scholarly journals EVIDENCE-BASED STROKE REHABILITATION

2017 ◽  
pp. 57
Author(s):  
Ivona D. Stanković ◽  
Anita Stanković ◽  
Marija Spalević ◽  
Dragan Zlatanović ◽  
Tamara Stanković
Keyword(s):  
Stroke Rehabilitation ◽  
New Technologies ◽  
Scientific Evidence ◽  
Experimental Studies ◽  
Holistic Approach ◽  
Functional Independence ◽  
Current Evidence ◽  
Home Based ◽  
Rehabilitation Strategy

Stroke can have different clinical characteristics and consequences, with unequal disability and outcome, thus demanding individual approach, specific skills and general knowledge. Treatment of stroke has significantly improved during the last twenty years, mainly because of clinical and experimental studies, adequate medicamentous therapy, and the use of new technologies as well. Use-dependent rehabilitation strategy includes repetitive training with proper adjustment of the program. Other rehabilitation practices should also be incorporated, such as self-care, recreation, and home-based activities. Motivation of the patients, improving quality of life, functional independence, activities of daily life are crucial. Holistic approach means that the patient as a whole should be considered and treated. Scientific evidence is sufficient to confirm the necessity of physical rehabilitation of patients after stroke in order to achieve the optimal results. Current evidence on the effect of physical therapy in stroke rehabilitation is presented.

scholarly journals Effectiveness of Shock Wave Therapy as a Treatment for Spasticity: A Systematic Review

2020 ◽  
Vol 11 (1) ◽  
pp. 15
Author(s):  
Isabel María Martínez ◽  
Nuria Sempere-Rubio ◽  
Olga Navarro ◽  
Raquel Faubel
Keyword(s):  
Shock Wave ◽  
Botulinum Toxin ◽  
Methodological Quality ◽  
Scientific Evidence ◽  
Motor Impairment ◽  
Functional Independence ◽  
Shock Wave Therapy ◽  
Jadad Scale ◽  
Type Of Injury

Background: The purpose of this study was to collect and analyse the available scientific evidence on the effectiveness of shock wave therapy as a treatment for spasticity. Methods: the search was performed in the following databases: PubMed, PEDro, Cochrane, Embase, and the Virtual Health Library. All publications from November 2009 to November 2019 were selected that included a sample of patients with spasticity and prior suspension of botulinum toxin, to whom shock wave therapy was applied. The methodological quality of the articles was evaluated using the Jadad scale and the pyramid of quality of scientific evidence. Results: 25 studies involving 866 participants with spasticity were selected. The results obtained suggest that shock wave therapy appears to be effective in reducing spasticity levels irrespective of the age of the participants, the type of injury, and the tool used to measure the effect. Conclusions: shock wave therapy reports evidence of improvement in motor function, motor impairment, pain, and functional independence, applied independently of botulinum toxin. However, due to the heterogeneity of the protocols, there is no optimum protocol for its application, and it would be appropriate to gain more high-quality scientific evidence through primary studies.

scholarly journals The Use of Evidence-Based Acupuncture: Current Evidence

2022 ◽  
Author(s):  
Dedi Ardinata
Keyword(s):  
Clinical Evidence ◽  
Scientific Evidence ◽  
Current Evidence ◽  
Systematic Research ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Quality Of Evidence ◽  
Assessment Development ◽  
Evidence Quality

Evidence-based medicine (EBM), which emphasizes that medical decisions must be based on the most recent best evidence, is gaining popularity. Individual clinical expertise is combined with the best available external clinical evidence derived from systematic research in the practice of EBM. The key and core of EBM is the hierarchical system for categorizing evidence. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system divides evidence quality into four categories: high, moderate, low, and very low. GRADE is based on the lowest quality of evidence for any of the outcomes that are critical to making a decision, reducing the risk of mislabeling the overall evidence quality, when evidence for a critical outcome is lacking. This principle is also used in acupuncture as a complementary and integrative treatment modality, but incorporating scientific evidence is more difficult due to a number of factors. The goal of this chapter is to discuss how to establish a clinical evidence system for acupuncture, with a focus on the current quality of evidence for a variety of conditions or diseases.

scholarly journals Adherence to Post-Acute Rehabilitation Guidelines Improves Functional Recovery in Stroke

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 333-333
Author(s):  
Pamela W Duncan ◽  
Ronnie D Horner ◽  
Dean M Reker ◽  
VA Medical Ctr ◽  
Kansas City ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Acute Stroke ◽  
Functional Recovery ◽  
Stroke Rehabilitation ◽  
Functional Independence ◽  
Case Mix ◽  
Stroke Patients ◽  
Sf 36 ◽  
Acute Rehabilitation

