Stroke Duration Research Articles

EVALUATION OF FUNCTIONALITY, DEPRESSION AND QUALITY OF LIFE IN HEMIPLEGIC PATIENTS DURING COVID-19 PANDEMIC

OBJECTIVE: The aim of this study was to investigate the changes of the functionality, mood and life quality of patients diagnosed with hemiplegia due to an ischemic or hemorrhagic stroke during the COVID-19 pandemic. MATERIAL AND METHODS: A total of 83 patients (mean age, 62.0±6.43 years) diagnosed with hemiplegia due to stroke, who received 30 sessions of rehabilitation therapy, before the COVID-19 pandemic, were included in this study. Data regarding the participants’ age, gender, body mass index (BMI), duration of stroke, stroke type, affected side, and education level were recorded. All the assessments were undertaken before the COVID-19 pandemic and repeated at the first year after the beginning of the pandemic. The functional status of the patients was evaluated with the Functional Independence Measure (FIM). The depression levels of the participants were evaluated using the Beck Depression Inventory (BDI). The life quality of the participants was evaluated using the Stroke-Specific Quality of Life Scale (SS-QOL). RESULTS: There were significant differences in the FIM total scores of the patients evaluated before and during COVID-19 (91.32±15.94 and 87.15±15.60, respectively, p<0.001).When the FIM domain scores were evaluated before COVID-19 and at the first-year control during COVID-19, the FIM self-care scores were 27.45±6.62 and 25.27±7.08, respectively, the FIM sphincter control scores were 10.10±2.56 and 9.39±2.87, respectively, the FIM transfers scores were 14.67±3.36 and 13.61±3.54, respectively, the FIM social cognition scores were 18.40±1.86 and 17.67±1.93 respectively (p<0.001). The BDI score was 10.06±3.18 before the pandemic and 13.66±3.04 at the first year of the pandemic, the SS-QOL scores was 136.48±29.63 before the pandemic and 133.63±29.63 at the first year evaluation (p<0.001). CONCLUSIONS: The COVID-19 pandemic has caused delays in both follow-up and rehabilitation therapy in patients with chronic hemiplegia. The functionality, life quality and mood of the patients have been affected due to the lack of therapy and social isolation.

The Relationship Between Sociodemographic Factors and Self Management in Stroke Patients

Stroke is very common in society and can cause physical disability and even death. Stroke can be affected by poor self-management. Sociodemographic factors can influence self-management. The purpose of this study was to determine the relationship between sociodemographic factors and self-management in stroke patients. This study used an observational approach with a cross-sectional design. 64 people were recruited using purposive sampling. The inclusion criteria included patients with a stroke diagnosis, who were conscious and able to communicate both verbally and in writing. Data collection was through the SSMQ questionnaire and data analysis involved the Chi-square test. The results indicated that most of the respondents had good self-management (64.1%). There was no significant influence of age (p = 0.111), gender (p = 0.885), occupation (p = 0.596), stroke duration (p = 0.182) or education (p = 0.588) on self-management. Income had a significant relationship with self-management of (p = 0.044).
 Keywords: sociodemography, self management, stroke

Sleep duration, daytime napping, and risk of incident stroke: Nuances by metabolic syndrome from the China health and retirement longitudinal study.

