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Total 466 results found since Jan 2013.

Bilateral vertebral artery dissection and cerebellar stroke: a rare complication of massage.
We describe the case of a 39-year-old male, who presented to our emergency department after a one-day history of headache and vomiting, with associated sudden onset posterior neck pain and cerebellar signs following a massage. Computed tomography angiogram and brain demonstrated bilateral vertebral artery dissection and cerebellar stroke. He was admitted to hospital for monitoring and conservative management with antiplatelet therapy, resulting in a good outcome. This is the first reported case of bilateral vertebral artery dissection and stroke to be associated with massage. This case also suggests, unlike many reports in...
Source: New Zealand Medical Journal - April 5, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Ischemic Stroke in Young Adults
This article reviews current knowledge on epidemiology, risk factors and causes, diagnostic considerations, management, and prognosis of ischemic stroke in young adults (those 55 years old and younger). RECENT FINDINGS The incidence of ischemic stroke in young adults has been increasing since the 1980s, which has occurred in parallel with increasing prevalence of vascular risk factors and substance abuse among the younger population. Young adults have a considerably wider range of risk factors than older patients, including age-specific factors such as pregnancy/puerperium and oral contraceptive use. Behavioral risk fac...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Quality benchmarks for chest pain units and stroke units in Germany.
CONCLUSION: As reimbursement for emergency medicine in Germany was recently rearranged, quality benchmarking has gained incremental importance. Mandatory joint quality measurement in both concepts ensuring gap analysis and process improvement is encouraged. PMID: 31970463 [PubMed - as supplied by publisher]
Source: Herz - January 25, 2020 Category: Cardiology Tags: Herz Source Type: research

Appraisal of Health States Worse than Death in Patients with Acute Stroke (S714)
Goals of care discussions are frequently indicated after acute stroke. Many of these conversations happen without direct patient participation secondary to aphasia or encephalopathy.
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Elyse Everett, William Everett, Matthew Brier, Patrick White Source Type: research

This Stroke Changed My Life and I Need Help: Social Media Resources for Bilingual Caregivers of Stroke Victims (S753)
Stroke remains a leading cause of long-term disability and burdened quality of life not only for stroke survivors with remaining disability (SSRDs) but also for the informal caregivers (ICGs) who care for them. Approximately 50% of SSRDs will require ICG hands-on support, precluding them from leaving home. With current technology, social media might be the only way for ICG to gain training/access support. What resources are available out there for ICGs of SSRDs?
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Sandra Sanchez-Reilly, Laura Reilly-Sanchez, Valeria Restrepo, Marcos Restrepo, Jeanette Ross, Michael Mader Source Type: research

Phase I/II parallel double-blind randomized controlled clinical trial of perispinal etanercept for chronic stroke: improved mobility and pain alleviation.
Conclusions: Perispinal etanercept can provide significant and ongoing benefits for the chronic post-stroke management of pain and greater shoulder flexion by the paretic arm. Effects are rapid and highly significant, supporting direct action on brain function.Trial registration: ACTRN12615001377527 and Universal Trial Number U1111-1174-3242. PMID: 31899977 [PubMed - as supplied by publisher]
Source: Expert Opinion on Investigational Drugs - January 6, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Investig Drugs Source Type: research

Spontaneous spinal epidural hematoma treated with tissue plasminogen activator mimicking ischemic stroke
ConclusionHemiplegic spontaneous cervical EDH occurs very rarely. It is often misdiagnosed as ischemic stroke and is likely to be administered with thrombolytic agents, making the patient's symptoms worse. Early diagnosis and rapid management of cervical EDH increase the likelihood of complete recovery of the patient's symptoms. Therefore, if there are unilateral weakness and neck pain without cranial nerve dysfunction and there is no evidence of stroke in the brain imaging, spinal EDH should be considered.
Source: Interdisciplinary Neurosurgery - August 20, 2019 Category: Neurosurgery Source Type: research

