Sequelae Of Stroke Research Articles

Research Best Practices for Eye Stroke Vision Rehabilitation: A Qualitative Study

Purpose Central retinal artery occlusion, also known as an eye stroke, results in visual impairment and functional challenges. Our study objectives were to identify meaningful measures and factors that indicate or enable successful recovery after eye stroke and to determine optimal processes to support research, including exploring barriers and facilitators to successful research participation. Methods We used qualitative methods including the 5Ts Framework (target population identification, team composition, time considerations, tips to accommodate older adults, tools for inclusive enrollment of older adults) to provide a guide to the development of the semi-structured interviews and to help facilitate the research process such as the set-up of interviews. We enrolled three groups: individuals living with the sequelae of eye stroke, care partners, and health care providers. We conducted a descriptive content analysis with an inductive approach. Results Twenty-five people participated. This group included 10 eye stroke survivors (median age, 62.5; range, 56–84 years; 20% were women), 4 care partners (median age, 57 years; range, 56–59 years; 100% were women), and 11 health care providers (median age, 33 years; 25–60 years; 54.5% were women). Four themes emerged from the data: (1) returning to full independence, (2) family support, (3) strategies for participation, and (4) lack of accessibility. Conclusions The themes identified by participant groups indicated that strategies such as providing sufficient lighting and incorporating family support are key for research participation by individuals with vision impairment related to eye stroke. Furthermore, it is essential that researchers determine ways to address inequities, including lack of accessibility to research sites. This work has implications for how research teams develop research processes and implement research findings into clinical settings for eye stroke survivors.

A bibliometric analysis of the development trend of Tuina research: Based on the Web of Science (WOS) platform.

Tuina has been proven to significantly relieve symptoms, demonstrating its clinical value. With the growth of related research, a comprehensive review is urgently needed to promote its development. This study aims to clarify the collaboration and current research status in the field of Tuina research using bibliometric analysis, and to discuss future directions. On February 4, 2023, the Web of Science Core Collection (WoSCC) database was searched using the keywords "tuina," "tui-na," "tui na," and "Chinese massage" to collect literature related to Tuina from its inception until December 31, 2022. The collected literature included all types of research articles and reviews. VOSviewer, CiteSpace, Pajek, and Scimago Graphica were utilized to perform a visual analysis of annual publication volume, as well as publication volume and collaboration networks of different countries, institutions, and authors, along with journal publication volume and keyword network analysis. A total of 761 publications were included in the analysis, with the total number of papers showed an increasing trend over time. The countries and institutions with the most publications were China and Shanghai University of Traditional Chinese Medicine, respectively. The authors who contributed the most were Min Fang, Qingguang Zhu, Zhiwei Wu, Lingjun Kong and Yufeng Wang. The most widely published journal in the field was the Journal of Acupuncture and Tuina Science. The clinical efficacy evaluation of Tuina therapy for musculoskeletal and spinal diseases, apoplexy sequelae, chronic diseases, and pediatric diseases were research hotspots and developing trends in this field. The research on Tuina has been increasing year by year. Currently, the focus of Tuina research lies in clinical studies, including the treatment of skeletal muscle and spinal diseases, stroke sequelae, chronic diseases, and pediatric illnesses, with pediatric Tuina emerging as a hot topic of research. Basic research in this field is relatively scarce, and the mechanisms of action of this therapy have not yet been fully elucidated. Future efforts in this area should aim to strengthen basic research and promote cooperation among international institutions.

Research on the Application of Bundle Nursing Combined with Traditional Chinese Medicine Nursing in Patients with Sequelae of Stroke

Research on the Application of Bundle Nursing Combined with Traditional Chinese Medicine Nursing in Patients with Sequelae of Stroke

Risk factors and predictive models for sequelae of heat stroke primarily involving cerebellar dysfunction

