Reliability of Body Fat Measures by Near-Infrared Spectroscopy in Elderly Hemiplegic Stroke Patients in Long-Term Care

Background and Purpose: Stroke treatment is often delayed before patients reach the emergency department (ED). Some patients arrive in time to receive medication that can reverse new stroke symptoms. Some are not as fortunate. They are either admitted to the palliative unit, or discharged only to live with their new disabilities possibly for the rest of their lives. In 2013, nurses observed many long term care (LTC) patients were not getting to the ED in time to receive tPA (tissue plasminogen activator), a medication used to reverse stroke symptoms. The purpose of this process improvement was to increase the number of LTC patients with stroke symptoms arriving in the ED within the tPA window. Methods: To determine how many patients from nursing homes were missing the tPA window, data from the ED’s records was abstracted from the month of June 2013. The sample size was all patients who presented with possible stroke symptoms, and who were also from LTC facilities. Surprisingly, 100% of LTC patients presenting with stroke symptoms missed the tPA window. With the support of ED leadership, we decided to raise awareness about the tPA window in the LTC facilities. No evidence existed from ED’s related to LTC patients and the tPA window. Approximately 1,000 unused stroke pamphlets were collected. A PowerPoint presentation based on AHA guidelines was used. A lecture occurred at the community’s senior services meeting, and many LTC administrators were willing to adopt this education initiative at their facilities. ED staff became involved and helped conduct the in-services. In exchange for their volunteering, they received credit to help with career ladders at their hospital. Results: The number of possible stroke patients from LTC facilities getting to the ED within eight hours of the last time seen normal (LTSN) has increased from 0% in June 2013, to 25% in March 2014. Conclusions: Stroke education teams of ED nurses showed improvement in LTC patients arriving in the ED within the tPA window. In conclusion, it is encouraged that other ED staff volunteer to teach in LTC facilities in their own communities, in assisting their stroke patients as well.

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P660Associations of 26 circulating inflammatory and renal biomarkers with near-infrared spectroscopy and long term cardiovascular outcome in patients undergoing coronary angiography [ATHEROREMO study]

European Heart Journal ◽

10.1093/eurheartj/ehx501.p660 ◽

2017 ◽

Vol 38 (suppl_1) ◽

Author(s):

S.S. Anroedh ◽

K.M. Akkerhuis ◽

R.M. Oemrawsingh ◽

H.M. Garcia-Garcia ◽

M. Brankovic ◽

...

Keyword(s):

Infrared Spectroscopy ◽

Coronary Angiography ◽

Near Infrared Spectroscopy ◽

Near Infrared ◽

Cardiovascular Outcome ◽

Renal Biomarkers

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Factors Affecting the Activities of Daily Living of Chronic Stroke Patients Requiring Long-term Care

Rigakuryoho Kagaku ◽

10.1589/rika.31.325 ◽

2016 ◽

Vol 31 (2) ◽

pp. 325-328

Author(s):

Tomohiko KAMO ◽

Katsuhiko EGUCHI ◽

Hideaki ISHII ◽

Yusuke NISHIDA

Keyword(s):

Activities Of Daily Living ◽

Daily Living ◽

Long Term Care ◽

Chronic Stroke ◽

Stroke Patients ◽

Term Care ◽

Factors Affecting

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Median Nerve Electrical Stimulation–Induced Changes in Effective Connectivity in Patients With Stroke as Assessed With Functional Near-Infrared Spectroscopy

Neurorehabilitation and Neural Repair ◽

10.1177/1545968319875952 ◽

2019 ◽

Vol 33 (12) ◽

pp. 1008-1017 ◽

Cited By ~ 1

Author(s):

Congcong Huo ◽

Xinglou Li ◽

Jing Jing ◽

Yanping Ma ◽

Wenhao Li ◽

...

