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  1 / 10015 MEDLINE  
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[PMID]:29203753
[Au] Autor:Starostka-Tatar A; Labuz-Roszak B; Skrzypek M; Gasior M; Gierlotka M
[Ad] Endereço:Katedra I Klinika Neurologii W Zabrzu, Slaski Uniwersytet Medyczny W Katowicach, Zabrze, Polska.
[Ti] Título:[Definition and treatment of stroke over the centuries].
[So] Source:Wiad Lek;70(5):982-987, 2017.
[Is] ISSN:0043-5147
[Cp] País de publicação:Poland
[La] Idioma:pol
[Ab] Resumo:Stroke was already diagnosed in the ancient times. For hundreds of years the treatment of this disease has changed radically. According to the current WHO definition, stroke is a clinical syndrome caused by focal or generalized brain injury that lasts more than 24 hours or leads to death and has no other cause than vascular. Stroke constitutes a big social and economic problem, as it can lead to death or disability. In the highly developed countries stroke is the third most common cause of adult deaths, the second leading cause of dementia, and the most common cause of disability. The consequences of stroke also include epilepsy and depression. In the twentieth century, stroke was only treated symptomatically and rehabilitation was limited to passive exercises. The first breakthrough in ischemic stroke therapy was the introduction of aspirin (ASA), followed by intravenous thrombolysis using recombinant tissue plasminogen activator (rtPA), initially available in our country only in the drug programs, and since 2009 it has been reimbursed by the National Health Fund (NFZ). Gradually invasive stroke treatment has been developed. Mechanical thrombectomy is currently only performed in selected centers, giving hope for more effective stroke treatment. The purpose of this work was to show how stroke treatment has changed over the centuries.
[Mh] Termos MeSH primário: Isquemia Encefálica/terapia
Reabilitação do Acidente Vascular Cerebral
Acidente Vascular Cerebral/terapia
[Mh] Termos MeSH secundário: Terapia Combinada
Fibrinolíticos/uso terapêutico
Seres Humanos
Trombectomia/métodos
Terapia Trombolítica/métodos
Ativador de Plasminogênio Tecidual/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Fibrinolytic Agents); EC 3.4.21.68 (Tissue Plasminogen Activator)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE


  2 / 10015 MEDLINE  
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[PMID]:29203746
[Au] Autor:Cwielag J; Woldanska-Okonska M
[Ad] Endereço:Sosnowiecki Szpital Miejski Sp. Z O.O. Oddzial Ortopedii I Traumatologii Narzadu Ruchu, Sosnowiec , Polska.
[Ti] Título:[Effectiveness of early physiotherapy treatment for ischaemic stroke patients suffering intercurrently from post-stroke depression and/or hemispatial neglect syndromes].
[So] Source:Wiad Lek;70(5):939-945, 2017.
[Is] ISSN:0043-5147
[Cp] País de publicação:Poland
[La] Idioma:pol
[Ab] Resumo:Wstep: Depresja poudarowa i zespol pomijania stronnego sa jednymi z szeregu zaburzen neurologicznych wystepujacych jako konsekwencje incydentu udarowego. Oba zaburzenia uwaza sie za czynniki negatywnie wplywajace na szybszy powrot pacjenta do zdrowia. Zadaniem wczesnej fizjoterapii po incydencie udarowym jest poprawa funkcji motorycznych oraz poprawa jakosci zycia pacjenta. Material i metody: W badaniu wzielo udzial 51 pacjentow zakwalifikowanych do wziecia udzialu w "Narodowym Programie Profilaktyki i Leczenia Chorob Ukladu Sercowo-Naczyniowego na lata 2006-2008 POLCARD". Wyniki badan pacjentow notowano w skali Barthel, NIH oraz Geriatrycznej Skali Oceny Depresji. Analiza statystyczna zostala wykonana w programie STATISTICA 6PL za pomoca testu Wilcoxona dla prob zaleznych. Wyniki: Analiza wynikow wykazala, ze osoby z zespolem zaniedbywania osiagnely wiekszy przyrost punktow w skali Barthel niz osoby bez zespolu pomijania stronnego (p≤0,05). Natomiast badanie osob z depresja poudarowa wykazaly wiekszy przyrost punktow w skali Barthel niz pacjenci, u ktorych depresja nie zostala stwierdzona. Wnioski: Skutecznosc wczesnej fizjoterapii zalezy od ciezkosci udaru, stopnia niepelnosprawnosci oraz czynnikow zaburzajacych, takich jak m.in. agnozja wzrokowo-przestrzenna lub depresja. Jednakze pacjenci ze wspolistniejacymi zespolami neurologicznymi poddani kompleksowej fizjoterapii we wczesnym okresie po udarze mozgu maja prawdopodobnie wieksza rezyliencje w zakresie motywacji, zdolnosci adaptacyjno-kompensacyjnych, czyli generalnie dotyczacych plastycznosci mozgu.