Background and purposeThe relationship between sleep duration and stroke are inconclusive in China, especially in those individuals with metabolic syndrome. We aimed to investigate the association between sleep duration and incident stroke in participants with metabolic syndrome or its specific components in China.Materials and methodsData were taken from the 2011 and 2015 waves of China Health and Retirement Longitudinal Study (CHARLS). Habitual sleep duration (≤6, 6∼8 [reference], >8 h), daytime napping (0, 1∼60 [reference], and >60 min) were determined by self-reported questionnaires. Metabolic syndrome was defined by blood assessment and biomarkers combined with self-reported doctors’ diagnosis. Incident stroke was determined by reported stroke from 2011 to 2015 wave. Cross-sectional and longitudinal associations between sleep and (incident) stroke at baseline and 4-year follow-up period were tested among the population with metabolic syndrome and its components.ResultsA U-shaped relationship was observed between sleep duration and stroke in cross-sectional analysis. Sleep ≤ 6 h/night had a greater risk of incident stroke (hazard ratio [HR] 1.65; 95% confidence interval [CI] 1.04–2.61) compared with sleep 6∼8 h/night. And the HR of stroke was 1.62 (95%CI, 1.03–2.53) for sleep < 7 h/day compared to 7∼9 h/day. These associations were more evident in the female and individuals aged 45–65 years. Furthermore, the effect of short sleep duration on incident stroke was different in each component of metabolic syndrome, which was more pronounced in participants with elevated blood pressure. And a significant joint effect of sleeping ≤ 6 h/night and no napping on risk of stroke was observed (HR 1.82, 95%CI 1.06–3.12).ConclusionShort sleep duration was an independent risk factor for incident stroke, especially among females, individuals aged 45–65 years, or those with some components of metabolic syndrome, such as hypertension. Napping could buffer the risk of short sleep duration on incident stroke.

Impact of Inpatient Rehabilitation on Quality of Life Among Stroke Patients

Abstract Background Despite remarkable progression in the treatment of stroke, the quality of life (QoL) and social-related events caused by stroke have received limited attention in our country. The assessment of QOL is an important part of the evaluation of stroke patients and their management. Objective To assess the QoL in patients with stroke at the time of admission in the rehabilitation unit and assess the impact of inpatient rehabilitation on change in QoL in these patients. Materials and methods Adult patients with first arterial stroke of any duration, with presentation as hemiplegia were recruited. The clinical outcome scales and SF-36 parameters for QOL were assessed at both admission and discharge. The scales used were Scandinavian Stroke Scale (SSS), Barthel Index (BI), modified Rankin Scale (mRS). SF-36 scores were assessed after 6 weeks of discharge also. Results Ten patients with a median age of 36.5 years and a median duration of stroke 75 days were recruited. There was significant improvement in functional scores of BI and SSS scales at the time of discharge. Majority of the components of both physical and mental domains of QOL SF-36 questionnaire showed significant improvement. The QOL scores after 6 weeks of discharge did not show significant change except for the emotional well-being. Conclusion The QOL in patients with stroke improves with inpatient rehabilitation along with motor and functional scores. Improved functional independence leads to better emotional state after discharge also.

Relationship Between Duration of Stroke and Hand Function Recovery in Patient with Stroke

Background- Stroke is sudden loss of neurological function caused by an interruption of the blood flow to the brain. The fine motor activities are also affected which leads to difficulty in writing, prehension and precision are also affected so patient is also not able to hold the or any object in the hand which required to performed in daily activities. Methods - This is an Observational study with a study duration was of 1 year. A total of 30 participants were recruited using the purposive sampling method from the Department of neuroscience, Vikhe Patil Memorial Hospital, Ahmednagar; Puntamba stroke center, Puntamba and Rahuri stroke center. Result - The study shows in jebson taylor hand function test, the most affected component is writing which requires more time followed by moving heavy objects and stimulated feeding, in addition requires less time for card turning, followed by small common object and checkers stacking and the least time required for performing moving light object in stroke patients. Conclusion- The study concludes that there is no relationship between duration of stroke and hand function recovery in patients with stroke. The jebson taylor hand function test shows that the most time required is for small dexterity movement like writing, stimulated feeding. The patients find difficulty in moving heavy objects. The less difficulty task is card turning, checkers stacking, moving light objects, which requires use of all the fingers.

