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Source: BMJ Open

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Total 555 results found since Jan 2013.

Evaluation of a community-based performance arts programme for people who have experienced stroke in the UK: protocol for the SHAPER-Stroke Odysseys study
In this study, we aim to evaluate the implementation, impact and experiences of SO for stroke survivors. Methods and analysis Scaling-up Health Arts Programmes: Implementation and Effectiveness Research (SHAPER)-SO aims to scale-up SO to 75 participants and 47 stakeholders, while simultaneously evaluating the effectiveness and implementation of the programme. The main research aim is to evaluate the implementation, effectiveness, impact and experiences of a community-based performance arts programme (SO for stroke survivors). This mixed-methods study will evaluate the experience and impact of SO on those participating usi...
Source: BMJ Open - March 11, 2022 Category: General Medicine Authors: Estevao, C., Baldellou Lopez, M., Davis, R. E., Jarret, L., Soukup, T., Bakolis, I., Healey, A., Harrington, J., Woods, A., Crane, N., Jones, F., Pariante, C., Fancourt, D., Sevdalis, N. Tags: Open access, Qualitative research Source Type: research

Repetitive transcranial magnetic stimulation for upper limb motor function and activities of daily living in patients with stroke: a protocol of a systematic review and Bayesian network meta-analysis
Introduction Patients with stroke usually suffer from varying degrees of movement dysfunction, which seriously affects their quality of life, especially for the upper limb dysfunction. Therefore, this study aims to compare the effects of different repetitive transcranial magnetic stimulation (rTMS) modalities on upper limb motor function and daily activities in patients with stroke. Methods and analysis Relevant research will be collected systematically from PubMed, Web of Science, Embase, Cochrane Library, ProQuest, Wanfang Database, China National Knowledge Infrastructure and Chinese Scientific and Journal Database (VIP...
Source: BMJ Open - March 10, 2022 Category: General Medicine Authors: Lu, Y., Xia, Y., Wu, Y., Pan, X., Wang, Z., Li, Y. Tags: Open access, Evidence based practice Source Type: research

Telerehabilitation for lower extremity recovery poststroke: a systematic review and meta-analysis protocol
Introduction Approximately 30% of individuals with stroke report unmet lower extremity recovery needs after formal hospital-based rehabilitation programmes have ended. Telerehabilitation can mitigate issues surrounding accessibility of rehabilitation services by providing ongoing support to promote recovery, however, no review exists that is specific to telerehabilitation for lower extremity recovery. This paper describes the protocol of a systematic review and meta-analysis that aims to describe and evaluate the effectiveness of lower extremity-focused telerehabilitation interventions on clinical outcomes poststroke. Met...
Source: BMJ Open - March 9, 2022 Category: General Medicine Authors: Park, S., Tang, A., Pollock, C., Sakakibara, B. M. Tags: Open access, Rehabilitation medicine Source Type: research

Effects of ACE inhibitors and angiotensin receptor blockers: protocol for a UK cohort study using routinely collected electronic health records with validation against the ONTARGET trial
Introduction Cardiovascular disease is a leading cause of death globally, responsible for nearly 18 million deaths worldwide in 2017. Medications to reduce the risk of cardiovascular events are prescribed based on evidence from clinical trials which explore treatment effects in an indicated sample of the general population. However, these results may not be fully generalisable because of trial eligibility criteria that generally restrict to younger patients with fewer comorbidities. Therefore, evidence of effectiveness of medications for groups underrepresented in clinical trials such as those aged ≥75 years, from ethni...
Source: BMJ Open - March 8, 2022 Category: General Medicine Authors: Baptiste, P. J., Wong, A. Y. S., Schultze, A., Cunnington, M., Mann, J. F. E., Clase, C., Leyrat, C., Tomlinson, L. A., Wing, K. Tags: Open access, Epidemiology 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 of mortality in acute ischemic stroke treated with endovascular thrombectomy despite successful reperfusion: subgroup analysis of a multicentre randomised clinical trial
Conclusions Symptomatic ICH and high post-thrombectomy NIHSS score are strong predictor of 90-day mortality in acute ischaemic stroke treated with mechanical thrombectomy despite successful reperfusion, as well as high NIHSS score and high glucose level at hospital arrival. However, further studies need to be performed to confirm the association between smoking and mortality.
Source: BMJ Open - March 1, 2022 Category: General Medicine Authors: Li, H., Huang, J., Ye, S., Chen, H., Yuan, L., Liao, G., Du, W., Li, C., Fang, L., Liu, S., Yang, P., Zhang, Y., Xing, P., Zhang, X., Ye, X., Peng, Y., Cao, J., Zhang, L., Yang, Z., Liu, J., on behalf of the DIRECT-MT investigators, Yang, Zhang, Zhang, Zh Tags: Open access, Neurology Source Type: research

