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Source: BMJ Open

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Total 555 results found since Jan 2013.

Rehabilitation using virtual gaming for Hospital and hOMe-Based training for the Upper limb post Stroke (RHOMBUS II): protocol of a feasibility randomised controlled trial
Introduction Upper limb (UL) rehabilitation is most effective early after stroke, with higher doses leading to improved outcomes. For the stroke survivor, the repetition may be monotonous. For clinicians, providing a clinically meaningful level of input can be challenging. As such, time spent engaged in UL activity among subacute stroke survivors remains inadequate. Opportunities for the stroke survivor to engage with UL rehabilitation in a safe, accessible and engaging way are essential to improving UL outcomes following stroke. The NeuroBall is a non-immersive virtual reality (VR) digital system designed for stroke rehab...
Source: BMJ Open - June 7, 2022 Category: General Medicine Authors: Kilbride, C., Warland, A., Stewart, V., Aweid, B., Samiyappan, A., Ryan, J., Butcher, T., Athanasiou, D. A., Baker, K., Singla-Buxarrais, G., Anokye, N., Pound, C., Gowing, F., Norris, M. Tags: Open access, Rehabilitation medicine Source Type: research

FIND Stroke Recovery Study (FIND): rationale and protocol for a longitudinal observational cohort study of trajectories of recovery and biomarkers poststroke
Introduction Comprehensive studies mapping domain-specific trajectories of recovery after stroke and biomarkers reflecting these processes are scarce. We, therefore, initiated an exploratory prospective observational study of stroke cases with repeated evaluation, the FIND Stroke Recovery Study. We aim to capture trajectories of recovery from different impairments, including cognition, in combination with broad profiling of blood and imaging biomarkers of the recovery. Methods and analysis We recruit individuals with first-ever stroke at the stroke unit at the Sahlgrenska University Hospital, Sweden, to FIND. The inclusio...
Source: BMJ Open - May 10, 2023 Category: General Medicine Authors: Brännmark, C., Klasson, S., Stanne, T. M., Samuelsson, H., Alt Murphy, M., Sunnerhagen, K. S., Aberg, N. D., Jalnefjord, O., Björkman-Burtscher, I., Jood, K., Tatlisumak, T., Jern, C. Tags: Open access, Neurology Source Type: research

Acupuncture treatment for ischaemic stroke in young adults: protocol for a randomised, sham-controlled clinical trial
Introduction Stroke in young adults is not uncommon. Although the overall incidence of stroke has been recently declining, the incidence of stroke in young adults is increasing. Traditional vascular risk factors are the main cause of young ischaemic stroke. Acupuncture has been shown to benefit stroke rehabilitation and ameliorate the risk factors for stroke. The aims of this study were to determine whether acupuncture treatment will be effective in improving the activities of daily living (ADL), motor function and quality of life (QOL) in patients of young ischaemic stroke, and in preventing stroke recurrence by controlli...
Source: BMJ Open - January 6, 2016 Category: Journals (General) Authors: Chen, L., Fang, J., Jin, X., Keeler, C. L., Gao, H., Fang, Z., Chen, Q. Tags: Open access, Complementary medicine, Neurology, Rehabilitation medicine Protocol Source Type: research

Stroke survivors', caregivers' and GPs' attitudes towards a polypill for the secondary prevention of stroke: a qualitative interview study
Conclusions Participants acknowledged potential advantages in a polypill approach for secondary prevention of stroke; however, significant concerns remain. Further research on the efficacy of a polypill is needed to reassure practitioners whose concerns around inflexibility and treatment suitability are likely to influence the decision to prescribe a polypill for secondary prevention of stroke. Acceptability among survivors, caregivers and GPs is likely to determine the uptake and subsequent use of a polypill in the future.
Source: BMJ Open - May 12, 2016 Category: Journals (General) Authors: Jamison, J., Graffy, J., Mullis, R., Mant, J., Sutton, S. Tags: Open access, Cardiovascular medicine, Qualitative research Source Type: research

Primary care interventions and current service innovations in modifying long-term outcomes after stroke: a protocol for a scoping review
Introduction Interventions delivered by primary and/or community care have the potential to reach the majority of stroke survivors and carers and offer ongoing support. However, an integrative account emerging from the reviews of interventions addressing specific long-term outcomes after stroke is lacking. The aims of the proposed scoping review are to provide an overview of: (1) primary care and community healthcare interventions by generalist healthcare professionals to stroke survivors and/or their informal carers to address long-term outcomes after stroke, (2) the scope and characteristics of interventions which were s...
Source: BMJ Open - October 23, 2016 Category: Journals (General) Authors: Pindus, D. M., Lim, L., Rundell, A. V., Hobbs, V., Aziz, N. A., Mullis, R., Mant, J. Tags: Open access, Cardiovascular medicine, Health services research Protocol Source Type: research

