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Source: BMJ Open

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Total 555 results found since Jan 2013.

Safety and performance of oropharyngeal muscle strength training in the treatment of post-stroke dysphagia during oral feeding: protocol for a systematic review and meta-analysis
Introduction Dysphagia is a common functional disorder after stroke. Most patients post-stroke are incapable of oral feeding, which often leads to complications such as malnutrition, aspiration pneumonia and dehydration that seriously affect the quality of life of patients. Oropharyngeal muscle strength training is a major method of swallowing training, and recent studies have focused on healthy adults, elderly persons, and patients with head and neck cancer or neurodegenerative diseases; but there have been few studies on such training in patients with post-stroke dysphagia. Our study aims to systematically review the saf...
Source: BMJ Open - June 15, 2022 Category: General Medicine Authors: Gao, M., Wang, Y., Xu, L., Wang, X., Wang, H., Song, J., Yang, X., Zhou, F. Tags: Open access, Neurology Source Type: research

Effect of home-based interventions on basic activities of daily living for patients who had a stroke: a systematic review with meta-analysis
Conclusion Home-based rehabilitation with usual care, which varied from no therapy to inpatient or outpatient therapy, may have a short-term effect on the ability to do basic activities of daily living for patients who had a stroke compared with usual care alone. However, the evidence quality is low because of the limited number of studies and participants included in the meta-analysis and the possible publication bias. Future research is needed to investigate the effectiveness of home-based rehabilitation in groups with stratification by stroke severity and time since stroke onset, with elaboration of details of the home-...
Source: BMJ Open - July 28, 2022 Category: General Medicine Authors: Qin, P., Cai, C., Chen, X., Wei, X. Tags: Open access, Rehabilitation medicine Source Type: research

Incidence of stroke, systemic embolism and bleeding events in patients without anticoagulation based on real-world data in Japan: a retrospective cohort study
Conclusions Approximately one-third of the patients do not receive any anticoagulation in the modern DOAC era in Japan. The SSE rate increases by the CHADS2 score. The SSE rate is low in patients with a CHADS2 score <1, supporting no indication of anticoagulation in current guidelines. In patients with a CHADS2 score >1, the use of anticoagulant drug therapy is recommended because of a higher risk of stroke.
Source: BMJ Open - November 10, 2022 Category: General Medicine Authors: Tanizawa, K., Nishimura, Y., Sera, S., Yaguchi, D., Okada, A., Nishikawa, M., Tamaru, S., Nagai, N. Tags: Open access, Epidemiology Source Type: research

Benefit finding in first-ever young and middle-aged patients who had a stroke and their spousal caregivers in China: a longitudinal mixed-methods study protocol
This study is a longitudinal mixed-methods, multicentre study. A total of 142 patients who had a stroke and 142 spousal caregivers will be investigated. Participants will be recruited from four large public hospitals in northern China. Quantitative and qualitative data will be collected at five time points (near discharge and 1, 3, 6 and 12 months following discharge). Validated and reliable questionnaires will be used in quantitative studies. Information on sociodemographic data, BF, functional status, perceived stress, coping styles and mutuality will be collected from the dyads. Qualitative data will be collected via se...
Source: BMJ Open - November 14, 2022 Category: General Medicine Authors: Li, H., Zhang, L., Wang, W., Xiang, D., Zhang, Z., Mei, Y. Tags: Open access, Nursing Source Type: research

Identifying factors explaining practice variation in secondary stroke prevention in primary care: a cohort study based on all patients with ischaemic stroke in the Stockholm region
Conclusions A high practice variation for dispensation of all secondary preventive drugs was observed. Patient and PCC level factors indicating good continuity of care and high level of general practitioner education were associated with higher use of statins. Findings are of importance to policymakers as well as individual providers of care, and more research and actions are needed to minimise inequality in healthcare.
Source: BMJ Open - November 21, 2022 Category: General Medicine Authors: Wolf, M., Hasselström, J. K., Carlsson, A., Euler, M. v., Hasselström, J. Tags: Open access, Neurology Source Type: research

