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stroke rehabilitation

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161. [Possibility of treatment of emotional and behavioral disorders in patients with stroke during rehabilitation]. (Abstract)

[Possibility of treatment of emotional and behavioral disorders in patients with stroke during rehabilitation]. To assess the effect of the comprehensive rehabilitation, which includes mechanotherapy and cognitive stimulation based on tablet technologies, on emotional and behavioral disorders in patients in the acute stage of ischemic stroke.The study enrolled 100 patients admitted to the hospital in the acute stage of ischemic stroke. The patients were randomized into treatment and control (...) of comprehensive rehabilitation in the acute stage of ischemic stroke helps to decrease emotional and behavioral disorders (p=0.0001). In patients of the treatment group, the severity of depressive disorders was lower at discharge from the hospital and continued to decrease for 6 months (p=0.001). The level of anxiety decreased over the study period (p=0.0001) compared with the patients of the control group who did not demonstrate improvement. Patients of the treatment group displayed better functional

2019 Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova Controlled trial quality: uncertain

162. Guided Self-rehabilitation Contract vs conventional therapy in chronic stroke-induced hemiparesis: NEURORESTORE, a multicenter randomized controlled trial. Full Text available with Trip Pro

Guided Self-rehabilitation Contract vs conventional therapy in chronic stroke-induced hemiparesis: NEURORESTORE, a multicenter randomized controlled trial. After discharge from hospital following a stroke, prescriptions of community-based rehabilitation are often downgraded to "maintenance" rehabilitation or discontinued. This classic therapeutic behavior stems from persistent confusion between lesion-induced plasticity, which lasts for the first 6 months essentially, and behavior-induced (...) plasticity, of indefinite duration, through which intense rehabilitation might remain effective. This prospective, randomized, multicenter, single-blind study in subjects with chronic stroke-induced hemiparesis evaluates changes in active function with a Guided Self-rehabilitation Contract vs conventional therapy alone, pursued for a year.One hundred and twenty four adult subjects with chronic hemiparesis (> 1 year since first stroke) will be included in six tertiary rehabilitation centers. For each

2019 BMC Neurology Controlled trial quality: predicted high

163. Does hand robotic rehabilitation improve motor function by rebalancing interhemispheric connectivity after chronic stroke? Encouraging data from a randomised-clinical-trial. (Abstract)

Does hand robotic rehabilitation improve motor function by rebalancing interhemispheric connectivity after chronic stroke? Encouraging data from a randomised-clinical-trial. The objective of this study was the evaluation of the clinical and neurophysiological effects of intensive robot-assisted hand therapy compared to intensive occupational therapy in the chronic recovery phase after stroke.50 patients with a first-ever stroke occurred at least six months before, were enrolled and randomised

2019 Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology Controlled trial quality: uncertain

164. Intermittent theta burst stimulation applied during early rehabilitation after stroke: study protocol for a randomised controlled trial. Full Text available with Trip Pro

Intermittent theta burst stimulation applied during early rehabilitation after stroke: study protocol for a randomised controlled trial. Intermittent theta burst stimulation (iTBS) applied to primary motor cortex (M1) has been shown to modulate both the excitability and connectivity of the motor system. A recent proof-of-principle study, based on a small group of hospitalised patients with acute ischemic stroke, suggested that iTBS applied to the ipsilesional M1 combined with physical therapy (...) early after stroke can amplify motor recovery with lasting after effects. A randomised controlled clinical trial using a double-blind design is warranted to justify the implementation of iTBS-assisted motor rehabilitation in neurorehabilitation from an acute ischaemic stroke.We investigate the effects of daily iTBS on early motor rehabilitation after stroke in an investigator-initiated, longitudinal randomised controlled trial. Patients (n=150) with hemiparesis receive either iTBS (600 pulses

2019 BMJ open

165. Scoping review of acute stroke care management and rehabilitation in low and middle-income countries. Full Text available with Trip Pro

