Posts Tagged ischemic

[NEWS] Nerve Stimulation Therapy May Help Some People Recover After a Stroke

Electrical stimulation may help people recover after having a common type of stroke.

Experts are investigating a new type of treatment for strokes. Getty Images

Each year, more than 795,000 people in the United States have a stroke.

Of them, nearly 40 percent go on to experience moderate to severe physical and mental complications, estimates the National Stroke Association. Another 25 percent have minor issues in the aftermath of a stroke.

Now stroke patients may have access to a new type of treatment that may help minimize the degree of complications.

The therapy, known as active nerve cell cluster stimulation, uses a small device implanted through the roof of the mouth that sends electrical stimulation to the nerves behind the nose.

When administered within 24 hours after a stroke, the nerve stimulation treatment was found to reduce the degree of disability in stroke patients three months after having the most common type of stroke, according to a new study published in The LancetTrusted Source last month.

The new treatment could be a safe, effective option for many stroke patients who are not eligible to receive traditional clot-busting medications, the researchers said.

“This study opens the avenues to develop treatment options for patients with acute ischemic stroke who are not eligible for standard of care acute stroke therapy to improve functional outcomes and to reduce long-term disabilities,” Dr. Anand Patel, a vascular neurologist at North Shore University Hospital in Manhasset, New York, told Healthline.

Nerve stimulation reduces degree of disability

To measure just how effective the therapy is, researchers from multiple institutions, including UCLA and Northwestern University, studied 1,000 participants who had an acute cortical ischemic stroke. In this type of stroke, blood flow to the brain is obstructed.

The participants were randomly assigned into two groups: one that received the stimulation therapy and another that underwent a placebo therapy.

Throughout the study, the first group received stimulation to the nerve-cell cluster behind the nose four hours per day for five consecutive days.

In a subgroup of 520 participants who’d experienced major deficits and injury to the brain, nearly half of the participants who received the new, experimental nerve therapy experienced favorable outcomes, versus 40 percent of the participants who didn’t receive the stimulation.

Although these findings aren’t statistically significant, the researchers note, when the results are combined with previous research from earlier trials, there’s enough evidence to suggest that the therapy is a safe, effective stroke treatment when given anywhere from 8 to 24 hours after a stroke.

Here’s how the therapy could help stroke patients

During a stroke, there’s an interruption of blood supply to the brain.

The key to treating a stroke and minimizing long-term damage is to quickly and effectively restore blood flow to the brain.

Typically, doctors treat stroke by opening blocked arteries or removing a clot. They do this with either clot-dissolving medications or surgically reopening clotted blood vessels.

However, the medication’s effectiveness drops significantly if it’s given more than three hours after a stroke. The medicine also doesn’t work for all patients, and some aren’t able to take it due to other health issues.

Furthermore, not every medical center has the proper expertise needed to treat patients with clot-retrieval devices.

Stimulating the nerve cells behind the nose may improve stroke outcomes in one of three ways, according to health experts.

“First, stimulation of this nerve bundle actually improved blood flow to the brain starved of oxygen during a stroke. Second, stimulation seems to fortify the blood-brain barrier, thereby [decreasing] the leakiness that causes swelling after a stroke,” said Dr. Jason Tarpley, a stroke neurologist and director of the Stroke and Aneurysm Center at Providence St. Joseph Health Pacific Neuroscience Institute.

“Finally, stimulation enhances plasticity of the brain, in which noninjured parts of the brain can pick up the job of the injured brain areas,” Tarpley added.

In other words, this therapy can quickly feed oxygen to the brain and protect tons of brain cells.

Stroke is one of the leading causes of death in the U.S.

Ischemic stroke is the leading cause of long-term physical and psychological disabilities, according to Patel.

The road to recovery can be a long and difficult one.

Following a stroke, many people will experience a wide range of complications, including slurred speech, double vision, an inability to perform tasks, and trouble maintaining balance, among several others.

Strokes are also responsible for about 140,000 deaths in the United States each year, according to the Centers for Disease Control and Prevention (CDC)Trusted Source.

Seeing as stroke is such a common and debilitating health issue in the United States, it is crucial to develop new, powerful treatment options to maximize the chances of people returning to their regular lives as soon as possible after a stroke.

The bottom line

Each year, nearly 795,000 people in the United States have a stroke. More than half go on to experience a range of physical and mental complications.

Scientists have found that a new type of therapy, called active nerve cell cluster stimulation, may have what it takes to effectively reduce the degree of disability in some people after a stroke.

 

via Nerve Stimulation Therapy May Help Some People Recover After a Stroke

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[Guide] LIFE AFTER STROKE Our Path Forward – American Stroke Association

THERE IS LIFE – AND HOPE – AFTER STROKE. WITH TIME, NEW ROUTINES WILL BECOME SECOND NATURE. REHABILITATION CAN BUILD YOUR STRENGTH, CAPABILITY AND CONFIDENCE. IT CAN HELP YOU CONTINUE YOUR DAILY ACTIVITIES DESPITE THE EFFECTS OF YOUR STROKE.

