Disability In Stroke Patients Research Articles

Pengaruh Pelatihan Deteksi Dini Stroke dengan Metode Fast bagi Kader di Desa Nania Kecamatan Baguala Kota Ambon

The frequency of strokes is increasing, with World Health Organization (WHO) data showing that around 15 million people suffer strokes every year. From the increase in the incidence of stroke above, death and disability due to stroke are still the biggest problems from year to year. Stroke can be prevented by early detection of stroke. This research aims to determine the effect of early stroke detection training using the fast method for cadres in Nania Village, Baguala District, Ambon City.This type of research is quantitative research. This research uses a quasi-experiment research design with a pre-post test control group design. Researchers provided an explanation to respondents about the FAST Act for early detection of signs of stroke. The sample in this study was 30 health cadres in the working area of ​​the Nania Community Health Center.The research results of the Pre Test knowledge scores were (10, 12 and 13) out of the highest total score of 20, the lowest score was 8 for 1 person (3.3%) and the highest score was 15 for 1 person (3.3%). Meanwhile, the Post Test Knowledge (17 and 18) of the highest total score was 20. The lowest score was 14, amounting to 1 person (3.3%), and the highest score was 20, amounting to 4 people (13.3%).The conclusion is that there is an influence of early stroke detection training using fast methods for cadres at the Nania Community Health Center, Baguala District, Ambon City. It is hoped that the research results will provide additional knowledge for medical personnel about the importance of preventing complications in diabetes sufferers, so that as much as possible we can help reduce the rate of death or disability in stroke patients.

Plama Osmolality Status in Acute Stroke Patients and in Healthy Individuals in Rajshahi Medical College Hospital

Background: Stroke is the most prevalent neurological emergency and accounts for approximately 50% of all neurological disorders in medical college hospitals. It is the leading cause of adult neurological morbidity and the third leading cause of death globally. Changes in plasma osmolality are associated with increased complications, mortality, morbidity, and disability in stroke patients. Objective: This study aims to investigate the changes in plasma osmolality in different types of acute stroke patients and its impact on stroke outcomes. Method: The study included two groups: Group I comprised 104 acute stroke patients (mean age 58.87±13.70) as cases, and Group II consisted of 104 age- and sex-matched healthy individuals (mean age 57.55±12.60) as controls. Each stroke patient underwent cranial computed tomography within the first 24 hours. Blood tests for blood sugar, serum electrolytes, lipid profile, and blood urea were performed. The CT findings and pathological test results were analyzed using SPSS software. Result: Among the 104 stroke patients, 71 (68.27%) had ischemic stroke, and 33 (31.73%) had hemorrhagic stroke. Dyselectrolytaemia was observed in 73 (70.20%) of the stroke patients, while 31 (29.80%) had normal electrolyte levels. Hyperosmolality was present in 58 (55.77%) of the patients, and hypoosmolality was found in 3 (2.88%). Conclusions: Abnormal plasma osmolality is a significant independent risk factor for complications in acute stroke patients, both ischemic and hemorrhagic. Plasma osmolality estimation should be considered a crucial clinical investigation for evaluating acute stroke patients in the early stages.

Training on Early Detection of Stroke for Health Cadres to Prevent Disability After Stroke in the Kebonsari Village Area

ABSTRACT Early detection of stroke is an effort to prevent more severe disability in stroke patients. Delays in bringing stroke patients to the hospital are one of the reasons why patients miss the golden period of stroke treatment. Health cadres play an important role in identifying health problems in the community, but most cadres do not understand how to carry out early stroke detection. To increase the knowledge and ability of cadres in detecting strokes so that treatment does not exceed the golden period of strokes. The method used in this community service activity is a participative educational approach, including providing health education and demonstrations regarding early stroke detection. This activity was conducted in April 2023 and was attended by 35 health cadres. Knowledge and ability to detect stroke are evaluated used knowledge questionnaire instruments and observation sheets. The results of community service show that the knowledge and ability to perform stroke detection among cadres has increased after training. Cadres' knowledge and ability to detect stroke in the health community can be improved through early stroke detection training. It is hoped that trained health cadres can provide health education to other residents to increase residents' knowledge about stroke and when is the right time to take patients to hospital. Keywords: Early Detection, Health Cadres, Non-Communicable Disease, Stroke