Scoping review of acute stroke care management and rehabilitation in low and middle-income countries. Stroke is a major public health concern, affecting millions of people worldwide. Care of the condition however, remain inconsistent in developing countries. The purpose of this scoping review was to document evidence of stroke care and service delivery in low and middle-income countries to better inform development of a context-fit stroke model of care.An interpretative scoping literature (...) review based on Arksey and O'Malley's five-stage-process was executed. The following databases searched for literature published between 2010 and 2017; Cochrane Library, Credo Reference, Health Source: Nursing/Academic Edition, Science Direct, BioMed Central, Cumulative Index to Nursing and Allied Health Literature (CINNAHL), Academic Search Complete, and Google Scholar. Single combined search terms included acute stroke, stroke care, stroke rehabilitation, developing countries, low and middle-income

2019 BMC health services research

166. Patient and service factors associated with referral and admission to inpatient rehabilitation after the acute phase of stroke in Australia and Norway. Full Text available with Trip Pro

Patient and service factors associated with referral and admission to inpatient rehabilitation after the acute phase of stroke in Australia and Norway. Unequal access to inpatient rehabilitation after stroke has been reported. We sought to identify and compare patient and service factors associated with referral and admission to an inpatient rehabilitation facility (IRF) after acute hospital care for stroke in two countries with publicly-funded healthcare.We compared two cohorts of stroke (...) admission, living in the community, and independent pre-stroke mobility. Directions of associations were mostly congruent; however younger patients were more likely to be referred and admitted in Norway only. Models for admission among patients referred identified few associated factors suggesting that additional factors were important for this stage of the process.Similar factors were associated with referral to inpatient rehabilitation after acute stroke in both countries, despite differing service

2019 BMC health services research

167. Family-led rehabilitation after stroke in India (ATTEND): a randomised controlled trial. Full Text available with Trip Pro

Family-led rehabilitation after stroke in India (ATTEND): a randomised controlled trial. Most people with stroke in India have no access to organised rehabilitation services. The effectiveness of training family members to provide stroke rehabilitation is uncertain. Our primary objective was to determine whether family-led stroke rehabilitation, initiated in hospital and continued at home, would be superior to usual care in a low-resource setting.The Family-led Rehabilitation after Stroke (...) sustainability, our results do not support investment in new stroke rehabilitation services that shift tasks to family caregivers, unless new evidence emerges. A future avenue of research should be to investigate the effects of task shifting to health-care assistants or team-based community care.The National Health and Medical Research Council of Australia.Copyright © 2017 Elsevier Ltd. All rights reserved.

2017 Lancet Controlled trial quality: predicted high

168. Long-Term Improvements After Multimodal Rehabilitation in Late Phase After Stroke: A Randomized Controlled Trial Full Text available with Trip Pro

Long-Term Improvements After Multimodal Rehabilitation in Late Phase After Stroke: A Randomized Controlled Trial Treatments that improve function in late phase after stroke are urgently needed. We assessed whether multimodal interventions based on rhythm-and-music therapy or horse-riding therapy could lead to increased perceived recovery and functional improvement in a mixed population of individuals in late phase after stroke.Participants were assigned to rhythm-and-music therapy, horse-riding (...) therapy, or control using concealed randomization, stratified with respect to sex and stroke laterality. Therapy was given twice a week for 12 weeks. The primary outcome was change in participants' perception of stroke recovery as assessed by the Stroke Impact Scale with an intention-to-treat analysis. Secondary objective outcome measures were changes in balance, gait, grip strength, and cognition. Blinded assessments were performed at baseline, postintervention, and at 3- and 6-month follow-up.One

2017 EvidenceUpdates

169. Evaluating the effect and mechanism of upper limb motor function recovery induced by immersive virtual-reality-based rehabilitation for subacute stroke subjects: study protocol for a randomized controlled trial. Full Text available with Trip Pro