[Mh] Termos MeSH primário: Isquemia Encefálica/complicações
Isquemia Encefálica/reabilitação
Depressão/terapia
Transtornos da Percepção/terapia
Reabilitação do Acidente Vascular Cerebral/métodos
[Mh] Termos MeSH secundário: Animais
Depressão/etiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Modalidades de Fisioterapia
Síndrome
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE


  3 / 10015 MEDLINE  
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[PMID]:29390330
[Au] Autor:Zhang J; Li Y; Wang H
[Ad] Endereço:Shanghai Tongren Hospital, Shanghai Jiaotong University School of Medicine Affiliated Tongren Hospital, Shanghai.
[Ti] Título:Musculoskeletal ultrasound-guided physical therapy in hemiplegic shoulder pain: A CARE-compliant case report.
[So] Source:Medicine (Baltimore);96(50):e9188, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: The use of musculoskeletal ultrasound (MU) method in the diagnosis of shoulder pain and injury and guidance of injection and pain blocking has been established. However, the treatment of posthemiplegic shoulder pain (HSP) with MU-guided precise physical therapy has not been reported. PATIENT CONCERNS: Here, we present the first case report of a 64-year-old man with a right basal ganglia hemorrhage. Left side shoulder pain remained unbearable, which seriously affected sleep and shoulder-related activities. INTERVENTIONS: The patient received MU-guided precise drug administration, laser, and other physical therapy in addition to exercise training for 2 months. OUTCOMES: The pain was significantly relieved and shoulder function was improved. Effusion extent and tendon thickness were reduced. LESSONS: MU-guided precise physical therapy can effectively reduce symptoms of HSP and improve inflammation and effusion absorption of lesioned tissue.
[Mh] Termos MeSH primário: Hemiplegia/reabilitação
Modalidades de Fisioterapia
Dor de Ombro/reabilitação
Reabilitação do Acidente Vascular Cerebral/métodos
Ultrassonografia de Intervenção
[Mh] Termos MeSH secundário: Hemiplegia/etiologia
Seres Humanos
Masculino
Meia-Idade
Manejo da Dor
Medição da Dor
Recuperação de Função Fisiológica
Dor de Ombro/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009188


  4 / 10015 MEDLINE  
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[PMID]:29390290
[Au] Autor:Zhang Y; Liu S; Yue W; Shi Z; Guan Y; Li M; Ji Y; Li X
[Ad] Endereço:Department of Neurology, The Second Hospital of Tianjin Medical University,Tianjin, China.
[Ti] Título:Association of apolipoprotein E genotype with outcome in hospitalized ischemic stroke patients.
