Latest & greatest articles for stroke

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Top results for stroke

61. The Active Ingredient of Cognitive Restoration: A Multicenter Randomized Controlled Trial of Sequential Combination of Aerobic Exercise and Computer-Based Cognitive Training in Stroke Survivors With Cognitive Decline

The Active Ingredient of Cognitive Restoration: A Multicenter Randomized Controlled Trial of Sequential Combination of Aerobic Exercise and Computer-Based Cognitive Training in Stroke Survivors With Cognitive Decline To investigate the efficacy of a sequential combination of aerobic exercise and cognitive training on cognitive function and other health-related outcomes in stroke survivors with cognitive decline.Intervention study and randomized controlled trial.Hospital-based rehabilitation (...) units.Survivors of stroke with cognitive decline (N=30) were randomized to sequential combination training (SEQ) (n=15) or an active control (n=15) group.The SEQ group received 30 minutes of aerobic exercise, followed by 30 minutes of computerized cognitive training. The control group received 30 minutes of nonaerobic physical exercise, followed by 30 minutes of unstructured mental activities.The primary outcome measure was cognitive function. Secondary outcome measures included physical function, social

2019 EvidenceUpdates

62. Additional early active repetitive motor training did not prevent contracture in adults receiving task-specific upper limb training after stroke: a randomised trial

Additional early active repetitive motor training did not prevent contracture in adults receiving task-specific upper limb training after stroke: a randomised trial In adults undergoing rehabilitation after stroke, does 1 hour of additional active repetitive reaching per day prevent or reduce upper limb contracture?Multi-centre, randomised controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis.Fifty adults undergoing rehabilitation after stroke who were (...) ), and shoulder flexion 5 deg (95% CI -8 to 17). There were no statistically significant or clinically important effects of the intervention on any secondary outcomes.In adults who are already receiving task-specific motor training for upper limb rehabilitation following stroke, 5 weeks of up to 1 hour of additional daily active repetitive motor training using the SMART Arm device did not prevent or reduce contracture in upper limb muscles.ACTRN12614001162606.Copyright © 2019 Australian Physiotherapy

2019 EvidenceUpdates

63. Action observation therapy for improving arm function, walking ability, and daily activity performance after stroke: a systematic review and meta-analysis

Action observation therapy for improving arm function, walking ability, and daily activity performance after stroke: a systematic review and meta-analysis This study was to investigate the effectiveness of action observation therapy on arm and hand motor function, walking ability, gait performance, and activities of daily living in stroke patients.Systematic review and meta-analysis of randomized controlled trials.Searches were completed in January 2019 from electronic databases, including (...) PubMed, Scopus, the Cochrane Library, and OTseeker.Two independent reviewers performed data extraction and evaluated the study quality by the PEDro scale. The pooled effect sizes on different aspects of outcome measures were calculated. Subgroup analyses were performed to examine the impact of stroke phases on treatment efficacy.Included were 17 articles with 600 patients. Compared with control treatments, the action observation therapy had a moderate effect size on arm and hand motor outcomes

2019 EvidenceUpdates

64. Stroke and transient ischaemic attack in over 16s: diagnosis and initial management

Stroke and transient ischaemic attack in over 16s: diagnosis and initial management Strok Stroke and tr e and transient ischaemic attack in ansient ischaemic attack in o ov ver 16s: diagnosis and initial er 16s: diagnosis and initial management management NICE guideline Published: 1 May 2019 www.nice.org.uk/guidance/ng128 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility (...) and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Stroke and transient ischaemic attack in over 16s: diagnosis and initial management (NG128) © NICE 2019. All rights reserved. Subject

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

65. Effect of Transcutaneous Electrical Nerve Stimulation on Spasticity in Adults With Stroke: A Systematic Review and Meta-analysis

Effect of Transcutaneous Electrical Nerve Stimulation on Spasticity in Adults With Stroke: A Systematic Review and Meta-analysis (1) To determine the effect of transcutaneous electrical nerve stimulation (TENS) on poststroke spasticity. (2) To determine the effect of different parameters (intensity, frequency, duration) of TENS on spasticity reduction in adults with stroke. (3) To determine the influence of time since stroke on the effectiveness of TENS on spasticity.PubMed, PEDro, CINAHL, Web (...) of Science, CENTRAL, and EMBASE databases were searched from inception to March 2017.Randomized controlled trial (RCT), quasi-RCT, and non-RCT were included if (1) they evaluated the effects of TENS for the management of spasticity in participants with acute or subacute or chronic stroke using clinical and neurophysiological tools; and (2) TENS was delivered either alone or as an adjunct to other treatments.Two authors independently screened and extracted data from 15 of the 829 studies retrieved through