Perfusion Assessment in Critical Limb Ischemia: Principles for Understanding and the Development of Evidence and Evaluation of Devices: A Scientific Statement From the American Heart Association.
Abstract There are >12 million patients with peripheral artery disease in the United States. The most severe form of peripheral artery disease is critical limb ischemia (CLI). The diagnosis and management of CLI is often challenging. Ethnic differences in comorbidities and presentation of CLI exist. Compared with white patients, black and Hispanic patients have higher prevalence rates of diabetes mellitus and chronic renal disease and are more likely to present with gangrene, whereas white patients are more likely to present with ulcers and rest pain. A thorough evaluation of limb perfusion is important in the ...
Source: Circulation - August 11, 2019 Category: Cardiology Authors: Misra S, Shishehbor MH, Takahashi EA, Aronow HD, Brewster LP, Bunte MC, Kim ESH, Lindner JR, Rich K, American Heart Association Council on Peripheral Vascular Disease; Council on Clinical Cardiology; and Council on Cardiovascular and Stroke Nursing Tags: Circulation Source Type: research

Acupuncture for Post-stroke Shoulder-Hand Syndrome: A Systematic Review and Meta-Analysis
Conclusions: Acupuncture therapy seems effective for motor function, pain relief and activities of daily living in stroke patients with mild SHS, when it is used in combination with rehabilitation. The low certainty of evidence downgrades our confidence in making recommendations to clinical practice. Introduction Shoulder-hand syndrome (SHS) is a common condition among people who have had a stroke, with its reported prevalence ranging from 12% to 49% (1, 2). The main symptoms of SHS include pain, hyperalgesia, joint swelling and limitations in range of motion (ROM) (3). Post-stroke SHS is also named type I complex ...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology Source Type: research

Prevalence of upper-limb spasticity and its impact on care among nursing home residents with prior stroke.
CONCLUSIONS: A high proportion (70%) of nursing home residents with stroke demonstrated upper-limb spasticity, associated with pain and passive care difficulties. These data suggest there is an unmet need for spasticity management among nursing-home residents. Implications for rehabilitation Upper-limb spasticity is prevalent among nursing home residents with prior stroke; here, observed in 70% of cases. Spasticity was associated with increased pain and more difficult passive limb care in this population. There is an unmet need for spasticity management among nursing home residents with prior stroke. Efforts should be made...
Source: Disability and Rehabilitation - March 30, 2019 Category: Rehabilitation Authors: Shiner CT, Vratsistas-Curto A, Bramah V, Faux SG, Watanabe Y Tags: Disabil Rehabil Source Type: research

The three-dimensional shoulder pain alignment (3D-SPA) mobilization improves pain-free shoulder range, functional reach and sleep following stroke: a pilot randomized control trial.
CONCLUSIONS: The Three-Dimensional Shoulder Pain Alignment mobilization protocol significantly improved pain-free range of motion, functional reach and pain during sleep in shoulders with moderate/severe post-stroke upper-extremity impairment. Implications for rehabilitation Although three-dimensional clavicular/scapular/humeral rotations are an essential component of normal pain-free shoulder range of motion, current guidelines for treatment of post-stroke shoulder pain only includes uni-dimensional mobilizations for joint alignment and pain management. The Three-Dimensional Shoulder Pain Alignment (3D-SPA) mobilization p...
Source: Disability and Rehabilitation - March 22, 2019 Category: Rehabilitation Authors: Pain LAM, Baker R, Sohail QZ, Hebert D, Zabjek K, Richardson D, Agur AMR Tags: Disabil Rehabil Source Type: research

Interventions for treating urinary incontinence after stroke in adults.
CONCLUSIONS: There is insufficient evidence to guide continence care of adults in the rehabilitative phase after stroke. As few trials tested the same intervention, conclusions are drawn from few, usually small, trials. CIs were wide, making it difficult to ascertain if there were clinically important differences. Only four trials had adequate allocation concealment and many were limited by poor reporting, making it impossible to judge the extent to which they were prone to bias. More appropriately powered, multicentre trials of interventions are required to provide robust evidence for interventions to improve urinary inco...
Source: Cochrane Database of Systematic Reviews - February 1, 2019 Category: General Medicine Authors: Thomas LH, Coupe J, Cross LD, Tan AL, Watkins CL Tags: Cochrane Database Syst Rev Source Type: research