[So] Source:Medicine (Baltimore);96(50):e8964, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to study the ability of the genotype to predict impairment and disability in hospitalized ischemic stroke (IS) patients after hospital discharge and 6 months after the onset of stroke symptoms.A total of 786 patients with a first IS were enrolled. Apolipoprotein E (ApoE) polymorphism was examined using polymerase chain reaction. Stroke subtype was classified using the Oxfordshire Community Stroke Project classification scheme and the Trial of Org 10172 in Acute Stroke Treatment criteria. Impairment as assessed using the National Institutes of Health Stroke Scale (NIHSS), and disability as measured using the modified Rankin Scale (mRS), were compared against the ApoE genotype.There was no significant association between the type of ApoE allele present and the stroke subtype. On multivariate regression analysis, the apolipoprotein EE4 allele genotype did not predict poor outcome at discharge and or at 6 months after stroke onset. A higher NIHSS score on admission, older age, and higher fasting glucose levels did predict poor outcome at hospital discharge. Higher glucose levels and higher NIHSS scores on admission were independent risk factors predicting poor neurologic status at 6 months after stroke onset.The presence of the apolipoprotein EE4 and apolipoprotein EE2 genotypes, although related to cholesterol and triglyceride levels, do not affect recovery during rehabilitation. A higher NIHSS score on admission and a higher fasting glucose level predict poor neurologic status, both at hospital discharge and 6 months after onset.
[Mh] Termos MeSH primário: Apolipoproteínas E/genética
Isquemia Encefálica/genética
Acidente Vascular Cerebral/genética
[Mh] Termos MeSH secundário: Alelos
Isquemia Encefálica/classificação
Feminino
Genótipo
Seres Humanos
Masculino
Reação em Cadeia da Polimerase
Fatores de Risco
Acidente Vascular Cerebral/classificação
Reabilitação do Acidente Vascular Cerebral
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Apolipoproteins E)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008964


  5 / 10015 MEDLINE  
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[PMID]:28458488
[Au] Autor:Ekechukwu N; Olaleye O; Hamzat T
[Ad] Endereço:Department of Medical Rehabilitation, College of Medicine, University of Nigeria, Enugu, Nigeria.
[Ti] Título:Clinical and Psychosocial Predictors of Community Reintegration of Stroke Survivors Three Months Post In-Hospital Discharge.
[So] Source:Ethiop J Health Sci;27(1):27-34, 2017 Jan.
[Is] ISSN:2413-7170
[Cp] País de publicação:Ethiopia
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: There appears to be a dearth of published literature on the biopsychosocial predictors of community reintegration (CR) among stroke survivors. This study aims to investigate the clinical and psychosocial predictors of CR among stroke survivors three months post in-hospital discharge. METHODS: Fifty-two stroke survivors took part in this prospective exploratory study. The participants' clinical attributes of motor function (MF), balance (Bal) and psychosocial characteristics of Fall Self-Efficacy (FSE), Balance Self-Efficacy (BSE), Self-Esteem (SEst) and Social Support (SS) were assessed pre-discharge and at three months post-discharge. CR was also assessed at three months post-discharge. Data were analyzed using paired t-test, Pearson's Moment correlation and multiple regressions. Level of significance was set at p = 0.05. RESULTS: The mean age of the participants was 61.21±11.25 years with mean hospital length of stay of 5.31±3.71weeks. There were significant differences in the mean MF, Bal, FSE, BSE, SEst and SS scores of the participants pre- and post-discharge (p < 0.05). Also, there was a significant correlation between CR and each of MF, Bal, FSE, BSE, SEst and SS. Pre-discharge Age (ß = -0.226, p = 0.001) and FSE (ß = 1.387, p = 0.040) significantly predicted CR. Post-discharge age (ß = -0.164, p = 0.005) and Bal (ß = 0.142, p = 0.048). FSE (ß = 1.243, p = 0.034) also significantly predicted CR. CONCLUSION: Age, Bal and FSE are important predictors of CR among stroke survivors. Therefore, rehabilitation programmes should focus on improving Bal and FSE in order to enhance community reintegration among stroke survivors.