ABSTRACT The occurrence of sequelae is common after heatstroke. There is a lack of risk prediction data regarding the prevalence of sequelae. This study aims to develop a predictive model for the sequelae after heatstroke, including cerebellar dysfunction. Heatstroke patients admitted to our hospital in the past 8 years were retrospectively enrolled. Regression analyses were conducted to identify risk factors associated with sequelae and cerebellar dysfunction. A prediction model for post-heatstroke sequelae was developed and internally and externally validated. Twenty-three percent of the patients experienced sequelae, with cerebellar dysfunction accounting for 51.7%. Patients with sequelae had longer duration of hyperthermia and coma, lower Glasgow Coma Scales scores, elevated core temperature, increased incidence of multiple organ dysfunction upon admission, and a worse prognosis compared to non-sequelae patients. Patients with cerebellar injury exhibited impaired balance, and a Sepsis-related Organ Failure Assessment (SOFA) score > 5 is an independent risk factor. The prediction system included advanced age, coma, and an APACHE-II score > 10 upon admission, predicting sensitivity = 0.8966, specificity = 0.8925, and AUC of ROC curve = 0.941 (95% CI: 0.884 ~ 0.976). The C-index in the internal verification was 0.942 (95% CI: 0.847 ~ 0.981) and the AUC in the external verification was 0.816 (95% CI: 0.699 ~ 0.902). The prediction system included advanced age, coma, and higher APACHE-II scores as variables, indicating a significant prevalence of sequelae. Higher SOFA scores were associated with the increased occurrence of cerebellar dysfunction and balance impairment. The prediction system could better predict sequelae after heatstroke.

Risk of long-term post-stroke dementia using a linked dataset of patients with ischemic stroke without a history of dementia.

Post-stroke dementia (PSD) is a common and disabling sequela of stroke. However, the long-term incidence of PSD after an ischemic stroke and factors which predict its occurrence are incompletely understood. Linkage of large health datasets is being increasing used to study long term outcomes after disease. We used large scale linked data from Korea to determine the long-term incidence of PSD after ischemic stroke, and identify which factors predicted it occurrence. From January 2008 to December 2014, patients with ischemic stroke (n=37,553) without a history of dementia were included in a linked dataset comprising the claims database of the Health Insurance Review and Assessment Service and the Clinical Research Center for Stroke registry data. The outcome measure was PSD after ischemic stroke. Clinical factors evaluated included vascular risk factors, acute stroke management including reperfusion therapy, antithrombotics, and statins, stroke severity, and educational levels, were evaluated. Results: Among 37,553 patients with ischemic stroke without a history of dementia (mean age: 64.9 years; 61.9% males), 6,052 (16.1%) experienced PSD during a median follow-up period of 5 (interquartile range 3.4-7.0) years. The 10 year estimated cumulative incidence of dementia was 23.5%. Age [hazard ratio (HR) 1.82 per 10 years, 95% confidence interval (CI) 1.75-1.88] and a lower educational level [illiteracy or no education HR 1.65 (CI, 1.44-1.88), 0-3 years 1.53 (CI, 1.31-1.79), 4-6 years 1.60 (CI, 1.43-1.80), 7-9 years 1.32 (CI, 1.16-1.49), 10-12 years 1.17 (CI, 1.04-1.32)] were independently associated with an elevated risk of PSD. Male sex was associated with a significantly lower risk of PSD (HR 0.86, CI 0.79-0.92). Diabetes mellitus (HR 1.21, CI 1.14-1.29), a history of stroke before index stroke (HR 1.31, CI 1.21-1.41), and initial National Institutes of Health Stroke Scale (HR 1.03, CI 1.03-1.04) were independent risk factors for PSD. Regarding medications, the use of anticoagulation and antipsychotic medications after stroke appeared to be associated with increased PSD risk whereas statin therapy was associated with a reduced risk. PSD is common with a 5 and 10 year incidence in patients with ischemic stroke without a history of dementia of 16.1% and 23.5% respectively. Factors associated with PSD include age, female sex, lower educational level, diabetes mellitus, initial stroke severity, antipsychotics and anticoagulants. Further studies are required to determine whether reducing those risk factors which are treatable reduces the incidence of PSD.

