Global Functional Outcome Research Articles

Emerging Therapies for Cerebrovascular Disorders

Emerging Therapies for Cerebrovascular Disorders

Intravenous Magnesium for Neuroprotection in Acute Stroke: Clinical Hope Versus Basic Neuropharmacology

To the Editor: Saver and colleagues investigated the neuroprotective effect of early magnesium infusion in ischemic or hemorrhagic stroke in the field; three quarters of the infarct cohort were treated within 2 hours of onset, and nearly one-third within 1 hour of onset.1 Dramatic early and good results were reported in the early (42% of <2-hour infarct patients) and 90-day global functional outcomes (69% of all patients and 75% of <2 hour infarct patients), respectively. These authors recommend large-scale trials with field initiation of magnesium for early neuroprotection in stroke. An essential prerequisite for any pharmacological agent to offer significant brain neuronal protection during strokes is its ability to freely cross the blood–brain barrier (BBB). Transport of magnesium from blood to cerebrospinal fluid across BBB is limited in normal humans; intravenous administration of magnesium sulfate does not increase …

Intravenous Magnesium for Neuroprotection in Acute Stroke: Neuropharmacology Supports Clinical Hope. Response

Intravenous Magnesium for Neuroprotection in Acute Stroke: Neuropharmacology Supports Clinical Hope. Response

Poster 5: Short-term effects of locomotor-oriented rehabilitation on postarthroplasty hip impairments and functional ability

Objective: To evaluate the effects of intensive rehabilitation offered 6 months after total hip arthroplasty (THA). Design: Intervention pilot study, before-after trial. Setting: Ambulatory care. Patients: 10 patients were evaluated 7.2±0.5 months after THA (pretest) and 2 months later (posttest). Intervention: 12 supervised sessions and unsupervised home exercises. Main Outcome Measures: Functional ability measured with Western Ontario and McMaster Universities Osteoarthritis Index (pain and disability scales), clinical locomotor tests, and laboratory gait evaluation. Hip strength and mobility impairments were also quantified. Comparisons were made with Wilcoxon signed-rank tests. Results: At posttest, patients had less pain (–56%) and less difficulty in performing daily activities (disability scale, −42%), and they performed better during the 10m walk (15%), 6-minute walk (16%), and timed stair (17%) tests, as compared with pretest. No differences were revealed in gait kinematics and kinetics or impairment measures on the operated limb. Significant changes were found in the movements of the sound limb. Conclusions: The intervention promoted better functional ability. Functional gains seem related to more efficient compensations with the sound limb and better locomotor endurance. These results stress the importance of measuring joint-specific outcomes and using bilateral measures to understand changes in global functional outcomes.