Journal of stroke medicine最新文献_第9页

Quantifying Poststroke Gait Deviations: A Meta-analysis of Observational and Cross-sectional Experimental Trials 量化中风后步态偏差:观察性和横断面实验试验的荟萃分析

Journal of stroke medicine Pub Date : 2019-08-28 DOI: 10.1177/2516608519856246

Sharareh Sharififar, H. Vincent, J. Shuster, Andrew Bishop

{"title":"Quantifying Poststroke Gait Deviations: A Meta-analysis of Observational and Cross-sectional Experimental Trials","authors":"Sharareh Sharififar, H. Vincent, J. Shuster, Andrew Bishop","doi":"10.1177/2516608519856246","DOIUrl":"https://doi.org/10.1177/2516608519856246","url":null,"abstract":"Abstract The hemiparetic walking pattern is a common feature of an upper motor neuron impairment caused by stroke. Previous studies have recorded deviations in hemiparetic walking patterns. We aimed to quantify gait alterations poststroke relative to healthy gait across a range of walking speeds by a systematic review and meta-analysis. We searched databases including MEDLINE via PubMed, Web of Science, SPORTDiscus, Cumulative Literature Index to Nursing and Allied Health Literature, and Cochrane Central Register of Controlled Trials from 1927 to the end of July 2015 for all instrumented measured gait variables in (a) observational studies with stroke patients only and (b) interventional studies in healthy, age-matched (elderly) participants, and those with stroke published in English. We analyzed data using a patient-weighted random-effects method. The heterogeneity of methods and measures employed across studies limited the intended analyses. The search pooled 2,223 articles, of which we included 49 observational and 124 interventional studies involving 960 healthy elders and 4,691 participants with stroke. As expected, those with stroke have gait-speed-related statistical differences from those without stroke. Specifically, this meta-analysis determined that (a) only 2 spatial parameters consistently changed according to gait speed – step length and stride length – and (b) irrespective of speed, 9 spatiotemporal measures, 5 sagittal kinematic, and 3 kinetic measures from the analysis were statistically different from the healthy counterparts (P < .05). These findings suggest the importance of using instrumented measurement techniques for evaluating stroke gait rehabilitation.","PeriodicalId":93323,"journal":{"name":"Journal of stroke medicine","volume":"15 1","pages":"23 - 31"},"PeriodicalIF":0.0,"publicationDate":"2019-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75220324","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}

引用次数: 6

Task-oriented Motor Learning in Upper Extremity Rehabilitation Post Stroke 任务导向运动学习在脑卒中后上肢康复中的应用

Journal of stroke medicine Pub Date : 2019-08-27 DOI: 10.1177/2516608519864760

A. Alashram, G. Annino, N. Mercuri

{"title":"Task-oriented Motor Learning in Upper Extremity Rehabilitation Post Stroke","authors":"A. Alashram, G. Annino, N. Mercuri","doi":"10.1177/2516608519864760","DOIUrl":"https://doi.org/10.1177/2516608519864760","url":null,"abstract":"Abstract Background: Upper extremity deficits are the most popular symptoms following stroke. Task-oriented training has the ability to increase motor area excitability in the brain, which can stimulate the recovery of motor control. Objective: This study was aimed to examine the efficiency of the task-oriented approach on paretic upper extremity following a stroke, and to identify efficient treatment dosage in those populations. Method: We searched through PubMed, Scopus, Physiotherapy Evidence Database (PEDro), National Rehabilitation Information (REHABDATA), and Web of Science databases. Randomized clinical trials (RCTs) and pseudo-RCTs those investigating upper extremity in patients with stroke published in English language were selected. Different scales and measurement methods to assess range of motion, strength, spasticity, and upper extremity function were considered. The quality assessment of included articles was evaluated utilizing the PEDro scale. Effect sizes were calculated. Results: Six RCTs were included in the present study. The quality assessment for included studies ranged from 6 to 8 with 6.5 as a median. A total of 456 post-stroke patients, 41.66% of which were women, were included in all studies. The included studies demonstrated a meaningful influence of task-oriented training intervention on the hemiplegic upper limb motor functions but not spasticity post-stroke. Conclusion: Task-oriented training does not produce a superior effect than other conventional physical therapy interventions in treating upper extremity in patients with stroke. There is no evidence supporting the beneficial effect of task-oriented on spasticity. Task-oriented training with the following dosage 30 to 90 minutes/session, 2 to 3 sessions weekly for 6 to 10 weeks may improve motor function and strength of paretic upper extremity post-stroke.","PeriodicalId":93323,"journal":{"name":"Journal of stroke medicine","volume":"86 1","pages":"104 - 95"},"PeriodicalIF":0.0,"publicationDate":"2019-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90429335","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}