A qualitative study on palliative needs of stroke patients in an Indian tertiary care setting - Doctors & #39; perspective
Conclusions: From the interviews of the clinicians, we can conclude that care of a stroke patient is more than medical management and rehabilitation, as several other aspects of the patient's life are affected by the condition. The quality of life aspect has to be looked upon as an area that requires active intervention in a setting of stroke. Physical disabilities were viewed as the most significant factor in reducing the quality of life. Spiritual needs have a low priority in comparison to other physical needs. Due to high patient load and time constraints, many of the needs are unaddressed. Two important area...
Source: Indian Journal of Palliative Care - January 31, 2019 Category: Palliative Care Authors: Jacob Lloyd Ashna Maria Pinto Shoba Nair Subhash Tarey Source Type: research

Headaches Attributed to Ischemic Stroke and Transient Ischemic Attack.
CONCLUSION: Headache attributed to ischemic stroke is frequent and usually has a tension-type headache pattern. Its frequency varies according to the stroke's etiology. Further studies are required on pain management, prophylactic treatment, and characteristics of this headache. PMID: 30667047 [PubMed - as supplied by publisher]
Source: Headache - January 22, 2019 Category: Neurology Authors: Oliveira FAA, Sampaio Rocha-Filho PA Tags: Headache Source Type: research

End-of-Life Care for Stroke
Stroke is a leading cause of disability and the third leading cause of death in Canada, according to the Heart and Stroke Association. Despite a high mortality rate, the experience of dying from a stroke has received limited attention from a palliative point of view. When attempting to make inferences from other specialties that have well researched methods of palliation, there was an obvious gap when considering the stroke population. Palliative stroke patients, at the Royal University Hospital, rarely have access to a bed on a specialized palliative care unit.
Source: Journal of Pain and Symptom Management - November 30, 2018 Category: Palliative Care Authors: Shelley Jolly, Ruth Whelan, Kimberly Davy Source Type: research

Post-stroke Spasticity: A Review of Epidemiology, Pathophysiology, and Treatments
Publication date: Available online 19 June 2018Source: International Journal of GerontologyAuthor(s): Chih-Lin Kuo, Gwo-Chi HuSummarySpasticity is a common condition in stroke survivors, and may be associated with pain and joint contracture, leading to poor quality of life and increased caregiver burden. Although the underlying mechanisms are not well-understood, it may be due to disruption of the balance of supra-spinal inhibitory and excitatory sensory inputs directed to the spinal cord, leading to a state of disinhibition of the stretch reflex. The treatment options include physical therapy, modality and pharmacological...
Source: International Journal of Gerontology - July 10, 2018 Category: Geriatrics Source Type: research

Establishing Goals of Care for Patients with Stroke and Feeding Problems: An Interdisciplinary Trigger-Based Continuous Quality Improvement Project
Few patients with dysphagia due to stroke receive early palliative care to align treatment goals with their values, as called for by practice guidelines, particularly before enteral access procedures for artificial nutrition.
Source: Journal of Pain and Symptom Management - June 25, 2018 Category: Palliative Care Authors: Franchesca Hwang, Christine Boardingham, Susanne Walther, Molly Jacob, Andrea Hidalgo, Chirag D. Gandhi, Anne C. Mosenthal, Sangeeta Lamba, Ana Berlin Source Type: research