[Mh] Termos MeSH primário: Nível de Saúde
Reabilitação do Acidente Vascular Cerebral/métodos
Reabilitação do Acidente Vascular Cerebral/psicologia
Acidente Vascular Cerebral/fisiopatologia
Acidente Vascular Cerebral/psicologia
Sobreviventes/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
Meia-Idade
Nigéria
Alta do Paciente
Equilíbrio Postural
Estudos Prospectivos
Autoeficácia
Apoio Social
Reabilitação do Acidente Vascular Cerebral/estatística & dados numéricos
Sobreviventes/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


  6 / 10015 MEDLINE  
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[PMID]:29360872
[Au] Autor:Pugliese M; Ramsay T; Johnson D; Dowlatshahi D
[Ad] Endereço:School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
[Ti] Título:Mobile tablet-based therapies following stroke: A systematic scoping review of administrative methods and patient experiences.
[So] Source:PLoS One;13(1):e0191566, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: Stroke survivors are often left with deficits requiring rehabilitation to recover function and yet, many are unable to access rehabilitative therapies. Mobile tablet-based therapies (MTBTs) may be a resource-efficient means of improving access to timely rehabilitation. It is unclear what MTBTs have been attempted following stroke, how they were administered, and how patients experienced the therapies. The review summarizes studies of MTBTs following stroke in terms of administrative methods and patient experiences to inform treatment feasibility. METHODS: Articles were eligible if they reported the results of an MTBT attempted with stroke participants. Six research databases were searched along with grey literature sources, trial registries, and article references. Intervention administration details and patient experiences were summarized. RESULTS: The search returned 903 articles of which 23 were eligible for inclusion. Most studies were small, observational, and enrolled chronic stroke patients. Interventions commonly targeted communication, cognition, or fine-motor skills. Therapies tended to be personalized based on patient deficits using commercially available applications. The complexity of therapy instructions, fine-motor requirements, and unreliability of internet or cellular connections were identified as common barriers to tablet-based care. CONCLUSIONS: Stroke patients responded positively to MTBTs in both the inpatient and home settings. However, some support from therapists or caregivers may be required for patients to overcome barriers to care. Feasibility studies should continue to identify the administrative methods that minimize barriers to care and maximize patient adherence to prescribed therapy regiments.
[Mh] Termos MeSH primário: Microcomputadores/utilização
Reabilitação do Acidente Vascular Cerebral/métodos
Acidente Vascular Cerebral/psicologia
[Mh] Termos MeSH secundário: Seres Humanos
Destreza Motora
Cooperação do Paciente
Acidente Vascular Cerebral/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191566


  7 / 10015 MEDLINE  
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[PMID]:29338060
[Au] Autor:Saita K; Morishita T; Arima H; Hyakutake K; Ogata T; Yagi K; Shiota E; Inoue T
[Ad] Endereço:Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
[Ti] Título:Biofeedback effect of hybrid assistive limb in stroke rehabilitation: A proof of concept study using functional near infrared spectroscopy.
[So] Source:PLoS One;13(1):e0191361, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Robot-assisted rehabilitation has been increasingly drawing attention in the field of neurorehabilitation. The hybrid assistive limb (HAL) is an exoskeleton robot developed based on the "interactive biofeedback" theory, and several studies have shown its efficacy for patients with stroke. We aimed to investigate the mechanisms of the facilitative effect of neurorehabilitation using a single-joint HAL (HAL-SJ) and functional near-infrared spectroscopy (fNIRS). MATERIALS AND METHODS: Subacute stroke patients admitted to our hospital were assessed in this study for HAL eligibility. We evaluated motor-related cortical activity using an fNIRS system at baseline and immediately after HAL-SJ treatment on the same day. Cortical activity was determined through the relative changes in the hemoglobin concentrations. For statistical analysis, we compared the number of flexion/extension movements before and immediately after HAL-SJ treatment using paired t-test. fNIRS used both the methods of statistical parametric mapping and random effect analysis. RESULTS: We finally included 10 patients (eight men, two women; mean age: 66.8 ± 12.0 years). The mean number of flexion/extension movements within 15 s increased significantly from 4.2 ± 3.1 to 5.3 ± 4.1 immediately after training. fNIRS showed increased cortical activation in the primary motor cortex of the ipsilesional hemisphere immediately after HAL-SJ treatment compared to the baseline condition. CONCLUSIONS: This study is the first to support the concept of the biofeedback effect from the perspective of changes in cortical activity measured with an fNIRS system. The biofeedback effect of HAL immediately increased the task-related cortical activity, and this may address the functional recovery. Further studies are warranted to support our findings.