Remote Monitoring of Cardiovascular Risks of Medical Rehabilitation of Ischemic Stroke Patients Using Information and Telecommunication Systems

Due to the high incidence of cerebral stroke, the relevance of the problem of medical rehabilitation for this category of patients is beyond doubt. The increase in disability rates due to movement disorders among stroke survivors (3.2 per 100,000 population) necessitates the introduction of innovative rehabilitation technologies. Patients with cerebral stroke have a high risk of cardiocerebral complications, which should not limit the possibilities of medical rehabilitation. Therefore, the control of possible MR-risks is an important organizational aspect and can be implemented through the introduction of information and communication (ICT) and telemedicine technologies. Conducting dynamic telemetric ECG monitoring during of medical rehabilitation allows to prevent the development of possible cardiovascular risks and personalize the medical rehabilitation program. Aim. To study the effectiveness of remote tele-ECG monitoring based on information and communication technologies for assessing the cardiovascular risks of medical rehabilitation in patients with ischemic stroke. Material and methods. The study included 83 patients with ischemic stroke, mean age 55 [51; 57]), women – 44.6%, men – 55.4%; 42 patients in the early and 41 patients in the late recovery periods of ischemic stroke. All patients underwent a complex of multimodal rehabilitation techniques to restore hand dysfunction and statolocomotor disorders, carried out sequentially during one visit. For the purpose of dynamic control of probable cardiovascular risks, objectification of the state of the cardiovascular system, correction of the intensity and duration of rehabilitation loads, a portable information and communication technologies-based telecardiac complex was used for ECG registration. The ECG parameters were assessed in real time, as well as the stored data on the CardioOblako service. Results and discussion. The spectrum of ECG changes in patients in the early and late recovery periods of ischemic stroke was revealed. The dependence of ECG indexes and their dynamics on the duration of ischemic stroke and its subtype was determined. Asymptomatic changes in the form of heart rhythm disorders (14,4% – supraventricular rhythm disorders, 9,6% – ventricular extrasystoles of the 1st class), as well as repolarization processes (9,6% of cases) were registered during the course of rehabilitation measures. When discussing the results obtained, the probable neurogenic character of cardiac rhythm and conduction disturbances as a consequence of central neurogenic cardiovascular regulation, which is stabilized by central nervous system neuroplasticity over time, is emphasized. At the same time, the literature indicates that these processes can be regulated by therapeutic and rehabilitative measures. In our study, correction of the intensity and duration of rehabilitation loads normalized the changes of ECG indices registered in the process of medical rehabilitation. Conclusion. We determined the need for a comprehensive cardiovascular risk assessment program for patients with IS with the participation of a therapist/cardiologist using dynamic telemetric ECG monitoring during of medical rehabilitation for the timely detection and prevention of cardiovascular complications of medical rehabilitation, personalization of the medical rehabilitation program.

Frequency of Undiagnosed Diabetes Mellitus in Patients Presenting with Acute Stroke in a Medical Emergency

Objective: The goal of this study was to assess the prevalence of undiagnosed DM in individuals who came with an acute stroke in a medical emergency. Methods: This descriptive cross-section study was carried out at the Shifa International Hospital's Department of Medicine in Islamabad, Pakistan from 24-11-2020 to 23-05-2021. A total number of 150 patients of either gender presenting with acute stroke were included. Venous blood samples from all patients were sent to hospital laboratory for determination of HbA1c levels. Diabetes (DM) was labeled if HbA1c &gt; 6.0%. Results: The mean age was 54.04±10.25 years. The mean duration of stroke was 14.92±7.99 days. There were 92 (60.67%) males and 58 (39.33%) female patients. 61 (40.67%) out of 150 patients were smokers. Undiagnosed diabetes mellitus was found in 42 (28.00%) patients. Conclusion: The frequency of newly diagnosed diabetes is high among patients with ischemic stroke. So, it is recommended that every patient who present with ischemic stroke, should be sorted out for diabetes mellitus. However, it is also required that every setup should have their surveillance in order to know the frequency of the problem. Keywords: undiagnosed diabetes mellitus, acute stroke, diabetes mellitus (DM),

A nuclear quadrupolar spin quantum heat engine

We give an implementable scheme which uses intrinsic quadrupolar nuclear spin interactions to harvest efficient energy from a quantum Otto cycle. We employ realistic parameter regimes for the 23Na nucleus in sodium nitrate. The processes of the cycle are accomplished by orienting the sample with respect to the static magnetic field. The effects of stroke duration on the work output and efficiency are revealed in detail. Finite-time adiabatic transformations leading to quantum friction are found to substantially reduce cycle outputs which are stimulated from the non-secular parts of the quadrupolar interaction. An estimation for the power output at maximum efficiency is also given. We show that with the precise control and manipulation of the intrinsic nuclear spin interactions, for example in an advanced nuclear magnetic resonance setup, makes our scheme implement as a powerful quantum Otto cycle.