Evaluating the effect and mechanism of upper limb motor function recovery induced by immersive virtual-reality-based rehabilitation for subacute stroke subjects: study protocol for a randomized controlled trial. There is compelling evidence of beneficial effects of non-immersive virtual reality (VR)-based intervention in the rehabilitation of patients with stroke, whereby patients experience both the real world and the virtual environment. However, to date, research on immersive VR-based (...) rehabilitation is minimal. This study aims to design a randomized controlled trial to assess the effectiveness of immersive VR-based upper extremity rehabilitation in patients with subacute stroke and explore the underlying brain mechanisms of immersive VR-based rehabilitation.Subjects (n = 60) with subacute stroke (defined as more than 1 week and less than 12 weeks after stroke onset) will be recruited to participate in a single-blinded, randomized controlled trial. Subjects will be randomized 1:1 to either

2019 Trials Controlled trial quality: uncertain

170. Access to rehabilitation for patients with stroke in Australia. Full Text available with Trip Pro

Access to rehabilitation for patients with stroke in Australia. To identify factors associated with receiving acute goal-directed treatment, being assessed for ongoing rehabilitation, and receiving post-acute rehabilitation after having a stroke.Retrospective analysis of National Stroke Audit data for patients with acute stroke treated at Australian hospitals during 1 September 2014 - 28 February 2015.112 Australian hospitals that admit adults with acute stroke.Associations between patient (...) -related and organisational factors and the provision of rehabilitation interventions.Data for 3462 patients were eligible for analysis; their median age was 74 years, 1962 (57%) were men, and 2470 (71%) had received care in a stroke unit. 2505 patients (72%) received goal-directed treatment during their acute admission; it was not provided to 364 patients (10.5%) who were responsive, had not fully recovered, and did not refuse treatment. Factors associated with higher odds of receiving goal-directed

2019 Medical Journal of Australia

171. A low cost kinect-based virtual rehabilitation system for inpatient rehabilitation of the upper limb in patients with subacute stroke: A randomized, double-blind, sham-controlled pilot trial. Full Text available with Trip Pro

A low cost kinect-based virtual rehabilitation system for inpatient rehabilitation of the upper limb in patients with subacute stroke: A randomized, double-blind, sham-controlled pilot trial. We designed this study to prove the efficacy of the low-cost Kinect-based virtual rehabilitation (VR) system for upper limb recovery among patients with subacute stroke.A double-blind, randomized, sham-controlled trial was performed. A total of 23 subjects with subacute stroke (<3 months) were allocated (...) VR and control (64,575 ± 27,533).Low-cost Kinect-based upper limb rehabilitation system was not more efficacious compared with sham VR. However, the compliance in VR was good and VR system induced more arm motion than control and similar activity compared with the conventional therapy, which suggests its utility as an adjuvant additional therapy during inpatient stroke rehabilitation.

2018 Medicine Controlled trial quality: predicted high

172. Stroke, Diagnosis and Initial Treatment of Ischemic Stroke

early care for persons with an onset of stroke symp- toms. The recommendations in this guideline are for early management of stroke due to ischemic brain ischemia/infarction. This guideline does not address stroke prevention, transient ischemic stroke (TIA) or management of hemorrhagic stroke. To increase access to appropriate early care for stroke, Minnesota passed legislation to authorize the Minnesota Department of Health (MDH) to designate hospitals as Acute Stroke-Ready Hospitals, Primary (...) infarct” present yes Return to Table of Contents www.icsi.org 2 Table of Contents Diagnosis and Initial Treatment of Ischemic Stroke Twelfth Edition/June 2019 Work Group Co-Leaders David Anderson, MD Neurology, University of Minnesota Physicians David Larson, MD Emergency Medicine, Ridgeview Medical Center Work Group Members HealthEast Care System Tess Sierzant, MS, RN Neurology Nursing Lakeview Hospital Bjorn Peterson, MD Emergency Medicine Mayo Clinic James Klaas, MD Neurology Minneapolis Clinic