97 Purpose & Methods: To assess if compliance with post-stroke rehabilitation guidelines improves functional recovery. The design of the study was an inception cohort of stroke patients followed prospectively for 6 months. The setting was eleven Department of Veteran Affairs Medical Centers providing care to stroke patients. The subjects included 288 selected patients with stroke admitted between January 1998 - March 1999. Data were abstracted from medical records and telephone interviews. Primary outcome was the Functional Independence Motor Score (FIM). Secondary outcomes included Instrumental Activities of Daily Living (IADL), SF-36 physical functioning, and the Stroke Impact Scale (SIS). Acute and post-acute rehabilitation composite compliance scores (range 0–100) were derived from an algorithm. All outcomes were adjusted for case mix. Results: Average compliance scores in acute and post acute care settings were 68.2% (+ 14) and 69.5% (+ 14.4), respectively. After case-mix adjustment, level of compliance with post-acute rehabilitation guidelines was significantly associated with FIM motor, IADL, and the SIS physical domain scores. SF-36 physical function scores and mortality were not affected by compliance with post-acute rehabilitation guidelines. Level of compliance with rehabilitation guidelines in acute settings was unrelated to any of the outcome measures. Conclusion: Process of care in post-acute stroke rehabilitation affects 6-month functional recovery. Our findings support the use of guidelines as means of assessing quality of care and improving outcomes. These quality indicators are needed to ensure that quality of care is not comprised with new organizational and funding changes involving post-acute stroke care.

scholarly journals Influence of New Technologies on Post-Stroke Rehabilitation: A Comparison of Armeo Spring to the Kinect System

Medicina ◽  
2019 ◽  
Vol 55 (4) ◽  
pp. 98 ◽  
Author(s):  
Adomavičienė ◽  
Daunoravičienė ◽  
Kubilius ◽  
Varžaitytė ◽  
Raistenskis
Keyword(s):  
Virtual Reality ◽  
Grip Strength ◽  
Functional Recovery ◽  
Stroke Rehabilitation ◽  
New Technologies ◽  
Functional Independence ◽  
Upper Limbs ◽  
Post Stroke ◽  
Visuospatial Abilities ◽  
Attention Memory

Background: New technologies to improve post-stroke rehabilitation outcomes are of great interest and have a positive impact on functional, motor, and cognitive recovery. Identifying the most effective rehabilitation intervention is a recognized priority for stroke research and provides an opportunity to achieve a more desirable effect. Objective: The objective is to verify the effect of new technologies on motor outcomes of the upper limbs, functional state, and cognitive functions in post-stroke rehabilitation. Methods: Forty two post-stroke patients (8.69 ± 4.27 weeks after stroke onset) were involved in the experimental study during inpatient rehabilitation. Patients were randomly divided into two groups: conventional programs were combined with the Armeo Spring robot-assisted trainer (Armeo group; n = 17) and the Kinect-based system (Kinect group; n = 25). The duration of sessions with the new technological devices was 45 min/day (10 sessions in total). Functional recovery was compared among groups using the Functional Independence Measure (FIM), and upper limbs’ motor function recovery was compared using the Fugl–Meyer Assessment Upper Extremity (FMA-UE), Modified Ashworth Scale (MAS), Hand grip strength (dynamometry), Hand Tapping test (HTT), Box and Block Test (BBT), and kinematic measures (active Range Of Motion (ROM)), while cognitive functions were assessed by the MMSE (Mini-Mental State Examination), ACE-R (Addenbrooke’s Cognitive Examination-Revised), and HAD (Hospital Anxiety and Depression Scale) scores. Results: Functional independence did not show meaningful differences in scores between technologies (p > 0.05), though abilities of self-care were significantly higher after Kinect-based training (p < 0.05). The upper limbs’ kinematics demonstrated higher functional recovery after robot training: decreased muscle tone, improved shoulder and elbow ROMs, hand dexterity, and grip strength (p < 0.05). Besides, virtual reality games involve more arm rotation and performing wider movements. Both new technologies caused an increase in overall global cognitive changes, but visual constructive abilities (attention, memory, visuospatial abilities, and complex commands) were statistically higher after robotic therapy. Furthermore, decreased anxiety level was observed after virtual reality therapy (p < 0.05). Conclusions: Our study displays that even a short-term, two-week training program with new technologies had a positive effect and significantly recovered post-strokes functional level in self-care, upper limb motor ability (dexterity and movements, grip strength, kinematic data), visual constructive abilities (attention, memory, visuospatial abilities, and complex commands) and decreased anxiety level.

