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The effect of telerehabilitation on balance in stroke patients: is it more effective than the traditional rehabilitation model? A meta-analysis of randomized controlled trials published during the COVID-19 pandemic
ConclusionStudies on changes in medical conditions during the COVID-19 pandemic also demonstrated that, for stroke patients, telerehabilitation achieves similar effects as the conventional rehabilitation model and can act as a continuation of the conventional rehabilitation model. Owing to the different equipment and intervention programs of telerehabilitation, its curative effect on the static balance and reactive balance of stroke patients may be different. Currently, telerehabilitation may be more conducive to the rehabilitation of patients' static balance abilities, while conventional rehabilitation is more effective f...
Source: Frontiers in Neurology - May 17, 2023 Category: Neurology Source Type: research

Botulinum toxin use in patients with post-stroke spasticity: a nationwide retrospective study from France
ConclusionOur analysis of the exhaustive PMSI database showed a suboptimal implementation of BoNT-A treatment recommendations in France. BoNT-A treatment initiation and re-administration are low, particularly in patients with post-stroke spasticity. Further investigations may help explain this observation, and may target specific actions to improve spasticity-related care pathway.
Source: Frontiers in Neurology - August 23, 2023 Category: Neurology Source Type: research

Triage of Acute Ischemic Stroke in Confirmed COVID-19: Large Vessel Occlusion Associated With Coronavirus Infection
We present our experience with an in-hospital stroke code called on a COVID-19-positive patient with a left middle cerebral artery syndrome and the challenges faced for timely examination, imaging, and decision to intervene. The outlook for the ongoing COVID-19 pandemic necessitates the development of protocols to sustain timely and effective acute stroke care while mitigating healthcare-associated transmission.
Source: Frontiers in Neurology - April 20, 2020 Category: Neurology Source Type: research

Care Process of Recanalization Therapy for Acute Stroke during the COVID-19 Outbreak in South Korea.
CONCLUSIONS: These findings suggest that a prehospital delay occurred during the COVID-19 outbreak, and that patients with acute stroke might have been reluctant to visit and stay in hospitals. Our findings indicate that attention should be paid to prehospital care and the behavior of patients with acute stroke during the COVID-19 outbreak. PMID: 33480200 [PubMed]
Source: Journal of Clinical Neurology - January 24, 2021 Category: Neurology Tags: J Clin Neurol Source Type: research

Impact of the COVID-19 lockdown on the adherence of stroke patients to direct oral anticoagulants: a secondary analysis from the MAAESTRO study
ConclusionOur data suggest that a major disruption of social life (i.e., the imposed COVID-19 lockdown) is unlikely to relevantly affect the medication intake behaviour of patients with high pre-established adherence, but might have an impact in patients with previously suboptimal adherence.Trial registration numberMAAESTRO: electronic Monitoring and improvement of Adherence to direct oral Anticoagulant treatment —a randomized crossover study of an Educational and reminder-based intervention in ischaemic STROke patients under polypharmacy, NCT03344146.
Source: Journal of Neurology - June 3, 2021 Category: Neurology Source Type: research

Impact of improved stroke green channel process on the delay of intravenous thrombolysis in patients with acute cerebral infarction during the COVID-19 pandemic: An observational study
ConclusionDuring the two periods of the COVID-19 outbreak (SARS-CoV-2 and Omicron), after the improvement of the green channel for intravenous thrombolysis, there might be some delay in in-hospital DIT during the SARS-CoV-2 outbreak, however, the in-hospital delay indicator DNT for intravenous thrombolysis were not affected.
Source: Frontiers in Neurology - September 26, 2022 Category: Neurology Source Type: research

Acute stroke management pathway during Coronavirus-19 pandemic
AbstractSince the outbreak of the COVID-19 epidemic which in our region, Veneto (Italy), dates back to February, we were confronted with several challenges, but with a constant aim of keeping our Stroke Unit COVID-free. For this reason, in addition to creating a dedicated hot-spot as a pre-triage just outside the Emergency Department, together with the Neuroradiology Unit we obtained a mobile CT unit that could be used by COVID-positive or COVID-suspected patients. Furthermore, thanks to the collaboration with colleagues from different specialties (Infectious Disease, Internal Medicine, Intensive Care, Emergency Medicine),...
Source: Neurological Sciences - April 8, 2020 Category: Neurology Source Type: research