The perspectives of elderly people hospitalized with hip fractures on their condition and prolonged hospitalization

Hip fractures are the most common cause of hospitalization in orthopaedic wards, and are frequent in the elderly population. There is a high level of morbidity and mortality during hospitalization and it requires urgent treatment. The aim was to analyze the narratives of patients hospitalized with hip fractures, in order to consider the events that led to the fall and their experience of hospitalization. This is a qualitative, descriptive and analytical study carried out at an Urgency and Emergency Hospital in São Luís-MA. Patients hospitalized due to a proximal femur fracture and cognitively able to express themselves verbally were included. Those in ICU/semi-intensive care beds, with senile disease, Alzheimer's, Parkinson's, stroke sequelae and cognitive impairment were excluded. Participant observation and semi-structured interviews were used, based on the thematic analysis proposed by Minayo. The sample included 12 women and 3 men, with an average age of 71, minimum of 60 and maximum of 85. The complaint of pain was described as a near-death experience. Prolonged hospitalization was a factor in the users' negative evaluation of the hospitalization, as well as the ward environment and the privacy between beds. Patients hospitalized for more than 30 days do not know the name of the doctor, nurse or nursing technician. There is no privacy in the 04-patient ward for bathing in bed or for physiological needs, which are taken care of by a companion, if there is one. There is a change, at the end of the second week, to a more depressed mood.

Safety assessment of Gami-daebo-tang gagambang used for treating stroke sequelae

Objectives: This study aimed to investigate wheter Gami-daebo-tang gagambang, commonly used for treating stroke sequelae, induces acute toxicity or genetoxicity.Methods: Gami-daebo-tang gagambang contains that the root of <i>Angelica gigas Nakai</i> inducing acute headache and weakness, and the rhizome of <i>Cnidium officinale</i> MAKINO, an herb with potential teratogenicity. Teratogenicity is closely associated with genotoxicity. We analyzed whether Gami-daebo-tang gagambang induces acute toxicity and genotoxicity in accordance with Korean non-clinical test standards and OECD test guidelines TG471, TG473, TG474.Results: When male and female rats were given a single dose of Gami-daebo-tang gagambang, no toxic effects or organ damage were observed at dosages reaching 2,500 mg/kg. The bacterial reverse mutation assay showed no evidence of DNA mutations at concentrations up to 5,000 <i>μ</i>g/plate. In vitro studies indicated that Gami-daebo-tang gagambang did not cause structural or numerical chromosomal aberrations at concentrations as high as 2,000 <i>μ</i>g/mL. Moreover, animal studies demonstrated that the substance did not induce bone marrow toxicity or the formation of micronuclei in erythrocytes at doses up to 2,000 mg/kg.Conclusions: The studies conducted with different models showed that Gami-daebo-tang gagambang did not cause acute toxicity or genotoxicity. This study provides evidence for the safety of Gami-daebo-tang gagambang in terms of acute toxicity and genotoxicity, supporting its potential safe application in treating stroke sequelae.

The Multitarget Action of Vitamins in the Ischemic Stroke.

A stroke, also known as a cerebral hemorrhage, occurs when there is an interruption in the blood supply to a part of the brain, resulting in damage to brain cells. This issue is one of the leading causes of death in developed countries, currently killing about 5 million people annually. Individuals who survive ischemic stroke often face serious vision problems, paralysis, dementia, and other sequelae. The numerous efforts to prevent and/or treat stroke sequelae seem insufficient, which is concerning given the increasing global elderly population and the well-known association between aging and stroke risk. In this review, we aim to present and discuss the importance of vitamins in stroke prevention and/or incidence. Vitamins from diet or dietary supplements influence the body at various levels; they are a relevant factor but are reported only in isolated articles. This review reports and updates the multitarget role of vitamins involved in reducing stroke risk.

Ideas of acupuncture diagnosis and treatment of stroke sequela based on the differentiation of disease location

Through collecting the relevant records of "brain" in ancient traditional Chinese medicine literature, the potential structure and function of the "motor system of brain-meridian-muscle region" and "perception system of brain-meridian-cutaneous region" of the human body are analyzed preliminarily. In view of the characteristics of the symptoms of stroke sequela, focusing on the differentiation of disease location and associated with the identification of disease property, the pathogenesis of stroke is determined, "malnutrition of the sea of marrow, dysfunction of meridian muscle region and disharmony of the nutrient and the defensive in the meridian cutaneous region", while, the basic principle of treatment is formulated, "filling up the marrow, replenishing the brain, regulating meridian muscle regions, tonifying qi and facilitating blood circulation in meridians and collaterals". Based on the above, the acupoints selected in treatment and the techniques of acupuncture and moxibustion are clarified. This article presents the references for the clinical practice of acupuncture and moxibustion and provides the individual therapeutic regimen for stroke patients.