Combined robot motor assistance with neural circuit-based virtual reality (NeuCir-VR) lower extremity rehabilitation training in patients after stroke: a study protocol for a single-centre randomised controlled trial
Introduction Improving lower extremity motor function is the focus and difficulty of post-stroke rehabilitation treatment. More recently, robot-assisted and virtual reality (VR) training are commonly used in post-stroke rehabilitation and are considered feasible treatment methods. Here, we developed a rehabilitation system combining robot motor assistance with neural circuit-based VR (NeuCir-VR) rehabilitation programme involving procedural lower extremity rehabilitation with reward mechanisms, from muscle strength training, posture control and balance training to simple and complex ground walking training. The study aims ...
Source: BMJ Open - December 23, 2022 Category: General Medicine Authors: Zhou, Z.-Q., Hua, X.-Y., Wu, J.-J., Xu, J.-J., Ren, M., Shan, C.-L., Xu, J.-G. Tags: Open access, Rehabilitation medicine Source Type: research

Using body cameras to quantify the duration of a Code Stroke and identify workflow issues: a continuous observation workflow time study
Conclusions Codes are time intensive. Time spent on decision-making was a relatively small component of the overall Code duration. Data from body cameras can provide granular data on all aspects of Code workflow to inform potential areas for improvement at individual centres.
Source: BMJ Open - January 25, 2023 Category: General Medicine Authors: Wong, J. Z. W., Park, P. S. W., Frost, T., Stephens, K., Newk-Fon Hey Tow, F. K., Garcia, P. G., Senanayake, C., Choi, P. M. C. Tags: Open access, Neurology Source Type: research

Recovery beyond functional restoration: a systematic review of qualitative studies of the embodied experiences of people who have survived a stroke
Conclusion The findings demonstrated that the embodied experiences of people who have survived a stroke progressed from feeling disconnected to reconnecting with themselves, others and the world. Stroke recovery should not only be limited to functional restoration. Approaching ‘re-embodiment’, the realignment between oneself and one’s body, is crucial in reintegrating with others and the world on the trajectory toward recovery. PROSPERO registration number CRD42020183125
Source: BMJ Open - February 9, 2023 Category: General Medicine Authors: Lo, T. L. T., Lee, J. L. C., Ho, R. T. H. Tags: Open access, Rehabilitation medicine Source Type: research

Transcranial direct current stimulation combined with bodyweight support-tai chi footwork for motor function of stroke survivors: a study protocol of randomised controlled trial
This study will be an assessor-blinded randomised controlled trial involving 12-week intervention and 6-month follow-up. One hundred and thirty-five individuals with stroke will be randomly divided in a ratio of 1:1:1 into three groups. Control group A, control group B and intervention group C will receive tDCS and conventional rehabilitation programmes (CRPs), BWS-TC and CRP, tDCS-BWS-TC and CRP for 12 weeks, respectively. The primary outcome measures will include the efficacy (Fugl-Meyer Assessment), acceptability and safety of these interventions. The secondary outcome measures will include balance ability (ie, limits o...
Source: BMJ Open - March 7, 2023 Category: General Medicine Authors: Lai, M.-h., Xu, H.-c., Huang, M.-c., Lu, Y., Yang, K., Jiang, L.-m., Yu, X.-m. Tags: Open access, Rehabilitation medicine Source Type: research

Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) in adults with chronic stroke: protocol of a randomised controlled trial
This study will compare the effect of 50 hours of HABIT-ILE against usual motor activity and regular rehabilitation. HABIT-ILE will be provided in a 2-week, adult’s day-camp setting, promoting functional tasks and structured activities. These tasks will continuously progress by increasing their difficulty. Assessed at baseline, 3 weeks after and at 3 months, the primary outcome will be the adults-assisting-hand-assessment stroke; secondary outcomes include behavioural assessments for hand strength and dexterity, a motor learning robotic medical device for quality of bimanual motor control, walking endurance, question...
Source: BMJ Open - April 13, 2023 Category: General Medicine Authors: Ebner-Karestinos, D., Gathy, E., Carton de Tournai, A., Herman, E., Araneda, R., Dricot, L., Macq, B., Vandermeeren, Y., Bleyenheuft, Y. Tags: Open access, Rehabilitation medicine Source Type: research