Frequency of Stroke Acquired Pneumonia in Patients Admitted in Intensive Care Unit with Stroke

Introduction: Stroke is a highly morbid entity, and it can be fatal directly due to neurological damage and affecting the respiratory system or can add to overall morbidity and mortality due to its associated complications like stroke-associated pneumonia (SAP). Objective: The objective of this study was to investigate the prevalence of stroke-associated pneumonia in ICU patients. Study Design: This Descriptive case series was conducted in Saddique Family Hospital Gujranwala from October 2020 to April 2021. In this study, the cases of either gender agaged0 to 70 years suffering from stroke within 12 hours were included. SAP was labels on fever, cough, and non-homogenous opacities on chest X-ray. Results: In the present study, 160 cases of stroke were included, and out of these 82 (51.25%) were males and 78 (48.75%) females. The mean age of the subjects was 54.24±7.15 years and the mean duration of stroke was 7.05±2.54 hours. There were 35 (21.88%) cases that had DM, 28 (17.50%) had HTN and 30 (18.75%) of cases had a history of smoking. In 20 (12.50%) of the patients, stroke-acquired pneumonia (SAP) was discovered. With a p= 0.34, SAP was found in 12 (15.38%) female patients compared to 8 (9.75%) male cases. With a p= 0.15, SAP was more common in instances with DM, where it was detected in 7 (20%) of the cases compared to 13 (10.4%) in cases without DM. SAP was found in 5 (17.85%) instances of HTN and 4 (13.33%) cases of smoking history, with p values of 0.35 and 1.0, respectively. SAP was found in 15 (14.42%) patients with a stroke length of 6-12 hours, compared to 5 (8.92%) instances with a stroke duration of shorter than this, with a p= 0.45. Conclusion: Stroke acquired pneumonia is not uncommon and is seen in more than 1 out of every 10 cases and it is more seen in females and those with history of DM, HTN and duration of stroke 6 to 12 hours, though none of this variable was found statistically significant. Keywords: SAP, DM, HTN, Smoking.

The Relationship between Sleep Duration and Stroke Risk: The Mediating Role of Physical Activity.

Background: This study aimed to investigate the mediating effect of physical activity (PA) on the relationship between average sleep duration and risk of stroke in suburban residents without stroke. Methods: A cross-sectional study was executed, and participants were recruited through a multistage, stratified, probability-proportional-to-size sampling method in this research. The stroke risk was measured using a risk assessment form for a high-risk stroke population. The PA score was calculated by the Physical Activity Rating Scale-3 (PARS-3). The average sleep duration was calculated by adding up night sleep and afternoon nap durations. A multiple linear regression analysis was conducted to identify the association between stroke risk, average sleep duration, and PA. The direct and indirect effects of average sleep duration on stroke risk were analyzed by using the PA in a mediation framework. Results: A total of 5312 suburban residents (average: 54.96 ± 12.21 years, 2970 women) participated in the study. After adjusting for covariates, relatively inappropriate sleep duration (<7 h/>8 h~9 h/>9 h) and stroke risk were significantly associated, compared with the moderate average sleep duration (7~8 h) (β = 0.038, 95% CI: 0.024~0.128; β = 0.078, 95% CI: 0.128~0.250; β = 0.150, 95% CI: 0.390~0.549). The PA total score (indirect effect ab = 0.013, 95% CI: 0.003~0.022) partially mediated the relationship between the long average sleep duration and stroke risk, in which the activity intensity (ab = −0.015, 95% CI: −0.021~−0.008), the activity duration (ab = 0.043, 95% CI: 0.029~0.058), and the activity frequency (ab = 0.012, 95% CI: 0.004~0.020; ab = 0.037, 95% CI: 0.026~0.050) all played a mediating role in the different sleep duration. Conclusions: A significant relationship between a long average sleep duration and stroke risk factors among people without stroke was found in this study. The PA and its components partially mediated the association between a long average sleep duration and stroke risk. Suitable prevention methods and interventions for PA and sleep may reduce the risk of stroke.

