The relationship between balance and functional outcomes of subacute in-patient rehabilitation in stroke patients

2004 ◽  
Author(s):  
Yuen Tsang
Keyword(s):  
Functional Outcomes ◽  
Stroke Patients ◽  
The Relationship

scholarly journals Relationships between Pre-Stroke SARC-F Scores, Disability, and Risk of Malnutrition and Functional Outcomes after Stroke—A Prospective Cohort Study

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3586
Author(s):  
Masafumi Nozoe ◽  
Hiroki Kubo ◽  
Masashi Kanai ◽  
Miho Yamamoto
Keyword(s):  
Multivariate Analysis ◽  
Functional Outcomes ◽  
Primary Outcome ◽  
Screening Tool ◽  
High Specificity ◽  
Receiver Operating Curve ◽  
Modified Rankin Scale ◽  
Stroke Patients ◽  
Moderate Sensitivity ◽  
The Relationship

SARC-F is a screening tool for sarcopenia; however, it has not yet been established whether SARC-F scores predict functional outcomes. Therefore, we herein investigated the relationship between SARC-F scores and functional outcomes in stroke patients. The primary outcome in the present study was the modified Rankin Scale (mRS) 3 months after stroke. The relationship between SARC-F scores and poor functional outcomes was examined using a logistic regression analysis. Furthermore, the applicability of SARC-F scores to the assessment of poor functional outcomes was analyzed based on the area under the receiver operating curve (ROC). Eighty-one out of the 324 patients enrolled in the present study (25%) had poor functional outcomes (mRS ≥ 4). The results of the multivariate analysis revealed a correlation between SARC-F scores (OR = 1.29, 95% CI = 1.05–1.59, p = 0.02) and poor functional outcomes. A cut-off SARC-F score ≥ 4 had low-to-moderate sensitivity (47.4%) and high specificity (87.3%). The present results suggest that the measurement of pre-stroke SARC-F scores is useful for predicting the outcomes of stroke patients.

Pre-Admission CHADS2 and CHA2DS2-VASc Scores on Early Neurological Worsening

2021 ◽  
pp. 1-8
Author(s):  
Ki-Woong Nam ◽  
Chi Kyung Kim ◽  
Sungwook Yu ◽  
Jong-Won Chung ◽  
Oh Young Bang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Stroke Risk ◽  
Multivariable Analysis ◽  
National Institutes Of Health ◽  
Risk Scores ◽  
Stroke Patients ◽  
Nihss Score ◽  
Early Neurological Deterioration ◽  
Close Relationship ◽  
The Relationship

<b><i>Background:</i></b> Stroke risk scores (CHADS<sub>2</sub> and CHA<sub>2</sub>DS<sub>2</sub>-VASc) not only predict the risk of stroke in atrial fibrillation (AF) patients, but have also been associated with prognosis after stroke. <b><i>Objective:</i></b> The aim of this study was to evaluate the relationship between stroke risk scores and early neurological deterioration (END) in ischemic stroke patients with AF. <b><i>Methods:</i></b> We included consecutive ischemic stroke patients with AF admitted between January 2013 and December 2015. CHADS<sub>2</sub> and CHA<sub>2</sub>DS<sub>2</sub>-VASc scores were calculated using the established scoring system. END was defined as an increase ≥2 on the total National Institutes of Health Stroke Scale (NIHSS) score or ≥1 on the motor NIHSS score within the first 72 h of admission. <b><i>Results:</i></b> A total of 2,099 ischemic stroke patients with AF were included. In multivariable analysis, CHA<sub>2</sub>DS<sub>2</sub>-VASc score (adjusted odds ratio [aOR] = 1.17, 95% confidence interval [CI] = 1.04–1.31) was significantly associated with END after adjusting for confounders. Initial NIHSS score, use of anticoagulants, and intracranial atherosclerosis (ICAS) were also found to be closely associated with END, independent of the CHA<sub>2</sub>DS<sub>2</sub>-VASc score. Multivariable analysis stratified by the presence of ICAS demonstrated that both CHA<sub>2</sub>DS<sub>2</sub>-VASc (aOR = 1.20, 95% CI = 1.04–1.38) and CHADS<sub>2</sub> scores (aOR = 1.24, 95% CI = 1.01–1.52) were closely related to END in only patients with ICAS. In patients without ICAS, neither of the risk scores were associated with END. <b><i>Conclusions:</i></b> High CHA<sub>2</sub>DS<sub>2</sub>-VASc score was associated with END in ischemic stroke patients with AF. This close relationship is more pronounced in patients with ICAS.

