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Total 923 results found since Jan 2013.

Statin and dual antiplatelet therapy for the prevention of early neurological deterioration and recurrent stroke in branch atheromatous disease: a protocol for a prospective single-arm study using a historical control for comparison
Introduction Branch atheromatous disease (BAD) contributes to small-vessel occlusion in cases of occlusion or stenosis of large calibre penetrating arteries, and it is associated with a higher possibility of early neurological deterioration (END) and recurrent stroke in acute ischaemic stroke. As the pathology of BAD is due to atherosclerosis, we postulate that early intensive medical treatment with dual antiplatelet therapy (DAPT) and high-intensity statins may prevent END and recurrent stroke in acute small subcortical infarction caused by BAD. Methods and analysis In this prospective, single-centre, open-label, non-ran...
Source: BMJ Open - November 26, 2021 Category: General Medicine Authors: Huang, Y.-C., Lee, J.-D., Weng, H.-H., Lin, L.-C., Tsai, Y.-H., Yang, J.-T. Tags: Open access, Neurology Source Type: research

Person-centred care transitions for people with stroke: study protocol for a feasibility evaluation of codesigned care transition support
This study protocol describes the evaluation of a feasibility study using a non-randomised controlled design. The codesigned care transition support includes patient information using videos, leaflets and teach back; what-matters-to me dialogue; a coordinated rehabilitation plan; bridged e-meeting; and a message system for cross-organisational collaboration. Patients with stroke, first time or recurrent, who are to be discharged home from hospital and referred to a rehabilitation team in primary healthcare for continued rehabilitation in the home will be included. One week after stroke, data will be collected on the primar...
Source: BMJ Open - December 23, 2021 Category: General Medicine Authors: Flink, M., Lindblom, S., Tistad, M., Laska, A. C., Bertilsson, B. C., Wärlinge, C., Hasselström, J., Elf, M., von Koch, L., Ytterberg, C. Tags: Open access, Neurology Source Type: research

Exploring the experiences of stroke survivors, informal caregivers and healthcare providers in Sierra Leone: a qualitative study protocol
This study has received ethical approval from the Sierra Leone Ethics and Scientific Review Committee (8 December 2020) and the KCL Biomedical & Health Sciences, Dentistry, Medicine and Natural & Mathematical Sciences Research Ethics Subcommittee (reference: HR-20/21-21050). The findings of the study and learning in terms of the process of coproduction and involvement of stroke survivors will be disseminated via peer-reviewed publications, conferences, media and lay reports.
Source: BMJ Open - December 30, 2021 Category: General Medicine Authors: O'Hara, J., Thompson, M., Deen, G., Leather, A. J. M., Youkee, D., Wall, J., Sackley, C., Parmar, D., McKevitt, C., NIHR Global Health Research Group at Kings College London, Wolfe, Langhorne, Lisk, Deen, McKevitt, Watkins, Leather, Prince, Youkee, Wang, Tags: Open access, Qualitative research Source Type: research

A Scoping Review of the Incidence, Predictors, and Outcomes of Delirium Among Critically Ill Stroke Patients
CONCLUSIONS: Current findings are limited by heterogenous populations, assessments, and measurement parameters. Detection and management of delirium among critically ill stroke patients requires an approach with specific considerations to the complexities of acute neurological injury and concomitant critical illness.
Source: Journal of Neuroscience Nursing - May 13, 2022 Category: Neuroscience Tags: Articles Source Type: research

Effects of a nurse-led peer support intervention for stroke survivors: protocol for a randomised controlled trial
This study aims to develop a nurse-led peer support intervention for stroke survivors based on the Person–Environment–Occupation–Performance Model and evaluate its effects on the psychosocial outcomes of stroke survivors. Methods and analysis This is an assessor-blinded two-arm randomised controlled trial. A convenience sample of 120 stroke survivors will be recruited from two community centres and one rehabilitation unit in Yangzhou, a medium-sized city in eastern China, with 60 participants each in the intervention and control groups. The participants allocated to the intervention group will receive th...
Source: BMJ Open - June 10, 2022 Category: General Medicine Authors: Wan, X., Chau, J. P. C., Wu, Y., Xu, L., Gong, W. Tags: Open access, Rehabilitation medicine Source Type: research

