View clinical trials related to Stroke.
Filter by:- Aphasia, the loss or impairment of language caused by brain damage, is one of the most devastating cognitive impairments of stroke. Aphasia can be treated with combination of speech-language therapy and drugs. Conventional speech-language therapy in chronic aphasic subjects is of little help and several drugs have been studied with limited success. Therefore other therapeutic strategies are warranted. - Recent data suggest that drugs (memantine) acting on the brain chemical glutamate may help the recovery of cognitive deficits, included language, in subjects with vascular dementia. The present study examines the safety profile and efficacy of memantine paired with intensive language therapy in subjects with stroke-related chronic aphasia (more than 1 yr. of evolution).
Tripping over obstacles is one of the common movements in daily life and is the most frequently mentioned cause of falls in the elderly. Indeed, crossing obstacles is a more complex motor skill than walking, and ensuring sufficient clearance of an obstacle during locomotion requires accurate movement and appropriate modifications of the swing limb. However, little is known about the obstacle crossing deficits that following stroke, especially in good outcome and function independently strokes. It is still a mystery about motor control and motor plastic of central nerve system. The purpose of the study was to observe and quantify certain characteristics of the performance of subjects following stroke with good outcome to understand the damage of central nerve system how to affect motor control. The present study investigated selected spatial-temporal characteristics, kinematic variables and kinetic variables of the gait pattern to define further the problems in obstacle crossing following strokes. To quantify the deficits, we compared results from a group of subjects with stroke with a group of healthy subjects matched for age, gender, and height.
We will employ modern test theory (i.e., Rasch model) to refine the Stroke Rehabilitation Assessment of Movement instrument (STREAM), which will be called the refined version of the STREAM, R-STREAM).
This study is going to comprehensively examine the psychometric properties of the three depression scales (Hamilton depression scale (HAMD), Hospital anxiety and depression scale (HADS), and Beck Depression Inventory (BDI)) in stroke patients over a period of three years.
our research team will develop a new CADL scale for stroke patients over the next three years. In the first year, we had established a CADL item bank of 50 items. The investigators will administer the 50 items on 300 patients with stroke living in the community. Then we will select 10 to 15 items from the item bank for the CADL scale based on the International Classification of Functioning, Disability and Health (ICF), the opinions of an expert panel, and Rasch analysis. It is anticipated that the CADL scale will have unidimensionality, an interval level of measurement, soundly psychometric characteristics, a reduced number of items, and ease of administration. In the second and third years, we will compare the psychometric properties of the CADL scale and the combined BI and FAI scale. The psychometric properties investigated will include reliability (e.g. inter-rater reliability, intra-rater reliability, and internal consistency), validity (e.g. concurrent validity, convergent validity, predictive validity and discriminant validity), and responsiveness. A total of 150 patients will be recruited. Both the CADL scale and the combined BI and FAI scale will be used on patients from the initial stage (within one month) to six months after hospital discharge. The results will be useful for researchers and clinicians to determine whether the CADL scale is better than the combined BI and FAI scale in stroke patients.
According to the theory of wave transmission, the speed of wave transmission is dependent on the nature of the transmission medium, which is the vessel wall for pulse wave transmission. Then, the pulse wave velocity is related to the mechanical property of the vessel wall. The mechanical property of the vessel wall is determined by the texture of the vessel wall and the contraction status of the smooth muscle within the vessel wall. Because the texture of the vessel wall could not be changed in a short duration, the sympathetic nerve activity, which controls the contractibility of the smooth muscle, becomes the only determinant factor of pulse wave velocity. So, pulse wave velocity may reflect the status of sympathetic nerve activity. The purpose of this project is to use the pulse wave velocity to measure the sympathetic activity of stroke and spinal cord patients. The present project plans to measure the pulse wave simultaneously at four limbs by pressure receptors, and use the electrocardiogram as the reference to synchronize the recorded pulse wave at different vessels, using the corrected data to calculate the pulse wave velocity. With the pulse wave velocity of different vessels, we, the investigators at National Taiwan University Hospital, can understand the local sympathetic nerve activity in different diseases and different sites. The first year, we will set up the equipment for measuring the pulse wave velocity, and then apply it to 20 healthy subjects to adjust the measurement error and ascertain the reproducibility of the machine. The second year, we will apply the measurement to 15 complete cervical cord injury individuals and 15 healthy subjects in different erected angles by a tilting table. This procedure will make us understand the response of sympathetic nerve activity to different postures in normal subjects and cervical cord injury patients. The third year, we will apply the measurement to 30 cerebrovascular accident patients to understand the change of sympathetic nerve activity after having a stroke. By comparing the clinical information, we hope to clear up the relationship between sympathetic nerve activity and pulse wave velocity.