Frequency Of Stroke Acquired Pneumonia in Patients Admitted in Intensive Care Unit with Stroke

Stroke is a highly morbid entity, and it can be fatal directly due to neurological damage and affecting the respiratory system or can add to overall morbidity and mortality due to its associated complications like stroke-associated pneumonia (SAP). Objective: To investigate the prevalence of stroke-associated pneumonia in ICU patients. Methods: A descriptive case series was conducted at Faisalabad Medical University from October 2020 to April 2021. In this study, the cases of either gender suffering from stroke within 12 hours were included. SAP was labelled on the basis of fever, cough, and non-homogenous opacities on chest X-ray. Results: In the present study, 160 cases of stroke were included, and out of these 82 (51.25%) were males and 78 (48.75%) females. The mean age of the subjects was 54.24±7.15 years and the mean duration of stroke was 7.05±2.54 hours. There were 35 (21.88%) cases that had DM, 28 (17.50%) had HTN and 30 (18.75%) of cases had a history of smoking. In 20 (12.50%) of the patients, SAP was discovered. With a p= 0.34, SAP was found in 12 (15.38%) female patients compared to 8 (9.75%) male cases. With a p= 0.15, SAP was more common in instances with DM, where it was detected in 7 (20%) of the cases compared to 13 (10.4%) in cases without DM. SAP was found in 5 (17.85%) instances of HTN and 4 (13.33%) cases of smoking history, with p values of 0.35 and 1.0, respectively. SAP was found in 15 (14.42%) patients with a stroke length of 6-12 hours, compared to 5 (8.92%) instances with a stroke duration shorter than this, with a p= 0.45. Conclusions: Stroke acquired pneumonia is not uncommon and is seen in more than 1 out of every 10 cases and it is more seen in females and those with a history of DM, HTN, and duration of stroke is 6 to 12 hours, though none of these variables was found statistically significant.

Association of Left Ventricular Hypertrophy on Echocardiography with Hemorrhagic and Non-Hemorrhagic Stroke

Introduction: Left ventricular hypertrophy (LVH) is related to increased risk of stroke. However, very few studies analyzed association of LVH assessed by Echocardiography (Echo) in ischemic and hemorrhagic stroke separately.&#x0D; Aims &amp; Objectives: To determine the association of left ventricular hypertrophy on echocardiography with hemorrhagic or non-hemorrhagic stroke.&#x0D; Place &amp; Duration of Study: Study was done in Department of Cardiology Shaikh Zayed Hospital Lahore for six months from 01-01-2019 to 30-06-2019.&#x0D; Material &amp; Methods: Total 190 patients, fulfilling inclusion and exclusion criteria were selected. All patients underwent for echo and LVH was noted. Left ventricular posterior wall (PW) and inter ventricular septum (IVS) thickness&gt;11mm in males and &gt;10mm in females labeled as LVH.&#x0D; Results: Results of this study showed that risk of LVH was 1.66 times higher among patients who presented with Hemorrhagic: 57.9% vs Non-hemorrhagic stroke: 34.7%. Elderly age group patients (RR: 1.85), female patients (RR:2.53), overweight patients (RR:2.38), longer duration of stroke (RR:2.42) and diabetic patients had higher association with LVH in hemorrhagic stroke.&#x0D; Conclusion: It was observed in this study that patients having hemorrhagic stroke had higher association of left ventricular hypertrophy (LVH) as compared to Non- Hemorrhagic stroke. Further studies are needed in this domain to address the association between LVH and hemorrhagic stroke.

