Stroke Research and Treatment最新文献

{"title":"Validation of the Malta Gait Scale: A Time-Efficient Tool for Poststroke Assessment.","authors":"Valerio Sarmati, Carlos Carmona, Alessandro Morciano, Samuel Gutiérrez, Ingrid Velásquez, José Fernández","doi":"10.1155/srat/8849857","DOIUrl":"10.1155/srat/8849857","url":null,"abstract":"<p><p>Over 80% of stroke survivors experience walking dysfunction, impacting quality of life. Rehabilitation is crucial for gait recovery, and accurate assessments facilitate tailored programs. While computerized gait analysis is the gold standard, it is costly and requires specialized training, making observational gait analysis (OGA) more common. However, OGA can also be time-consuming. This study validates the Malta Gait Scale (MGS), a concise, illustrated 7-item observational tool using video recordings for gait measurements. The aim is to provide an effective, time-efficient method for gait evaluations by comparing the MGS with the established Wisconsin Gait Scale (WGS) and Gait Assessment Intervention Tool (GAIT), which have 14 and 31 items, respectively. Forty-nine participants were included in a retrospective study to validate the MGS. We evaluated its reliability using weighted Cohen's kappa (<i>κ</i>) for intrarater and interrater reliability. Concurrent validity was assessed by comparing the MGS with the WGS and GAIT scales using Spearman's rho (<i>ρ</i>). The Wilcoxon test assessed the efficacy of the MGS in detecting rehabilitation-induced changes, differentiating healthy from stroke participants, and evaluating time efficiency. The MGS demonstrated almost perfect agreement, with interrater and intrarater <i>κ</i> values of 0.952 and 0.977, respectively. It showed high positive correlations with the WGS and GAIT, with <i>ρ</i> values of 0.898 and 0.877. MGS required an average administration time of 7 min and 29 s, significantly less than the WGS (27 min and 46 s) and GAIT (50 min and 6 s) (<i>p</i> < 0.001). Following rehabilitation, significant improvements were observed in patients using both the MGS and WGS scales (<i>p</i> = 0.018), and the MGS effectively distinguished between healthy individuals and stroke patients (<i>p</i> < 0.001). The MGS is a valid, reliable, and efficient tool for gait assessment in stroke survivors, supporting smartphone use and facilitating rapid measurements in clinical settings where time is critical.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2025 ","pages":"8849857"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic, Interpretable, Machine Learning-Based Outcome Prediction as a New Emerging Opportunity in Acute Ischemic Stroke Patient Care: A Proof-of-Concept Study.","authors":"Ivan Petrović, Sava Njegovan, Olivera Tomašević, Dmitar Vlahović, Sonja Rajić, Željko Živanović, Isidora Milosavljević, Ana Balenović, Nikola Jorgovanović","doi":"10.1155/srat/3561616","DOIUrl":"10.1155/srat/3561616","url":null,"abstract":"<p><p><b>Introduction:</b> While the machine learning (ML) model's black-box nature presents a significant barrier to effective clinical application, the dynamic nature of stroke patients' recovery further undermines the reliability of established predictive scores and models, making them less suitable for accurate prediction and appropriate patient care. This research is aimed at building and evaluating an interpretable ML-based model, which would perform outcome prediction at different time points of patients' recovery, giving more secure and understandable output through interpretable packages. <b>Materials and Methods:</b> A retrospective analysis was conducted on acute ischemic stroke (AIS) patients treated with alteplase at the Neurology Clinic of the University Clinical Center of Vojvodina (Novi Sad, Serbia), for 14 years. Clinical data were grouped into four categories based on collection time-baseline, 2-h, 24-h, and discharge features-serving as inputs for three different classifiers-support vector machine (SVM), logistic regression (LR), and random forest (RF). The 90-day modified Rankin scale (mRS) was used as the outcome measure, distinguishing between favorable (mRS ≤ 2) and unfavorable outcomes (mRS ≥ 3). <b>Results:</b> The sample was described with 49 features and included 355 patients, with a median age of 67 years (interquartile range (IQR) 60-74 years), 66% being male. The models achieved strong discrimination in the testing set, with area under the curve (AUC) values ranging from 0.80 to 0.96. Additionally, they were compared with a model based on the DRAGON score, which showed an AUC of 0.760 (95% confidence interval (CI), 0.640-0.862). The