Stress In Stroke Patients Research Articles

The Effect of Five-Finger Relaxation Technique on Anxiety and Stress in Non-Hemorrhagic Stroke Patients at the Inpatient Installation of RSUD Cimacan Cianjur District

Aims: The purpose of this study was to examine the effect of five-finger relaxation technique on anxiety and stress in hemorrhagic stroke patients at Cimacan Hospital. Methods: This study used quasi-experiment with nonequivalent control group design. Sample collection using purposive sampling. The sample was 40 people and divided into two groups with 20 people each for the intervention group and control group. Data analysis using Paired Sample T-Test and Independent Sample T-Test. Results: The results showed that after the five-finger relaxation technique was performed on the intervention group, there was a decrease in anxiety levels (p = 0.000) and stress (p = 0.000) in stroke patients, while in the control group there was a decrease in anxiety (p = 0.000) and stress (p = 0.000), and there was a difference between anxiety levels (p = 0.000) and stress (p = 0.000) in the intervention and control groups. Conclusion: There is an effect of five-finger relaxation technique on anxiety and stress in non-hemorrhagic stroke patients, and there are differences in anxiety and stress in the control and intervention groups. It is hoped that this five-finger relaxation technique can be used as an evidence base nursing on non-pharmacological treatment as a form of independent nursing intervention by a nurse in providing nursing care to help in the process of reducing anxiety and stress in stroke patients.

Topical issues of nutritional support for patients with acute cerebrovascular accident

The incidence of malnutrition in stroke patients varies widely and amounts to 6.1–62%. Risk factors for malnutrition in stroke patients are diverse and include the type and severity of stroke, gender, age, dysphagia, cognitive impairment, polysensory insufficiency, severe comorbid conditions, lack of adequate care, etc. At the same time, both the previous and the malnutrition that developed as a result of the stroke is the reason for a longer stay in the hospital, deterioration of functional results and an increase in mortality rates. The metabolic response to stress in stroke patients is represented by the hypermetabolism-hypercatabolism syndrome and is an essential component of the systemic inflammatory response, the development and progression of which leads to infectious complications, multiple organ dysfunction, increased hospitalization and increased mortality. Currently, clinical nutrition, or nutritional support (NS), is considered not only as a process of providing the body with energy and plastic material for the prevention and treatment of malnutrition, but also as an opportunity to influence structural, functional and metabolic processes in order to increase the adaptive reserves of the body, which is necessary for the recovery and rehabilitation of patients. The objectives of this review are the analysis of modern scientific data on clinical nutrition strategies and the development of an optimal algorithm of actions for the implementation of NS in clinical practice in the treatment and rehabilitation of stroke patients.

Oxidative Stress Status in Post Stroke Patients: Sex Differences.

After a cerebral stroke insult, there is an overproduction of Reactive Oxygen Species (ROS), which overcome the antioxidant defenses, causing further tissues damage. The status of oxidative stress in stroke patients over time, particularly in those undergoing rehabilitation treatments, has been poorly investigated. We analyzed the oxidative stress status in 61 subacute stroke patients (33 females and 28 males) admitted to our rehabilitation center by measuring, in serum: hydroperoxides levels (d-ROMs), antioxidant activity (BAP test), and the relative antioxidant capacity (OSI index). We also analyzed patients for glucose levels and lipid profile. In addition, we analyzed the correlation between oxidative stress status biomarkers and motor deficits, disability, and pain. Almost all patients showed high or very high levels of d-ROMs, while BAP levels were apparently in the reference range of normality. Females had lower BAP values (females: 2478 ± 379; males: 2765 ± 590; p = 0.034) and lower OSI index (females: 5.7 ± 1.9; males: 6.8 ± 1.9; p = 0.043). Moreover, in the male group, the correlation with motor impairment and disability showed a worsened motor performance when oxidative stress is higher. Female group, on the other hand, had an unexpected different trend of correlation, probably due to an unbalanced systemic oxidative stress. Further research is needed to see if sex differences in oxidative stress status in subacute stroke patients persist after rehabilitation.

Haematological Indices and Antioxidant Enzyme Activity in Ghanaian Stroke Patients.