Modafinil for the Improvement of Patient Outcomes Following Traumatic Brain Injury
Conclusion. Modafinil is a central nervous system stimulant with well-established effectiveness in the treatment of narcolepsy and shift-work sleep disorder. There is conflicting evidence about the benefits of modafinil in the treatment of fatigue and EDS secondary to TBI. One randomized, controlled study states that modafinil does not significantly improve patient wakefulness, while another concludes that modafinil corrects EDS but not fatigue. An observational study provides evidence that modafinil increases alertness in fatigued patients with past medical history of brainstem diencephalic stroke or multiple sclerosis. ...
Source: Innovations in Clinical Neuroscience - April 1, 2018 Category: Neuroscience Authors: ICNS Online Editor Tags: Current Issue Review excessive daytime sleep fatigue head injury modafinil stroke TBI traumatic brain injury Source Type: research

Passive accessory joint mobilization in the multimodal management of chronic dysesthesia following thalamic stroke.
CONCLUSION: Manual therapy may be a beneficial intervention in management of thalamic stroke-related dysesthesia. Implications for Rehabilitation While pain is common following thalamic stroke, patients may present with chronic paresthesia or dysesthesia, often in a hemisensory distribution. Passive movement may promote inhibition of hyperexcitable cortical pathways, which may diminish aberrant sensations. Passive oscillatory manual therapy may be an effective way to treat sensory disturbances such as paresthesias or dysesthesia. PMID: 29557687 [PubMed - as supplied by publisher]
Source: Disability and Rehabilitation - March 20, 2018 Category: Rehabilitation Authors: Griffin K, O'Hearn M, Franck CC, Courtney CA Tags: Disabil Rehabil Source Type: research

Cerebral Hyperperfusion Syndrome After Carotid Revascularization and Acute Ischemic Stroke
AbstractPurpose of ReviewCerebral hyperperfusion syndrome (CHS) is a rare but significant complication after carotid revascularization and is increasingly recognized after acute stroke treatments. In this review, we discuss the epidemiology and pathophysiology of CHS, clinical presentation including ipsilateral headache, seizures, and focal neurological deficits, and radiographic presentation. We propose preventive therapies with emphasis on acute stroke post-thrombectomy hyperperfusion.Recent FindingsCHS was first described after carotid revascularization but is now also reported in patients with acute ischemic stroke. Pr...
Source: Current Pain and Headache Reports - March 19, 2018 Category: Neurology Source Type: research

Successful deep brain stimulation for central post-stroke pain and dystonia in a single operation
Conclusions Deep brain stimulation targeting multiple brain networks in one operation is feasible and safe. Deep brain stimulation may be considered in some refractory cases of central post-stroke pain; however, it requires meticulous programming.
Source: Journal of Clinical Neuroscience - March 16, 2018 Category: Neuroscience Source Type: research

Palliative Care and Stroke: An Integrative Review of the Literature (S740)
Stroke survivors and their family members face unique needs related to life-altering functional and cognitive changes and burdensome symptoms, which negatively impact quality of life (QOL). Guidelines recommend that primary palliative care (PC) be offered to all stroke patients; however, gaps exist in understanding how PC is perceived and implemented within stroke.
Source: Journal of Pain and Symptom Management - February 1, 2018 Category: Palliative Care Authors: Kristen Overbaugh, Stephanie Molidor, Carole White, Deborah James Source Type: research

Changes in the Use of Intensive and Supportive Procedures for Patients with Stroke in Taiwan in the Last Month of Life between 2000 and 2010
Stroke is the second leading cause of death and the primary cause of disability worldwide. It is uncertain what care patients with stroke receive in their end of life care and what trends in care are in recent years.
Source: Journal of Pain and Symptom Management - November 27, 2017 Category: Palliative Care Authors: Pei-Yi Wang, Yen-Ni Hung, Robert Smith, Chia-Chin Lin Source Type: research

Upper-limb sensory impairments after stroke: Self-reported experiences of daily life and rehabilitation.
CONCLUSION: Stroke survivors perceive that sensory impairment of the upper limb has a highly negative impact on daily life, but specific rehabilitation for the upper limb is lacking. These findings imply that the clinical management of upper limb sensory impairment after stroke requires more attention. PMID: 29068038 [PubMed - as supplied by publisher]
Source: Journal of Rehabilitation Medicine - October 29, 2017 Category: Rehabilitation Tags: J Rehabil Med Source Type: research