Safety, feasibility, acceptability and preliminary effects of the Neurofenix platform for Rehabilitation via HOMe Based gaming exercise for the Upper-limb post Stroke (RHOMBUS): results of a feasibility intervention study
Conclusion The Neurofenix platform is a safe, feasible and well accepted way to support UL training for people at least three months poststroke. Trial registration number ISRCTN60291412.
Source: BMJ Open - February 28, 2022 Category: General Medicine Authors: Kilbride, C., Scott, D. J. M., Butcher, T., Norris, M., Warland, A., Anokye, N., Cassidy, E., Baker, K., Athanasiou, D. A., Singla-Buxarrais, G., Nowicky, A., Ryan, J. Tags: Open access, Rehabilitation medicine Source Type: research

Bedtime versus morning use of antihypertensives for cardiovascular risk reduction (BedMed): protocol for a prospective, randomised, open-label, blinded end-point pragmatic trial
Introduction Sleep-time blood pressure correlates more strongly with adverse cardiovascular events than does daytime blood pressure. The BedMed trial evaluates whether bedtime antihypertensive administration, as compared with conventional morning use, reduces major adverse cardiovascular events. Methods and analysis Design Prospective randomised, open-label, blinded end-point trial. Participants Hypertensive primary care patients using blood pressure lowering medication and free from glaucoma. Setting Community primary care providers in 5 Canadian provinces (British Columbia, Alberta, Saskatchewan, Manitoba and Ontario) a...
Source: BMJ Open - February 24, 2022 Category: General Medicine Authors: Garrison, S. R., Kolber, M. R., Allan, G. M., Bakal, J., Green, L., Singer, A., Trueman, D. R., McAlister, F. A., Padwal, R. S., Hill, M. D., Manns, B., McGrail, K., O'Neill, B., Greiver, M., Froentjes, L. S., Manca, D. P., Mangin, D., Wong, S. T., MacLea Tags: Open access, Cardiovascular medicine Source Type: research

Impact of interankle blood pressure difference on major adverse cardiovascular events in cryptogenic stroke patients without peripheral artery disease: a retrospective cohort study
Conclusions Large IAND is independently associated with the long-term occurrence of MACEs in patients with CS without PAD. In particular, the association between IAND and MACEs is only valid in elderly patients.
Source: BMJ Open - February 23, 2022 Category: General Medicine Authors: Han, M., Baik, M., Kim, Y. D., Choi, J., Seo, K., Park, E., Heo, J. H., Nam, H. S. Tags: Open access, Neurology Source Type: research

Development of cognition decline in non-acute symptomatic patients with cerebral small vessel disease: Non-Acute Symptomatic Cerebral Ischemia Registration study (NASCIR)--rationale and protocol for a prospective multicentre observational study
This study aims to investigate risk factors, clinical course, cerebral and retinal imaging changes, proteomics features of non-symptomatic ischaemia symptomatic patients with cognitive decline. Methods and analysis The Non-Acute Symptomatic Cerebral Ischemia Registration study is a multicentre, registry-based, prospective observational study, is designed to investigate the cognitive decline in non-acute ischaemia symptomatic patients. We will recruit 500 non-acute ischaemia symptomatic patients from four tertiary hospitals in China. For this study, non-acute ischaemia symptoms will be defined as headaches, dizziness and m...
Source: BMJ Open - February 22, 2022 Category: General Medicine Authors: Zhang, S., Wang, Z., Liu, P., Tuo, Q., Cheng, Y., Xu, M., Wu, Q., Lei, P., Dai, L., Kwapong, W. R., Tan, M., Liu, M. Tags: Open access, Neurology Source Type: research