Background Stroke is a cardiovascular disorder causing mortality globally and long-lasting harm worldwide. The disease occurs when the blood flow to the brain is either interrupted or blocked. This disruption leads to the increase in reactive oxygen species (ROS), especially superoxide free radicals, resulting in oxidative stress. The superoxide radicals are removed by superoxide dismutase (SOD), a key antioxidant enzyme. In this work, we investigated haematological indices and superoxide dismutase enzyme activity in Ghanaian patients with stroke and healthy control participants. Materials and Methods Thirty stroke patients attending a stroke clinic and thirty apparently healthy control participants were recruited into the study. Blood samples were collected to determine haematological indices and SOD enzyme activity in red blood cells. Results The stroke patients had significantly high blood parameters such as white blood cell (p < 0.001), neutrophil (p < 0.001), lymphocyte (p = 0.003), and eosinophil (p < 0.001) comparing with study participants without stroke, who were the control group in the study. Other blood parameters such as red blood cell, (p < 0.001), haemoglobin (p < 0.001), and haematocrit (p < 0.001) levels and mean cell haemoglobin concentration (p = 0.030), platelet (p = 0.010), and plateletcrit (p = 0.027) were high in stroke patients comparing with study control participants and statistically significant. Blood lymphocyte levels observed in stroke patients correlated negatively and significantly with SOD activity levels. SOD activity levels were significantly lower in stroke patients compared with the control group (p < 0.001). Low values of the antioxidant enzyme SOD activity levels, lymphocytes, and high values of plateletcrit were significant predictors of stroke. Conclusion Haematological parameters such as WBC, lymphocyte, platelet levels, and red cell indices were significantly different in the stroke patients being studied. There was negative correlation between lymphocyte significantly with SOD activity and high oxidative stress in stroke patients compared with the control group. Lymphocytes and plateletcrit levels were also good predictors of the occurrence of stroke.

The Overexpression of Sonic Hedgehog Associates with Collateral Development and Amelioration of Oxidative Stress in Stroke Patients

PurposeSonic hedgehog (SHH) signaling pathway in oxidative stress condition has been acknowledged as a key trigger for angiogenesis and collateral vessel growth in the ischemic brain, and it exerts a protective effect on neuronal cells during oxidative stress. MethodsA total of sixty patients (n = 30 good collateral profile and n = 30 poor collateral profile) diagnosed with acute cerebral ischemia were enrolled in this study. qRT-PCR was performed to analyze the expression levels of SHH, Gli1, and superoxide dismutase (SOD), genes. Also, the serum levels of oxidative stress markers were determined in experimental groups. ResultsThe expression levels of SHH and Gli1 genes were significantly (p < 0.05) higher in stroke patients with good collateral circulation compared with those with poor collateral circulation, while SOD gene expression was similar between two groups (p > 0.05). A significantly positive correlation was found between the gene expression of SHH and Gli1 (r = 0.604, p < 0.001), SOD and Gli1 (r = 0.372, p < 0.003) genes. Our findings showed that the serum level of total antioxidant capacity (TAC) and Glutathione (GSH) and SOD enzyme activity was significantly (p < 0.05) increased, while serum total oxidant status (TOS) and malondialdehyde (MDA) levels were significantly (p < 0.05) decreased in patients with good collateral circulation as compared with those with poor collateral circulation. ConclusionOur observations shed light on the association of the SHH/Gli1 signaling pathway with cerebral collateral vessel development following ischemia. Oxidative stress in stroke patients with poor collateral circulation may result in the overexpression of SHH/Gli1 signaling pathway which possibly contribute to oxidative stress attenuation, as well as modulate angiogenesis and collateral vessels development.

Depression, Anxiety, and Stress in Stroke Patients in Lhokseumawe City, Indonesia

Strokes or disorders of the neurovascular system continue to increase, leading to increased disability and death rates. This research aims to determine the level of depression, anxiety, and stress of stroke patients at the Lhokseumawe Hospital. A cross-sectional design with a total sample of 113 respondents was used. Furthermore, to measure the level of depression, anxiety, and stress, the Depression Anxiety Stress Scale (DASS-21) questionnaire consisting of 21 questions with a Likert scale of 0-3 was used. The results showed that the majority of respondents experienced mild depression (34.5%), moderate anxiety (55.8%), and normal stress levels (33.6%). Therefore, health services should investigate patients' mental health with chronic diseases such as stroke to avoid persistent complications.

Salivary Gland Dysfunction in Stroke Patients Is Associated with Increased Protein Glycoxidation and Nitrosative Stress.