A Study to Find Out Correlation of Depression with The Level of Disability in Stroke Patients

BACKGROUND: Stroke is a medical emergency, and can cause permanent neurological damage, complications, and even death. Depressive disorders and diminished functional capabilities have been recognized as common consequences of stroke More than one half of all stroke survivors are left with disabilities that prevent them from returning to their prestroke level of health and productivity. Poststroke depression is considered as the most frequent and important neuro-psychiatric consequence of stroke. As both depressive disorders and disability occurs after stroke, the purpose of the study is to correlate and find the relationship of depression with the level of disability in stroke patients. METHOD: A total of 100 stroke patients of both sexes in the age group of 30 to 60 years within a given time duration of 6 months after stroke were assessed for their depression and disability level. Depression was measured using Hamilton Depression Rating Scale (HDRS) with scores ranging from 0 to 54 and Disability was measured using modified Rankin Scale (mRS) with scores ranging from 0 to 6. OUTCOME MEASURE: The following outcome measures were measured: 1. Depression was measured using Hamilton Depression Rating Scale (HDRS) 2. Disability was measured using modified Rankin Scale (mRS) STATISTICAL ANALYSIS: • Karl Pearson’s correlation • P value <0.05 is taken up for statistical significance RESULTS: The r- value is 0.836, p- value is 0.000 and the result is highly significant with p<0.05 significance. In this study, r is between -1 and 1. Since it is a positive value (0.836), we can conclude that there exist a significant positive correlation between depression (HDRS) and level of disability (mRS) in stroke patients. CONCLUSION: Depression had a strong positive correlation with Disability in stroke patients Keywords: Stroke, Depression, Disability, Hamilton Depression Rating Scale (HDRS), Modified Rankin Scale (mRS).

The Effect of Cupping Ttherapy on Sleep Quality in Post Stroke Patients

Background: Stroke is the leading cause of disability and the fifth cause of death. In addition to death and disability, it turns out that other effects of stroke disease can experience sleep disturbances and problems, so the quality of sleep becomes poor and can affect the degree of disability in stroke patients, so it is necessary to undergo therapy with various modalities, such as cupping therapy.
 Objectives: The purpose of this study was to identify the effect of cupping therapy on the sleep quality of post-stroke patients, identify the picture of sleep quality before being bought cupping therapy in post-stroke patients, and identify the picture of sleep quality after being given cupping therapy in post stroke patients.
 Methods: The research design in this study used a quasi with a pre-test post-test group one design for 2 weeks without any control groups with the Pittsburgh Sleep Quality Index (PSQI) questionnaire.
 Results: After 2 weeks of treatment, the respondents showed an increase in their ability to sleep, the average quality of sleep before being given intelligence, namely 9.200, and the average value of cells that were given intelligence, namely 3.733. The results of the effect test obtained a p-value <0.001 and the result of the effect size was 3.42 and it was obtained It was concluded that there was a significant difference between sleep quality before intelligence was given and sleep quality after intelligence was given.
 Conclusion: A complementary therapy that can be used for stroke is cupping therapy. stroke sufferers can experience sleep disturbances so that the quality of sleep becomes poor and affects the degree of disability. then there is a takeover, the impact is that it can cause drowsiness and deep sleep.

Correlation between family support and self-efficacy in stroke survivors

Introduction: The sudden change in condition due to disability in stroke patients impacts their psychological condition and behavior. Low self-efficacy in stroke patients can affect depression and low quality of life. One of the factors that can increase self-efficacy in stroke patients is family support. This study analyzed the correlation between family support and self-efficacy in stroke survivors. Methods: This cross-sectional study involved seventy-one stroke survivors who were included in the inclusion criteria selected through purposive sampling. Data were collected using a demographic data questionnaire, the Family Support Questionnaire, and the Stroke Self-Efficacy Questionnaire (SSEQ). The data were analyzed using the Spearman rho correlation test with a significance level of α ≤ 0.05. Results: Half of the participants were women (50.7%), married (88.7%), and aged (Mean±SD, 56,23± 6,273). The result showed a significant correlation between family support and self-efficacy (p = 0,000) with medium relationship strength (r = 0,58). Conclusion: The higher the family support, the higher the self-efficacy of stroke patients. Nurses are expected to be able to provide family education to provide continuous support to family members who suffer from a stroke so that self-efficacy in stroke survivors increases.