RECREATE: a study protocol for a multicentre pilot cluster randomised controlled trial (cRCT) in UK stroke services evaluating an intervention to reduce sedentary behaviour in stroke survivors (Get Set Go) with embedded process and economic evaluations
This study is a pragmatic, multicentre, two-arm, external pilot cluster randomised controlled trial with embedded process and economic evaluations. UK-based stroke services will be randomised 1:1 to the intervention (usual care plus Get Set Go) or control (usual care) arm. Fifteen stroke services will recruit 300–400 stroke inpatient and carer participants, with follow-up at 6, 12 and 24 months. The proposed primary endpoint is stroke survivor self-reported Nottingham Extended Activities of Daily Living scale at 12 months. Endpoint analyses will be exploratory and provide preliminary estimates of intervention effect....
Source: BMJ Open - July 30, 2023 Category: General Medicine Authors: Airlie, J., Burton, L.-J., Copsey, B., English, C., Farrin, A., Fitzsimons, C. F., Holloway, I., Horrocks, J., Johansson, J. F., Mead, G., Moreau, L. A., Ozer, S., Patel, A., Yaziji, N., Forster, A., on behalf of the RECREATE Programme Management Group, A Tags: Open access, Rehabilitation medicine Source Type: research

Electromechanical-assisted training for walking after stroke.
CONCLUSIONS: People who receive electromechanical-assisted gait training in combination with physiotherapy after stroke are more likely to achieve independent walking than people who receive gait training without these devices. Specifically, people in the first three months after stroke and those who are not able to walk seem to benefit most from this type of intervention. The role of the type of device is still not clear. Further research should consist of a large definitive, pragmatic, phase III trial undertaken to address specific questions such as the following: What frequency or duration of electromechanical-assisted ...
Source: Cochrane Database of Systematic Reviews - July 25, 2013 Category: Journals (General) Authors: Mehrholz J, Elsner B, Werner C, Kugler J, Pohl M Tags: Cochrane Database Syst Rev Source Type: research

Gamma aminobutyric acid (GABA) receptor agonists for acute stroke.
CONCLUSIONS: This review does not provide the evidence to support the use of GABA receptor agonists (chlormethiazole or diazepam) for the treatment of patients with acute ischemic or hemorrhagic stroke. Chlormethiazole appeared to be beneficial in improving functional independence in patients with TACS according to the subgroup analysis, but this result must be interpreted with great caution. More well-designed RCTs with large samples of TACS would be required for further confirmation. However, somnolence and rhinitis are frequent adverse events related to chlormethiazole. PMID: 25097101 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - August 6, 2014 Category: Journals (General) Authors: Liu J, Wang LN Tags: Cochrane Database Syst Rev Source Type: research

Retrospective case review of missed opportunities for primary prevention of stroke and TIA in primary care: protocol paper
This study will investigate: (1) the proportion of strokes/TIAs with prior missed opportunities for prevention in primary care; (2) the influence of patient characteristics on missed prevention opportunities and (3) how the proportion of missed prevention opportunities has changed over time. Methods and analysis A retrospective case review will identify first-ever stroke and patients with TIA between 2000 and 2013 using anonymised electronic medical records extracted from the health improvement network (THIN) database. Four categories of missed opportunities for stroke/TIA prevention will be sought: untreated high blood p...
Source: BMJ Open - November 11, 2014 Category: Journals (General) Authors: Moran, G. M., Calvert, M., Feltham, M. G., Marshall, T. Tags: Open access, Cardiovascular medicine, Epidemiology, General practice / Family practice, Global health Protocol Source Type: research