Stroke is one of the leading causes of disability and death worldwide. Despite intensive medical care, many of the complaints directly threatening the patient's life marginalize their dental needs after the stroke. Recent studies indicate reduced saliva secretion in stroke patients in addition to the increased incidence of caries and periodontal disease. Since oxidative stress plays a vital role in the pathogenesis of salivary gland hypofunction and neurodegenerative disorders (including stroke), this is the first to evaluate the relationship between salivary gland activity and protein glycoxidation and nitrosative damage. The content of glycation and protein oxidation products and nitrosative stress was assessed in nonstimulated (NWS) and stimulated (SWS) whole saliva of stroke patients with normal salivary secretion and hyposalivation (reduced saliva production). The study included 30 patients in the stroke's subacute phase and 30 healthy controls matched by age and sex. We have shown that stroke patients with hyposalivation show increased contents of protein glycation (↑Amadori products and ↑advanced glycation end products), glycoxidation (↑dityrosine), and nitration (↑nitrotyrosine) products compared to stroke cases with normal salivary secretion and control group. Interestingly, higher oxidative/nitrosative stress was found in NWS, which strongly correlates with salivary flow rate, total protein content, and salivary amylase activity. Such relationships were not observed in the control group. Summarizing, oxidative and nitrosative stress may be one of the mechanisms responsible for the impairment of saliva secretion in stroke patients. However, extraglandular sources of salivary oxidative stress in stroke patients cannot be excluded. Further studies to assess salivary gland hypofunction in stroke cases are necessary.

PSYCHOLOGICAL RESPONSE (STRESS) IN STROKE PATIENTS WITH PHYSIOTHERAPY PROGRAMS

Strokes can occur at any age, but the number of strokes increases with age. Stroke is caused by disruption of blood flow to the brain, usually because blood vessels rupture or are blocked by blood clots thereby cutting off the supply of oxygen and nutrients that cause damage to brain tissue. The purpose of this study is to describe the symptoms of stress in stroke patients. Data collection uses observation and interviews. Data validation techniques using triangulation of data sources and methods. The data analysis technique uses an interactive model of qualitative analysis. The results found that stroke sufferers generally experience stress, which is caused by the mind and mood, which is thinking about a disease that does not go away, and must be forced to depend on others when doing daily activities. Stress in stroke patients can be seen from physical, emotional, and behavioral signs. To reduce stress as well as an effort to relieve or cure a stroke, one with behavioral therapy is based on learning theory, and perform self-improvement psychologically or mentally, physically and socially, as well as spiritually.

Evaluating the Role of Oxidative Stress in Acute Ischemic Stroke.

Background The role of oxidative stress in neuronal injury due to ischemic stroke has been an interesting topic in stroke research. Malondialdehyde (MDA) has emerged as a sensitive oxidative stress biomarker owing to its ability to react with the lipid membranes. Total antioxidant power (TAP) is another biomarker to estimate the total oxidative stress in stroke patients. We aimed to determine the oxidative stress in acute stroke patients by measuring MDA and TAP. Materials and Methods MDA and TAP were determined in 100 patients with ischemic stroke and compared with that in 100 age- and sex-matched healthy adults. Demographic data, stroke severity measured by the National Institutes of Health Stroke Scale (NIHSS), and disability measured by the Barthel index (BI) were recorded. The association of MDA and TAP with other variables was analyzed by paired t -test. Results Of the whole sample, 74% represented males. The mean NIHSS score was 13.11 and BI was 38.87. MDA was significantly higher in stroke patients (7.11 ± 1.67) than in controls (1.64 ± 0.82; p = 0.00). TAP was significantly lower in stroke patients (5.72 ± 1.41) than in controls (8.53 ± 2.4; p = 0.00). The lipid profile and blood sugar levels were also significantly higher in stroke patients. There was no association of MDA and TAP with other variables. Conclusion We found that oxidative stress was associated with acute ischemic stroke. However, we could not establish an association between oxidative stress and the severity of acute stroke.

Evaluation of Oxidative Stress and Antioxidant Level of Stroke Patients in Osun State, South-Western Nigeria

Stroke is a leading cause of morbidity and mortality worldwide. Oxidative stress which is as a result of increased activity of free radicals and decreased antioxidant mechanism plays a major role in the pathogenesis of stroke. This study determined the plasma level of malondialdehyde (MDA), a marker of lipid peroxidation and oxidative stress and enzymatic Antioxidants namely, superoxide dismutase (SOD), Glutathione peroxidase (GPx), and Catalase (CAT) in sixty stroke patients of both sexes attending Wesley Guide Hospital, Obafemi Awolowo University Teaching Hospital, Ilesa, Osun State. An equal number of healthy subjects were used as control. The result of this study revealed a significantly (p < 0.05) high plasma level of MDA in stroke patients when compared with the control subjects. Plasma level of SOD in stroke patients was significantly higher (p < 0.05) than the control subjects while plasma GPx and CAT level were found to be significantly lower (p < 0.05) in stroke patients than the control subjects. The result of the study indicated high level of lipid peroxidation and oxidative stress in stroke patients and high degree of free radicals presence as indicated by the high level of SOD.