Effect of lockdown on the management of ischemic stroke: an Italian experience from a COVID hospital
ConclusionsDue to the COVID-19 pandemic and lockdown measures, the stroke care pathway changed, involving both pre-hospital and in-hospital performances.
Source: Neurological Sciences - July 5, 2020 Category: Neurology Source Type: research

Impact of SARS-CoV-2 on reperfusion therapies for acute ischemic stroke in Lombardy, Italy: the STROKOVID network
AbstractWhether and how SARS-CoV-2 outbreak affected in-hospital acute stroke care system is still matter of debate. In the setting of the STROKOVID network, a collaborative project between the ten centers designed as hubs for the treatment of acute stroke during SARS-CoV-2 outbreak in Lombardy, Italy, we retrospectively compared clinical features and process measures of patients with confirmed infection (COVID-19) and non-infected patients (non-COVID-19) who underwent reperfusion therapies for acute ischemic stroke. Between March 8 and April 30, 2020, 296 consecutive patients [median age, 74 years (interquartile range (IQ...
Source: Journal of Neurology - March 8, 2021 Category: Neurology Source Type: research

Increased Incidence of In-Hospital Ischemic Stroke During SARS-CoV-2 Outbreak: A Single-Center Study
ConclusionsSARS-CoV-2 outbreak was associated with an increase in the incidence of IHIS when compared with inpatients from a historical cohort. Viral infection itself may be related to the increased risk of IHIS among patients with COVID-19, but in view of our results from the 20NCC, it is likely that other factors, such as hospital saturation and overwhelming of health systems, may have played a role in the increased frequency of IHIS.
Source: Neurocritical Care - July 15, 2021 Category: Neurology Source Type: research

Covert COVID-19 complications: Continuing the use of evidence-based drugs to minimize potentially lethal indirect effects of the pandemic in stroke patients
Stroke and cardiovascular diseases are the world's biggest killers, globally accounting for over 15 million deaths each year (https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death). Since the Coronavirus Disease 2019 (COVID-19) outbreak in Wuhan, China and its rapid spread to other countries, as of April 272,020, there were about 3 million cases with over 190,000 deaths worldwide. However, actual situation might be even more dire, since such statistics likely do not fully display the entire impact of COVID-19, especially with regard to its influence on patients with a history of stroke who need to tak...
Source: Journal of the Neurological Sciences - May 5, 2020 Category: Neurology Authors: Meng Lee, Chi-Hsin Sally Chen, Bruce Ovbiagele Tags: Letter to the Editor Source Type: research

COVID-19 and Stroke: Casual or Causal Role?
We present a case of stroke in a 62-year-old COVID-19-positive patient, with multiple vascular risk factors. The patient arrived 1 h after onset of symptoms, was treated with recombinant tissue plasminogen activator (rtPA) with improvement of neurologic deficits, and later developed right foot arterial ischemia (recanalized by balloon catheter angioplasty) and left arm superficial venous thrombosis. A control computed tomography (CT) scan 7 days after onset showed hemorrhagic transformation of ischemic lesion without mass effect. However, respiratory and neurologic conditions improved so that the patient was discharged to ...
Source: Cerebrovascular Diseases - July 7, 2020 Category: Neurology Source Type: research

A single-centre experience of intravenous thrombolysis for stroke in COVID-19 patients
In conclusion, in this article, we provide information about these cases and discuss the possible explanation behind this trend.
Source: Neurological Sciences - July 11, 2020 Category: Neurology Source Type: research

An Example of a Stroke Unit Reshaping in the Context of a Regional Hub and Spoke System in the COVID-19 Era
In conclusion, we were able to manage the new hub-and-spoke system safely and without significant delays. The reshaping of the SU was made possible by the significant reduction of out-patient activity. The consequences of this reduction are still unknown but eventually, this emergency will suggest ways to reconsider the management and the allocation of health system resources.
Source: Frontiers in Neurology - October 15, 2020 Category: Neurology Source Type: research

Delayed Stroke Treatment during COVID-19 Pandemic in China
Conclusions: COVID-19 pandemic has remarkable impacts on the management of AIS. Both pre- and posthospital delays were prolonged significantly, and proportion of patients arrived within the 4.5-h time window for intravenous thrombolysis treatment was decreased. Given that anti-COVID-19 measures are becoming medical routines, efforts are warranted to shorten the delay so that the outcomes of stroke could be improved.Cerebrovasc Dis
Source: Cerebrovascular Diseases - July 9, 2021 Category: Neurology Source Type: research

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