View clinical trials related to Stroke.
Filter by:Problem: Stroke is a leading cause of disability in the United States . Motor deficits caused by stroke are commonly paired with loss of sensory perception. Sensory deficits significantly impair functional activity and slow down motor recovery during rehabilitation. Several studies demonstrated that for individuals whose sensation was preserved, motor recovery was achieved faster. The main objective of this study is to test the feasibility and preliminary efficacy of novel approach to treat sensory deficits after stroke with combination of repetitive Transcranial Magnetic Stimulation (rTMS) and peripheral arm and hand sensory therapy. Rationale: Sensory deficits can be partially recovered with peripheral manipulation of skin, muscles and joints using sensory re-education-based rehabilitation. Sensory re-education is associated with adaptive functional and structural alterations in the brain, called neuroplasticity. Despite mechanisms of reorganization, sensory recovery is usually slow and incomplete. There is a non-invasive method of brain modulation, called repetitive Transcranial Magnetic Stimulation (rTMS) that can potentially drive the adaptive functional and structural brain changes that lead to functional improvements. Although rTMS of motor control regions has been shown to enhance motor rehabilitation after stroke, evidence in support of enhancement of sensory abilities is only preliminary and rTMS has not been tested to treat sensory deficits. We propose to test the feasibility and preliminary efficacy of rTMS targeting sensory cortical regions to augment effectiveness of sensory rehabilitation. Study Design. We propose to enroll a total of up to 16 individuals with sensory deficits after a first ever stroke (stroke onset > 6 months prior). Subjects will be treated with 5 sensory treatment sessions one week apart that will consist of rTMS with the peripheral sensory re-education rehabilitation therapies (vibration and functional electrical stimulation of the affected arm). rTMS be either facilitatory or inhibitory and will target contralesional primary sensory region. The First Hypothesis is that a combination of rTMS and sensory re-education therapy results in a greater improvement of sensory deficits than sensory therapy alone. We will test this hypothesis by comparing subject's sensory evaluation results between the active and sham rTMS treatment sessions. Sensory evaluation will include a battery of sensory testing measures. The Second Hypothesis is that a combination of facilitatory rTMS and peripheral sensory therapy leads to functional brain changes. We will test this hypothesis by measuring functional brain changes using somatosensory evoked potential (SEP) induced by median nerve stimulation. Overall, the study is designed as a proof of concept to be used for development of a novel approach for sensory rehabilitation after stroke.
Novel coronavirus 2019 (COVID-19) has emerged as a major international public health concern. While much of the morbidity and mortality associated with COVID-19 has been attributed to acute respiratory distress syndrome (ARDS) or end-organ failure, emerging data suggest that disorders of coagulation, in particular hypercoagulability and venous thromboembolism (VTE), may represent an additional major, and possibly preventable, complication (Wu C, et al. JAMA Intern Med. 2020 Mar 13. [Epub ahead of print] and Tang N, et al. Thromb. Haemost. 2020 Feb 19. [EPub Ahead of Print]). Abnormal coagulation testing results, especially markedly elevated D-dimer and FDP, have been associated with a poor prognosis in COVID-19 infection. We propose the following Electronic Health Record (EHR)-guided 10000-patient, retrospective observational cohort study to assess VTE incidence, risk factors, prevention and management patterns, and thrombotic outcomes in patients with COVID-19 infection. In order to gain the valuable perspective of other regional and national centers providing care for large populations of COVID-19, we have started a collaborative network with 5 additional sites which will provide us with de-identified data from 1000 patients each. These 5000 patients in addition to the 5000-patient cohort we are enrolling within the Mass General Brigham Network will comprise this study population.
Texas Biomedical Device Center (TxBDC) has developed an innovative strategy to enhance recovery of motor and sensory function after neurological injury termed targeted plasticity therapy (TPT). This technique uses brief pulses of vagus nerve stimulation to engage pro-plasticity neuromodulatory circuits during rehabilitation exercises. Preclinical findings demonstrate that VNS paired with rehabilitative training enhances recovery in multiple models of neurological injury, including stroke, spinal cord injury, intracerebral hemorrhage, and traumatic brain injury. Recovery is associated with neural plasticity in spared motor networks in the brain and spinal cord. Moreover, two initial studies and a recently completed Phase 3 clinical trial using a commercially available device demonstrates that paired VNS with rehabilitation is safe and improves motor recovery after stroke. The purpose of this study is to extend these findings and evaluate whether VNS delivered with the new device paired with rehabilitation represents a safe and feasible strategy to improve recovery of motor and sensory function in participants with stroke.