Efficacy of electromechanical-assisted gait training on clinical walking function and gait symmetry after brain injury of stroke: a randomized controlled trial

Electromechanical-assisted gait training may be an effective intervention to promote motor recovery after brain injury. However, many studies still have difficulties in clarifying the difference between electromechanical-assisted gait training and conventional gait training. To evaluate the effectiveness of electromechanical-assisted gait training compared to that of conventional gait training on clinical walking function and gait symmetry of stroke patients. We randomly assigned patients with stroke (n = 144) to a control group (physical therapist-assisted gait training) and an experimental group (electromechanical gait training). Both types of gait training were done for 30 min each day, 5 days a week for 4 weeks. The primary endpoint was the change in functional ambulatory category (FAC). Secondary endpoints were clinical walking functions and gait symmetries of swing time and step length. All outcomes were measured at baseline (pre-intervention) and at 4 weeks after the baseline (post-intervention). FAC showed significant improvement after the intervention, as did clinical walking functions, in both groups. The step-length asymmetry improved in the control group, but that in the experimental group and the swing-time asymmetry in both groups did not show significant improvement. In the subgroup analysis of stroke duration of 90 days, FAC and clinical walking functions showed more significant improvement in the subacute group than in the chronic group. However, gait symmetries did not show any significant changes in either the subacute or the chronic group. Electromechanically assisted gait training by EXOWALK was as effective as conventional gait training with a physiotherapist. Although clinical walking function in the subacute group improved more than in the chronic group, gait asymmetry did not improve for either group after gait training.Trial registration: KCT0003411 Clinical Research Information Service (CRIS), Republic of Korea.

Family Functioning and Optimism as Protective Factors of Life Satisfaction Among Stroke Patients During the COVID-19 Epidemic in Shenyang, China.

The coronavirus disease-19 (COVID-19) pandemic may result in detrimental consequences for stroke patient's wellbeing. Family functioning and optimism could help stroke patients cope with crises leading to possible improvements in life satisfaction. This study aims to explore the protective effects of family functioning and optimism on life satisfaction among stroke patients during the COVID-19 pandemic in China. This study was designed as a cross-sectional survey. A total of 207 stroke inpatients who were receiving pharmacotherapy and rehabilitation in general public hospital of Liaoning province during the COVID-19 pandemic in China were consecutive selected and interviewed by online questionnaires via the WeChat platform effectively from April 8 to 30, 2020. The scales included: Satisfaction with Life Scale (SWLS), Family Adaptation, Partnership, Growth, Affection, and Resolve (APGAR) Scale and Revised Life Orientation Test (LOT-R). Hierarchical multiple regression (HMR) analysis was conducted to test the associated factors of life satisfaction. Stroke patient's life satisfaction was at a high level (Mean = 26.46, SD = 6.23) during the pandemic. Stroke patient's residence, duration of stroke, stroke type, and community shut down measures were the strong predictors of life satisfaction. Family functioning and optimism increased life satisfaction among stroke patients. This study contributes to the research on the association between family functioning and optimism on life satisfaction among stroke patients during the COVID-19 pandemic. Interventions that improve family functioning and enhance optimism should be provided in order to elevate life satisfaction for stroke patients.

POST-STROKE MOTOR IMPAIRMENTS: THE POSSIBILITIES OF INNOVATIVE TECHNOLOGIES AND THE RESULTS OF THE OWN RESEARCH

Introduction.The article presents an overview of innovative technologies based on methods sensomotor retraining of the patient using neuromuscular electrical stimulation (NFES) and biofeedback (BFB) as the most promising in the medical rehabilitation (MR) of motor impairment in patients with brain stroke (BS). The results of our own study are also presented.The aim of the study - an assessment of the effectiveness of a comprehensive rehabilitation program with the inclusion of NFES and stabilometric postural control using the BFB method in patients with after-stroke motor disfunction in the chronic ischemic stroke (IS).Material and methods. We examined 87 patients (41 women and 46 men) in the chronic IS, mean age 58.4±6.4 years. The stroke duration was 228.59±31.9 days. The main group included 52 patients who, along with the standard treatment regimen, underwent NFES and BFB-stabilometric training. The comparison group consisted of 35 patients whose rehabilitation complex did not include the above methods.Results and conclusion. Due to comlex rehabilitation with NFES and BFB stabilometric postural training it has been improved the function of walking. The clinical effect was noted 3 weeks after the start of rehabilitation, reaching a maximum by the 5th week. The inclusion of BFB-based methods in the medical rehabilitation leads to earlier motor and social adaptation of the after-stroke patient, restoration of the impairment balance function, which is associated with an increase in neuroplasticity.