Barriers to evidence-based acute stroke care in Ghana: a qualitative study on the perspectives of stroke care professionals
Conclusion Barriers from low/middle-income countries differ substantially from those in high-income countries. For evidence-based acute stroke care in low/middle-income countries such as Ghana, health policy-makers and hospital managers need to consider the contrasts and uniqueness in these barriers in designing quality improvement interventions to optimise patient outcomes.
Source: BMJ Open - April 27, 2017 Category: Journals (General) Authors: Baatiema, L., de-Graft Aikins, A., Sav, A., Mnatzaganian, G., Chan, C. K. Y., Somerset, S. Tags: Research Source Type: research

The Taking Charge After Stroke (TaCAS) study protocol: a multicentre, investigator-blinded, randomised controlled trial comparing the effect of a single Take Charge session, two Take Charge sessions and control intervention on health-related quality of life 12 months after stroke for non-Maori, non-Pacific adult New Zealanders discharged to community living
Introduction Stroke is one of the leading causes of disability worldwide. Recent data support the possibility that person-centred, self-management interventions can reduce dependence after stroke. However, there is limited information on the generalisability and optimum dose of these interventions. Methods The Taking Charge After Stroke (TaCAS) study is a multicentre, investigator-blinded, randomised controlled trial recruiting 400 participants following acute stroke from seven hospitals in New Zealand. All patients discharged to community living who have ongoing symptoms at time of discharge (modified Rankin scale>0) ...
Source: BMJ Open - June 1, 2017 Category: General Medicine Authors: Fu, V. W. Y., Weatherall, M., McNaughton, H. Tags: Open access, Rehabilitation medicine Protocol Source Type: research

Incidence of stroke, transient ischaemic attack and determinants of poststroke mortality among immigrants in Denmark, 2004-2018: a population-based cohort study
Conclusions The age-standardised risk of stroke and TIA was significantly higher among the majority of immigrants than Danish-born individuals. Interventions that reduce the burden of comorbidities, improve acute stroke care and target sociodemographic factors may address the higher risk of poststroke mortality among immigrants.
Source: BMJ Open - October 21, 2021 Category: General Medicine Authors: Mkoma, G. F., Johnsen, S. P., Iversen, H. K., Andersen, G., Norredam, M. Tags: Open access, Neurology Source Type: research

Major cardiovascular events in patients presenting with acute stroke: a 5-year follow-up study in patients who had ischaemic stroke and stroke mimics
Conclusions Prior CVD significantly increases the risk of MACE and early mortality in IS or SM patients. Age, male gender, obesity, atrial fibrillation and admission National Institute of Health Stroke Scale also increases risk of MACE during follow-up. Hence, aggressive vascular risk factor modification is needed even in patients with SM.
Source: BMJ Open - March 2, 2022 Category: General Medicine Authors: Al Jerdi, S., Akhtar, N., Mahfoud, Z., Kamran, S., Shuaib, A. Tags: Open access, Neurology Source Type: research

Predictors for the prognosis and recurrence of ischaemic stroke among young Chinese patients: a cohort study
Conclusions Our research shows that when developing prevention strategies for young people, measures that focus on mitigating risk factors should be considered. In addition, vascular screening of young populations is also of vital importance for stroke prevention and poor prognosis prediction.
Source: BMJ Open - May 2, 2022 Category: General Medicine Authors: Wang, L., Ge, J., Chen, Y., Liu, Y., Li, C., Dong, Y., Liu, L., Xing, Y. Tags: Open access, Neurology Source Type: research