Process improvement to enhance existing stroke team activity toward more timely thrombolytic treatment.
CONCLUSIONS: PI is effective for continuous improvement of the existing process by reducing the time delays between ED arrival and IV thrombolysis in acute stroke patients. PMID: 25324882 [PubMed]
Source: Journal of Clinical Neurology - December 2, 2014 Category: Neurology Tags: J Clin Neurol Source Type: research

Transcranial direct current stimulation (tDCS) for improving aphasia in patients with aphasia after stroke.
CONCLUSIONS: Currently there is no evidence of the effectiveness of tDCS (anodal tDCS, cathodal tDCS and bihemispheric tDCS) versus control (sham tDCS) for improving functional communication, language impairment and cognition in people with aphasia after stroke. Further RCTs are needed in this area to determine the effectiveness of this intervention. Authors of future research should adhere to the CONSORT Statement. PMID: 25929694 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - May 1, 2015 Category: Journals (General) Authors: Elsner B, Kugler J, Pohl M, Mehrholz J Tags: Cochrane Database Syst Rev Source Type: research

Cerebrolysin for acute ischaemic stroke.
CONCLUSIONS: Routine administration of Cerebrolysin to people with acute ischaemic stroke cannot be supported by the available evidence from RCTs. PMID: 26083192 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - June 17, 2015 Category: Journals (General) Authors: Ziganshina LE, Abakumova T Tags: Cochrane Database Syst Rev Source Type: research

Fibrates for secondary prevention of cardiovascular disease and stroke.
CONCLUSIONS: Moderate evidence showed that the fibrate class can be effective in the secondary prevention of composite outcome of non-fatal stroke, non-fatal MI, and vascular death. However, this beneficial effect relies on the inclusion of clofibrate data, a drug that was discontinued in 2002 due to its unacceptably large adverse effects. Further trials of the use of fibrates in populations with previous stroke and also against a background treatment with statins (standard of care) are required. PMID: 26497361 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - October 25, 2015 Category: Journals (General) Authors: Wang D, Liu B, Tao W, Hao Z, Liu M Tags: Cochrane Database Syst Rev Source Type: research

Design, methodology and baseline characteristics of Tai Chi and its protective effect against ischaemic stroke risk in an elderly community population with risk factors for ischaemic stroke: a randomised controlled trial
Introduction Controlling risk factors with regular exercise is effective and cost-effective for the primary prevention of ischaemic stroke. As a traditional Chinese form of exercise, Tai Chi might be beneficial in decreasing ischaemic stroke, but the evidence remains insufficient. We hypothesise that elderly community adults with risk factors for ischaemic stroke will decrease their ischaemic stroke risk by improving cerebral haemodynamic parameters, cardiopulmonary function, motor function, plasma risk indices, physical parameters or psychological outcomes after receiving 12 weeks of regular Tai Chi training compared...
Source: BMJ Open - December 23, 2015 Category: Journals (General) Authors: Zheng, G., Zheng, X., Li, J., Duan, T., Qi, D., Ling, K., He, J., Chen, L. Tags: Open access, Public health, Sports and exercise medicine Protocol Source Type: research

Understanding stroke survivors and informal carers experiences of and need for primary care and community health services--a systematic review of the qualitative literature: protocol
Introduction Despite the rising prevalence of stroke, no comprehensive model of postacute stroke care exists. Research on stroke has focused on acute care and early supported discharge, with less attention dedicated to longer term support in the community. Likewise, relatively little research has focused on long-term support for informal carers. This review aims to synthesise and appraise extant qualitative evidence on: (1) long-term healthcare needs of stroke survivors and informal carers, and (2) their experiences of primary care and community health services. The review will inform the development of a primary care mode...
Source: BMJ Open - January 6, 2016 Category: Journals (General) Authors: Aziz, N. A., Pindus, D. M., Mullis, R., Walter, F. M., Mant, J., Lim, Rundell, Hobbs Tags: Open access, General practice / Family practice, Qualitative research, Research methods Protocol Source Type: research