decision-making process was more thoroughly understood using interpretable packages: Shapley additive explanation (SHAP) and local interpretable model-agnostic explanation (LIME). They revealed the most significant features at both the group and individual patient levels. <b>Conclusions and Clinical Implications:</b> This study demonstrated the moderate to strong efficacy of interpretable ML-based models in predicting the functional outcomes of alteplase-treated AIS patients. In all constructed models, age, onset-to-treatment time, and platelet count were recognized as the important predictors, followed by clinical parameters measured at different time points, such as the National Institutes of Health Stroke Scale (NIHSS) and systolic and diastolic blood pressure values. The dynamic approach, coupled with interpretable models, can aid in providing insights into the potential factors that could be modified and thus contribute to a better outcome.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2025 ","pages":"3561616"},"PeriodicalIF":1.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Advantageous Impact of Telestroke: Global Insights and Implications for Africa: A Scoping Review of Literature.","authors":"Jonathan Kissi, Caleb Annobil","doi":"10.1155/srat/5635369","DOIUrl":"10.1155/srat/5635369","url":null,"abstract":"<p><p><b>Introduction:</b> Stroke is a leading global contributor to mortality and disability. Low- and middle-income countries are disproportionately affected and account for 87% of stroke-related disabilities and 70% of stroke-related fatalities. The challenges of stroke care accessibility in Africa are compounded by financial constraints, geographical barriers, and inadequate healthcare infrastructure, necessitating the adoption of innovative models such as telestroke. Telestroke is a critical component of modern stroke care systems. Telestroke enables real-time remote assessments, optimizes patient triage and hospital transfers, improves the efficiency of thrombolysis administration, and enhances poststroke management by mitigating logistical and mobility-related challenges. This demonstrates telestroke's potential to expand access to specialized stroke care, improve functional outcomes, and address critical gaps in stroke management within underserved regions such as Africa. This paper assesses the advantageous impact of telestroke on stroke management, with the aim of drawing global insights for Africa. <b>Methodology:</b> This scoping review adhered to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted across ProQuest, PubMed, Google Scholar, and Scopus to identify peer-reviewed studies published in English from 2017 to 2023. This ensured the inclusion of the most recent advancements in telestroke research. <b>Results:</b> The initial literature search retrieved 881 articles, of which 143 duplicates (16.2%) and 58 non-English studies (6.6%) were removed, followed by the exclusion of 451 nonpeer-reviewed publications (51.2%) and 128 articles (14.5%) unrelated to the study area, leaving 101 studies (11.5%) for full-text review. After further screening, 70 studies were excluded for not aligning with the study's title, objectives, or key search terms. This resulted in 31 studies (3.5%) being included in the final analysis, with 21 studies originating from outside Africa. The limited availability of high-indexed, peer-reviewed African telestroke studies highlighted a research gap, impacting the generalizability of findings. <b>Conclusion:</b> Telestroke has demonstrated significant benefits in stroke management, including improved functional outcomes, reduced onset-to-treatment time, enhanced diagnostic accuracy, and increased healthcare accessibility, particularly in medically underserved regions. However, its implementation in Africa faces challenges related to ethical concerns, technological infrastructure, regulatory inconsistencies, financial sustainability, and limited clinician buy-in. This necessitates strategic interventions such as standardized regulatory frameworks, network expansion, sustainable financing, capacity-building, and the integration of cost-effective imaging technologies to enhance stroke care delivery across the continent.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2025 ","pages":"5635369"},"PeriodicalIF":1.