If you are the caregiver, family member or friend of a stroke survivor, your role is vital. You should know the prevention plan and help your loved one to comply with the plan. With a committed health care team and a rehabilitation plan specific to their needs, most stroke survivors can prevent another stroke and thrive.

We hope this guide will help you and your loved ones understand the effects of stroke and how to maximize your rehabilitation and recovery.

Download PDF file

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[ARTICLE] Hemorrhagic versus ischemic stroke: Who can best benefit from blended conventional physiotherapy with robotic-assisted gait therapy? – Full Text

Abstract

Background

Contrary to common belief of clinicians that hemorrhagic stroke survivors have better functional prognoses than ischemic, recent studies show that ischemic survivors could experience similar or even better functional improvements. However, the influence of stroke subtype on gait and posture outcomes following an intervention blending conventional physiotherapy with robotic-assisted gait therapy is missing.

Objective

This study compared gait and posture outcome measures between ambulatory hemorrhagic patients and ischemic patients, who received a similar 4 weeks’ intervention blending a conventional bottom-up physiotherapy approach and an exoskeleton top-down robotic-assisted gait training (RAGT) approach with Lokomat.

Methods

Forty adult hemiparetic stroke inpatient subjects were recruited: 20 hemorrhagic and 20 ischemic, matched by age, gender, side of hemisphere lesion, stroke severity, and locomotor impairments. Functional Ambulation Category, Postural Assessment Scale for Stroke, Tinetti Performance Oriented Mobility Assessment, 6 Minutes Walk Test, Timed Up and Go and 10-Meter Walk Test were performed before and after a 4-week long intervention. Functional gains were calculated for all tests.

Results

Hemorrhagic and ischemic subjects showed significant improvements in Functional Ambulation Category (P<0.001 and P = 0.008, respectively), Postural Assessment Scale for Stroke (P<0.001 and P = 0.003), 6 Minutes Walk Test (P = 0.003 and P = 0.015) and 10-Meter Walk Test (P = 0.001 and P = 0.024). Ischemic patients also showed significant improvements in Timed Up and Go. Significantly greater mean Functional Ambulation Category and Tinetti Performance Oriented Mobility Assessment gains were observed for hemorrhagic compared to ischemic, with large (dz = 0.81) and medium (dz = 0.66) effect sizes, respectively.

Conclusion

Overall, both groups exhibited quasi similar functional improvements and benefits from the same type, length and frequency of blended conventional physiotherapy and RAGT protocol. The use of intensive treatment plans blending top-down physiotherapy and bottom-up robotic approaches is promising for post-stroke rehabilitation.

Continue —>  Hemorrhagic versus ischemic stroke: Who can best benefit from blended conventional physiotherapy with robotic-assisted gait therapy?

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[Abstract] Canadian stroke best practice recommendations: Stroke rehabilitation practice guidelines, update 2015

Abstract

Stroke rehabilitation is a progressive, dynamic, goal-orientated process aimed at enabling a person with impairment to reach their optimal physical, cognitive, emotional, communicative, social and/or functional activity level.

After a stroke, patients often continue to require rehabilitation for persistent deficits related to spasticity, upper and lower extremity dysfunction, shoulder and central pain, mobility/gait, dysphagia, vision, and communication.

Each year in Canada 62,000 people experience a stroke. Among stroke survivors, over 6500 individuals access in-patient stroke rehabilitation and stay a median of 30 days (inter-quartile range 19 to 45 days). The 2015 update of the Canadian Stroke Best Practice Recommendations: Stroke Rehabilitation Practice Guidelines is a comprehensive summary of current evidence-based recommendations for all members of multidisciplinary teams working in a range of settings, who provide care to patients following stroke.

These recommendations have been developed to address both the organization of stroke rehabilitation within a system of care (i.e., Initial Rehabilitation Assessment; Stroke Rehabilitation Units; Stroke Rehabilitation Teams; Delivery; Outpatient and Community-Based Rehabilitation), and specific interventions and management in stroke recovery and direct clinical care (i.e., Upper Extremity Dysfunction; Lower Extremity Dysfunction; Dysphagia and Malnutrition; Visual-Perceptual Deficits; Central Pain; Communication; Life Roles).

In addition, stroke happens at any age, and therefore a new section has been added to the 2015 update to highlight components of stroke rehabilitation for children who have experienced a stroke, either prenatally, as a newborn, or during childhood.

All recommendations have been assigned a level of evidence which reflects the strength and quality of current research evidence available to support the recommendation. The updated Rehabilitation Clinical Practice Guidelines feature several additions that reflect new research areas and stronger evidence for already existing recommendations.

It is anticipated that these guidelines will provide direction and standardization for patients, families/caregiver(s), and clinicians within Canada and internationally.

Source: Canadian stroke best practice recommendations: Stroke rehabilitation practice guidelines, update 2015

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