2019 EvidenceUpdates

66. Caregivers' effects of augmented cognitive-behavioural therapy for post-stroke depressive symptoms in patients: secondary analyses to a randomized controlled trial

Caregivers' effects of augmented cognitive-behavioural therapy for post-stroke depressive symptoms in patients: secondary analyses to a randomized controlled trial To investigate the concomitant effects of two patient-directed interventions for post-stroke depressive symptoms on caregivers' well-being.Secondary analyses of the results of a randomized controlled trial.Fifty caregivers of stroke patients receiving outpatient rehabilitation.Stroke patients and their caregivers were randomly

2019 EvidenceUpdates

67. Prehospital stroke scales as screening tools for early identification of stroke and transient ischemic attack. (PubMed)

Prehospital stroke scales as screening tools for early identification of stroke and transient ischemic attack. Rapid and accurate detection of stroke by paramedics or other emergency clinicians at the time of first contact is crucial for timely initiation of appropriate treatment. Several stroke recognition scales have been developed to support the initial triage. However, their accuracy remains uncertain and there is no agreement which of the scales perform better.To systematically identify (...) and review the evidence pertaining to the test accuracy of validated stroke recognition scales, as used in a prehospital or emergency room (ER) setting to screen people suspected of having stroke.We searched CENTRAL, MEDLINE (Ovid), Embase (Ovid) and the Science Citation Index to 30 January 2018. We handsearched the reference lists of all included studies and other relevant publications and contacted experts in the field to identify additional studies or unpublished data.We included studies evaluating

2019 Cochrane

68. Diagnostic evaluation of cryptogenic stroke

Diagnostic evaluation of cryptogenic stroke Diagnostic Evaluation of Cryptogenic Stroke – Clinical Correlations Search Diagnostic Evaluation of Cryptogenic Stroke April 2, 2019 8 min read Dixon Yang, MD Peer Reviewed Case and Introduction A 52-year-old right-handed woman with hypertension is brought in by ambulance after her daughter notices a sudden onset of nonsensical speech and trouble walking. On exam, she has an expressive aphasia with right-sided hemiparesis. Her vitals are stable (...) with her blood pressure well-controlled by a home medication. Computed tomography (CT) with angiography reveals signs of early acute ischemic changes in the right middle cerebral artery territory but no large vessel occlusion. She has no metabolic disturbances, an unremarkable complete blood count, and normal coagulation profile. She receives intravenous tissue plasminogen activator with improvement in symptoms and is admitted to the stroke unit. Further work up with 24-hour Holter monitor records

2019 Clinical Correlations

69. The effect and optimal parameters of repetitive transcranial magnetic stimulation on motor recovery in stroke patients: a systematic review and meta-analysis of randomized controlled trials

The effect and optimal parameters of repetitive transcranial magnetic stimulation on motor recovery in stroke patients: a systematic review and meta-analysis of randomized controlled trials The primary aim of this meta-analysis was to evaluate the effects of repetitive transcranial magnetic stimulation (rTMS) on limb movement recovery post-stroke and cortex excitability, to explore the optimal parameters of rTMS and suitable stroke population. Second, adverse events were also included.The (...) databases of PubMed, EBSCO, MEDLINE, the Cochrane Central Register of Controlled Trials, EBM Reviews-Cochrane Database, the Chinese National Knowledge Infrastructure, and the Chinese Science and Technology Journals Database were searched for randomized controlled trials exploring the effects of rTMS on limb motor function recovery post-stroke before December 2018.The effect sizes of rTMS on limb motor recovery, the effect size of rTMS stimulation parameters, and different stroke population were

2019 EvidenceUpdates

70. Safety and efficacy of sonothrombolysis for acute ischaemic stroke: a multicentre, double-blind, phase 3, randomised controlled trial

Safety and efficacy of sonothrombolysis for acute ischaemic stroke: a multicentre, double-blind, phase 3, randomised controlled trial Pulsed-wave ultrasound increases the exposure of an intracranial thrombus to alteplase (recombinant tissue plasminogen activator), potentially facilitating early reperfusion. We aimed to ascertain if a novel operator-independent transcranial ultrasound device delivering low-power high-frequency ultrasound could improve functional outcome in patients treated (...) with alteplase after acute ischaemic stroke.We did a multicentre, double-blind, phase 3, randomised controlled trial (CLOTBUST-ER) at 76 medical centres in 14 countries. We included patients with acute ischaemic stroke (National Institutes of Health Stroke Scale score ≥10) who received intravenous thrombolysis (alteplase bolus) within 3 h of symptom onset in North America and within 4·5 h of symptom onset in all other countries. Participants were randomly allocated (1:1) via an interactive web response