The beneficial effects of transitional care for patients with stroke: A meta-analysis.

Transitional care interventions have emerged as a promising method of ensuring treatment continuity and health care coordination when patients are discharged from hospital to home. However, few studies have investigated the frequency and duration of interventions and the effects of interventions on physical function. Therefore, this study aimed to determine the efficacy of transitional care for patients with stroke. Six databases and the grey literature were searched to obtain relevant articles from October 1, 2022 to March 10, 2023. The primary outcomes studied were motor performance, walking speed, activities of daily living (ADLs) and caregiver burden following hospital-to-home transitional care. The quality of the studies was assessed with Cochrane risk of bias version 2. The quality and sensitivity of the evidence were assessed to ensure rigour of the findings. Meta-analyses were performed using stata 17.0. A total of 2966 patients were identified from 23 studies. Transitional care improved post-stroke motor performance, walking speed and ADLs, and reduced caregiver burden. The findings suggest that provision of transitional care model implementation in patients with stroke is important because it reduces disability in stroke patients and helps to decrease caregivers' burden. The findings of the study emphasize the importance of transitional care programmes for stroke patients after they are discharged from the hospital and returned to their homes. To meet the needs of patients, all levels of health professionals including nurses should be aware of the discharge process and care plan.

Effect of Executive Function on Health and Disability of Stroke Patients

Effect of Executive Function on Health and Disability of Stroke Patients

Shared Decision-Making to Improve Health-Related Outcomes for Adults with Stroke Disease.

Stroke is one of the leading causes of disability and death worldwide, a severe medical condition for which new solutions for prevention, monitoring, and adequate treatment are needed. This paper proposes a SDM framework for the development of innovative and effective solutions based on artificial intelligence in the rehabilitation of stroke patients by empowering patients to make decisions about the use of devices and applications developed in the European project ALAMEDA. To develop a predictive tool for improving disability in stroke patients, key aspects of stroke patient data collection journeys, monitored health parameters, and specific variables covering motor, physical, emotional, cognitive, and sleep status are presented. The proposed SDM model involved the training and consultation of patients, medical staff, carers, and representatives under the name of the Local Community Group. Consultation with LCG members, consists of 11 representative people, physicians, nurses, patients and caregivers, which led to the definition of a methodological framework to investigate the key aspects of monitoring the patient data collection journey for the stroke pilot, and a specific questionnaire to collect stroke patient requirements and preferences. A set of general and specific guidelines specifying the principles by which patients decide to use wearable sensing devices and specific applications resulted from the analysis of the data collected using the questionnaire. The preferences and recommendations collected from LCG members have already been implemented in this stage of ALAMEDA system design and development.

Comparative Analysis of Wolf Motor Function Test and Fugl Meyer Assessment Tool for Evaluating Upper Limb Disability in Stroke Patients

Comparative Analysis of Wolf Motor Function Test and Fugl Meyer Assessment Tool for Evaluating Upper Limb Disability in Stroke Patients

Relationship Between Pain and Disability Among Stroke Patients.

Stroke is prevalent in Iran, and its complications can decline patients' quality of life and psychological state. This study aimed to investigate the relationship between pain following stroke (PFS) and disability in stroke patients. The current case-control study was conducted on 184 stroke patients (92 cases and 92 controls). Data collection tools included a demographic questionnaire, the Visual Analog Scale (VAS), and the Disabilities of the Arm Shoulder and Hand (DASH) questionnaire. Based on the medical files of all patients with stroke, eligible ones were invited to participate in the study via phone calls. The collected data were then analyzed. The disability rate was higher in the case group of patients with a history of hemorrhagic stroke, smoking, stroke, and diabetes (P < 0.05). The mean ± SD age was 72.45 (11.54). Also, the level of disability in patients increased with age (P = 0.000). The mean ± SD disability score was 78.63 (6.92) in patients with PFS and 54.9 (10.87) in patients without PFS. Also, R = 0.795 and R2= 0.631 indicated the significance of disability severity in patients with PFS. The prevalence of disability was higher in patients with higher PFS levels. Hence, drug interventions or rehabilitation programs can be used to reduce the disability of stroke patients.