scholarly journals Interactions between hippocampal activity and striatal dopamine in people at clinical high risk for psychosis: relationship to adverse outcomes

2021 ◽  
Author(s):  
Gemma Modinos ◽  
Anja Richter ◽  
Alice Egerton ◽  
Ilaria Bonoldi ◽  
Matilda Azis ◽  
...  
Keyword(s):  
High Risk ◽  
Functional Outcomes ◽  
Mental States ◽  
Adverse Outcomes ◽  
Striatal Dopamine ◽  
Psychotic Symptoms ◽  
Dopamine Synthesis ◽  
Clinical High Risk ◽  
Hippocampal Activity ◽  
The Relationship

AbstractPreclinical models propose that increased hippocampal activity drives subcortical dopaminergic dysfunction and leads to psychosis-like symptoms and behaviors. Here, we used multimodal neuroimaging to examine the relationship between hippocampal regional cerebral blood flow (rCBF) and striatal dopamine synthesis capacity in people at clinical high risk (CHR) for psychosis and investigated its association with subsequent clinical and functional outcomes. Ninety-five participants (67 CHR and 28 healthy controls) underwent arterial spin labeling MRI and 18F-DOPA PET imaging at baseline. CHR participants were followed up for a median of 15 months to determine functional outcomes with the global assessment of function (GAF) scale and clinical outcomes using the comprehensive assessment of at-risk mental states (CAARMS). CHR participants with poor functional outcomes (follow-up GAF < 65, n = 25) showed higher rCBF in the right hippocampus compared to CHRs with good functional outcomes (GAF ≥ 65, n = 25) (pfwe = 0.026). The relationship between rCBF in this right hippocampal region and striatal dopamine synthesis capacity was also significantly different between groups (pfwe = 0.035); the association was negative in CHR with poor outcomes (pfwe = 0.012), but non-significant in CHR with good outcomes. Furthermore, the correlation between right hippocampal rCBF and striatal dopamine function predicted a longitudinal increase in the severity of positive psychotic symptoms within the total CHR group (p = 0.041). There were no differences in rCBF, dopamine, or their associations in the total CHR group relative to controls. These findings indicate that altered interactions between the hippocampus and the subcortical dopamine system are implicated in the pathophysiology of adverse outcomes in the CHR state.

Prestroke statin use enhances collateralization in acute ischemic stroke patients

2020 ◽  
Vol 38 (4) ◽  
pp. 311-321
Author(s):  
Jiaying Zhu ◽  
Mengmeng Ma ◽  
Jinghuan Fang ◽  
Jiajia Bao ◽  
Shuju Dong ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Middle Cerebral Artery ◽  
Acute Ischemic Stroke ◽  
Statin Therapy ◽  
Cerebral Artery ◽  
Functional Outcomes ◽  
Collateral Circulation ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Statin Use

Background: Statin therapy has been shown to be effective in the prevention of ischemic stroke. In addition, recent studies have suggested that prior statin therapy could lower the initial stroke severity and improve stroke functional outcomes in the event of stroke. It was speculated that prestroke statin use may enhance collateral circulation and result in favorable functional outcomes. Objective: The aim of the study was to investigate the association of prestroke statin use with leptomeningeal collaterals and to determine the association of prestroke statin use with stroke severity and functional outcome in acute ischemic stroke patients. Methods: We prospectively and consecutively enrolled 239 acute ischemic stroke patients with acute infarction due to occlusion of the middle cerebral artery within 24 h in the neurology department of West China Hospital from May 2011 to April 2017. Computed tomographic angiography (CTA) imaging was performed for all patients to detect middle cerebral artery thrombus; regional leptomeningeal collateral score (rLMCS) was used to assess the degree of collateral circulation; the National Institutes of Health Stroke Scale (NIHSS) was used to measure stroke severity at admission; the modified Rankin scale (mRS) was used to measure outcome at 90 days; and premorbid medications were recorded. Univariate and multivariate analyses were performed. Results: Overall, 239 patients met the inclusion criteria. Fifty-four patients used statins, and 185 did not use statins before stroke onset. Prestroke statin use was independently associated with good collateral circulation (rLMCS > 10) (odds ratio [OR], 4.786; 95% confidence interval [CI], 1.195–19.171; P = 0.027). Prestroke statin use was not independently associated with lower stroke severity (NIHSS score≤14) (OR, 1.955; 95% CI, 0.657–5.816; p = 0.228), but prestroke statin use was independently associated with favorable outcome (mRS score≤2) (OR, 3.868; 95% CI, 1.325–11.289; P = 0.013). Conclusions: Our findings suggest that prestroke statin use was associated with good leptomeningeal collaterals and clinical outcomes in acute ischemic stroke (AIS) patients presenting with occlusion of the middle cerebral artery. However, clinical studies should be conducted to verify this claim.