Simulation modelling to study the impact of adding comprehensive stroke centres. Can we deliver endovascular thrombectomy sooner?
Conclusions This study suggests that adding one or two CSCs in the north of the Netherlands would have modest impact. Improving workflow efficiencies seems to be more potent when aiming to improve existing acute stroke care systems.
Source: BMJ Open - July 24, 2023 Category: General Medicine Authors: Maas, W. J., van der Zee, D.-J., Buskens, E., Uyttenboogaart, M., Lahr, M. M., CONTRAST investigators, Dippel, Majoie, Beusekom, Cate, Dammers, Dijkhuizen, Kappelle, Klijn, Koudstaal, Lingsma, Lugt, Maat, Nederkoorn, Oostenbrugge, Roos, Vivian, Zwam Tags: Open access, Neurology Source Type: research

Exoskeletal wearable robot on ambulatory function in patients with stroke: a protocol for an international, multicentre, randomised controlled study
This study is an international, multicentre, randomised controlled study at five institutions with a total of 150 patients with subacute stroke. Participants will be randomised into two groups (75 patients in the robot-assisted gait training (RAGT) group and 75 patients in the control group). The gait training will be performed with a total of 20 sessions (60 min/session); 5 sessions a week for 4 weeks. The RAGT group will receive 30 min of gait training using an exoskeleton (ANGEL LEGS M20, Angel Robotics) and 30 min of conventional gait training, while the control group will receive 60 min conventional gait training. In ...
Source: BMJ Open - August 11, 2023 Category: General Medicine Authors: Chang, W. H., Kim, T.-W., Kim, H. S., Hanapiah, F. A., Kim, D. H., Kim, D. Y. Tags: Open access, Rehabilitation medicine Source Type: research

Effectiveness of acceptance and commitment therapy in patients who had a stroke: a systematic review protocol
This study aimed to systematically evaluate the intervention effect of ACT in patients who had a stroke, which may provide further clinical evidence. Methods and analysis A systematic search of databases, including CNKI, WanFang Data, VIP, CBM, PubMed, Embase, Cochrane Library, CINAHL and APA PsycArticles, will be conducted from their inception to 31 October 2022. All randomised controlled trials, quasi-experiments and case studies relevant to ACT will be included in English and Chinese. Two independent reviewers will conduct the review, with data extraction and quality evaluation. Review Manager V.5.4 will be used to ass...
Source: BMJ Open - August 17, 2023 Category: General Medicine Authors: Xu, K., Zhang, X. Y., Ma, J. Y., Guo, X., Zhu, S.-S., Zhang, H., Sun, Y. Y. Tags: Open access, Mental health Source Type: research

Supportive care needs of patients who had a stroke: a scoping review protocol
Introduction Incidences of stroke are on the rise and approximately 80 million stroke survivors worldwide live with disabilities. Supportive care needs of stroke survivors are not adequately defined, and the assessment tools to help care service providers identify these needs are unclear. The overall aim of this scoping review will be to map the supportive care needs of stroke survivors against the Supportive Care Needs Framework. Methods and analysis This scoping review will be conducted following Arksey and O’Malley’s methodological framework and Joanna Briggs Institute (JBI) updated methodological guidance ...
Source: BMJ Open - August 24, 2023 Category: General Medicine Authors: Zhang, H., Xu, K., Ma, J. Y., Zhang, X. Y., Sun, Y. Y., Xiao, L. D., Yan, F., Luo, Y. Y., Tang, S. Tags: Open access, Health services research Source Type: research

A randomised controlled trial to compare the clinical and cost-effectiveness of prism glasses, visual search training and standard care in patients with hemianopia following stroke: a protocol
This study has been developed and supported by the UK Stroke Research Network Clinical Studies Group working with service users. Multicentre ethical approval was obtained through the North West 6 Research ethics committee (Reference 10/H1003/119). The trial is funded by the UK Stroke Association. Trial Registration: Current Controlled Trials ISRCTN05956042. Dissemination will consider usual scholarly options of conference presentation and journal publication in addition to patient and public dissemination with lay summaries and articles. Trial Registration Current Controlled Trials ISRCTN05956042.
Source: BMJ Open - July 17, 2014 Category: Journals (General) Authors: Rowe, F. J., Barton, P. G., Bedson, E., Breen, R., Conroy, E. J., Cwiklinski, E., Dodridge, C., Drummond, A., Garcia-Finana, M., Howard, C., Johnson, S., MacIntosh, C., Noonan, C. P., Pollock, A., Rockliffe, J., Sackley, C., Shipman, T., VISION (vision im Tags: Open access, Neurology, Ophthalmology, Rehabilitation medicine Protocol Source Type: research