Female Caregivers and Stroke Severity Determines Caregiver Stress in Stroke Patients.

Background:Stroke is among the major causes of short- and long-term disability. This study aimed to understand the caregivers (CGs) stress in stroke survivors.Materials and Methods:A 22-item questionnaire was administered to 201 CGs of stroke survivors. The variables tested were physical and mental health, social support, financial, and personal problems. CGs were divided into Group A (Barthel index [BI] <75) and B (BI >75) according to patient's BI, according to gender (male and female CG) and relation; spouses (wife, husband), daughters, sons, daughter-in-law, grandchildren, and rest (father, mother, brother, sister, and in-laws). Data were analyzed using SPSS software version–21. Data were analyzed to determine which variables of the patient effects the CG stress.Results:Majority of the CGs (74.62%) were females. 65% of CGs graded their burden as moderate to severe. 81% of CGs had left their work for caregiving. More than half of the CGs felt sleep disturbance and physical strain. Psychological instability and financial burdens were reported in 3/4th of CGs. Group A CGs faced more sleep, financial, health, and social life disturbance. Patient's bladder and bowel problems, shoulder pain, patients noncooperative attitude for medication administration, and physiotherapy were more upsetting for Group A CGs. Female CGs were subjected to more sleep disturbance, physical and psychological stress, faced more difficulty regarding the patient's bladder, bowel, personal hygiene needs, and physiotherapy. Female CGs felt less motivated in caregiving than male CGs. Wives and daughters-in-law experienced more burden. Time spent and burden perceived was more by female CGs (χ2 = 15.199, P = 0.002) than males (χ2 = 11.931, P = 0.018); wives and daughters than other relations (χ2 = 32.184, P = 0.000), (χ2 = 35.162, P = 0.019).Conclusion:Our study showed that caregiving burden was predominantly shouldered by females CGs. CGs faced physical, psychological, and socioeconomic burden. The burden was more evident in female CGs and in patients with severe stroke.

Effects of Augmented Reality Games on the Upper Extremity Function and Stress of Stroke Patients

To examine the effects of an augmented reality game on upper extremity function and stress in stroke patients with upper extremity function difficulty. Twenty stroke patients were randomized into a control group of 10 subjects and an experimental group of 10 subjects. The control group received conventional occupational therapy, while the experimental group received the same conventional occupational therapy as for the control group but also played an augmented reality game for 30 minutes per session, three times a week over the course of 8 weeks. The subjects were evaluated using the manual function test (MFT) and CMS-10 (Compact Measuring System) for their upper extremity functions and using the stress scale for psychological factors before and after the intervention. MFT showed significant differences before and after the experiment in both groups (p .05). The range of motion of the elbow joint showed significant differences before and after the experiment in the experimental group only (p<.05). The intragroup and intergroup changes in stress showed significant differences before and after the experiment only in the experimental group (p<.05). The findings of this study revealed that augmented reality games are effective in the improvement of upper extremity function and reduction of stress in stroke patients.

비디오 게임을 이용한 재활운동이 뇌졸중 편마비 환자의 상지 관절가동 범위와 통증, 스트레스에 미치는 효과

Purpose: This study was to evaluate the effects of rehabilitation training using video game on improvement range of motion for upper -extremity, shoulder pain and stress in stroke patients with hemiplegia. Methods: The study utilized nonequivalent control group non-synchronized design. Participants are sampled from a group of people who are hospitalized in rehabilitation medicine ward at 'K' university hospital in 'S' city from January 1st 2011 to October 31th. Each 28members of control group and experimental group, total 56members were participated. One task is for 10minutes, and the video game for total 30minutes performed 5 times a week, for 3weeks. Data were analyzed by SPSS WIN 17.0. Results: The range of motion for upper-extremity in experimental group was significantly different from that in control group(shoulder flexion t=7.70, <TEX>$p$</TEX> <.001, extension t=7.80, p<.001, abduction t=6.95, <TEX>$p$</TEX> <.001, elbow flexion t=6.47, <TEX>$p$</TEX> <.001). The shoulder pain score in experimental group was significantly different from that in control group(t=-14.58, <TEX>$p$</TEX> <.001). The level of stress in experimental group was significantly different from that in control group(t=-4.89, <TEX>$p$</TEX> <.001). Conclusion: The result proved that rehabilitation training using video game was an effective stroke patients to increase in range of motion for upper-extremity and decrease in the shoulder pain, stress.