2019 Institute for Clinical Systems Improvement

173. CADASIL (Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy) (Overview)

, Ducros A, Vahedi K, Chabriat H, Mouton P, et al. Notch3 mutations in CADASIL, a hereditary adult-onset condition causing stroke and dementia. Nature . 1996 Oct 24. 383(6602):707-10. . Peters N, Freilinger T, Opherk C, Pfefferkorn T, Dichgans M. Effects of short term atorvastatin treatment on cerebral hemodynamics in CADASIL. J Neurol Sci . 2007 Sep 15. 260(1-2):100-5. . Meschia JF, Brott TG, Brown RD Jr. Genetics of cerebrovascular disorders. Mayo Clin Proc . 2005 Jan. 80(1):122-32. . Dichgans M (...) with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). (Reprinted with permission from Mayo Clin Proc, Meschia, 2005.) of 2 Tables Contributor Information and Disclosures Author Reza Behrouz, DO, FACP Assistant Professor, Division of Cerebrovascular Diseases and Neurological Critical Care, Department of Neurology, The Ohio State University College of Medicine Reza Behrouz, DO, FACP is a member of the following medical societies: , , , , Disclosure: Nothing

2014 eMedicine.com

174. CADASIL (Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy) (Follow-up)

Infarcts and Leukoencephalopathy) Follow-up Further Outpatient Care Patients with CADASIL should be followed routinely by a neurologist or a vascular neurologist to monitor their degree of disability and rate of progression. Management is primarily symptom-based and addressing rehabilitation needs is paramount. Routine psychiatric follow-up is also reasonable if the patient suffers from a complex mental disorder. Next: Further Inpatient Care Inpatient care of patients with CADASIL depends on the reason (...) for admission. Inpatient care of patients with CADASIL who present with a stroke is not entirely different than patients without CADASIL who have a stroke (see ). However, safety and efficacy of recombinant tissue plasminogen activator (rtPA) in patients with CADASIL who present with an acute cerebral infarction within the therapeutic window has not been systematically assessed. Previous Next: Inpatient & Outpatient Medications See Medication. Previous Next: Prognosis Exact mortality rate in patients

2014 eMedicine.com

175. CADASIL (Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy) (Treatment)

and Leukoencephalopathy) Treatment Medical Care Neither a cure nor a specific treatment exist for CADASIL. Treatment endeavors should be focused on management of headaches, mood and psychiatric disturbances, and rehabilitation following a brain ischemic injury. Next: Surgical Care There is no specific surgical procedure indicated for the treatment of CADASIL. Previous Next: Consultations See the list below: Vascular neurology: To assist in diagnosis, patients who are suspected to have CADASIL should be seen and later (...) . Neuropsychology: A neuropsychologist can assist in gauging cognitive status or rate of deterioration. Physical therapy Occupational therapy Speech therapy Previous Next: Diet No specific diet is recommended for patients with CADASIL. However, because of the risk of developing dysphagia secondary to cerebral infarctions, some may eventually require percutaneous endoscopic gastrostomy (PEG) or jejunal feeding tube. Swallow evaluation should be performed after every ischemic episode or if the swallowing ability

2014 eMedicine.com

176. CADASIL (Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy) (Diagnosis)

, Ducros A, Vahedi K, Chabriat H, Mouton P, et al. Notch3 mutations in CADASIL, a hereditary adult-onset condition causing stroke and dementia. Nature . 1996 Oct 24. 383(6602):707-10. . Peters N, Freilinger T, Opherk C, Pfefferkorn T, Dichgans M. Effects of short term atorvastatin treatment on cerebral hemodynamics in CADASIL. J Neurol Sci . 2007 Sep 15. 260(1-2):100-5. . Meschia JF, Brott TG, Brown RD Jr. Genetics of cerebrovascular disorders. Mayo Clin Proc . 2005 Jan. 80(1):122-32. . Dichgans M (...) with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). (Reprinted with permission from Mayo Clin Proc, Meschia, 2005.) of 2 Tables Contributor Information and Disclosures Author Reza Behrouz, DO, FACP Assistant Professor, Division of Cerebrovascular Diseases and Neurological Critical Care, Department of Neurology, The Ohio State University College of Medicine Reza Behrouz, DO, FACP is a member of the following medical societies: , , , , Disclosure: Nothing