[Mh] Termos MeSH primário: Biorretroalimentação Psicológica/instrumentação
Exoesqueleto Energizado
Espectroscopia de Luz Próxima ao Infravermelho
Reabilitação do Acidente Vascular Cerebral/instrumentação
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180117
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191361


  8 / 10015 MEDLINE  
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[PMID]:28464421
[Au] Autor:Sebastianelli L; Versace V; Martignago S; Brigo F; Trinka E; Saltuari L; Nardone R
[Ad] Endereço:Department of Neurorehabilitation, Hospital of Vipiteno, Vipiteno, Italy.
[Ti] Título:Low-frequency rTMS of the unaffected hemisphere in stroke patients: A systematic review.
[So] Source:Acta Neurol Scand;136(6):585-605, 2017 Dec.
[Is] ISSN:1600-0404
[Cp] País de publicação:Denmark
[La] Idioma:eng
[Ab] Resumo:The aim of this review was to summarize the evidence for the effectiveness of low-frequency (LF) repetitive transcranial magnetic stimulation (rTMS) over the unaffected hemisphere in promoting functional recovery after stroke. We performed a systematic search of the studies using LF-rTMS over the contralesional hemisphere in stroke patients and reviewed the 67 identified articles. The studies have been gathered together according to the time interval that had elapsed between the stroke onset and the beginning of the rTMS treatment. Inhibitory rTMS of the contralesional hemisphere can induce beneficial effects on stroke patients with motor impairment, spasticity, aphasia, hemispatial neglect and dysphagia, but the therapeutic clinical significance is unclear. We observed considerable heterogeneity across studies in the stimulation protocols. The use of different patient populations, regardless of lesion site and stroke aetiology, different stimulation parameters and outcome measures means that the studies are not readily comparable, and estimating real effectiveness or reproducibility is very difficult. It seems that careful experimental design is needed and it should consider patient selection aspects, rTMS parameters and clinical assessment tools. Consecutive sessions of rTMS, as well as the combination with conventional rehabilitation therapy, may increase the magnitude and duration of the beneficial effects. In an increasing number of studies, the patients have been enrolled early after stroke. The prolonged follow-up in these patients suggests that the effects of contralesional LF-rTMS can be long-lasting. However, physiological evidence indicating increased synaptic plasticity, and thus, a more favourable outcome, in the early enrolled patients, is still lacking. Carefully designed clinical trials designed are required to address this question. LF rTMS over unaffected hemisphere may have therapeutic utility, but the evidence is still preliminary and the findings need to be confirmed in further randomized controlled trials.
[Mh] Termos MeSH primário: Reabilitação do Acidente Vascular Cerebral/métodos
Estimulação Magnética Transcraniana/métodos
[Mh] Termos MeSH secundário: Idoso
Feminino
Lateralidade Funcional
Seres Humanos
Masculino
Meia-Idade
Recuperação de Função Fisiológica
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1111/ane.12773


  9 / 10015 MEDLINE  
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[PMID]:29390585
[Au] Autor:Lee SY; Jeon YT; Kim BR; Han EY
[Ad] Endereço:Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Republic of Korea.
[Ti] Título:Combined treatment of botulinumtoxin and robot-assisted rehabilitation therapy on poststroke, upper limb spasticity: A case report.