引用次数: 8

First Experience of Mechanical Thrombectomy Outcomes Without Bridging Technique: A 3-Year Retrospective Analysis 无桥接技术机械取栓的首次经验:3年回顾性分析

Journal of stroke medicine Pub Date : 2019-08-26 DOI: 10.1177/2516608519866553

Saima Ahmad, U. Chaudhry, O. Mansour

{"title":"First Experience of Mechanical Thrombectomy Outcomes Without Bridging Technique: A 3-Year Retrospective Analysis","authors":"Saima Ahmad, U. Chaudhry, O. Mansour","doi":"10.1177/2516608519866553","DOIUrl":"https://doi.org/10.1177/2516608519866553","url":null,"abstract":"Abstract Introduction: Mechanical thrombectomy has become the cornerstone and standard of care for acute stroke patients. Early reperfusion in patients experiencing acute ischemic stroke is the most important factor. The motivation behind this investigation is to display the aftereffects of mechanical thrombectomy in patients with large vessel occlusion in anterior and posterior circulation and to demonstrate that it lessens the level of handicap 3 months post stroke. Methods: A retrospective analysis was conducted of patients who presented with acute ischemic stroke at our center from 2015 to 2018 and received mechanical thrombectomy using combined manual aspiration with a stent retriever and with large bore catheters without the bridging technique. Result factors including recanalization rate and modified Rankin Scale at 90 days post procedure were assessed. An aggregate of 30 patients were included. Results: About 30 patients presented at the institute and met the inclusion criteria for the study. Successful recanalization (the Thrombolysis in Cerebral Infarction Score [TICI 2B]) was accomplished in 90% of patients, TICI 3 score was accomplished in 56% of the patients. 67% of the patients had good modified Rankin Scale score 0-2 result at 90 days. There were 3 symptomatic hemorrhages and 3 procedure and comorbidity-related deaths (10%). Conclusion: Mechanical thrombectomy using combined manual aspiration with a stent retriever and with large bore catheters alone without the bridging technique is an effective and safe procedure for endovascular revascularization of large vessel occlusion presenting with acute ischemic stroke.","PeriodicalId":93323,"journal":{"name":"Journal of stroke medicine","volume":"55 1","pages":"105 - 110"},"PeriodicalIF":0.0,"publicationDate":"2019-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76603191","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}

引用次数: 0

Abstracts from the Indian National Stroke Conference (INSC) held on 15-17 March 2019 2019年3月15日至17日举行的印度国家卒中会议(INSC)摘要

Journal of stroke medicine Pub Date : 2019-01-01 DOI: 10.1177/2516608519860317

S. Saxena, Vivek Kumar, Rajesh Gupta, G. Rajpal, Ankur Verma, D. Selvaraj, D. Kamath

引用次数: 1

Management of Oral Anticoagulant-associated Intracerebral Hemorrhage 口服抗凝剂相关脑出血的处理

Journal of stroke medicine Pub Date : 2018-12-01 DOI: 10.1177/2516608518821745

C. Epple, T. Steiner

{"title":"Management of Oral Anticoagulant-associated Intracerebral Hemorrhage","authors":"C. Epple, T. Steiner","doi":"10.1177/2516608518821745","DOIUrl":"https://doi.org/10.1177/2516608518821745","url":null,"abstract":"Abstract Introduction: Oral anticoagulant-associated intracerebral hemorrhages (OAC-ICHs) account for nearly 20% of all ICH and are associated with high mortality. The number of patients with an indication for oral anticoagulant therapy (OAT) is increasing with the aging population; therefore, despite the improved safety profile of non-vitamin K oral anticoagulants (NOACs), the number of patients with OAC-ICH will increase. OAT was simplified with the introduction of NOACs, which are easy to handle and show a favorable risk-benefit profile. The rate of ICH is lower than for vitamin K antagonists (VKA) and routine coagulation testing is not required. Nevertheless, OAC-ICH does occur and is still a devastating disease, thus representing the most feared complication in OAT, irrespective of treatment with VKA or NOAC. Purpose: The aim of this article is to address the clinical problem of bleeding management in patients with ICH due to OAC and will consider anticoagulation with NOAC and VKA. Recommendations: Restoring coagulation as soon as possible is the main goal and, therefore, knowledge of the actual coagulation status is essential. In VKA-associated ICH, the international normalized ratio (INR) should be lowered to below 1.3. However, laboratory measurement of anticoagulant activity in NOAC patients is more complex, rendering OAC-ICH treatment more complicated. The best assays are specialized and not widely available, whereas more accessible tests such as prothrombin time and activated partial thromboplastin time have important limitations. For VKA-ICH, prothrombin complex concentrate (PCC) should be administered to reverse the INR. For dabigatran-related ICH, 5 g idarucizumab should be administered. For factor Xa inhibitors, PCC is recommended in the absence of andexanet alfa as soon as an OAC-related ICH evolves. Resuming OAC after ICH should be considered, depending on risk factors and a risk-benefit evaluation.","PeriodicalId":93323,"journal":{"name":"Journal of stroke medicine","volume":"2 1","pages":"114 - 125"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87110192","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}