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Increasing or Decreasing Use of Polypharmacy on Recovery of Activities of Daily Living in Patients With Stroke in the Recovery-Phase Rehabilitation Ward: A Retrospective Cohort Study Using Propensity Score Matching.","authors":"Shunsuke Hanaoka, Kaede Iwabuchi, Toshiyuki Hirai, Toshiichi Seki, Hiroyuki Hayashi","doi":"10.1155/srat/2381790","DOIUrl":"10.1155/srat/2381790","url":null,"abstract":"<p><p><b>Background:</b> Polypharmacy is a predictor of adverse outcomes, making its management crucial for improving patient health and recovery. Managing polypharmacy is particularly challenging in patients with stroke with many comorbidities and sequelae. Although reducing inappropriate prescribing is necessary, the number of medications may increase to effectively implement secondary prevention, potentially offsetting any changes in medication count. For patients with stroke undergoing recovery-phase rehabilitation, balancing secondary prevention and optimizing drug use early without hindering recovery of activities of daily living are crucial. This study is aimed at examining the effect of increasing or decreasing the use of polypharmacy on recovery of motor and cognitive function during recovery-phase rehabilitation in patients with stroke. <b>Methods:</b> The study was conducted from July 2010 to June 2019 among patients with stroke discharged from the convalescent rehabilitation ward during the study period. Patients who were using more than five drugs on admission and had either an increase or decrease in the number of drugs used on discharge were compared. Propensity score matching (PSM) was used to control for background variables such as patient demographics, laboratory values, and functional independence measure (FIM) scores at baseline. The primary outcomes were motor, cognition, and total FIM gain. <b>Results:</b> Of the 226 patients initially enrolled, 156 were matched on propensity score. The total motor FIM gain, total cognitive FIM gain, and total FIM gain were significantly higher in the decreased group than in the increased group (<i>p</i> = 0.0139, <i>p</i> = 0.0377, and <i>p</i> = 0.0077, respectively). <b>Conclusion</b>: In patients with stroke, reducing rather than increasing the number of drugs administered during recovery-phase rehabilitation could improve rehabilitation outcomes. Therefore, it is important to consider whether the drugs are essential for the patient and proactively revise the drug regimen to ensure rapid rehabilitation of patients with stroke.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2024 ","pages":"2381790"},"PeriodicalIF":1.8,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Action Observation of the Whole Task Influence Mirror Neuron System and Upper Limb Muscle Activity Better Than Part Task in People With Stroke?","authors":"A Sulfikar Ali, Mayur Bhat, Hari Prakash Palaniswamy, Selvam Ramachandran, Senthil D Kumaran","doi":"10.1155/2024/9967369","DOIUrl":"https://doi.org/10.1155/2024/9967369","url":null,"abstract":"<p><p><b>Background:</b> Task-based action observation and imitation (AOI) is a promising intervention to enhance upper limb (UL) motor function poststroke. However, whether whole/part task must be trained in the AOI therapy needs further substantiation. <b>Objective:</b> The objective of this study is to assess and compare the mirror neuron activity and UL muscle activity during AOI of reaching task in terms of whole task (complete movement) and part task (proximal arm movements and distal arm movements). <b>Methods:</b> In this cross-sectional study, 26 participants with first-time unilateral stroke were asked to observe the prerecorded videos of a reaching task in terms of a whole task and proximal and distal components, followed by imitation of the task, respectively. Electroencephalographic (EEG) mu rhythm suppression and electromyographic amplitude of six UL muscles were measured during the task. <b>Results:</b> The analysis of EEG revealed a statistically significant mu suppression score, indicating mirror neuron system activity, during AOI of the whole task in C3 (<i>p</i> = <0.001) and C4 (<i>p</i> = <0.001) electrodes compared to the part task. Percentage maximum voluntary contraction amplitudes of the deltoid (<i>p</i> = 0.002), supraspinatus (<i>p</i> = <0.001), triceps brachii (<i>p</i> = 0.002), brachioradialis (<i>p</i> = 0.006), and extensor carpi radialis (<i>p</i> = <0.001) muscles showed a significant increase in muscle activity during AOI of the whole task. Also, there seems to be a task observation-specific activation of muscles following AOI of proximal or distal tasks. <b>Conclusion:</b> The practice of the whole task should be given emphasis while framing the AOI treatment module to enhance reaching in people with stroke. <b>Trial registration:</b> Clinical Trials Registry-India (CTRI) identifier: CTRI/2018/04/013466.