Tenecteplase versus Alteplase for Stroke Thrombolysis Evaluation Trial in the Ambulance (Mobile Stroke Unit--TASTE-A): protocol for a prospective randomised, open-label, blinded endpoint, phase II superiority trial of tenecteplase versus alteplase for ischaemic stroke patients presenting within 4.5 hours of symptom onset to the mobile stroke unit
Introduction Mobile stroke units (MSUs) equipped with a CT scanner are increasingly being used to assess and treat stroke patients’ prehospital with thrombolysis and transfer them to the most appropriate hospital for ongoing stroke care and thrombectomy when indicated. The effect of MSUs in both reducing the time to reperfusion treatment and improving patient outcomes is now established. There is now an opportunity to improve the efficacy of treatment provided by the MSU. Tenecteplase is a potent plasminogen activator, which may have benefits over the standard of care stroke lytic alteplase. Specifically, in the MSU ...
Source: BMJ Open - April 29, 2022 Category: General Medicine Authors: Bivard, A., Zhao, H., Coote, S., Campbell, B., Churilov, L., Yassi, N., Yan, B., Valente, M., Sharobeam, A., Balabanski, A., Dos Santos, A., Ng, F., Langenberg, F., Stephenson, M., Smith, K., Bernard, S., Thijs, V., Cloud, G., Choi, P., Ma, H., Wijeratne, Tags: Open access, Neurology Source Type: research

Effects of a social participation-focused virtual reality intervention for community-dwelling stroke survivors with physical disabilities: a randomised controlled trial protocol
Introduction Studies show that stroke survivors encounter physical and psychological limitations that restrict their participation in social and community activities. Systematic reviews have yielded inconclusive evidence regarding the effectiveness of different interventions intended to support stroke survivors’ social participation. Recent advances in virtual reality technology may offer promising solutions, although the optimal approach to enhance social participation among stroke survivors is yet to be determined. This trial aims to develop and evaluate the effectiveness of a social participation-focused virtual r...
Source: BMJ Open - July 5, 2022 Category: General Medicine Authors: Chau, J. P. C., Lo, S. H. S., Lau, A. Y. L., Lee, V. W. Y., Choi, K. C., Kwok, E. C. F., Thompson, D. R. Tags: Open access, Rehabilitation medicine Source Type: research

Protocol for Home-Based Solution for Remote Atrial Fibrillation Screening to Prevent Recurrence Stroke (HUA-TUO AF Trial): a randomised controlled trial
The objective of the study was to explore the use of long-term home-based ECG monitoring for AF detection and stroke prevention in patients with a history of stroke. Methods and analysis This prospective, randomised, open-label trial with blinded endpoint adjudication aimed to evaluate the efficacy of long-term home-based ECG monitoring for AF detection and stroke prevention in a 24-month period. Patients aged >18 years with a history of ischaemic stroke will be stratified according to the time from the index ischaemic stroke: <1, 1–3 and >3 years and then randomised in 1:1 to (1) home-based AF screening an...
Source: BMJ Open - July 15, 2022 Category: General Medicine Authors: Wong, C. K., Hai, J. J., Lau, Y.-M., Zhou, M., LUI, H.-W., Lau, K. K., Chan, K.-H., Mok, T. M., Liu, Y., Feng, Y., Tan, N., Tam, W.-C., Tam, K.-C., Feng, X., Zuo, M.-L., Yin, L.-X., Tan, J., Zhang, W.-J., Jiang, X., Huang, X., Ye, J., Liang, Y., Jiang, W. Tags: Open access, Cardiovascular medicine Source Type: research

Real-world, feasibility study to investigate the use of a multidisciplinary app (Pulsara) to improve prehospital communication and timelines for acute stroke/STEMI care
Conclusions In this Australian-first study, uptake of the digital communication app was strong, patient-centred care timelines improved, although door-to-treatment times remained similar.
Source: BMJ Open - July 18, 2022 Category: General Medicine Authors: Bladin, C. F., Bagot, K. L., Vu, M., Kim, J., Bernard, S., Smith, K., Hocking, G., Coupland, T., Pearce, D., Badcock, D., Budge, M., Nadurata, V., Pearce, W., Hall, H., Kelly, B., Spencer, A., Chapman, P., Oqueli, E., Sahathevan, R., Kraemer, T., Hair, C. Tags: Open access, Communication Source Type: research

Temporal trend of first-ever ischaemic stroke incidence from 2010 to 2019 in South Korea: a nationwide retrospective cohort study
Conclusions Age-standardised incidence rate of ischaemic stroke has decreased from 2010 to 2019 for both man and women. The incidence rate was stable in the younger age groups and decreased in the older age groups, and the disparities between income groups have widened over the past decade. Stroke prevention strategies are needed for the younger age group and the low-income group. Further research is needed to study the risk factors contributing to the incidence of ischaemic stroke in different groups.
Source: BMJ Open - August 24, 2022 Category: General Medicine Authors: Lee, J., Kim, H., Moon, J., Shin, J., Jeong, H., Kim, Y. Tags: Open access, Epidemiology Source Type: research