Effect and Optimal Timing of Extracorporeal Shock-Wave Intervention to Patients With Spasticity After Stroke: A Systematic Review and Meta-analysis.

This study investigated the efficacy of extracorporeal shock wave therapy as well as the optimal intervention timing for extracorporeal shock wave therapy for patients with spasticity after stroke. A search of randomized controlled trials was conducted in different electronic databases. We performed a meta-analysis to measure the effect of extracorporeal shock wave therapy versus sham interventions on spasticity and limb functionality. The meta-regression analysis was performed to determine the adequate intervention timing of extracorporeal shock wave therapy. The follow-up period of the outcomes was divided into the short (<2 wks), mid (>2 wks and ≤4 wks), and long (>4 wks and ≤3 mos) terms. Thirteen studies with 677 participants were evaluated. Spasticity significantly improved throughout the follow-up duration. Limb functionality significantly improved in the short-term follow-up period. The meta-regression analysis showed that patients with stroke duration less than 45 mos may be benefited from extracorporeal shock wave therapy in improving limb function in all follow-up periods. Extracorporeal shock wave therapy is an effective method for reducing spasticity in patients with stroke, and the effect could be maintained for up to 3 mos. Its effects on limb functionality could persist for at least 2 wks. Patients who had stroke for less than 45 mos may have significant benefit from extracorporeal shock wave therapy in all follow-up periods.

Frequency of Stroke Acquired Pneumonia in Patients Admitted In Intensive Care Unit with Stroke

Stroke is a highly morbid entity and it can be fatal directly due to neurological damage and affecting the respiratory system or can add to over all morbidity and mortality due to its associated complications like stroke associated pneumonia (SAP). Objective: To determine the frequency of stroke acquired pneumonia in ICU patients. Study Design: Descriptive case series. Settings: Department of Medicine, THQ Hospital, Sargodha. Period: Six months from October, 2020 to April, 2021 Material &amp; Methods: In this study, the cases of either gender and age 30 to 70 years suffering from stroke within 12 hours were included. SAP was labelled on the basis of fever, cough and non homogenous opacities on chest X-ray. Results: In the present study, 160 cases of stroke were included and out of these 82 (51.25%) were males and 78 (48.75%) females. The mean age of the subjects was 54.24±7.15 years and mean duration of stroke was 7.05±2.54 hours. There were 35 (21.88%) cases that had DM, 28 (17.50%) had HTN and 30 (18.75%) of cases had history of smoking. Stroke acquired pneumonia (SAP) was seen in 20 (12.50%) of the cases. SAP was seen in 12 (15.38%) female cases as compared to 8 (9.75%) males with p= 0.34. SAP was more seen in cases with DM where this was observed in 7 (20%) of the cases as compared to 13 (10.4%) with no DM with p= 0.15. SAP was seen in 5 (17.85%) cases with HTN and 4 (13.33%) cases with history of smoking with p values of 0.35 and 1.0 respectively. SAP was seen in 15 (14.42%) cases with duration of stroke 6-12 hours in contrast to 5 (8.92%) cases with duration less than this with p= 0.45. Conclusion: Stroke acquired pneumonia is not uncommon and is seen in more than 1 out of every 10 cases and it is more seen in females and those with history of DM, HTN and duration of stroke 6 to 12 hours; though none of this variable was found statistically significant.