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2024 ","pages":"9967369"},"PeriodicalIF":1.8,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11470815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Contralateral Limb Cross Education and High-Frequency Repetitive Transcranial Magnetic Stimulation on Functional Indices of the Affected Upper Limb in Subacute Phase of Stroke","authors":"Katayoon Rezaei, Amin Kordi Yoosefinejad, Farzaneh Moslemi Haghighi, Mohsen Razeghi","doi":"10.1155/2023/4387667","DOIUrl":"https://doi.org/10.1155/2023/4387667","url":null,"abstract":"Background. Stroke is one of the causes of long-term morbidity. Despite rehabilitation strategies, most survivors live with motor deficits in the upper limbs. Objectives. The aim of the study was to compare the effect of contralateral cross education (CE) and high-frequency repetitive magnetic stimulation (HF-rTMS) on the function of upper extremity in subacute phase of stroke. Methods. Forty patients were randomly assigned into 4 groups. Group “A” received physical therapy (PT) for 10 sessions, 3 times per week. Group “B” received PT and HF-rTMS as follows: stimulation of 20 Hz for 5 s, intertrain interval for 50 s, 20 trains, 2000 pulses at 90% resting motor threshold, and conventional PT. Group “C” was treated with CE and PT. In group “D,” HF-rTMS, CE, and PT were administered. Results. Significant differences were found in the Fugl-Meyer scale between “A” and “C” (\u0000 \u0000 P\u0000 =\u0000 0.01\u0000 \u0000 ), “A” and “D” (\u0000 \u0000 P\u0000 =\u0000 0.02\u0000 \u0000 ), and “B” and “C” groups (\u0000 \u0000 P\u0000 =\u0000 0.01\u0000 \u0000 ). In the box-block test, there were significant differences between “A” and “B” (\u0000 \u0000 P\u0000 =\u0000 0.01\u0000 \u0000 ), “A” and “C” (\u0000 \u0000 P\u0000 <\u0000 0.001\u0000 \u0000 ), “B” and “D” (\u0000 \u0000 P\u0000 =\u0000 0.001\u0000 \u0000 ), and “B” and “C” groups (\u0000 \u0000 P\u0000 =\u0000 0.01\u0000 \u0000 ). Statistical differences were observed in grip strength between “A” and “B” (\u0000 \u0000 P\u0000 =\u0000 0.01\u0000 \u0000 ) and “A” and “C” groups (\u0000 \u0000 P\u0000 =\u0000 0.02\u0000 \u0000 ). Conclusions. It is suggested that clinicians select the therapeutic methods in line with their expected goal. When the goal is to improve upper extremity function, CE+PT could be more effective than HF-rTMS+PT. Also, CE+PT and HF-rTMS+PT were more effective than CE+HF-rTMS+PT at improving grip strength. Therefore, combining several methods would not always lead to better results.","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":" 1236","pages":""},"PeriodicalIF":1.5,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138960073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External Validation of SAFE Score to Predict Atrial Fibrillation Diagnosis after Ischemic Stroke: A Retrospective Multicenter Study","authors":"Miguel Quesada López, L. Amaya Pascasio, Sara Blanco Madera, Jorge Pagola, Diana Vidal de Francisco, Elena de Celis Ruiz, Inmaculada Villegas Rodríguez, Joaquín Carneado-Ruiz, J. García‐Carmona, Juan Manuel García Torrecillas, Ana López Ferreiro, Iker Elosua Bayes, Ricardo Jaime Rigual Bobillo, María Isabel López López, Íñigo Esain González, María Dolores Ortega Ortega, Marina Blanco Ruiz, Irene Pérez Ortega, Carlos Lázaro Hernández, Blanca Fuentes Gimeno, A. Arjona Padillo, Patricia Martínez Sánchez","doi":"10.1155/2023/6655772","DOIUrl":"https://doi.org/10.1155/2023/6655772","url":null,"abstract":"Introduction. The screening for atrial fibrillation (AF) scale (SAFE score) was recently developed to provide a prediction of the diagnosis of AF after an ischemic stroke. It includes 7 items: \u0000 \u0000 a\u0000 g\u0000 e\u0000 ≥\u0000 65\u0000 \u0000 years, bronchopathy, thyroid disease, cortical location of stroke, intracranial large vessel occlusion, NT-ProBNP ≥250 pg/mL, and left atrial enlargement. In the internal validation, a good performance was obtained, with an \u0000 \u0000 A\u0000 U\u0000 C\u0000 =\u0000 0.88\u0000 \u0000 (95% CI 0.84-0.91) and sensitivity and specificity of 83% and 80%, respectively, for \u0000 \u0000 s\u0000 c\u0000 o\u0000 r\u0000 e\u0000 s\u0000 ≥\u0000 5\u0000 \u0000 . The aim of this study is the external validation of the SAFE score in a multicenter cohort. Methods. A retrospective multicenter study, including consecutive patients with ischemic stroke or transient ischemic attack between 2020 and 2022 with at least 24 hours of cardiac monitoring. Patients with previous AF or AF diagnosed on admission ECG were