引用次数: 1

World Stroke Award 2017 2017年世界中风奖

Journal of stroke medicine Pub Date : 2018-12-01 DOI: 10.1177/0973217918820725

B. Menon

引用次数: 0

Recommendations for the Early Management of Acute Ischemic Stroke: A Consensus Statement for Healthcare Professionals from the Indian Stroke Association 急性缺血性卒中早期管理建议:印度卒中协会医疗保健专业人员共识声明

Journal of stroke medicine Pub Date : 2018-09-20 DOI: 10.1177/2516608518777935

D. Khurana, M. Padma, R. Bhatia, S. Kaul, J. Pandian, P. Sylaja, D. Arjundas, Ashok Uppal, V. Pradeep, Vinit Suri, D. Nagaraja, A. Alurkar, S. Narayan

引用次数: 22

Effectively Combating Stroke in Low- and Middle-Income Countries: Placing Proof in Pragmatism—The Lancet Neurology Commission 在低收入和中等收入国家有效防治中风:将证据放在实用主义-柳叶刀神经病学委员会

Journal of stroke medicine Pub Date : 2018-08-24 DOI: 10.1177/2516608518776706

M. Owolabi, W. Johnson, T. Khan, V. Feigin

引用次数: 20

Stroke Care Services in Africa: A Systematic Review 非洲中风护理服务:系统回顾

Journal of stroke medicine Pub Date : 2018-07-20 DOI: 10.1177/2516608518775233

R. Akinyemi, Olaleye A. Adeniji

{"title":"Stroke Care Services in Africa: A Systematic Review","authors":"R. Akinyemi, Olaleye A. Adeniji","doi":"10.1177/2516608518775233","DOIUrl":"https://doi.org/10.1177/2516608518775233","url":null,"abstract":"Abstract Background: Stroke is the second leading cause of death and adult-onset disability globally. Although its incidence is reducing in developed countries, low- and middle-income countries, especially African countries, are witnessing an increase in cases of stroke, leading to high morbidity and mortality. Evidently, a new paradigm is needed on the continent to tackle this growing burden of stroke in its preventative and treatment aspects. Aims and Objectives: The aim of this study was to determine the scope of stroke care services, where they exist, and their relationship with currently existing health systems. Methods: A detailed literature search was undertaken referring to PubMed and Google Scholar for articles from January 1960 to March 2018, using a range of search terms. Of 93 publications, 45 papers were shortlisted, and 21 reviewed articles on existing stroke services were included. Results: The literature on models of stroke services in Africa is sparse. We identified focused systems of care delivery in the hyperacute, acute, and rehabilitative phases of stroke in a few African countries. There is a continent-wide paucity of data on the organization of prehospital stroke services. Only 3 African countries (South Africa, Egypt, and Morocco) reported experiences on thrombolysis. Also, the uptake of dedicated stroke units appears limited across the continent. Encouragingly, there are large-scale secondary prevention models on the continent, mostly within the context of experimental research projects, albeit with promising results. We found only 1 article on the interventional aspects of stroke care in our review, and this was a single-center report. Conclusions: The literature on the organization of stroke services is sparse in Africa. Dedicated action at policy, population, community, and hospital-based levels is urgently needed toward the organization of stroke services to tame the burgeoning burden of stroke on the African continent.","PeriodicalId":93323,"journal":{"name":"Journal of stroke medicine","volume":"28 1","pages":"55 - 64"},"PeriodicalIF":0.0,"publicationDate":"2018-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91292094","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}

引用次数: 10

Sonothrombolysis in Acute Ischemic Stroke: Current Status 急性缺血性卒中的超声溶栓:现状

Journal of stroke medicine Pub Date : 2018-06-01 DOI: 10.1177/2516608518773003

Arvind K Sharma, J. Navarro, C. Escabillas, V. Sharma

引用次数: 1