽  
Current Evidence ◽  
Cochrane Library ◽  
Post Stroke ◽  
Sensory Dysfunction ◽  
Electronic Database Search ◽  
External Stimuli

Sensory dysfunction is one of the common impairments that occurs post stroke. With sensory changes in all modalities, it also affects the quality of life and incites suicidal thoughts. The article attempts to review and describe the current evidence of various approaches of assessment and rehabilitation for post-stroke sensory dysfunction. After extensive electronic database search across Medline, Embase, EBSCO, and Cochrane library, it generated 2433 results. After screening according to inclusion and exclusion criteria, we included 11 studies. We categorized data based on type of sensory deficits and prevalence, role of sensory system on motor behavior, type of intervention, sensory modality targeted, and dosage of intervention and outcome measures used for rehabilitation. Results found the strong evidence of involvement of primary and secondary motor areas involved in processing and responding to somatosensation, respectively. We divided rehabilitation approaches into sensory stimulation approach and sensory retraining approach focused on using external stimuli and relearning, respectively. However, with varied aims and targeted sensory involvement, the study applicability is affected. Thus, this emerges the need of extensive research in future for evidence-based practice of assessments and rehabilitation on post-stroke sensory rehabilitation.

scholarly journals A Review on the Value of Imaging in Differentiating between Large Vessel Vasculitis and Atherosclerosis

2021 ◽  
Vol 11 (3) ◽  
pp. 236
Author(s):  
Pieter H. Nienhuis ◽  
Gijs D. van Praagh ◽  
Andor W. J. M. Glaudemans ◽  
Elisabeth Brouwer ◽  
Riemer H. J. A. Slart
Keyword(s):  
Fdg Pet ◽  
Large Vessel Vasculitis ◽  
Large Vessel ◽  
Current Evidence ◽  
Future Directions ◽  
Inflammatory Conditions ◽  
Positron Emission ◽  
Magnetic Resonance Imaging Mri ◽  
Review Reports ◽  
Ct Studies

Imaging is becoming increasingly important for the diagnosis of large vessel vasculitis (LVV). Atherosclerosis may be difficult to distinguish from LVV on imaging as both are inflammatory conditions of the arterial wall. Differentiating atherosclerosis from LVV is important to enable optimal diagnosis, risk assessment, and tailored treatment at a patient level. This paper reviews the current evidence of ultrasound (US), 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography (FDG-PET), computed tomography (CT), and magnetic resonance imaging (MRI) to distinguish LVV from atherosclerosis. In this review, we identified a total of eight studies comparing LVV patients to atherosclerosis patients using imaging—four US studies, two FDG-PET studies, and two CT studies. The included studies mostly applied different methodologies and outcome parameters to investigate vessel wall inflammation. This review reports the currently available evidence and provides recommendations on further methodological standardization methods and future directions for research.

Sign in / Sign up

Export Citation Format

Share Document