excluded. Results. Overall, 395 patients were recruited for analysis. The SAFE score obtained an \u0000 \u0000 A\u0000 U\u0000 C\u0000 =\u0000 0.822\u0000 \u0000 (95% CI 0.778-0.866) with a sensitivity of 87.2%, a specificity of 65.4%, a positive predictive value of 44.1%, and a negative predictive value of 94.3% for a SAFE \u0000 \u0000 s\u0000 c\u0000 o\u0000 r\u0000 e\u0000 ≥\u0000 5\u0000 \u0000 , with no significant gender differences. Calibration analysis in the external cohort showed an absence of significant differences between the observed values and those predicted by the model (Hosmer-Lemeshow’s test 0.089). Conclusions. The SAFE score showed adequate discriminative ability and calibration, so its external validation is justified. Further validations in other external cohorts or specific subpopulations of stroke patients might be required.","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"119 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138590566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modeling Survival Time to Death among Stroke Patients at Jimma University Medical Center, Southwest Ethiopia: A Retrospective Cohort Study.","authors":"Bikiltu Wakuma Negasa, Teramaj Wongel Wotale, Mesfin Esayas Lelisho, Legesse Kassa Debusho, Kibrealem Sisay, Wubishet Gezimu","doi":"10.1155/2023/1557133","DOIUrl":"10.1155/2023/1557133","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a life-threatening condition that occurs due to impaired blood flow to brain tissues. Every year, about 15 million people worldwide suffer from a stroke, with five million of them suffering from some form of permanent physical disability. Globally, stroke is the second-leading cause of death following ischemic heart disease. It is a public health burden for both developed and developing nations, including Ethiopia.</p><p><strong>Objectives: </strong>This study is aimed at estimating the time to death among stroke patients at Jimma University Medical Center, Southwest Ethiopia.</p><p><strong>Methods: </strong>A facility-based retrospective cohort study was conducted among 432 patients. The data were collected from stroke patients under follow-up at Jimma University Medical Center from January 1, 2016, to January 30, 2019. A log-rank test was used to compare the survival experiences of different categories of patients. The Cox proportional hazard model and the accelerated failure time model were used to analyze the survival analysis of stroke patients using R software. An Akaike's information criterion was used to compare the fitted models.</p><p><strong>Results: </strong>Of the 432 stroke patients followed, 223 (51.6%) experienced the event of death. The median time to death among the patients was 15 days. According to the results of the Weibull accelerated failure time model, the age of patients, atrial fibrillation, alcohol consumption, types of stroke diagnosed, hypertension, and diabetes mellitus were found to be the significant prognostic factors that contribute to shorter survival times among stroke patients.</p><p><strong>Conclusion: </strong>The Weibull accelerated failure time model better described the time to death of the stroke patients' data set than other distributions used in this study. Patients' age, atrial fibrillation, alcohol consumption, being diagnosed with hemorrhagic types of stroke, having hypertension, and having diabetes mellitus were found to be factors shortening survival time to death for stroke patients. Hence, healthcare professionals need to thoroughly follow the patients who pass risk factors. Moreover, patients need to be educated about lifestyle modifications.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2023 ","pages":"1557133"},"PeriodicalIF":1.5,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10733594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138831586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Self-Directed Home Therapy Adherence Combined with TheraBracelet on Poststroke Hand Recovery: A Pilot Study.","authors":"Gabrielle Scronce, Viswanathan Ramakrishnan, Amanda A Vatinno, Na Jin Seo","doi":"10.1155/2023/3682898","DOIUrl":"10.1155/2023/3682898","url":null,"abstract":"<p><p>Hand impairment is a common consequence of stroke, resulting in long-term disability and reduced quality of life. Recovery may be augmented through self-directed therapy activities at home, complemented by the use of rehabilitation devices such as peripheral sensory stimulation. The objective of this study was to determine the effect of adherence to self-directed therapy and the use of TheraBracelet (subsensory