The purposes of this study are to investigate the reliability and validity of the modified Postural Assessment Scale for Stroke Patients (mPASS) and its applications in early detection of fall-prone patients. The intraclass correlation coefficient will be used to examine the intra-rater reliability, inter-rater reliability, and the Cronbach’s alpha will be used to examine the internal consistency of the 16 items of mPASS.
All images in this study were acquired on a 1.5 T Sonata whole body scanner (Siemens Medical Inc., Erlangen, Germany) using 2D multi-echo gradient echo/spin echo sequence and 2D single-shot gradient echo-planar imaging sequence plus intravenous magnetic susceptibility contrast medium. The quantitative estimates and mapping of cerebral metabolic rate of oxygen utilization were calculated and plotted in all subjects.
The specific aims of this research are delineated as the following: Aim 1: To investigate the neuromuscular and biomechanical mechanisms of the emerging processes of proactive and reactive balance control during sitting and standing in patients with stroke at different stages of the recovery course. Aim 2: To determine the relationships between brain lesion sites and the recovery patterns of reactive and proactive balance control mechanisms in patients with stroke. Aim 3: To determine the relationships between the impairments in reactive and proactive balance control mechanisms and functional outcome as well as fall incidence in patients following stroke. Aim 4: To investigate the efficacy of different training regimens in improving reactive and proactive balance control strategies and in preventing falls in stroke patients with different brain lesion sites. Principally, three hypotheses are to be tested: Hypothesis 1:The emerging processes and recovery patternes of proactive and reactive balance control may be different among stroke patients with different brain lesion locations. Hypothesis 2:There are positive correlations between the level of impairments in reactive and proactive balance control mechanisms and functional outcome as well as fall incidence in patients following stroke. Hypothesis 3:Training regimens that could best facilitate the emergence or improvement in reactive and proactive balance control strategies are different.
Ultrasonographic examination has long been used to assess the swallowing function. It has the advantages of no ionizing radiation on examination and the possibility of using the real food instead of the barium meal in testing. Thus, the subjects can be examined repeatedly and in a more physiological status of swallowing. However, the ultrasonographic examination is only used in assessing the oral phase of swallowing. It can accurately visualize the tongue movement, measure the oral transit time of bolus, and sometimes the hypoid bone motion, but has not been applied on the evaluation of pharyngeal phase of swallowing. Physically, laryngeal elevation is an essential component of the swallowing movement on pharyngeal phase. It ensures the occlusion of airway and opening of criopharymgeus muscle, and thus prevents the aspiration. To evaluate the laryngeal elevation is crucial point in managing the dysphagic patients. The purpose of this project is to measure the laryngeal elevation in normal and in dysphagic patients with cerebrovascular (CVA) accident using ultrasonographic techniques. This work will include four group subjects. The first group consists of 20 young subjects (< 40 years); the second group consists of 20 age-matched normal subjects; the third group consists of 20 CVA patients without swallowing problems, and the fourth group consists of 20 CVA patients with dysphagia, which was proven by VFSS. The laryngeal elevation is detected by ultrasound with the transducer placing between the hyoid bone and thyroid cartilage. The two markers are easily detected on sonogram because of the presence of acoustic shadow, a specific character of bony structure on sonogram. The distance between the hyoid bone and thyroid cartilage before and during swallowing is measures and compared among the groups. The distance change of the patients with dysphagia is further compared with that defined by VFSS. With the result of this study, we will understand the status of laryngeal elevation during swallowing in normal and dysphagic subjects, and further determine the accuracy of ultrasonographic measurement in measuring the laryngeal elevation. With this knowledge, we might extend the usage of ultrasonographic examination on evaluating swallowing function.