A comparison study between single aspirin antiplatelet and single clopidogrel antiplatelet on average period of recurrent stroke dr. Sayidiman Magetan

Stroke is a common neurological disease that rapidly develops clinical signs of focal and global neurological deficits, lasts 24 hours or more, and leads to death. The danger that threatens stroke sufferers is recurrent strokes which can be fatal and result in a worse quality of life than the first attack. This condition indicates that the effect of antiplatelet drugs is not strong, or called antiplatelet resistance. Antiplatelet is a blood thinner used by stroke sufferers to prevent blood clots and treat the narrowing blood vessels in the legs, namely in peripheral artery disease. This research aims to compare single aspirin antiplatelet and single clopidogrel antiplatelet on the average period of recurrent stroke. This observational research employed a cross-sectional approach by processing the medical record data of stroke patients from 2018 to 2020 at dr. Sayidiman Magetan Regional Public Hospital. The obtained data were then analyzed and concluded. The results show that the mean duration of recurrent stroke on aspirin antiplatelet use is 357.88. Meanwhile, the mean duration of recurrent stroke in the antiplatelet clopidogrel is 138.59 days. Moreover, there is a significant difference between the use of a single aspirin antiplatelet and single clopidogrel antiplatelet on the duration of recurrent stroke with a p-value of 0.000.

Demographic and clinical characteristics of inpatient stroke patients in Turkey.

Objectives This study aims to assess the stroke rehabilitation facilities provided by university hospitals (UHs) and training and research hospitals (TRHs) and to evaluate the geographical disparities in stroke rehabilitation. Patients and methods Between April 2013 and April 2014 a total of 1,529 stroke patients (817 males, 712 females; mean age: 61.7±14.0 years; range, 12 to 91 years) who were admitted to the physical medicine and rehabilitation clinics in 20 tertiary care centers were retrospectively analyzed. Demographic, regional and clinical characteristics, details of rehabilitation period, functional status, and complications were collected. Results The median duration of stroke was five (range, 1 to 360) months. The ratio of the patients treated in the TRH in the Marmara region was 77%, but only 25% of the patients were living in the Marmara region. Duration of hospitalization was longer in the TRHs with a median of 28 days compared to those of UHs (median: 22 days) (p<0.0001). More than half of the patients (55%) were rehabilitated in the Marmara region. Time after stroke was the highest in the Southeast region with a median of 12 (range, 1 to 230) months and the lowest in the Aegean region with a median of four (range, 1 to 84) months. Conclusion This study provides an insight into the situation of stroke rehabilitation settings and characteristics of stroke patients in Turkey. A standard method of patient evaluation and a registry system may provide data about the efficacy of stroke rehabilitation and may help to focus on the problems that hinder a better outcome.

Comparison Between Effects of Functional Training Program and Conventional Therapy on Postural Control and Functional Mobility in Chronic Stroke

Objective: To Compare the Effects of Functional Training Program and Conventional Therapy on Postural Control and Functional Mobility in Chronic Stroke Place and duration of Study: This study was conducted in Qureshi Hospital Sahiwal, from September 2019 to March 2020. Methodology: A randomized clinical trial was conducted through non-probability convenient sampling technique in which 12 participants were recruited, randomization was done by Lottery method and participants were divided into 2 groups. Group A received functional training treatment and group B received conventional therapy. Participants of both genders with age 40-65 years were included in study with 6 months of confirmed stroke. Patients with any other neurological disorder or those who were Unable to keep any (Sitting or Standing) position for 30 Second were excluded from the study. Berg balance scale, trunk control measurement scale , 6 Min walk test and time up and go test were used as outcome measuring tools. Pre-treatment and post-treatment readings were taken. And data was analyzed by using SPSS version 21. Results: Mean age and standard deviation of the participants was 48.08±4.833. TUG pre value is 20.25± 2.26 while post treatment value is 15.25±1.14 and pre-value for BBS is 39.75±3.54 while post 48.42±3.2. in 6 MWT pre of the participants was Functional training program improves postural control and functional mobility in chronic stroke patients. Conclusion: It was concluded that functional Training program is better technique to improve patient’s condition as compare to Conventional therapy in TUG and BBS. Both interventions showed non-significant difference on TCMS and 6MWD. Keywords: Functional training program, chronic stroke, Postural control, Functional mobility