The effect of robot-assisted gait training on cortical activation in stroke patients: A functional near-infrared spectroscopy study

2021 ◽  
pp. 1-9
Author(s):  
Kyeong Joo Song ◽  
Min Ho Chun ◽  
Junekyung Lee ◽  
Changmin Lee
Keyword(s):  
Gait Speed ◽  
Functional Outcomes ◽  
Near Infrared ◽  
Gait Training ◽  
Berg Balance Scale ◽  
Cortical Activation ◽  
Control Group ◽  
Stroke Patients ◽  
Robot Assisted ◽  
Functional Near Infrared Spectroscopy

OBJECTIVE: To investigate the effects of the robot–assisted gait training on cortical activation and functional outcomes in stroke patients. METHODS: The patients were randomly assigned: training with Morning Walk® (Morning Walk group; n = 30); conventional physiotherapy (control group; n = 30). Rehabilitation was performed five times a week for 3 weeks. The primary outcome was the cortical activation in the Morning Walk group. The secondary outcomes included gait speed, 10-Meter Walk Test (10MWT), FAC, Motricity Index–Lower (MI–Lower), Modified Barthel Index (MBI), Rivermead Mobility Index (RMI), and Berg Balance Scale (BBS). RESULTS: Thirty-six subjects were analyzed, 18 in the Morning Walk group and 18 in the control group. The cortical activation was lower in affected hemisphere than unaffected hemisphere at the beginning of robot rehabilitation. After training, the affected hemisphere achieved a higher increase in cortical activation than the unaffected hemisphere. Consequently, the cortical activation in affected hemisphere was significantly higher than that in unaffected hemisphere (P = 0.036). FAC, MBI, BBS, and RMI scores significantly improved in both groups. The Morning Walk group had significantly greater improvements than the control group in 10MWT (P = 0.017), gait speed (P = 0.043), BBS (P = 0.010), and MI–Lower (P = 0.047) scores. CONCLUSION: Robot-assisted gait training not only improved functional outcomes but also increased cortical activation in stroke patients.

Abstract 12: Feasibility of Monitoring Covid-19 Related Stroke Patients Across a 14 Hospital Stroke System of Care

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Howard J Rho ◽  
Navdeep S Sangha
Keyword(s):  
Stroke Care ◽  
Stroke Patients ◽  
Specific Data ◽  
Related Data ◽  
Disease States ◽  
Hospital Systems ◽  
Pandemic Response ◽  
Relationship Of ◽  
The Relationship ◽  
Existing Data

Background: Identifying and tracking COVID-19 related data has been crucial to the pandemic response. Most hospital systems have created internal tracking databases specific to COVID-19 but separated from other disease specific data pools. Traditional methods for tracking and trending novel and specific data such as COVID-19 related strokes may require personnel with highly technical skills to abstract the data. We aimed to create a COVID-19 stroke dashboard which would easily auto-abstract and update data. Methods: A simple monitoring system was designed using PowerBI™ and Microsoft Suite™ products that model existing data sources without using other IT resources. Existing data queries from various sources were modeled into one report and the resulting data model was used to track and trend incidence of COVID-19 and its relationship to stroke care throughout a 14- hospital stroke system. Results: The report allowed region-wide identification and evaluation of several metrics, including: volume of code strokes, the volume of patients who had a stroke within two weeks before or after testing positive for COVID-19, the initial NIHSS, if alteplase was administered, reason for no alteplase administration, delay in alteplase administration and if related to COVID-19 and the relationship of COVID-19 cases to the volume of code strokes. It was found that the volume of code strokes significantly decreased during the time of the pandemic and was inversely related to the volume of COVID-19 positive cases being reported in a county. The tool also found that COVID-19 positive stroke patients increased as the overall COVID-19 hospital volume increased. Conclusion: Assessing the relationships between a novel disease and other disease states may lead to changes in hospital workflows and practices resulting into improved patient outcomes.

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