Hypertension in the South African public healthcare system: a cost-of-illness and burden of disease study
Conclusion Hypertension exerts a heavy health and economic burden on South Africa. Establishing cost-effective best practice guidelines for hypertension treatment requires further research. Such research will be essential if South Africa is to make progress in its efforts to implement universal healthcare.
Source: BMJ Open - February 22, 2022 Category: General Medicine Authors: Kohli-Lynch, C. N., Erzse, A., Rayner, B., Hofman, K. J. Tags: Open access, Health economics Source Type: research

Effectiveness of transcranial direct current stimulation on hand dexterity in stroke patients: a protocol for a systematic review and meta-analysis
Introduction Hand dexterity is the ability to execute the skilful movements using the hand and fingers. It is commonly impaired poststroke resulting in a profound deterioration in the quality of life for patients with stroke. Transcranial direct current stimulation (tDCS) is a form of non-invasive brain stimulation, which has gained a popularity as an adjunct therapy in recovering motor dysfunction poststroke. Promising results have been gained from applying tDCS in combination with motor rehabilitation, however, the outcome of tDCS on the upper limb motor function poststroke has been varied. Different results are potentia...
Source: BMJ Open - February 16, 2022 Category: General Medicine Authors: Alabdulaali, L., Hickman, L., Punt, T. D., Jenkinson, N. Tags: Open access, Rehabilitation medicine Source Type: research

Validating risk models versus age alone for atrial fibrillation in a young Dutch population cohort: should atrial fibrillation risk prediction be expanded to younger community members?
Conclusion Multivariable models accurately discriminate for 5-year and 10-year AF risk among young European community-dwelling individuals. However, their additional discriminatory value over age alone was limited. Selection strategies for primary AF screening using multivariable models should not be expanded to younger individuals.
Source: BMJ Open - February 16, 2022 Category: General Medicine Authors: Himmelreich, J. C. L., Harskamp, R. E., Geelhoed, B., Virdone, S., Lucassen, W. A. M., Gansevoort, R. T., Rienstra, M. Tags: Open access, Cardiovascular medicine Source Type: research

Effect of a tailored multidimensional intervention on the care burden among family caregivers of stroke survivors: a randomised controlled trial
Conclusion The main results showed that participants in the IG did not experience an improvement in the main outcomes. Nevertheless, the improvement in the psychological and social domains may have been attributed to our intervention. Trial registration number NCT04211662.
Source: BMJ Open - February 15, 2022 Category: General Medicine Authors: Elsheikh, M. A., Moriyama, M., Rahman, M. M., Kako, M., EL-Monshed, A. H., Zoromba, M., Zehry, H., Khalil, M. H., El-Gilany, A.-H., Amr, M. Tags: Open access, Nursing Source Type: research

TACTICS - Trial of Advanced CT Imaging and Combined Education Support for Drip and Ship: evaluating the effectiveness of an 'implementation intervention in providing better patient access to reperfusion therapies: protocol for a non-randomised controlled stepped wedge cluster trial in acute stroke
Introduction Stroke reperfusion therapies, comprising intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT), are best practice treatments for eligible acute ischemic stroke patients. In Australia, EVT is provided at few, mainly metropolitan, comprehensive stroke centres (CSC). There are significant challenges for Australia’s rural and remote populations in accessing EVT, but improved access can be facilitated by a ‘drip and ship’ approach. TACTICS (Trial of Advanced CT Imaging and Combined Education Support for Drip and Ship) aims to test whether a multicomponent, multidisciplinary impleme...
Source: BMJ Open - February 11, 2022 Category: General Medicine Authors: Ryan, A., Paul, C. L., Cox, M., Whalen, O., Bivard, A., Attia, J., Bladin, C., Davis, S. M., Campbell, B. C. V., Parsons, M., Grimley, R. S., Anderson, C., Donnan, G. A., Oldmeadow, C., Kuhle, S., Walker, F. R., Hood, R. J., Maltby, S., Keynes, A., Delcou Tags: Open access, Health services research Source Type: research