2019 EvidenceUpdates

71. Glucose Modifies the Effect of Endovascular Thrombectomy in Patients With Acute Stroke

Glucose Modifies the Effect of Endovascular Thrombectomy in Patients With Acute Stroke Background and Purpose- Hyperglycemia is a negative prognostic factor after acute ischemic stroke but is not known whether glucose is associated with the effects of endovascular thrombectomy (EVT) in patients with large-vessel stroke. In a pooled-data meta-analysis, we analyzed whether serum glucose is a treatment modifier of the efficacy of EVT in acute stroke. Methods- Seven randomized trials compared EVT (...) with standard care between 2010 and 2017 (HERMES Collaboration [highly effective reperfusion using multiple endovascular devices]). One thousand seven hundred and sixty-four patients with large-vessel stroke were allocated to EVT (n=871) or standard care (n=893). Measurements included blood glucose on admission and functional outcome (modified Rankin Scale range, 0-6; lower scores indicating less disability) at 3 months. The primary analysis evaluated whether glucose modified the effect of EVT over standard

2019 EvidenceUpdates

72. Effect of Workflow Improvements in Endovascular Stroke Treatment

Effect of Workflow Improvements in Endovascular Stroke Treatment Background and Purpose- Rapid initiation of endovascular stroke treatment is associated with better clinical outcome. The effect of specific improvements is not well known. We performed a systematic review and meta-analysis on the effectiveness of specific workflow improvements on time to treatment and outcome. Methods- A random-effects meta-analysis was used to evaluate the difference in mean time to treatment between (...) <0.001) for teamwork, and 64 minutes (95% CI, 24-104; P=0.002) for feedback. The mean difference in time to treatment of studies with multiple interventions implemented simultaneously was 50 minutes (95% CI, 31-69; P<0.001) in favor of the intervention group. Patients in the intervention group had increased likelihood of favorable outcome (risk ratio [RR], 1.39; 95% CI, 1.15-1.66; P<0.001). Conclusions- Interventions in the workflow of endovascular stroke treatment lead to a significant reduction

2019 EvidenceUpdates

73. A novel biomarker-based prognostic score in acute ischemic stroke: The CoRisk score

A novel biomarker-based prognostic score in acute ischemic stroke: The CoRisk score To derive and externally validate a copeptin-based parsimonious score to predict unfavorable outcome 3 months after an acute ischemic stroke (AIS).The derivation cohort consisted of patients with AIS enrolled prospectively at the University Hospital Basel, Switzerland. The validation cohort was prospectively enrolled after the derivation cohort at the University Hospital of Bern and University Hospital Basel (...) , Switzerland, as well as Frankfurt a.M., Germany. The score components were copeptin levels, age, NIH Stroke Scale, and recanalization therapy (CoRisk score). Copeptin levels were measured in plasma drawn within 24 hours of AIS and before any recanalization therapy. The primary outcome of disability and death at 3 months was defined as modified Rankin Scale score of 3 to 6.Overall, 1,102 patients were included in the analysis; the derivation cohort contributed 319 patients, and the validation cohort

2019 EvidenceUpdates

74. Post-Thrombolysis Recanalization in Stroke Referrals for Thrombectomy: Incidence, Predictors, and Prediction Scores

Post-Thrombolysis Recanalization in Stroke Referrals for Thrombectomy: Incidence, Predictors, and Prediction Scores Background and Purpose—Whether all acute stroke patients with large vessel occlusion need to undergo intravenous thrombolysis before mechanical thrombectomy (MT) is debated as (1) the incidence of post-thrombolysis early recanalization (ER) is still unclear; (2) thrombolysis may be harmful in patients unlikely to recanalize; and, conversely, (3) transfer for MT may be unnecessary

2019 EvidenceUpdates

75. Improvement of Upper Limb Motor Control and Function After Competitive and Noncompetitive Volleyball Exercises in Chronic Stroke Survivors: A Randomized Clinical Trial

Improvement of Upper Limb Motor Control and Function After Competitive and Noncompetitive Volleyball Exercises in Chronic Stroke Survivors: A Randomized Clinical Trial To investigate the effects of competitive and noncompetitive volleyball exercises on the functional performance and motor control of the upper limbs in chronic stroke survivors.Randomized clinical trial.Outpatient rehabilitation center.Chronic stroke survivors (N=48).Participants were randomly assigned to competitive (n=16 (...) the efficacy of the preprogramming and execution of reach and grasp movements, as well as a shift from feedback to feedforward control of the affected upper limb in chronic stroke survivors. This may well be a potential underlying mechanism for improving functional performance.Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