ATIVIDADE E PARTICIPAÇÃO SOCIAL: ANÁLISE DE CORRELAÇÃO EM PACIENTES HEMIPARÉTICOS CRÔNICOS

The International Classification of Functioning, Disability and Health (ICF) defines activities as actions performed by an individual, while social participation refers to involvement in life situations. The use of participation assessment questionnaires allows investigating the impact of these chronic conditions on functionality. In this cross-sectional study, ten individuals with chronic stroke sequelae were recruited. Activity and social participation were assessed using the Brazilian version of the Assessment of Life Habits 3.1. The results showed that nutrition-related activities had a significant positive correlation with community living (rs=0.7, p=0.02) and recreation (rs=0.7, p=0.01), while personal care and housing correlated significantly with responsibility (rs=0.6, p=0.02). Housing had a positive correlation with employment (rs=0.6, p=0.02) and recreation (rs=0.7, p=0.02). The positive correlations observed in this study suggest that better performance in activities is associated with better levels of social participation.

Progress and development trends of lower limb exoskeleton rehabilitation robots

Abstract. Currently, as the aging population intensifies, many elderly people are trapped by lower limb dysfunctions caused by diseases such as stroke sequelae, spinal cord injuries, and bone injuries. Research on lower limb exoskeleton robots has made progress both domestically and internationally. Foreign lower limb exoskeleton robot technology is very mature and widely applied; although starting later, domestic development in this field has been rapid. This paper studies the key technologies of lower limb exoskeleton robots from several aspects: the degrees of freedom in human lower limb movement, the cyclic movement of human gait, structural design, driving methods, and interactive control. With the continuous advancement of technology, lower limb exoskeleton robots will become more intelligent and focus more on personalized services and wearing comfort in future development, aiming to bring more convenience and help to disabled individuals, rehabilitation patients, and groups with special needs.

Gullian Barre syndrome secondary to heat stroke: a case report.

Heat waves are increasingly common in subcontinent countries, including Pakistan. Heat stroke (HS) is a critical condition resulting from extreme temperatures, often culminating in multiorgan dysfunction. Clinical manifestations of heat-related emergencies can include altered mentation, fever, and profound weakness. We present a compelling case of a previously healthy 49-year-old male who developed altered mentation, fever, and acute kidney injury following intense physical exertion amidst a severe heat wave. Although initially managed as heat stroke, the patient soon exhibited dysarthria, palatal weakness, and bilateral lower limb weakness with areflexia, prompting a detailed neurological assessment. Electromyography and nerve conduction studies revealed the acute motor-sensory axonal neuropathy (AMSAN) variant of Guillain-Barré Syndrome (GBS), an uncommon but severe sequel of heat stroke. GBS, an autoimmune disorder, typically presents with ascending bilateral lower limb flaccid paralysis, often following an acute infectious trigger. Treatment with plasmapheresis led to remarkable neurological recovery. This case represents the first documented instance of heat stroke-induced GBS in Pakistan, highlighting both the distinctive clinical features and the therapeutic complexities of this rare condition.

Not So Transient?: A Narrative Review on Cognitive Impairment After Transient Ischemic Attack.

Transient ischemic attack (TIA) is traditionally viewed as a self-resolving episode of neurological change without persistent impairments and without evidence of acute brain injury on neuroimaging. However, emerging evidence suggests that TIA may be associated with lingering cognitive dysfunction. Cognitive impairment is a prevalent and disabling sequela of ischemic stroke, but the clinical relevance of this phenomenon after TIA is less commonly recognized. We performed a literature search of observational studies of cognitive function after TIA. There is a consistent body of literature suggesting that rates of cognitive impairment following TIA are higher than healthy controls, but the studies included here are limited by heterogeneity in design and analysis methods. We go on to summarize recent literature on proposed pathophysiological mechanisms underlying the development of cognitive impairment following TIA and finally suggest future directions for further research in this field.

