Effects of the introduction of objective criteria for referral and discharge in physical therapy for ischemic stroke in China: a randomized controlled trial.
Effects of the introduction of objective criteria for referral and discharge in physical therapy for ischemic stroke in China: a randomized controlled trial. Clin Rehabil. 2019 Dec 26;:269215519896014 Authors: Xia N, Reinhardt JD, Liu S, Fu J, Ren C, Wang H, Li J Abstract OBJECTIVE: To examine the effectiveness of a set of rules for referral and therapy input in a three-tiered physiotherapy program on activities of daily living (ADL), motor function, and quality of life of stroke survivors. DESIGN: Randomized controlled study. SETTING: Rehabilitation departments of 11 teaching hospitals. SUBJECTS: A total of 285 participants with stroke. OUTCOME MEASURES: Primary outcome was ADL independence measured with the Modified Barthel Index (MBI) at weeks 3, 6, 9, 13, and 17. Secondary outcomes were motor function and quality of life measured with Fugel-Meyer Assessment (FMA) and Stroke-Specific Quality-of-Life (SSQOL) scale. INTERVENTION: Two complementary sets of rules governing rehabilitation delivery were introduced: a set of criteria that determined when someone ought to move from tier 1 onto tier 2, and from tier 2 onto tier 3, and a second set of rules that determined the amount and type of physiotherapy input given in each tier. Control group participants received conventional rehabilitation without any specified guidelines. RESULTS: With a difference of 3.97 (95% confidence interval (CI): 1.59-6.36), MBI increased stronger i...
Publication date: Available online 20 February 2020Source: Life SciencesAuthor(s): Mahsa Hassanipour, Mohammadreza Zarisfi, Vahid Ehsani, Mohammad AllahtavakoliAbstractLate treatment with tissue plasminogen activator (tPA) leads to reperfusion injury and poor outcome in ischemic stroke. We have recently shown the beneficial effects of local brain hypothermia after late thrombolysis. Herein, we investigated whether transient whole-body hypothermia was neuroprotective and could prevent the side effects of late tPA therapy at 5.5 h after embolic stroke. After induction of stroke, male rats were randomly assigned into four g...
This study aims to evaluate the safety and efficacy of performing mechanical thrombectomies in older adults.
Mechanical thrombectomy has been established as the standard of care for LVO (large-vessel occlusion) acute ischemic stroke following the favorable results of several prominent studies. Current guidelines and a recent meta-analysis endorse both thrombectomy techniques of aspiration and stent retriever as comparably effective treatments. The present study was conducted at a community hospital, which was recently certified as a comprehensive stroke center, to evaluate the efficacy of aspiration vs.
Endovascular treatment of ischemic stroke has shown positive clinical outcomes. Further optimization requires identifying patients who will benefit from reperfusion. We propose using deep learning, specifically 3D convolutional neural networks (CNN), to identify infarcted tissue (core) on CT perfusion (CTP) with diffusion weighted imaging (DWI) MRI as gold standard for irreversible brain infarction and evaluate lesion size impact on the network ’s performance.
Workflow optimization is essential in the setting of mechanical thrombectomy for acute ischemic stroke (AIS). Either conscious sedation or general anesthesia can be used during intervention. The purpose was to study the differences between the type of anesthesia used and its impact on time to recanalization during mechanical thrombectomy.
AbstractPurposeTo quantify the influence of interventionalist ’s experience on procedure time, radiation exposure, and fluoroscopy time during mechanical thrombectomy (MT) in the anterior circulation.MethodsRetrospective analysis of an institutional review board −approved stroke database of a comprehensive stroke center focusing on radiation exposure (as per dose area product in Gy × cm2, median [IQR]), procedure, and fluoroscopy time (in minutes, median [IQR]) in patients receiving MT in anterior circulation ischemic stroke. Procedures have been assigned according to the interventionalist ’s experi...
How often do strokes occur during elective spine surgeries, and what strategies may help prevent these events?Spine
CONCLUSIONS: Elevated levels of sdLDL-C were associated with a higher prevalence of AIS, especially in non-cardioembolic stroke subtypes. After adjustment for other risk factors, sdLDL-C was found to be an independent risk factor for AIS. Also, sdLDL-C level was strongly associated with AIS severity and poor functional outcomes. Logistic regression models for AIS risk and prognosis prediction were established to help clinicians provide better prevention for high-risk subjects and monitor their prognosis. PMID: 32062644 [PubMed - as supplied by publisher]
Conclusions: The results suggest the APRN-led clinic may impact 30-day hospital readmissions in stroke/transient ischemic attack survivors.