Stroke

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REVIEW our Selected Stroke Articles in 2006. Stay informed and updated!

Stroke

NIH - Medical Encyclopedia: Stroke

"The goal is to get the person to the emergency room immediately, determine if he or she is having a bleeding stroke or a stroke from a blood clot, and start therapy -- all within 3 hours of when the stroke began."

Highlighted Article

Transient Ischemic Attack: A Dangerous Harbinger and an Opportunity to Intervene. (Semin Neurol. 2005)

"Transient ischemic attack (TIA) and ischemic stroke are both characterized by sudden onset of neurological symptoms due to focal cerebral ischemia, but they are distinguished by the duration of neurological symptoms, with TIA traditionally defined by resolution of symptoms within 24 hours and stroke reserved for symptoms of longer duration. ... The short-term risk of ischemic stroke after TIA is very high ..."

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Stroke

Rehabilitation

NEWS:

Exercise Training in Ambulatory Stroke Survivors Has Benefits "For stroke survivors who have completed rehab and are ambulatory, exercise training is feasible and improves physical functioning and aspects of mental health, an exploratory study conducted in the UK shows."

Howard: The Helping Hand for Stroke Survivors

Not Enough 'Good' Cholesterol Makes It Harder To Recover From Stroke "Researchers found several factors predicted memory and disability problems after stroke: increased age, non-Caucasian race, recurrent stroke, diabetes, stroke in the left hemisphere of the brain, higher levels of homocysteine and lower levels of high-density lipoproteins (HDL), otherwise known as "good" cholesterol."

Speak Again After Stroke Through Song " When the language center on the brain's left side is damaged, therapists can tap into the music center on the healthy right side of the brain. It's called melodic intonation therapy."

Stroke Rehab Technique Has Lasting Results "With just two weeks of so-called constraint-induced movement therapy, some stroke patients can have significant improvement in the functioning of their affected hand and a better quality of life, a new study finds."

Stroke survivors may benefit from task training "Repeated practice of tasks similar to those commonly performed in daily life can improve mobility after stroke, according to a review of studies published online in The Cochrane Library."

ARTICLES:

JOURNAL ARTICLES:

Cognitive rehabilitation for memory deficits following stroke. (Cochrane Database Syst Rev. 2007)

Depression or apathy and functional recovery after stroke (International Journal of Geriatric Psychiatry 2007) "Apathy might be more frequently associated with functional abilities and likely interact with the recovery process as compared with depression after stroke."

Effect of training programs and exercise in adult stroke patients: literature review. (Ann Readapt Med Phys. 2007) "DISCUSSION-CONCLUSION: Training and exercise programs have value in stroke rehabilitation, and published results are, in general, promising. However, differences in the populations tested, methods, and criteria for analysis do not allow for recommending specific procedures."

Effects of Exercise Training Programs on Walking Competency After Stroke: A Systematic Review. (Am J Phys Med Rehabil. 2007) "This review shows that gait-oriented training is effective in improving walking competency after stroke."

Effects of stroke severity and training duration on locomotor recovery after stroke: a pilot study. (Neurorehabil Neural Repair. 2007)

Executive function deficits in acute stroke. (Arch Phys Med Rehabil. 2007) "CONCLUSIONS: Executive function deficits are common in stroke patients. The data suggest that limitations in information processing due to these deficits may require environmental and procedural accommodations to increase rehabilitation benefit."

Functional and Cognitive Capacity and Health-Related Quality of Life 2 Years After Day Hospital Rehabilitation for Stroke: A Prospective Study (Journal of Stroke and Cerebrovascular Diseases 2007)

Impact of patient's weight on stroke rehabilitation results. (Am J Phys Med Rehabil. 2007)

Mental Practice in Chronic Stroke. Results of a Randomized, Placebo-Controlled Trial. (Stroke. 2007) "BACKGROUND AND PURPOSE: Mental practice (MP) of a particular motor skill has repeatedly been shown to activate the same musculature and neural areas as physical practice of the skill. Pilot study results suggest that a rehabilitation program incorporating MP of valued motor skills in chronic stroke patients provides sufficient repetitive practice to increase affected arm use and function. … Subjects receiving MP showed significant reductions in affected arm impairment and significant increases in daily arm function (both at the P<0.0001 level). Only patients in the group receiving MP exhibited new ability to perform valued activities. CONCLUSIONS: The results support the efficacy of programs incorporating mental practice for rehabilitating affected arm motor function in patients with chronic stroke. These changes are clinically significant."

Mirror therapy enhances lower-extremity motor recovery and motor functioning after stroke: a randomized controlled trial. (Arch Phys Med Rehabil. 2007)

Pathophysiology of Stroke Rehabilitation: The Natural Course of Clinical Recovery, Use-Dependent Plasticity and Rehabilitative Outcome (Cerebrovascular Diseases 2007)

Physiotherapy treatment approaches for the recovery of postural control and lower limb function following stroke. (Cochrane Database Syst Rev. 2007) "AUTHORS' CONCLUSIONS: There is evidence that physiotherapy intervention, using a mix of components from different approaches, is significantly more effective than no treatment or placebo control in the recovery of functional independence following stroke. There is insufficient evidence to conclude that any one physiotherapy approach is more effective in promoting recovery of lower limb function or postural control following stroke than any other approach."

