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Poor balance capacity is one of clinical symptoms of stroke patient. The reason of loss balance capacity is motor impairment, as well as a diminished capacity to voluntarily shift body weight or to with stand external pertubations. An important determinant of activities of daily living performance is standing balance. Therefore, poor balance, or postural stability, is significant predictors the risk of fall. After a fall, the patient can experience psychological, physical, social, economic, and sometimes fatal effects. The injuries can reduce the patient's mobility as well as independence and influence quality of life. Postural movement patterns include three discrete control strategies: hip, knee, and ankle strategy. The ankle rocker is an important factor to maintain balance during standing and the ankle strategy restores the center of mass (CoM) to a position of stability through body movement. As a result, effective control of foot motion and ankle stability may decrease postural sway and the risk of fall in chronic stroke. The purpose of this study is to investigate the effects of the insole on balance capacity in chronic stroke.
Intravenous thrombolysis with recombinant tissue-type plasminogen activator (IV t-PA) has been the only proven therapy for acute ischemic stroke (AIS) for almost 20 years. Whether IV t-PA prior to endovascular clot retrieval is beneficial for AIS patients with a proximal vessel occlusion in the anterior circulation has currently become a matter of debate and is a relevant unanswered question in clinical practice. The main objective is to determine whether subjects experiencing an AIS due to large intracranial vessel occlusion in the anterior circulation will have non-inferior functional outcome at 90 days when treated with direct mechanical thrombectomy (MT) compared to subjects treated with combined IV t-PA and MT. The secondary objectives are to study causes of mortality, dependency and quality of life in these AIS patients.
Objectives - Primary: To test the hypothesis that apixaban is superior to aspirin for the prevention of recurrent stroke in patients with cryptogenic ischemic stroke and atrial cardiopathy. - Secondary: To test the hypothesis that the relative efficacy of apixaban over aspirin increases with the severity of atrial cardiopathy.
The aim of the study is to evaluate the effectiveness the SINEMA model via a one-year cluster randomized controlled trial in a resource-poor rural area in China. The hypothesis is that trained village doctors (VDs) and family caregivers, equipped with digital health technology, can provide essential evidence-based care to stroke survivors in rural China.
The objective of the clinical trial is to investigate whether weak transcranial direct current stimulation (tDCS) can ameliorate the motor cognitive deficit apraxia during stroke rehabilitation. Stroke patients with apraxia will either receive a real stimulation or a sham stimulation (placebo) for 10 minutes at a time on 5 consecutive days during their in-patient stay in a rehabilitation center. Additionally, motor tasks are performed before and after the stimulation. The effect of the weak current stimulation on motor function is assessed 3-4 days after the last stimulation and 3 months after enrollment.
This study aimed to examine the effects of functional action observation training on gait ability in chronic stroke patients.
Since august 2016, the researchers at a highly specialized neurorehabilitation hospital in a Danish region with 1.2 inhabitants have in cooperation with health professionals from a specialized neurorehabilitation in a Danish municipality with 336,000 inhabitants, worked through and is still working with an iterative process in the development of a novel self-management support intervention for elderly stroke individuals.The intervention is going to be implemented into the second phase- a randomized clinical controlled trial (RCT) in the project named 'Stroke - 65 plus. Continued active life'.
The effectiveness of acute ischemic stroke (AIS) management has improved considerably in recent years with thrombolysis and more recently with mechanical thrombectomy (MT). Currently, mechanical thrombectomy can only be performed in stroke unit with an interventional neuroradiology center by experienced/qualified interventional neuroradiologists. In the Rhone area, only one hospital has the authorization to perform mechanical thrombectomy. Therefore, transferring directly eligible acute ischemic stroke patients for mechanical thrombectomy to this center constitutes an important stake of the triage of suspected acute ischemic stroke patients. Some validated scores for the identification of severe strokes and large vessel occlusion, including the Cincinnati prehospital stroke severity scale (CPSSS), appear to be relevant for pre-hospital use in order to identify patients potentially eligible for mechanical thrombectomy and address them to a stoke unit with interventional radiology center.
Stroke is a leading causes of death and disability. At least 20% of strokes occur during sleep, so- called 'wake up stroke'. Thrombolysis with the clot-busting drug alteplase is effective for acute ischaemic stroke, provided that it is given within 4.5 hours of symptom onset. Patients with wake-up stroke are currently ineligible for clot-busting therapy. Previous studies indicate that many wake-up strokes occur just before awakening. In this study, patients with wake-up stroke will be randomized to thrombolysis with tenecteplase and best standard treatment or to best standard treatment without thrombolysis. Tenecteplase has several potential advantages over alteplase, including very rapid action and that it can be given as a single injection. Prior to thrombolysis, a brain scan must be done to exclude bleeding or significant brain damage as a result from the stroke. We will use a CT scan to inform this decision. CT is used as a routine examination in all stroke patients. Other studies testing clot-busting treatment in wake-up stroke are using alteplase and more complex brain scans, which are not routinely available in the emergency situation in all hospitals.
There is a need to improve the discharge process for patients with stroke, which has been reported to be a particularly stressful time for patients. A Patient Oriented Discharge Summary (PODS) meeting has been shown to be an effective approach for minimizing discharge-related stress and fostering self-management skills in other patients being discharged from rehabilitation into the community. The purpose of this study is to develop and evaluate whether a PODS meeting can minimize stress around the discharge process and improve patient satisfaction with this process. There are two main hypotheses regarding the PODS program: 1) it will help in-patients with stroke understand key issues related to knowledge required once discharged and 2) it will increase levels of self-efficacy in in-patients with stroke. Potential subjects are encouraged to participate if they are a Sunnybrook - St. John's Rehab admitted in-patient with a stroke diagnosis who are 18 years or older and meet the following criteria: (a) fluent in English; (b) cognitively intact; and (c) have minimal or no aphasia.The participant will be asked to answer some surveys 8-10 days prior to discharge about their knowledge and confidence in managing their stroke. The participant will then be asked to meet with a clinical staff member who will hold a one-hour PODS meeting. In the meeting, a discharge plan will be created and given to the patient that covers a number of topics that will be useful following their return to the community. One day following the PODS meeting, the participant will be asked to answer the same survey they completed prior to the PODS and again 3-5 days following discharge. If the participant is interested they will be asked to undergo a brief interview to get their feedback on the PODS Program. It is anticipated that about 20 people will participate in the program with all 20 patients completing the surveys with 6 being asked to complete the brief interview. To the best of the investigators knowledge, there is little risk associated with this study. Participants may become uncomfortable during the interview while discussing their experiences. By participating in this study, patients will be provided with a chance to gather information and learn problem solving and self-management skills prior to discharge. It is the hope of this project that it can lead to a more effective approach in supporting the transition from the hospital to the community for patients with stroke