random-frequency vibratory stimulation) on hand function for stroke survivors. In a double-blind, randomized controlled pilot trial, 12 chronic stroke survivors were assigned to a treatment or control group (<i>n</i> = 6/group). All participants were instructed to perform 200 repetitions of therapeutic hand tasks 5 days/week while wearing a wrist-worn device 8 hours/day for 4 weeks. The treatment group received TheraBracelet vibration from the device, while the control group received no vibration. Home task repetition adherence and device wear logs, as well as hand function assessment (Stroke Impact Scale Hand domain), were obtained weekly. Repetition adherence was comparable between groups but varied among participants. Participants wore the device to a greater extent than adhering to completing repetitions. A linear mixed model analysis showed a significant interaction between repetition and group (<i>p</i> = 0.01), with greater adherence resulting in greater hand function change for the treatment group (<i>r</i> = 0.94; <i>R</i> ² = 0.88), but not for the control group. Secondary analysis revealed that repetition adherence was greater for those with lower motor capacity and greater self-efficacy at baseline. This pilot study suggests that adherence to self-directed therapy at home combined with subsensory stimulation may affect recovery outcomes in stroke survivors. This trial is registered with NCT04026399.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2023 ","pages":"3682898"},"PeriodicalIF":1.8,"publicationDate":"2023-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10017223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9377934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Burden and In-Hospital Mortality of Stroke Admissions at a Tertiary Level Hospital in Namibia: A Retrospective Cohort Study.","authors":"Saara Ndinelago Neshuku,&nbsp;Jessica Kirchner-Frankle,&nbsp;Maria Nangolo,&nbsp;Maria Moses,&nbsp;Chalese Olivia Einbeck,&nbsp;Percy Kumire,&nbsp;Vaja Zatjirua,&nbsp;Justor Banda","doi":"10.1155/2023/1978536","DOIUrl":"https://doi.org/10.1155/2023/1978536","url":null,"abstract":"<p><strong>Background: </strong>Despite stroke being a leading cause of morbidity and mortality globally, there is a dearth of information on the burden and outcomes of stroke in sub-Saharan Africa and Namibia in particular.</p><p><strong>Methods: </strong>A hospital-based, retrospective cohort study was conducted to analyse non-electronic medical records of all consecutive stroke patients who were admitted to one of the highest tertiary-level hospitals in Namibia for 12 months (2019-2020). The primary outcome of the study was to establish the in-hospital mortality, stroke subtypes, and associated complications.</p><p><strong>Results: </strong>In total, 220 patients were included in the study, their mean age was 53 (SD13.8) years, and 55.5% were males. 61.0% had an ischaemic stroke (IS), and 39.0% had a haemorrhagic stroke (HS). The mean age was significantly lower in patients with HS vs. IS (48.2 ± 12.2 vs. 56.1 ± 13.3, <i>p</i> < 0.001). Of the IS patients, the majority (29.0%) had total anterior circulation infarct (TACI), while in the HS group, 34.0% had basal ganglia haemorrhage with or without intraventricular extension. Hypertension (<i>p</i> = 0.015), dyslipidaemia (<i>p</i> = 0.001), alcohol consumption (<i>p</i> = 0.022), and other cardiovascular diseases (<i>p</i> = 0.007) were more prevalent in patients with IS compared to those with HS. The prevalence rate of intravenous thrombolysis was 2.2% in IS and use of intravenous antihypertensives in 25.9% of patients with HS than IS. The in-hospital mortality was 26.4% with complications such as raised ICP, aspiration pneumonia, hydrocephalus, and sepsis significantly high in those that died. Aspiration pneumonia (OR 2.79, 95% CI 1.63-4.76, <i>p</i> < 0.001) and increased ICP (OR 0.30, 95% CI 0.16-057, <i>p</i> < 0.001) were independent predictors of in-hospital mortality on the multivariate analysis.</p><p><strong>Conclusion: </strong>Our findings showed a younger mean age for stroke and mortality rate comparable to other low- to middle-income countries (LMICs). Hypertension and alcohol consumption were the main risk factors for both stroke subtypes, while aspiration pneumonia and raised intracranial pressure predicted in-hospital mortality.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2023 ","pages":"1978536"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9908341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10707567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}