Deep brain stimulation for stroke: Current uses and future directions
Publication date: Available online 12 October 2017 Source:Brain Stimulation Author(s): Gavin J.B. Elias, Andrew A. Namasivayam, Andres M. Lozano Background Survivors of stroke often experience significant disability and impaired quality of life related to ongoing maladaptive responses and persistent neurologic deficits. Novel therapeutic options are urgently needed to augment current approaches. One way to promote recovery and ameliorate symptoms may be to electrically stimulate the surviving brain. Various forms of brain stimulation have been investigated for use in stroke, including deep brain stimulation (DBS). Objecti...
Source: Brain Stimulation - October 13, 2017 Category: Neurology Source Type: research

Is higher patient satisfaction associated with better stroke outcomes?
CONCLUSIONS: Global patient satisfaction was positively associated with the quality of stroke care; however, improvements in patient satisfaction were linked to higher stroke care costs. In addition, patient satisfaction with discharge information was linked to worse outcomes. As a result, patient satisfaction should be used with caution as a quality indicator for stroke care. PMID: 29087636 [PubMed - in process]
Source: The American Journal of Managed Care - October 1, 2017 Category: Health Management Authors: Xiang X, Xu WY, Foraker RE Tags: Am J Manag Care Source Type: research

BYMTOX: An observational study to consider the association of botulinum toxin and self-management program by serious game for post-stroke patients at the chronic phase
Discussion – conclusion Despite encouraging outcomes, high rate of withdrawal makes us wonder about program's relevance, regarding intensity and patients’ profile. Concerning patients who left the program, initial mobility was 47% lower than for those who finished the study. As 4 patients in booklet group and 6 in serious game group have finished and regarding results, it may do not question the interest of this new medium. Obviously, further studies must be conduct.
Source: Annals of Physical and Rehabilitation Medicine - September 27, 2017 Category: Rehabilitation Source Type: research

Effects of an intensive thalassotherapy and aquatic therapy program in stroke patients. A pilot study.
CONCLUSIONS: Our results suggest that an intensive program of thalassotherapy and aquatic therapy could be useful during stroke rehabilitation to improve balance, gait and pain. PMID: 28895998 [PubMed - in process]
Source: Revista de Neurologia - September 13, 2017 Category: Neurology Authors: Morer C, Boestad C, Zuluaga P, Alvarez-Badillo A, Maraver F Tags: Rev Neurol Source Type: research

Randomized clinical trial of deep brain stimulation for post ‐stroke pain
This article is protected by copyright. All rights reserved.
Source: Annals of Neurology - April 5, 2017 Category: Neurology Authors: Scott F. Lempka, Donald A. Malone, Bo Hu, Kenneth B. Baker, Alexandria Wyant, John Ozinga, Ela B. Plow, Mayur Pandya, Cynthia S. Kubu, Paul J. Ford, Andre G. Machado Tags: Research Article Source Type: research

Thalamic stroke resulting in rheumatoid appearances in the hand
The patient, a 72-year-old woman, presented with joint deformities for 3 years. She did not notice any joint pain or swelling, but the fingers of the left hand as well as the toes of the left foot gradually became deformed, with all the joints on the right side totally spared. The fingers of the left hand exhibited a swan-neck deformity, and the left thumb demonstrated a thumb-in-palm deformity (Fig. 1A). In her past medical history, she experienced a right thalamic infarct 4 years ago, 1 year before the occurrence of joint deformity (Fig. 1B). She denied any paraesthesia or obvious weakness of the left extremities. The la...
Source: Rheumatology - December 21, 2016 Category: Rheumatology Source Type: research