Poststroke Memory Function in Nondemented Patients (Stroke. 2007) "Conclusions— Not all patients with poststroke memory dysfunction 3 months after a stroke had memory dysfunction 1 year poststroke. Consequently, not all criteria for the dementia diagnosis were fulfilled any more. This may indicate that poststroke dementia may be reversible in a substantial proportion of patients with stroke. Preferably, standardized reassessment of cognitive function should be performed in each patient diagnosed with poststroke dementia."

Prediction of length of stay for stroke patients. (Acta Neurol Scand. 2007) "Independent predictors of acute LOS were stroke severity, lacunar stroke, prestroke dementia, and smoking. Independent predictors of total LOS were stroke severity and prestroke activities of daily living (ADL) dependency. The NIHSS items that best correlated with LOS were paresis, unilateral neglect and level of consciousness. Conclusions - Stroke severity is a strong and reliable predictor of LOS."

Rate, degree, and predictors of recovery from disability following ischemic stroke. (Neurology. 2007) "CONCLUSIONS: Half of patients with disabling ischemic stroke recovered within 18 months, and recovery was greatest within 6 months. Significant predictors of recovery included the severity of the index stroke and no history of ischemic stroke, peripheral artery disease, or diabetes."

Recovery and treatment of aphasia after stroke: functional imaging studies. (Current Opinion in Neurology 2007)

Recovery of standing balance and health-related quality of life after mild or moderately severe stroke. (Arch Phys Med Rehabil. 2007) "CONCLUSIONS: Subjects recovering from a stroke showed a significant improvement in physical HRQOL and functional and physiologic balance, yet the physiologic balance recovery was not complete even in the mild group."

Repetitive task training for improving functional ability after stroke. (Cochrane Database Syst Rev. 2007) "AUTHORS' CONCLUSIONS: Repetitive task training resulted in modest improvement in lower limb function, but not upper limb function. Training may be sufficient to impact on daily living function. However, there is no evidence that improvements are sustained once training has ended. The review potentially investigates task specificity rather more than repetition. Further research should focus on the type and amount of training, and how to maintain functional gain."

Robotic-assisted rehabilitation of the upper limb after acute stroke. (Arch Phys Med Rehabil. 2007) "CONCLUSIONS: Patients who received robotic therapy in addition to conventional therapy showed greater reductions in motor impairment and improvements in functional abilities. Robotic therapy may therefore effectively complement standard rehabilitation from the start, by providing therapeutic support for patients with poststroke plegic and paretic upper limb."

[Secondary prevention after stroke - lifestyle factors.] (Ugeskr Laeger. 2007)

Somatosensory recovery: a longitudinal study of the first 6 months after unilateral stroke. (Disabil Rehabil. 2007) " CONCLUSION: Of the 18 patients tested there were no consistent, generalizable, recognizable patterns of sensory recovery demonstrated."

Stroke: A Randomized Trial of Exercise or Relaxation (Journal of the American Geriatrics Society 2007) "Exercise training for ambulatory stroke patients was feasible and led to significantly greater benefits in aspects of physical function and perceived effect of physical health on daily life."

Tai Chi Exercise and Stroke Rehabilitation (Use of Complementary / Alternative Medicine in Stroke Rehabilitation 2007)

The effect of balance training on motor recovery and ambulation after stroke: a randomized controlled trial. (Eura Medicophys. 2007) "CONCLUSION: In our group of stroke patients, balance training combined with a conventional rehabilitation program does not provide additional benefit in terms of lower extremity motor recovery, mobility and activity level."

The effects of lingual exercise in stroke patients with Dysphagia. (Arch Phys Med Rehabil. 2007) " CONCLUSIONS: The findings indicate that lingual exercise enables acute and chronic dysphagic stroke patients to increase lingual strength with associated improvements in swallowing pressures, airway protection, and lingual volume."

Time frame and predictors of recovery from disability following recurrent ischemic stroke. (Neurology. 2007) "CONCLUSIONS: The rate of recovery from recurrent ischemic stroke was greatest in the first 6 months; one-third of patients recovered within 12 months. The significant predictors of recovery were a nondisabled state before recurrence and increasing severity of the recurrent stroke."

Using musical instruments to improve motor skill recovery following a stroke. ( Neurol. 2007) "In conclusion, this innovative therapeutic strategy is an effective approach for the motor skill neurorehabilitation of stroke patients."

Virtual Reality in Stroke Rehabilitation: A Systematic Review of its Effectiveness for Upper Limb Motor Recovery (Topics in Stroke Rehabilitation 2007) "Conclusion: The current evidence on the effectiveness of using VR in the rehabilitation of the UL in patients with stroke is limited but sufficiently encouraging to justify additional clinical trials in this population."

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