Abstract WMP29: Sex Differences On The Importance Of Multimorbidity In Post-stroke Disability:the Taiwan Stroke Registry

Background: Experiencing a clinical stroke may further aggravate the clinical condition of patients with multimorbidity and pose significant challenges regarding recommended poststroke therapies. However, there is limited evidence regarding the impact of multimorbidity on long-term disability in stroke patients, or whether any associations differ by sex. Hypotheses: Clusters of multimorbidity are associated with post-stroke disability. The association may depend on sex membership. Methods: In the Taiwan Stroke Registry study, 9818 patients with their first-ever recorded ischemic stroke were examined. Employing a hierarchical clustering approach, clusters of multimorbidity were generated based on 16 risk factors and were characterized using the observed/expected prevalence ratio ≥1.5 and the prevalence exclusivity measure ≥25%. Post-stroke disability was assessed using the mRS and categorized into less (mRS &lt;3) vs. more disability (mRS ≥3) over 12 months. The association between clusters of multimorbidity and post-stroke disability adjusted for age, sex, education, and stroke severity (NIHSS) was determined using logistic regression models, overall and stratified by sex. Results: Patients with a cluster profile of diabetes, peripheral artery disease and uremia had more disability than patients with a healthier cluster profile (Table 1). The association only remained significant in males, who had a higher multimorbidity burden, but not in females who more frequently had more severe strokes and more severe post-stroke disability. Conclusion: Patients with multimorbidity involving diabetes, peripheral artery disease and uremia have greater post-stroke disability and may require a more targeted rehabilitative approach. Certain clusters of multimorbidity may be more important for long-term post-stroke disability outcomes in males than in females.

Nerolidol Attenuates Cerebral Ischemic Injury in Middle Cerebral Artery Occlusion-Induced Rats via Regulation of Inflammation, Apoptosis, and Oxidative Stress Markers

Background Cerebral ischemia is a syndrome that occurs due to the restricted flow of oxygen-rich blood to the brain, causing damage to the brain cells. Globally, ischemia ranks second in causing mortality and third in causing disability in stroke patients. Nerolidol is a bioactive compound present in the essential oil of plants with a floral odour. It is a natural sesquiterpene alcohol used in cosmetics, perfumes, and as a food flavouring agent. It also possesses antioxidant, antimicrobial, anti-inflammatory, and anticancer properties. Materials and Methods In this study, we assessed the anti-ischemic property of nerolidol in cerebral ischemia-induced mice. Healthy male Wistar rats were induced into cerebral ischemia with middle cerebral artery occlusion (MCAO) and treated with 10 mg and 20 mg nerolidol for 21 days. The brain morphometric, antioxidant, and MMP levels were estimated in the brain tissue of MCAO-performed and nerolidol-treated rats. The cerebral infarct-alleviating potency of nerolidol was analysed by estimating the levels of inflammatory cytokines and apoptotic proteins. It was further confirmed by assessing the levels of COX-2/PGE-2 signalling proteins in brain tissue from MCAO-performed in rats. Results Nerolidol significantly reduced the cerebral infarct volume and brain edema via increased antioxidant levels and decreased MMPs. It also decreased the pro-inflammatory cytokines and proapoptotic proteins in brain tissue. The inflammatory signalling proteins NFκB, COX-2, and PGE-2 were significantly decreased in nerolidol-treated MCAO-performed rats, confirming the antiischemic property of nerolidol. Conclusion Our results prove nerolidol significantly alleviates cerebral ischemia in rats, and it can be subjected to further trials to be formulated as an anti-ischemic drug.

COMPARISON OF EXERGAMES VERSUS TRADITIONAL BALANCE EXERCISE TO IMPROVE BALANCE AND REDUCE RISK OF FALLS IN CHRONIC STROKE PATIENTS