Usefulness and effectiveness of herbal medicines in stroke: Narrative review
ABSTRACT Stroke causes various disabilities, reducing the quality of life and motivation for life. It is also one of the major causes of death in the aging population. Therefore, prevention and treatment are crucial. In conventional medicine, thrombolysis and various surgical techniques have been developed and used to treat stroke, but, despite the advancements and benefits, many patients still experience various disabilities. In East Asian countries, herbal prescriptions have been widely used for the treatment and prevention of stroke. Recently, the efficacy of herbal complexes as an adjunct to conventional treatment has ...
Source: Traditional and Kampo Medicine - September 30, 2016 Category: Complementary Medicine Authors: Ki ‐Ho Cho, Seungwon Kwon Tags: REVIEW Source Type: research

Hemiplegic Shoulder Pain Reduces Quality of Life After Acute Stroke: A Prospective Population-Based Study
Conclusion: Hemiplegic shoulder pain reduces health-related quality of life at 12 months. More effort should be directed towards screening and management of this frequent complication of stroke.
Source: American Journal of Physical Medicine and Rehabilitation - September 20, 2016 Category: Rehabilitation Tags: Original Research Articles Source Type: research

Short-term effect of local muscle vibration treatment versus sham therapy on upper limb in chronic post-stroke patients: a randomized controlled trial.
CONCLUSION: Rehabilitation treatment with local muscle high frequency (300 Hz) vibration for 30 minutes, 3 times a week for 4 weeks, could significantly improve muscle strength and decrease muscle tonus, disability and pain in upper limb of hemiplegic post-stroke patients. CLINICAL REHABILITATION IMPACT: Local muscle vibration treatment might be an additional and safe tool in the management of chronic post-stroke patients, granted its high therapeutic efficiency, limited cost and short and repeatable protocol of use. PMID: 27598342 [PubMed - as supplied by publisher]
Source: European Journal of Physical and Rehabilitation Medicine - September 5, 2016 Category: Rehabilitation Authors: Costantino C, Galuppo L, Romiti D Tags: Eur J Phys Rehabil Med Source Type: research

Demystifying post-stroke pain: from etiology to treatment
Publication date: Available online 16 June 2016 Source:PM&R Author(s): Andrew K. Treister, Maya N. Hatch, Steven C. Cramer, Eric Y. Chang Pain following stroke is commonly reported but often incompletely managed, which prevents optimal recovery. This is in part due to the esoteric nature of post-stroke pain and its limited presence in current discussions of stroke management. The major specific afflictions that affect patients with stroke who develop pain include central post-stroke pain (CPSP), complex regional pain syndrome (CRPS), and pain associated with spasticity and shoulder subluxation. Each disorder ...
Source: PMandR - June 15, 2016 Category: Rehabilitation Source Type: research

Musculoskeletal and central pain at 1 year post‐stroke: associated factors and impact on quality of life
ConclusionsPain is common 12 months post‐stroke. The factors associated with CPSP and MSP differ, but are both closely associated with fatigue rather than depression. QOL is the poorest in patients with combined pain. Management of pain and fatigue may be important for improving the QOL in stroke patients.
Source: Acta Neurologica Scandinavica - June 6, 2016 Category: Neurology Authors: S. Choi‐Kwon, S. H. Choi, M. Suh, S. Choi, K.‐H. Cho, H.‐W. Nah, H. Song, J. S. Kim Tags: Original Article Source Type: research

Musculoskeletal and central pain at 1  year post‐stroke: associated factors and impact on quality of life
ConclusionsPain is common 12 months post‐stroke. The factors associated with CPSP and MSP differ, but are both closely associated with fatigue rather than depression. QOL is the poorest in patients with combined pain. Management of pain and fatigue may be important for improving the QOL in stroke patients.
Source: Acta Neurologica Scandinavica - June 5, 2016 Category: Neurology Authors: S. Choi ‐Kwon, S. H. Choi, M. Suh, S. Choi, K.‐H. Cho, H.‐W. Nah, H. Song, J. S. Kim Tags: Original Article Source Type: research