Parasitology: today and tomorrow

1987 ◽  
Vol 65 (4) ◽  
pp. 812-822
Author(s):  
D. F. Mettrick
Keyword(s):  
New Technologies ◽  
Control Point ◽  
Experimental Studies ◽  
High Standard ◽  
Cellular Biology ◽  
Parasitic Infections ◽  
Host Parasite ◽  
Canadian Research ◽  
Very High

Parasites have, over the centuries, been responsible for high mortalities among humans and domestic and wild animals. The presence of parasitic infections has made vast areas of the world uninhabitable for both humans and animals. Major strengths of Canadian parasitology include wildlife parasitology, systematics, and taxonomy. Experimental studies in parasitology are limited; in particular the subdisciplines of parasite molecular and cellular biology, biochemistry, immunology, and neurobiology are very limited. There is concern that we will not be able to maintain the quality of Canadian research in parasitology, particularly in the emerging new technologies. It is greatly to the credit of those early Canadian parasitologists, who laid the foundations for today's advances in parasitology, that a relatively small group of approximately 100 professional parasitologists has today reached a very high standard of parasitological research. The next 25 years will be an exciting period as new insights allow us to further understand the complexity of host–parasite relationships. The development of new vaccines, drugs, and vector control point to significant reductions in parasitic infections.

scholarly journals Diet, nutrition and the ageing brain: current evidence and new directions

2018 ◽  
Vol 77 (2) ◽  
pp. 152-163 ◽  
Author(s):  
Katie Moore ◽  
Catherine F. Hughes ◽  
Mary Ward ◽  
Leane Hoey ◽  
Helene McNulty
Keyword(s):  
New Technologies ◽  
B Vitamins ◽  
Current Evidence ◽  
Vitamin B ◽  
Ageing Population ◽  
Brain Health ◽  
Nutrition Interventions ◽  
Ageing Brain ◽  
Totality Of Evidence

Globally populations are ageing. By 2050, it is estimated that there will be two billion people aged 60 years or over, of which 131 million are projected to be affected by dementia, while depression is predicted to be the second leading cause of disability worldwide by 2020. Preventing or delaying the onset of these disorders should therefore be a public health priority. There is some evidence linking certain dietary patterns, particularly the Mediterranean diet, with a reduced risk of dementia and depression. Specific dietary components have also been investigated in relation to brain health, with emerging evidence supporting protective roles forn-3 PUFA, polyphenols, vitamin D and B-vitamins. At this time, the totality of evidence is strongest in support of a role for folate and the metabolically related B-vitamins (vitamin B12, vitamin B6and riboflavin) in slowing the progression of cognitive decline and possibly reducing the risk of depression in ageing. Future studies incorporating new technologies, such as MRI and magnetoencephalography, offer much promise in identifying effective nutrition interventions that could reduce the risk of cognitive and mental disorders. This review will explore the ageing brain and the emerging evidence linking diet and specific nutrients with cognitive function and depression in ageing, with the potential to develop strategies that could improve quality of life in our ageing population.

scholarly journals Stress in the Volunteer Caregiver: Human-Centric Technology Can Support Both Caregivers and People with Dementia

Medicina ◽  
2020 ◽  
Vol 56 (6) ◽  
pp. 257
Author(s):  
Barbara Huelat ◽  
Sharon T. Pochron
Keyword(s):  
New Technologies ◽  
Medication Management ◽  
Memory Loss ◽  
Resource Network ◽  
Use Of Technology ◽  
The People ◽  
People With Dementia ◽  
Home Based ◽  
Stress Burden

Background and Objectives: Currently, one in eight people over the age of 65 have dementia, and approximately 75% of caregiving is provided by volunteer family members with little or no training. This study aimed to quantify points of stress for home-based caregivers with the aim of reducing stress for them while concurrently supporting quality of life for the people with dementia whom they cared for. The overreaching purpose was to increase our knowledge of the caregiver stress burden and explore potential technologies and behaviors to ease it. Materials and Methods: We interviewed home-based and professional caregivers regarding causes of emotional and physical stress and methods they used to alleviate it. Results: This study found that: (1) dementia symptoms created a burden of stress for home-based caregivers primarily in the areas of medication management, memory loss, hygiene care and disruptive behaviors; (2) home-based caregivers identified “finding available resources” as the most important source of stress relief; (3) a minority of home-based caregivers possessed a resource network and knew how to find resources but all professional caregivers were able to find resources and support; (4) home-based caregivers combated dementia symptoms with positive distractions and human touch with little use of technology, since it was mostly unknown; and (5) facility-based caregivers were knowledgeable and readily used dementia-based technology. Conclusion: Since professional caregivers have access to technological resources that our home-based caregivers lack, one might logically conclude that we should transfer technology used by professionals to those with dementia. However, great caution needs to be in place before we take that step. Successful technology should address the human experience as home-based caregivers try to use new technologies. Human-centric technology addresses the needs of both people with dementia and the home-based caregiver.