2019 EvidenceUpdates

76. The effectiveness of somatosensory retraining for improving sensory function in the arm following stroke: a systematic review

The effectiveness of somatosensory retraining for improving sensory function in the arm following stroke: a systematic review The aim of this study was to evaluate if somatosensory retraining programmes assist people to improve somatosensory discrimination skills and arm functioning after stroke.Nine databases were systematically searched: Medline, Cumulative Index to Nursing and Allied Health Literature, PsychInfo, Embase, Amed, Web of Science, Physiotherapy Evidence Database, OT seeker (...) , and Cochrane Library.Studies were included for review if they involved (1) adult participants who had somatosensory impairment in the arm after stroke, (2) a programme targeted at retraining somatosensation, (3) a primary measure of somatosensory discrimination skills in the arm, and (4) an intervention study design (e.g. randomized or non-randomized control designs).A total of 6779 articles were screened. Five group trials and five single case experimental designs were included ( N = 199 stroke survivors

2019 EvidenceUpdates

77. Does fluoxetine improve recovery after stroke? (PubMed)

Does fluoxetine improve recovery after stroke? The studyFOCUS Trial Collaboration. Effects of fluoxetine on functional outcomes after acute stroke (FOCUS): a pragmatic, double-blind, randomised, controlled trial. Lancet 2019;393:256-74.The study was funded by the UK Stroke Association and the NIHR Health Technology Assessment Programme project number 13/04/30.To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000729/a-commonly-used-antidepressant-doesnt-improve

2019 BMJ Controlled trial quality: predicted high

78. Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation: The CABANA Randomized Clinical Trial. (PubMed)

Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation: The CABANA Randomized Clinical Trial. Catheter ablation is effective in restoring sinus rhythm in atrial fibrillation (AF), but its effects on long-term mortality and stroke risk are uncertain.To determine whether catheter ablation is more effective than conventional medical therapy for improving outcomes in AF.The Catheter Ablation vs (...) Antiarrhythmic Drug Therapy for Atrial Fibrillation trial is an investigator-initiated, open-label, multicenter, randomized trial involving 126 centers in 10 countries. A total of 2204 symptomatic patients with AF aged 65 years and older or younger than 65 years with 1 or more risk factors for stroke were enrolled from November 2009 to April 2016, with follow-up through December 31, 2017.The catheter ablation group (n = 1108) underwent pulmonary vein isolation, with additional ablative procedures

2019 JAMA Controlled trial quality: predicted high

79. Evaluation of reconfigurations of acute stroke services in different regions of England and lessons for implementation: a mixed-methods study

Evaluation of reconfigurations of acute stroke services in different regions of England and lessons for implementation: a mixed-methods study Evaluation of reconfigurations of acute stroke services in different regions of England and lessons for implementation: a mixed-methods study Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose a page from (...) the navigation or try a website search above to find the information you need. >> >> >> >> Issue {{metadata .Issue }} Toolkit 1)"> 0)"> 1)"> {{metadata.Title}} {{metadata.Headline}} Centralising acute stroke services in urban areas can reduce mortality and length of stay, and increase delivery of evidence-based care; type of service model, planning change and context affect implementation. {{author}} {{($index , , , , , , , , , , & . Naomi J Fulop 1, * , Angus I G Ramsay 1 , Rachael M Hunter 2 , Christopher

2019 NIHR HTA programme

80. Stroke Outcomes in the COMPASS Trial

Stroke Outcomes in the COMPASS Trial Strokes were significantly reduced by the combination of rivaroxaban plus aspirin in comparison with aspirin in the COMPASS trial (Cardiovascular Outcomes for People Using Anticoagulation Strategies). We present detailed analyses of stroke by type, predictors, and antithrombotic effects in key subgroups.Participants had stable coronary artery or peripheral artery disease and were randomly assigned to receive aspirin 100 mg once daily (n=9126), rivaroxaban 5 (...) mg twice daily (n=9117), or rivaroxaban 2.5 mg twice daily plus aspirin (n=9152). Patients who required anticoagulation or had a stroke within 1 month, previous lacunar stroke, or intracerebral hemorrhage were excluded.During a mean follow-up of 23 months, fewer patients had strokes in the rivaroxaban plus aspirin group than in the aspirin group (83 [0.9% per year] versus 142 [1.6% per year]; hazard ratio [HR], 0.58; 95% CI, 0.44-0.76; P<0.0001). Ischemic/uncertain strokes were reduced by nearly

2019 EvidenceUpdates