Objective: One of the frequent causes of disability in stroke patients is balance impairment. Balance training is integral part of rehabilitation for stroke patients. Exergame is innovative technology which provides benefit of exercise in entertaining way. The objective was to compare the effects of exergames versus traditional balance exercise to improve balance and reduce risk of fall in chronic stroke patients.&#x0D; Method: A randomized control trial was conducted on 40 chronic stroke patients. Patients were randomly divided into exergaming group (n=20) and control group (n=20), using coin and toss method. Patients in control group performed traditional balance exercises while exergaming group performed supervised exergames along with traditional balance exercises. The treatment duration for both groups was 35-40 minutes/3 times a week for 6 weeks, with 5 minutes of warm up and cool down before and after intervention.&#x0D; The demographics were recorded, and assessment was done using Berg balance scale, Time Up and Go test and Dynamic gait index at baseline and after 6 weeks of intervention. Data was analyzed using SPSS 24.&#x0D; Results: Of the 46 patients assessed, 40 (86.9%) were included in the study. The overall mean age was 57.78±5.38 years, there were 20 (54.1 %) males and 17 (45.9 %) females. Significant improvements were seen between the groups for Berg balance scale, Time Up Go test and Dynamic gait index after six weeks of intervention (p&lt;0.05).&#x0D; Conclusion: Exergame is found to be effective in improving balance and reducing risk of fall in chronic stroke patients.

Efficacy of mechanical thrombectomy in stroke patients with large vessel involvement.

Ischemic stroke is a common disease worldwide and leads to a significant rate of mortality and disability in patients every year, and imposes high costs on the health care system. The aim of this study was to evaluate the efficacy of the invasive method of mechanical thrombectomy for rapid intervention in ischemic stroke patients with large vessel involvement. Patients suspected of having a stroke, who were referred to Imam Hossein Hospital, were examined, and the diagnosis of stroke was confirmed. In the next stage, patients' MRS index was measured and the possibility of emergency thrombectomy was evaluated in patients. Patients who underwent thrombectomy were considered as the case group and the other patients were contemplated as the control group; then, the cases of the two groups were evaluated and compared. The mean age of patients was 66.63 ± 12.26 years. the use of emergency thrombectomy in the study group significantly reduced the MRS index of patients after 90 days (p <0.001), while a significant increase in the mean scores of the MRS index was seen in patients receiving pharmacological treatments. Also, there was no significant difference in terms of gender between the group of patients undergoing thrombectomy and the group receiving other treatments (p = 0.375). Emergency mechanical thrombectomy significantly reduces disability in stroke patients in the long term and can be a good alternative to conventional drug treatments..

Quality of Life for Adult Stroke Patients: A Literature Review

Stroke is a disease that causes permanent disability. Disability in stroke patients dramatically affects the patient's quality of life. Nurses need to assess the quality of life of stroke patients. This review aims to identify the quality of life of adult stroke patients and the factors that influence it. The research method uses a literature review approach and a systematic selection process based on search results from databases: Pub Med Sciencedirect Scopus and Ebsco with the keywords Cerebrovascular, Stroke in adult, Quality of life, Health-Related, Quality Of Life. Of the 1817 articles that matched the keywords, screening was carried out based on the inclusion and exclusion criteria, and nine articles were obtained for review. From the nine articles, it was found that there was a decrease in the quality of life in stroke patients with a low level of quality of life. The main factors that affect the quality of life are physical domains: young age, the same sex between men and women, disability, and the type of hemorrhagic stroke is a type of stroke that causes the low quality of life. In the psychological domain: anxiety and depression experienced by stroke patients. In the social domain: education level, family support, and health and socio-economic support. In the environmental domain: length of hospital stay. The physical domain factor is the most significant factor that causes the low quality of life of stroke patients in adulthood.

Stroke ischemico e terapie iperacute nel bambino e nell’adolescente visti da un Pronto Soccorso pediatrico e da uno dell’adulto

The use of hyperacute therapies, such as thrombolysis and mechanical thrombectomy, has revolutionized the care of adult patients with arterial ischemic stroke. In this context, one of the most effective Diagnostic Therapeutic Assistance Pathways (PDTAs) in Italy, and particularly in the Friuli Venezia Giulia Region, describes the care received by the patient with cerebral stroke, who for epidemiological reasons is an adult patient. Drawn up in 2015 and operational in Trieste and Udine, it represented a fundamental step forward in medicine as it dramatically reduced mortality and disability in stroke patients. The effectiveness reported in the literature of the use of hyperacute therapies in children with ischemic stroke requires reflection on the management of such children so that they can take advantage of these therapeutic possibilities. The paper presents 3 cases with a brief comment each that suggests some reflections on stroke treatment in paediatrics and on the possibilities of treatment similar to that of adults.