From preoperative evaluation to stroke center: Management of postoperative acute ischemic stroke
This article reviews the perioperative management (covering diagnosis and treatment), prevention (covering surgery postponement, management with anticoagulant/antiplatelet and the growing interest in statins and beta-blockers) and intraoperative recommendations (covering anaesthetic techniques, ventilation strategies, transfusion and blood pressure management) specifically for the general surgical population. A summary of current treatments is enlightened by recently described evidence for the effectiveness of mechanical thrombectomy.
Source: Anaesthesia, Critical Care and Pain Medicine - May 31, 2016 Category: Anesthesiology Source Type: research

Palliative Care is Underutilized in Ischemic Stroke Patients with Poor Functional Outcome (P6.089)
Conclusions:Our observations suggest that PC may be underutilized in ischemic stroke patients, particularly in those who may benefit from it the most. PC has great potential to diminish suffering through physical and psychological symptom management. Providers should at least consider PC consults for hospitalized stroke patients.Disclosure: Dr. Gropen has nothing to disclose. Dr. Sisson has nothing to disclose. Dr. Albright has nothing to disclose. Dr. Lakkur has nothing to disclose. Dr. Bakitas has nothing to disclose. Dr. Sands has received research support from Biogen. Dr. Kaur has nothing to disclose. Dr. Lyerly has no...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Gropen, T., Sisson, A., Albright, K., Lakkur, S., Bakitas, M., Sands, K., Kaur, M., Lyerly, M., Burgio, K. Tags: Pain and Palliative Care: Patient Safety and Quality Source Type: research

OnabotulinumtoxinA Improves Pain in Patients With Post-Stroke Spasticity: Findings From a Randomized, Double-Blind, Placebo-Controlled Trial
Patients with post-stroke spasticity (PSS) commonly experience pain in affected limbs, which may impact quality of life.
Source: Journal of Pain and Symptom Management - March 28, 2016 Category: Palliative Care Authors: J örg Wissel, Vaidyanathan Ganapathy, Anthony B. Ward, Jörgen Borg, Per Ertzgaard, Christoph Herrmann, Anders Haggstrom, Mohamed Sakel, Julia Ma, Rozalina Dimitrova, Antony Fulford-Smith, Patrick Gillard Tags: Original Article Source Type: research

OnabotulinumtoxinA Improves Pain in Patients with Post-Stroke Spasticity: Findings from a Randomized, Double-Blind, Placebo-Controlled Trial
Patients with post-stroke spasticity (PSS) commonly experience pain in affected limbs, which may impact quality of life.
Source: Journal of Pain and Symptom Management - March 28, 2016 Category: Palliative Care Authors: Jörg Wissel, Vaidyanathan Ganapathy, Anthony B. Ward, Jörgen Borg, Per Ertzgaard, Christoph Herrmann, Anders Haggstrom, Mohamed Sakel, Julia Ma, Rozalina Dimitrova, Antony Fulford-Smith, Patrick Gillard Source Type: research

Predictive analysis for identifying potentially undiagnosed post-stroke spasticity patients in United Kingdom
Conclusions Using machine learning techniques, additional unrecorded post-stroke spasticity patients were identified, increasing the condition’s prevalence in THIN from 2% to 13%. This work shows the potential for under-reporting of PSS in primary care data, and provides a method for improved identification of cases and control records for future studies. Graphical abstract
Source: Journal of Biomedical Informatics - February 29, 2016 Category: Information Technology Source Type: research

Updating contextualized clinical practice guidelines on stroke rehabilitation and low back pain management using a novel assessment framework that standardizes decisions
Conclusions: The updating tool provides a simple, standard and novel approach that incorporates evidence hierarchy and quality, and wordings of recommendations. It could be used efficiently by other guideline updaters particularly in developing countries, where resources for guideline development and updates are limited. When many people are involved in guideline writing, there is always the possibility of ‘slippage’ in use of wording and interpretation of evidence. The PARM updating tool provides a mechanism for maintaining a standard process for guideline updating processes that can be followed by clinicians with bas...
Source: BMC Research Notes - November 4, 2015 Category: Research Authors: Ephraim GambitoConsuelo Gonzalez-SuarezKaren GrimmerCarolina ValdecañasJanine DizonMa. BeredoMarcelle Zamora Source Type: research