Keyword(s):

Electrical Stimulation ◽

Infrared Spectroscopy ◽

Median Nerve ◽

Near Infrared Spectroscopy ◽

Resting State ◽

Near Infrared ◽

Cerebral Oxygenation ◽

Effective Connectivity ◽

Stroke Patients ◽

Functional Near Infrared Spectroscopy

Background. The cortical plastic changes in response to median nerve electrical stimulation (MNES) in stroke patients have not been entirely illustrated. Objective. This study aimed to investigate MNES-related changes in effective connectivity (EC) within a cortical network after stroke by using functional near-infrared spectroscopy (fNIRS). Methods. The cerebral oxygenation signals in the bilateral prefrontal cortex (LPFC/RPFC), motor cortex (LMC/RMC), and occipital lobe (LOL/ROL) of 20 stroke patients with right hemiplegia were measured by fNIRS in 2 conditions: (1) resting state and (2) MNES applied to the right wrist. Coupling function together with dynamical Bayesian inference was used to assess MNES-related changes in EC among the cerebral low-frequency fluctuations. Results. Compared with the resting state, EC from LPFC and RPFC to LOL was significantly increased during the MNES state in stroke patients. Additionally, MNES triggered significantly higher coupling strengths from LMC and LOL to RPFC. The interregional main coupling direction was observed from LPFC to bilateral motor and occipital areas in responding to MNES, suggesting that MNES could promote the regulation function of ipsilesional prefrontal areas in the functional network. MNES can induce muscle twitch of the stroke-affected hand involving a decreased neural coupling of the contralesional motor area on the ipsilesional MC. Conclusions. MNES can trigger sensorimotor stimulations of the affected hand that sequentially involved functional reorganization of distant cortical areas after stroke. Investigating MNES-related changes in EC after stroke may help further our understanding of the neural mechanisms underlying MNES.

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Estimation of the Long-Term Care Needs of Stroke Patients by Integrating Functional Disability and Survival

PLoS ONE ◽

10.1371/journal.pone.0075605 ◽

2013 ◽

Vol 8 (10) ◽

pp. e75605 ◽

Cited By ~ 10

Author(s):

Mei-Chuan Hung ◽

Ching-Lin Hsieh ◽

Jing-Shiang Hwang ◽

Jiann-Shing Jeng ◽

Jung-Der Wang

Keyword(s):

Functional Disability ◽

Long Term Care ◽

Stroke Patients ◽

Care Needs ◽

Term Care

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Wearable Hip-assist Robot Modulates Cortical Activation during Gait in Stroke Patients: A Functional Near-Infrared Spectroscopy Study

10.21203/rs.3.rs-23523/v1 ◽

2020 ◽

Author(s):

Su-Hyun Lee ◽

Hwang-Jae Lee ◽

Youngbo Shim ◽

Won Hyuk Chang ◽

Byung-Ok Choi ◽

...

Keyword(s):

Infrared Spectroscopy ◽

Near Infrared Spectroscopy ◽

Near Infrared ◽

Late Phase ◽

Chronic Stroke ◽

Cortical Activation ◽

Stroke Patients ◽

Functional Near Infrared Spectroscopy ◽

Clinical Trial Registration ◽

Gait Function

Abstract BackgroundGait dysfunction is common in post-stroke patients as a result of impairment in cerebral gait mechanism. Powered robotic exoskeletons are promising tools to maximize neural recovery by delivering repetitive walking practice.ObjectivesThe purpose of this study was to investigate the modulating effect of the Gait Enhancing and Motivating System-Hip (GEMS-H) on cortical activation during gait in patients with chronic stroke. Methods. Twenty chronic stroke patients performed treadmill walking at a self-selected speed either with assistance of GEMS-H (GEMS-H) or without assistance of GEMS-H (NoGEMS-H). Changes in oxygenated hemoglobin (oxyHb) concentration in the bilateral primary sensorimotor cortex (SMC), premotor cortices (PMC), supplemental motor areas (SMA), and prefrontal cortices (PFC) were recorded using functional near infrared spectroscopy.ResultsWalking with the GEMS-H promoted symmetrical SMC activation, with more activation in the affected hemisphere than in NoGEMS-H conditions. GEMS-H also decreased oxyHb concentration in the late phase over the ipsilesional SMC and bilateral SMA.ConclusionsThe results of the present study reveal that the GEMS-H promoted more SMC activation and a balanced activation pattern that helped to restore gait function. Less activation in the late phase over SMC and SMA during gait with GEMS-H indicates that GEMS-H reduces the cortical participation of stroke gait by producing rhythmic hip flexion and extension movement and allows a more coordinate and efficient gait patterns.Clinical trial registration: NCT03048968. Registered 09 February 2017

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