Predictors of Poststroke Fatigue in Stroke Patients: A Prospective Cohort Study

ABSTRACTPoststroke fatigue (PSF) is a common, underestimated sequel of stroke that affects the quality of life of patients. In this study, the authors investigate the prevalence of PSF in three equal groups: control, ischemic, and hemorrhagic stroke patients. Some of the multidimensional factors that predict PSF are examined, and the implications for improvement of stroke management are highlighted.

Post-Stroke Dysarthria Voice Recognition based on Fusion Feature MSA and 1D

Post-stroke Dysarthria (PSD) is one of the common sequelae of stroke. PSD can harm patients’ quality of life and, in severe cases, be life-threatening. Most of the existing methods use frequency domain features to recognize the pathological voice, which makes it hard to completely represent the characteristics of pathological voice. Although some results have been achieved, there is still a long way to go for practical applications. Therefore, an improved deep learning-based model is proposed to classify between the pathological voice and the normal voice, using a novel fusion feature (MSA) and an improved 1D ResNet network hybrid bi-directional LSTM with dilated convolution (named 1D DRN-biLSTM). The experimental results show that our fusion features bring greater improvement in pathological speech recognition than the method that only analyzes the MFCC features, and can better synthesize the hidden features that characterize pathological speech. In terms of model structure, the introduction of dilated convolution and LSTM can further improve the performance of the 1D Resnet network, compared to ordinary networks such as CNN and LSTM. The accuracy of this method reaches 82.41% and 100% at the syllable level and speaker level, respectively. Our scheme outperforms other existing methods in terms of feature learning capability and recognition rate, and will help to play an important role in the assessment and diagnosis of PSD in China.

Analysis of the impact of underlying diseases in the elderly on postoperative re-fractures after osteoporotic compression fractures

BackgroundPostoperative refracture of osteoporotic compression fractures in the elderly due to underlying illnesses is a complicated matter involving several variables. A multidisciplinary approach involving orthopedics, geriatrics, endocrinology, and rehabilitation medicine is necessary for an investigation of these issues. investigating the impact of older patients’ underlying medical conditions on the refracture of osteoporotic compression fractures following surgery.MethodsA retrospective analysis was conducted on 2383 patients between August 2013 and August 2023. 550 patients with comorbid geriatric underlying diseases were screened, 183 patients underwent refractories, and 367 patients were classified as non-refractories. The patients were then divided into two groups: those undergoing refractories and those not, and the underlying diseases of the patients in both groups were examined using ROC curves and unifactorial and multifactorial logistic regression analyses.ResultsAmong the patients gathered, the frequency of re-fracture was 33.3%. A statistically significant difference was observed when re-fracture was linked to patients with long-term alcohol consumption, operated vertebrae ≤ 1, hypertension, COPD, diabetes mellitus, stroke sequelae, conservative treatment of coronary heart disease, trauma, mental abnormality, scoliosis, and chronic renal disease. Having hypertension decreased the risk of re-fracture (P = 0.018, OR = 0.548), while alcohol intake ≥ 10years (P = 0.003, OR = 2.165), mental abnormality (P < 0.001, OR = 4.093), scoliosis (P < 0.001, OR = 6.243), chronic kidney disease (P = 0.002, OR = 2.208), and traumatic injuries (P = 0.029, OR = 3.512) were the risk factors examined in a binary logistic regression analysis. The results of multiple linear stepwise regression analysis indicated that re-fracture was more influenced by scoliosis.ConclusionsHypertensive disorders were protective factors against the formation of re-fracture, while alcohol intake usage for more than ten years, psychological abnormalities, scoliosis, chronic kidney disease, and trauma were risk factors. Scoliosis had the highest influence on re-fracture.