Machine Learning For Identifying Potentially Undiagnosed Post-Stroke Spasticity Patients In United Kingdom
Spasticity is one of the well-recognized complications of stroke which may give rise to pain and limit patients’ ability to perform daily activities. The predisposing factors and direct effects of post-stroke spasticity (PSS) also involve high management costs in terms of healthcare resources and case-control designs are required for establishing such differences. In ‘The Health Improvement Network’ (THIN) database, such a study was difficult to provide reliable estimates since the prevalence of post-stroke spasticity was found to be substantially below the most conservative previously reported estimates.
Source: Value in Health - October 23, 2015 Category: Global & Universal Authors: A Cox, M Raluy-Callado, M Wang, A Bakheit, AP Moor, J Dinet Source Type: research

Constraint-induced movement therapy for upper extremities in people with stroke.
CONCLUSIONS: CIMT is a multi-faceted intervention where restriction of the less affected limb is accompanied by increased exercise tailored to the person's capacity. We found that CIMT was associated with limited improvements in motor impairment and motor function, but that these benefits did not convincingly reduce disability. This differs from the result of our previous meta-analysis where there was a suggestion that CIMT might be superior to traditional rehabilitation. Information about the long-term effects of CIMT is scarce. Further trials studying the relationship between participant characteristics and improved outc...
Source: Cochrane Database of Systematic Reviews - October 8, 2015 Category: Journals (General) Authors: Corbetta D, Sirtori V, Castellini G, Moja L, Gatti R Tags: Cochrane Database Syst Rev Source Type: research

A Medication Combination for the Treatment of Central Post-Stroke Pain (CPSP) via the Adjuvant use of Prednisone with Gabapentin: A Case Report
Publication date: Available online 25 September 2015 Source:PM&R Author(s): Luis Batlle, Ryan Mattie, Robert Irwin Case Description CPSP is a neuropathic pain syndrome that can occur from pathology of the brain. The case presented is of a female with multiple comorbidities and who was found to have an acute infarct in the left middle and anterior cerebral artery territories. She began to complain of worsening diffuse right upper and lower extremity pain, and central post-stroke pain was diagnosed. First-line agents were contraindicated due to medical comorbidities, and chronic kidney disease only permitted the...
Source: PMandR - September 26, 2015 Category: Rehabilitation Source Type: research

Foot and ankle impairments affect balance and mobility in stroke (FAiMiS): the views and experiences of people with stroke.
CONCLUSIONS: Foot and ankle impairments such as pain, altered somatosensory input and weakness significantly contribute to problems with community ambulation, balance and fear of falling in people with chronic stroke. Specific foot and ankle impairments may also negatively contribute to perceptions of physical appearance and self-esteem. Therapeutic management approaches within clinical practice appear to focus mostly on the gross performance of the lower limb with little emphasis on the specific assessment or treatment of the foot or ankle. Implications for Rehabilitation Foot pain, sensory impairments and muscle weakness...
Source: Disability and Rehabilitation - June 9, 2015 Category: Rehabilitation Authors: Gorst T, Lyddon A, Marsden J, Paton J, Morrison SC, Cramp M, Freeman J Tags: Disabil Rehabil Source Type: research

A Comprehensive Review of Central Post-Stroke Pain
Although central post-stroke pain is widely recognized as a severe chronic neuropathic pain condition, its consolidated definition, clinical characteristics, and diagnostic criteria have not been defined due to its clinically diverse features. The present study was undertaken to comprehensively review current literature and provide a more complete picture of central post-stroke pain with respect to its definition, prevalence, pathophysiology, clinical characteristics, and diagnostic problems, and to describe the range of therapies currently available.
Source: Pain Management Nursing - May 8, 2015 Category: Nursing Authors: HyunSoo Oh, WhaSook Seo Tags: Review Article Source Type: research