Agreement between information provided by stroke patients and their relatives on psychophysical and vascular risk factors

BackgroundIn studies examining vascular risk factors and the effects of stress in stroke patients, information sometimes has to be provided by a close relative. ObjectivesThe present study was designed to assess agreement between the information provided by a stroke patient and his/her next-of-kin or other close relative on prior vascular risk factors and situations of psychophysical stress based on a standardized interview within 72h after stroke. DesignCase–control observational study. Participants and settingsAll patients with incident stroke aged 18–65 years admitted to our centre were enrolled as cases, and their coinhabiting relatives as controls. The study was conducted from January to June 2008. MethodsA structured questionnaire about vascular risk factors and psychophysical stress factors were obtained from the participants within 72h after stroke. Subjects were required to grade themselves or their relatives using validated Spanish versions of the Life Events Stress Scale of Holmes and Rahe, Goldberg's General Health Questionnaire GHQ-28 and the SF-12 Health Survey, as well as the Spanish Type A Behaviour Scale. The questionnaires were self-administered. Cases and controls completed the same questionnaires and which were administered with a time difference of no longer than 24h between the two groups of subjects. Risk factors were analyzed by determining kappa statistics and interclass correlation coefficients (ICC). Bland–Altman plots were used to examine the scores obtained in graded scales. Results25 patients and 25 relatives were recruited. Agreement between cases and controls was good for reported atrial fibrillation, diabetes, alcohol consumption and smoking (range 0.83–1.0). ICC were low for the questionnaires Holmes–Rahe Life Events (0.26; 95%CI: 0.08-0.57), General Health GHQ-28 (0.39; 95%CI: 0.03–0.67) and SF12 Health Survey (0.52; 95%CI: 0.16–0.76 and 0.35; 95%CI: 0.06–0.66), and good for the Type A Behaviour Scale ERCTA (0.62; 95%CI: 0.32–0.81). ConclusionsThe information obtained from family members on patient risk factors could be considered reliable, while that related to psychophysical aspects was not sufficiently reliable for research purposes. Agreement assessments could be useful to avoid misclassification biases.

The effects of long-term aerobic and resistance combined exercise training on cardiovascular risk factors and oxidative stress in stroke patients

The effects of long-term aerobic and resistance combined exercise training on cardiovascular risk factors and oxidative stress in stroke patients

Treatment with the Iron Chelator, Deferoxamine Mesylate, Alters Serum Markers of Oxidative Stress in Stroke Patients

The iron chelator, deferoxamine mesylate (DFO), has shown neuroprotective effects, mediated via suppression of iron-induced hydroxyl radical formation, in various animal models of ischemic and hemorrhagic stroke. Therefore, the objective of this study was to investigate whether DFO can exert similar actions in stroke patients, by examining the effects of treatment with DFO on biological markers of oxidative stress, namely serum total hydroperoxides and lipoperoxides and total radical trapping antioxidant capacity (TRAP), in stroke patients. We found that serum levels of peroxides were reduced, and TRAP levels increased after a 3-day treatment with DFO (500mg). These findings provide a preliminary proof of concept that DFO can exert potential antioxidant neuroprotective effects in stroke patients. Future, larger-scale, randomized, and controlled studies to further evaluate the safety and efficacy of DFO in patients with stroke are warranted.

Raised plasma oxidised LDL in acute cerebral infarction

Background: The association between oxidised low density lipoprotein (OxLDL) and cerebral infarction is suspected but not established. Objectives: To determine whether plasma OxLDL is a useful marker for monitoring oxidative...

Effect of Oncotic Pressure of Diaspirin Cross-Linked Hemoglobin (DCLHb Trademark) on Brain Injury After Temporary Focal Cerebral Ischemia in Rats

Effect of Oncotic Pressure of Diaspirin Cross-Linked Hemoglobin (DCLHb Trademark) on Brain Injury After Temporary Focal Cerebral Ischemia in Rats