Clinical Measures for Tone Assessment in Adults with Central Nervous System Disorders—A Scoping Review in a Rehabilitation Context

Assessment of muscle tone in a clinical setting is important for the physiotherapist to better analyse and establish appropriate treatments for CNS disorders. This study aims to review and summarise how to assess changes in tone in the context of adult rehabilitation. Secondarily, this study aimed to identify the central nervous system disorders, the respective variable/concept under study, and the testing procedures employed. PRISMA-ScR guidelines were followed using the “population”, “concept”, and “context” to define the eligibility criteria and to delineate the research question. PubMed®, Science Direct®, Web of Science™, and Google Scholar® databases were used to search the literature. The search included studies published between 2011 and March 2023 in Portuguese, English, French, and Spanish that assessed an adult population (&gt;19 years) with CNS injury. Review articles, qualitative studies, conference proceedings, letters to the editor, and editorials were excluded. Initially, 1519 references were identified, of which eight met the eligibility criteria. The measurement instruments included the Modified Ashworth Scale (n = 5), the Modified Modified Ashworth Scale (n = 3), the BioTone™ system (n = 2), the Montreal Spasticity Measurement (n = 1), and the Tone Evaluation Scale (n = 1). The health conditions considered included stroke sequelae (n = 7), multiple sclerosis (n = 4), spinal cord injuries (n = 4), cerebral palsy (n = 2), brain tumour (n = 2), and traumatic brain injuries (n = 3). The concepts of spasticity (n = 7) and muscle tone (n = 2) were explored. Considering the variables spasticity and muscle tone in different CNS disorders, mainly stroke, subjective instruments were preferred compared to objective ones, with the Modified Ashworth Scale being highlighted.

Research Progress on the Combination of Acupuncture and Drugs for Treating Sequelae of Stroke

Research Progress on the Combination of Acupuncture and Drugs for Treating Sequelae of Stroke

Global research trends in acupuncture treatment for post-stroke depression: A bibliometric analysis

ObjectivePost-stroke depression (PSD) is a prevalent and severe sequela of stroke. It is an emotional disorder that significantly impacts functional recovery, prognosis, secondary stroke risk, and mortality among stroke survivors. The incidence rate of PSD is 18 %∼33 %, with symptoms such as low mood, decreased interest, sleep disorders, decreased appetite, impaired attention, and in severe cases, hallucinations and even suicidal tendencies. While diverse therapeutic modalities are employed globally to address PSD, each approach carries its inherent advantages and limitations. Notably, acupuncture stands out as a promising and effective intervention for ameliorating PSD symptoms and enhancing stroke prognosis. This study aims to conduct a bibliometric analysis to scrutinize the current landscape, identify hotspots, and explore frontiers in acupuncture research for PSD. MethodsA systematic search for acupuncture and PSD-related research was conducted from January 2014 to October 2023 on the Web of Science Core Collection (WoSCC). The data were downloaded and processed using Bibliometrix and VOSviewer to generate knowledge visualization maps. ResultsA total of 11,540 articles related to acupuncture and PSD were retrieved. China emerged as the leading contributor with the highest volume of articles on acupuncture and PSD. Author Liu CZ attained the highest H-index, focusing primarily on investigating the compatibility effects and mechanisms of acupoints. Common hotspot keywords included pain, stimulation, mechanisms, complementary, and alternative medicine. The main research frontiers were mechanisms, neuroinflammation, gut microbiota, and therapeutic methods. ConclusionThis study offered multifaceted insights into acupuncture for PSD, unveiling pivotal areas, research hotspots, and emerging trends. The findings aimed to guide researchers in exploring novel research directions and selecting appropriate journals for advancing the understanding and treatment of PSD through acupuncture interventions.

Dementia after Ischemic Stroke, from Molecular Biomarkers to Therapeutic Options.

Ischemic stroke is a leading cause of disability worldwide. While much of post-stroke recovery is focused on physical rehabilitation, post-stroke dementia (PSD) is also a significant contributor to poor functional outcomes. Predictive tools to identify stroke survivors at risk for the development of PSD are limited to brief screening cognitive tests. Emerging biochemical, genetic, and neuroimaging biomarkers are being investigated in an effort to unveil better indicators of PSD. Additionally, acetylcholinesterase inhibitors, NMDA receptor antagonists, dopamine receptor agonists, antidepressants, and cognitive rehabilitation are current therapeutic options for PSD. Focusing on the chronic sequelae of stroke that impair neuroplasticity highlights the need for continued investigative trials to better assess functional outcomes in treatments targeted for PSD.