2014 eMedicine.com

177. Telemedicine-guided education on secondary stroke and fall prevention following inpatient rehabilitation for Texas patients with stroke and their caregivers: a feasibility pilot study. Full Text available with Trip Pro

Telemedicine-guided education on secondary stroke and fall prevention following inpatient rehabilitation for Texas patients with stroke and their caregivers: a feasibility pilot study. The aftermath of stroke leaves many consequences including cognitive deficits and falls due to imbalance. Stroke survivors and families struggle to navigate the complex healthcare system with little assistance posthospital discharge, often leading to early hospital readmission and worse stroke outcomes (...) . Telemedicine Guided Education on Secondary Stroke and Fall Prevention Following Inpatient Rehabilitation feasibility study examines whether stroke survivors and their caregivers find value in telerehabilitation (TR) home visits that provide individualised care and education by a multidisciplinary team after discharge from inpatient rehabilitation.A prospective, single arm, pilot study is designed to evaluate the feasibility of weekly TR home visits initiated postdischarge from inpatient rehabilitation

2017 BMJ open

178. Factors associated with improvement or decline in cognitive function after an ischemic stroke in Korea: the Korean stroke cohort for functioning and rehabilitation (KOSCO) study. Full Text available with Trip Pro

Factors associated with improvement or decline in cognitive function after an ischemic stroke in Korea: the Korean stroke cohort for functioning and rehabilitation (KOSCO) study. We conducted a prospective cohort study to investigate prevalence of poststroke cognitive impairment at 3 and 12 months after stroke onset and identify clinical and demographic factors associated with improvement or decline in cognitive function between 3 months and 12 months.We analyzed the cognitive assessments (...) of total patients and patients older than 65 years separately. All patients with an ischemic stroke were divided into normal cognitive group (NCG) and impaired cognition group (ICG) by using a cutoff score on the Korean Mini-Mental State Examination (K-MMSE). Patients were additionally classified into 3 subgroups according to the changes in their K-MMSE scores between 3 and 12 months: Stable group with K-MMSE scores changes ranging from -2 to +2 points (-2 ≤ △MMSE ≤ +2); converter group with increase

2017 BMC Neurology

179. Rehabilitation following hemorrhagic stroke: building the case for stroke-subtype specific recovery therapies Full Text available with Trip Pro

Rehabilitation following hemorrhagic stroke: building the case for stroke-subtype specific recovery therapies Intracerebral hemorrhage (ICH), a form of brain bleeding and minor subtype of stroke, leads to significant mortality and long-term disability. There are currently no validated approaches to promote functional recovery after ICH. Research in stroke recovery and rehabilitation has largely focused on ischemic stroke, but given the stark differences in the pathophysiology between ischemic (...) and hemorrhagic stroke, it is possible that strategies to rehabilitate the brain in distinct stroke subtypes will be different. Here, we review our current understanding of recovery after primary intracerebral hemorrhage with the intent to provide a framework to promote novel, stroke-subtype specific approaches.

2017 F1000Research

180. Assessment of the Effects of Rehabilitation After Cerebrovascular Accident in Patients with Diabetes Mellitus and Hypertension as Risk Factors Full Text available with Trip Pro

Assessment of the Effects of Rehabilitation After Cerebrovascular Accident in Patients with Diabetes Mellitus and Hypertension as Risk Factors The aim of this study is to evaluate the results of rehabilitation, to determine the prevalence of major risk factors in cerebrovascular accident and their consequences, as well as to propose measures and procedures that will affect the better rehabilitation.The survey analyzed: age, sex, duration of rehabilitation, activities in daily life through (...) that there is a statistically significant correlation between the BI at admission, BI at discharge and risk factors of HTA and diabetes mellitus.The rehabilitation results in most patients is good results of rehabilitation. The most important risk factors in patients are HTA, DM and directly affect on results of rehabilitation. For the better results we should have energetic fight against risk factors for HTA and DM through primary and secondary prevention and patient education about early detection and treatment

2014 Medical Archives

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