scholarly journals Epilepsy, Physical Activity and Sports: A Narrative Review

2018 ◽  
Vol 45 (6) ◽  
pp. 624-632 ◽  
Author(s):  
Jaime Carrizosa-Moog ◽  
Lady Diana Ladino ◽  
Vanessa Benjumea-Cuartas ◽  
Juan Pablo Orozco-Hernández ◽  
Diana Marcela Castrillón-Velilla ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Psychological Health ◽  
Structural Changes ◽  
Experimental Studies ◽  
Inhibitory Effect ◽  
Current Evidence ◽  
Physical Conditioning ◽  
Randomized Controlled Studies

AbstractPeople with epilepsy (PWE) are less physically active compared with the general population. Explanations include prejudice, overprotection, unawareness, stigma, fear of seizure induction and lack of knowledge of health professionals. At present, there is no consensus on the role of exercise in epilepsy. This paper reviews the current evidence surrounding the risks and benefits associated with physical activity (PA) in this group of patients. In the last decade, several publications indicate significant benefits in physiological and psychological health parameters, including mood and cognition, physical conditioning, social interaction, quality of life, as well as potential prevention of seizure presentation. Moreover, experimental studies suggest that PA provides mechanisms of neuronal protection, related to biochemical and structural changes including release of β-endorphins and steroids, which may exert an inhibitory effect on the occurrence of abnormal electrical activity. Epileptic discharges can decrease or disappear during exercise, which may translate into reduced seizure recurrence. In some patients, exercise may precipitate seizures. Available evidence suggests that PA should be encouraged in PWE in order to promote wellbeing and quality of life. There is a need for prospective randomized controlled studies that provide stronger clinical evidence before definitive recommendations can be made.

scholarly journals The interdisciplinarity and innovativeness of methods in rehabilitation of children with cerebral palsy

2019 ◽  
Vol 10 (1) ◽  
pp. 125-135
Author(s):  
Luba Jakubowska ◽  
Magdalena Kazimierska-Zając ◽  
Karolina Nowak
Keyword(s):  
Quality Of Life ◽  
Cerebral Palsy ◽  
New Technologies ◽  
Holistic Approach ◽  
Space Suit ◽  
New Methods ◽  
Children With Cerebral Palsy ◽  
The Central Nervous System ◽  
Unconventional Methods

Thesis. Cerebral palsy (CP) is a group of disorders resulting from damage to the central nervous system in the early stages of its development. The aim of the rehabilitation of persons with CP is to make their dependence on the assistance of others as little as possible and to improve their quality of life, as well as the quality of life of their families. New methods are developed in which new technologies are employed and a holistic approach to the patient, requiring the cooperation of specialists in various fields, is assumed.             The most commonly used methods of working with children with cerebral palsy include the NDT-Bobath method and the Vojta method. Apart from them unconventional methods are also employed, including hippotherapy, virtual reality, the sensory integration method, the conductive education method, and the space suit method. Aim of the paper. The aim of the paper is to present the methods employed in increasing the agility of children with cerebral palsy. Focus has been placed on traditional and commonly used methods, as well as the unconventional methods which are currently undergoing evaluation. Results. Thanks to diversifying rehabilitation with new methods and enriching it with the experience of specialists in areas outside medicine patients with cerebral palsy are able to fully benefit from their own potential. Quality of life is improved, independence is increased, and new opportunities are discovered. Some of the newest methods may serve to supplement traditional therapies, others can substitute for them in the future. What is crucial is to focus not only on heightening the physical agility of the patients, but also to make the course of the therapy more attractive, and to work on improving the patients’ functioning in other areas of life, as well, such as social contacts or hobbies.

scholarly journals Ovarian Cryopreservation: An Overview of Current Evidence around the Globe

2021 ◽  
Vol 4 (1) ◽  
pp. 435-445
Author(s):  
Gkrozou F ◽  
Tsonis O
Keyword(s):  
Ovarian Tissue ◽  
Scientific Evidence ◽  
Current Evidence ◽  
Ovarian Tissue Cryopreservation ◽  
Reproductive Techniques ◽  
Efficient Alternative ◽  
Clinical Potential ◽  
Cumulative Evidence ◽  
Tissue Cryopreservation

Advancements in cancer as well as, autoimmunological or hematological conditions treatment have significantly increased the survival rate as well as, the Quality of Life (QoL) for these patients. In addition, Assisted Reproductive Techniques (ART) offers a variety of therapeutic approaches that aim towards fertility preservation and hormonal restoration after treatment. Ovarian Tissue Cryopreservation (OTC) and Ovarian Tissue Transplantation (OTT) have been proposed as an efficient alternative to reserve fertility and hormona function in cases of prepubertal young girls and women needed to be treated immediately with radiation and/or chemotherapy. In this narrative review, current scientific evidence is summarized in order to explore OTC/OTT. In addition to the qualitive presentation of our findings, we provide cumulative evidence from other published studies to demonstrate the clinical potential and limitations of these procedures.

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