Abstract WP85: Provider Perspectives On Stroke Treatment In Nebraska: Urban Vs. Rural Disparities

Introduction: Mission: Lifeline Stroke Nebraska (NE) is a four-year project which aims to improve stroke systems of care within the state through various interventions, including education of healthcare providers. Timely in-hospital treatment of stroke patients is key to reducing death and disability in stroke patients. Methods: An anonymous survey was administered to physicians and advanced practice providers that work in the ED at NE hospitals to assess the comfort/confidence level in administering IV thrombolytics and to learn more about the reasons for giving (and not giving) IV thrombolytics in various scenarios, including when an ischemic stroke is mild (NIHSS &lt;4). A total of 110 providers completed the survey between February and April of 2021. Results: Critical Access Hospital (CAH) providers represented 70% of respondents. Only 50% of providers at certified centers and 29% at CAHs feel comfortable/confident in giving IV thrombolytics to ischemic stroke patients before consulting another provider. After consulting another clinician, this percentage increases to 89.7% in CAH providers but does not change in certified center providers. Overall, only 26.5% of certified center providers and 21.8% of CAH providers stated they are likely to give IV thrombolytic to a mild ischemic stroke patient. Certified center providers indicated that improved feedback on patient outcomes post IV thrombolytic therapy (41.2%) is the top item that would increase their comfort/confidence with administering IV thrombolytic. Qualitative feedback from certified center providers also shows there is hesitancy in administering IV thrombolytics to stroke patients and a desire to see more research showing the benefits. CAH providers identified access to telestroke (78.2%) and annual stroke education including updated guidelines on IV thrombolytic administration (66.7%) as the top items that would increase their comfort/confidence. Conclusions: These results indicate there is hesitancy to use IV thrombolytics to treat mild ischemic stroke patients and a need for more telestroke/neurology consultation options for providers in CAHs. From these conclusions, Mission: Lifeline is catering educational opportunities to the needs of rural and urban providers in NE

On the Question of the Reflexotherapy Action Mechanisms in the Ischemic Stroke Acute Period (Literature Review)

A high degree of disability in stroke patients, along with severe social and economic losses, determine the enduring urgency of the problem of early rehabilitation for post-stroke patients. Despite the proven effectiveness of the various reflexotherapy techniques in rehabilitation of patients with ischemic stroke, the underlying mechanisms remain unclear. The aim of the review was to analyze the mechanisms of the acupuncture intervention effect on the main links of the ischemic stroke pathogenesis, on neurological deficit and the volume of cerebral infarction (based on publications in international databases). The use of acupuncture in the acute period of ischemic stroke can improve the ability to cerebrovascular reserve, reduce the severity of arterial stiffness and endothelial dysfunction, induce neuroprotection, inhibit cell apoptosis and stimulate neuroplasticity, alleviate the inflammatory response in acute cerebral ischemia, regulate mediators of inflammation and oxidative stress etc., thus improving cerebral blood flow. The analysis of literature data has shown that acupuncture induces multilevel regulation through complex mechanisms, and one factor may not be enough to explain the positive effect against cerebral ischemia.

A Primeval Mechanism of Tolerance to Desiccation Based on Glycolic Acid Saves Neurons in Mammals from Ischemia by Reducing Intracellular Calcium-Mediated Excitotoxicity.

Stroke is the second leading cause of death and disability worldwide. Current treatments, such as pharmacological thrombolysis or mechanical thrombectomy, reopen occluded arteries but do not protect against ischemia‐induced damage that occurs before reperfusion or neuronal damage induced by ischemia/reperfusion. It has been shown that disrupting the conversion of glyoxal to glycolic acid (GA) results in a decreased tolerance to anhydrobiosis in Caenorhabditis elegans dauer larva and that GA itself can rescue this phenotype. During the process of desiccation/rehydration, a metabolic stop/start similar to the one observed during ischemia/reperfusion occurs. In this study, the protective effect of GA is tested in different ischemia models, i.e., in commonly used stroke models in mice and swine. The results show that GA, given during reperfusion, strongly protects against ischemic damage and improves functional outcome. Evidence that GA exerts its effect by counteracting the glutamate‐dependent increase in intracellular calcium during excitotoxicity is provided. These results suggest that GA treatment has the potential to reduce mortality and disability in stroke patients.