The Parallel Process - Dramatherapy sessions with an older non-verbal client

An article outlining a case study examining a parallel process travelled by a dramatherapist and stroke victim. With all therapeutic relationships we embark on a journey with our client. This article examines just such a journey, one where the therapist and client moved together in a parallel process. These dramatherapy sessions were conducted with an older, non-verbal stroke victim and examine how the therapist experienced the transference changing through the therapy. This article explores work with a non-verbal individual with limited motor ability and how as dramatherapists we communicate with these individuals to create a therapeutic relationship and therefore meaningful therapeutic work.

A Brunnstrom Stage Evaluation System with Fuzzy-Accelerometer

Advances in medical care has reduced the rate of mortality from strokes, but the incidence of stroke has remained stable while the incidence of ministrokes has increased. Most stroke victims require long-term care, imposing a heavy financial and emotional burden on families while incurring a heavy cost to society. Thus, strokes are a key issue in the context of health care in Taiwan. This paper proposes using VBA (Visual Basic for Applications) to build a system for assessing Brunnstrom stages based on the observation of several obvious rehabilitation features The system calculates features for accelerometer readings, which are then used as input parameters for a fuzzy algorithm to obtain the Brunnstrom action level. Experimental results show the proposed approach effectively assesses Brunnstrom level, and that the approach can be used to assist physical therapists in performing longitudinal assessments of stroke victim progress, thus improving evaluation efficiency.

Stroke and the Orthopaedic Surgeon

The role that can be effectively played by the orthopaedic surgeon in the long-term management of the stroke victim is often overlooked. Post-stroke patients rely heavily on the orthopaedist, amongst other members of the multidisciplinary team, to regain the maximum possible functional status following the stroke event. A great need to understand and implement the principles of post-stroke orthopaedic treatment and rehabilitation exists in our own community and practice.DOI: http://dx.doi.org/10.3126/noaj.v2i1.8139 Nepal Orthopaedic Association Journal Vol.2(1) 2011: 43-46

Knowledge of stroke among a brazilian urban population

Knowledge of the population in regards to stroke has clinical and epidemiological importance. Prompt identification of the symptoms means efficient medical attendance within the window of therapeutic opportunities reducing significantly the morbi-mortality. Our aim was to evaluate the level of knowledge of the population of Teresina (PI) concerning factors of risk, symptoms and treatment of stroke. The door-to-door study was carried out by means of a standardized application of questionnaire on risk factors, symptoms and attitude when faced with a stroke victim. 991 forms were selected. Factors of risk more cited were hypertension identified by 416 [42.0%] and hyperlipidemia 284 [28.7%]. The most remembered symptoms were headache 277 [28.0%] and hemiplegia 219 [22.1%]. 375 (37.8%) respondents were unable to identify any risk factors and and 410 (41.4%) any symptom. The lack of knowledge of the population of Teresina in relation to stroke reflects the need for intervention through public and professional educational campaigns.

Testing for Antiphospholipid Antibody (aPL) Specificities in Retrospective “Normal” Cerebral Spinal Fluid (CSF)

Antiphospholipid antibodies (aPL) have been found in the blood of patients with systemic and neurological disease. The rare reports of aPL in cerebral spinal fluid (CSF) have been limited mostly to IgG and IgM anticardiolipin (aCL). Our published finding of IgA aPE in the CSF of a young stroke victim prompted us to establish “normal” CSF aPL values for a panel of aPL, which included aCL, antiphosphatidylserine (aPS), antiphosphatidylethanolamine (aPE) and antiphosphatidylcholine (aPC). CSF samples were tested by ELISA for IgG, IgM and IgA aPL. In addition, the CSF samples were tested for activity in the presence and absence of phospholipid (PL) binding plasma-proteins. A total of 24 data points were obtained for each CSF sample.We tested 59 CSF samples obtained from 59 patients who were undergoing evaluation for systemic or neurologic diseases. All CSF samples had normal protein, glucose and cell counts. Ten of the 59 CSF samples (17%) had elevated aPL optical density (OD) values an order of magnitude higher than the other 49 CSF samples for one or more aPL specificity and/or isotype. One CSF sample had both PL-binding protein dependent and independent IgG aPE activity. Another CSF sample showed both IgG aPE and aPC reactivity. The remaining eight CSF samples showed single aPL findings; IgG aPE (5), IgG aPC (1), IgG aCL (1) and IgM aPC (1). Seven of 10 patients with elevated CSF values were females. As expected, most “normal” aPL OD values were substantially lower in CSF than those we have reported in blood samples from volunteer blood donors.