Comparing the efficacy of Intracthecal Baclofen dose between the Prometra II and Medtronic SynchroMed II for patients with spasticity and with current a current SyncroMed II pump needing replacement.
This intervention study using the Stroke Riskometer Apps as health promotion and disease prevention tools for the stroke prevention. Study will specifically target the young adult population (18-50 years old) who are the population at risk for young stroke. The study will determine the effectiveness of Stroke Riskometer Apps by assessing the awareness (knowledge, perception of stroke risk and intention to change behaviours) using the translated ABCD risk questionnaire and stroke risk probability using Stroke Riskometer Apps.
This Observational study aims at the evaluation of stroke subjects with an inertial measurement unit (IMU) during the execution of a 6-Minute Walking test, to evaluate the associations between the kinematic parameters retrieved trough an IMU and the classical outcome scales. Moreover compare the stroke subjects with age-matched healthy subjects, and detect the differences of gait kinematic.
Stroke often results in impairments of upper extremity, including coordination deficits, reducing of force, weakness and changes in the kinetic and kinematic workspace of fingers with 75% of stroke survivors facing difficulties performing activities of daily living. The ability to oppose the fingertip of the thumb to each fingertip of the same hand is the basis of grasping objects of various sizes and operating tools and assessing and improving distal upper extremity function is of primary goal in the rehabilitation of stroke survivors. Moreover, repetitive movement practice seems to be crucial for maximizing therapeutic benefits. Recent studies, proposed an engineered glove to assess motor performance during finger-to-thumb opposition movements and to provide objective and reproducible measures. The same tool can be integrated with Virtual Reality and serious games to provide repetitive practice of activities improving motivation and adherence with therapy. the investigators developed a new integrated glove and virtual reality to facilitate the recovery of hand functionality. The aim of this study is to investigate the feasibility of the engineered glove in the assessment and treatment of hand dysfunction in people with Stroke.
Aim: To examine the effect of acupressure application on physiological parameters, anxiety and sleep quality in patients with acute stroke. Method: Randomized controlled trial will be carried out in the stroke patients in Turkey. The research will include two groups, an intervention (n=32) and a placebo (n=32). Since the critical period in the care of the patient who had an acute stroke is the first 72 hours; - An application and evaluation will be made every 12 hours after the first application. In other words, a person will be given 2 applications a day with an interval of 12 hours and a total of 6 applications within 72 hours. - Depending on the number of points selected and the duration of the print on each point; the session duration of an individual will be approximately 25 minutes. - Physiological measurements will be made before and after the acupressure application. Physiological measurements 10-15 min. From acupressure application. will be taken before and the same measurements after acupressure 20-30. Will be taken again in the min interval. - Application to acupressure points in a certain order; Baihui (GV20), Susanli (ST36), Hegu (LI4), Shenmen (HT 7) and Quchi (LI11) will be held. The application steps of the placebo group will be the same as the acupressure application steps. Unlike acupressure, it will be waited for 2 minutes only in contact with the thumb, without any pressure or scrub on the bone protrusions, away from the real acupressure points, where the meridian does not pass and there are no active points. To reduce the electrical effect of the touch, gloves will be worn only in contact.
Mechanical thrombectomy(MT) has been recommended in patients with acute large vessel occlusion stroke(LVO) , especially for those with National Institutes of Health Stroke Scale (NIHSS) score ≥6. However, it is still unclear if patients with minor strokes and LVO also benefit from MT.The aim of this study was to evaluate the safety and efficacy of MT for acute LVO and mild symptoms.
This study will conduct a cluster randomized controlled trial to evaluate the impact of an artificial intelligence-based clinical decision support system for the integrated management of patients with acute ischemic stroke on the adherence to guideline-based therapies and the incidence of new clinical vascular events.