[So] Source:Medicine (Baltimore);96(51):e9468, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Spasticity is a major complication after stroke, and botulinumtoxin A (BoNT-A) injection is commonly used to manage focal spasticity. However, it is uncertain whether BoNT-A can improve voluntary motor control or activities of daily living function of paretic upper limbs. This study investigated whether BoNT-A injection combined with robot-assisted upper limb therapy improves voluntary motor control or functions of upper limbs after stroke. PATIENT CONCERNS: Two subacute stroke patients were transferred to the Department of Rehabilitation. DIAGNOSES: Patients demonstrated spasticity in the upper extremity on the affected side. INTERVENTIONS: BoNT-A was injected into the paretic muscles of the shoulder, arm, and forearm of the 2 patients at the subacute stage. Conventional rehabilitation therapy and robot-assisted upper limb training were performed during the rehabilitation period. OUTCOMES: Manual dexterity, grip strength, muscle tone, and activities of daily living function were improved after multidisciplinary rehabilitation treatment. LESSONS: BoNT-A injection in combination with multidisciplinary rehabilitation treatment, including robot-assisted arm training, should be recommended for subacute spastic stroke patients to enhance appropriate motor recovery.
[Mh] Termos MeSH primário: Toxinas Botulínicas/uso terapêutico
Espasticidade Muscular/etiologia
Robótica/métodos
Reabilitação do Acidente Vascular Cerebral/métodos
Acidente Vascular Cerebral/complicações
[Mh] Termos MeSH secundário: Adulto
Braço
Terapia Combinada
Feminino
Seres Humanos
Masculino
Meia-Idade
Espasticidade Muscular/reabilitação
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
EC 3.4.24.69 (Botulinum Toxins)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009468


  10 / 10015 MEDLINE  
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[PMID]:29329286
[Au] Autor:Veerbeek JM; Winters C; van Wegen EEH; Kwakkel G
[Ad] Endereço:Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.
[Ti] Título:Is the proportional recovery rule applicable to the lower limb after a first-ever ischemic stroke?
[So] Source:PLoS One;13(1):e0189279, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To investigate (a) the applicability of the proportional recovery rule of spontaneous neurobiological recovery to motor function of the paretic lower extremity (LE); and (b) the presence of fitters and non-fitters of this prognostic rule poststroke. When present, the clinical threshold for fitting nor non-fitting would be determined, as well as within-subject generalizability to the paretic upper extremity (UE). METHODS: Prospective cohort study in which the Fugl-Meyer Assessment (FMA)-LE and FMA-UE were measured <72 hours and 6 months poststroke. Predicted maximum potential recovery was defined as [FMA-LEmax-FMA-LEinitial = 34 -FMA-LEinitial]. Hierarchical clustering in 202 first-ever ischemic stroke patients distinguished between fitting and not fitting the rule. Descriptive statistics determined whether fitters and non-fitters for LE were the same persons as for UE. RESULTS: 175 (87%) patients fitted the FMA-LE recovery rule. The observed average improvement of the fitters was ~64% of the predicted maximum potential recovery. In the non-fitter group, the maximum initial FMA-LE score was 13 points. Fifty-one out of 78 patients (~65%) who scored below the identified 14-point threshold at baseline fitted the FMA-LE rule. Non-fitters were more severely affected than fitters. All non-fitters of the FMA-LE rule did also not fit the proportional recovery rule for FMA-UE. CONCLUSIONS: Proportional recovery seems to be consistent within subjects across LE and UE motor impairment at the hemiplegic side in first-ever ischemic hemispheric stroke subjects. Future studies should investigate prospectively distinguishing between fitters and not-fitters within the subgroup of patients who have initial low FMA-LE scores. Subsequently, patients could be stratified based on fitting or not fitting the recovery rule as this would impact rehabilitation management and trial design.
[Mh] Termos MeSH primário: Reabilitação do Acidente Vascular Cerebral
Acidente Vascular Cerebral/fisiopatologia
[Mh] Termos MeSH secundário: Idoso
Seres Humanos
Meia-Idade
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180210
[Lr] Data última revisão:
180210
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180113
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189279



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