scholarly journals Relation Between the Corticospinal Tract State and Activities of Daily Living in Patients With Intracerebral Hemorrhage

Stroke ◽  
2021 ◽  
Author(s):  
Sung Ho Jang ◽  
Eun Bi Choi

Background and Purpose: We investigated the relation between the ipsilesional corticospinal tract (CST) state and activity of daily living independence in patients with chronic intracerebral hemorrhage. Methods: Fifty-six consecutive patients with unilateral intracerebral hemorrhage and 38 healthy control subjects were recruited for this study. The Motricity index and the modified Barthel index were used to evaluate motor function of the affected extremities and activity of daily living independence, respectively. The diffusion tensor imaging parameter values for fractional anisotropy (FA) and voxel number (VN) of the CST were determined. Ratios of the ipsilesional to the contralesional CST measures were calculated and are presented as the CST-ratio (FA value and VN). Results: The FA value and VN of the ipsilesional CST and the CST-ratio in the patient group were lower than those of the control group ( P <0.05). There was a strong positive correlation between the Motricity index score of the affected extremities and the modified Barthel index score ( P <0.05), while the FA value and VN of the ipsilesional CST and the CST-ratio showed moderate and strong positive correlations with the Motricity index and modified Barthel index scores, respectively ( P <0.05). In addition, the VN of the ipsilesional CST showed excellent utility as a classifier, whereas the FA value of the ipsilesional CST and the FA value and VN of the CST-ratio showed good classifier utility ( P <0.05). Conclusions: We demonstrated that impairment of activity of daily living independency was closely related to the injury severity of the ipsilesional CST in patients with chronic intracerebral hemorrhage. In addition, the injury severity of the ipsilesional CST can be used to classify the degree of activity of daily living independency. REGISTRATION: URL: http://www.e-irb.com/index.jsp ; Unique identifier: 2021-03-014.

2017 ◽  
Vol 6 (02) ◽  
pp. 15
Author(s):  
Agustina Novita Putri Soegiarto ◽  
Linda Suryakusuma ◽  
Jane Pelealu

Background: Stroke is the third cause of disability that can affect the Activity of Daily Living (ADL). Ischemicstroke had higher incidence compared to hemorrhagic strokes. Rehabilitation in the form of physiotherapy canreduce the level of ADL dependencies, that is be measured by Barthel Index Score. Stroke severity, weaknessside, and physiotherapy onset can be factors that influence the success of physiotherapy to reducing the levelof ADL dependencies.Methods:A descriptive analytic study with a cross-sectional design in ischemic stroke patients using secondarydata from the Stroke Registry and medical records at Atma Jaya Hospital for the period of January 2016 toDecember 2017. The data were analyzed using Chi-Square.Results: Study on 110 subjects, consisted of 62 men(56.4%), aged divided by under of 58 years, and above of 58years were 52(47.3%) and 58 (52.7%). While subjects divided by stroke severity, i.e. minor, moderate, moderateto severe, and severe; 44 (40%), 58 (52.7%), 5 (4.5%), and 3 (2.7%) respectively. There were 77 participants(70%) had right side weakness and 33 participants (30%) were left side weakness. The changes of Barthel Indexof ADL score, were 73 (66.4%) improvement, 6 (5.5%) deterioration, and 31 (28.2%) remained. The study hasshown relationship between severity of stroke (p=0.008), weakness side (p=0.000), and physiotherapy onset(p=0.039) with the changes of Barthel Indexscore after treatment.Conclusion: There was a relationship between stroke severity, the weakness side of stroke, and physiotherapyonset with the better result of Barthel Index of ADL score after the physiotherapy.Keywords: Activity of Daily Living (ADL), Barthel Index, ischemic stroke, physiotherapy onset, stroke severity,Weakness side


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Bastian Volbers ◽  
Angelika Mennecke ◽  
Nicola Kästle ◽  
Hagen B Huttner ◽  
Stefan Schwab ◽  
...  

Introduction: Intracerebral hemorrhage (ICH) is a devastating disease with poor outcome. Established predictive markers include initial hematoma size, clinical status, intraventricular bleeding and age. However, prognostic assessment is often difficult which additionally burdens patients and caregivers and complicates rehabilitation. Functional outcome especially relies on motor function which is correlated with the integrity of the Corticospinal Tract (CST). Diffusion Tensor (DT) Tractography allows visualization of the CST. However, sufficient data about the prognostic impact of quantitative CST assessment is lacking. Methods: We prospectively enrolled patients with spontaneous supratentorial ICH admitted between 08/2012 und 08/2015. Informed consent and ethical approval was obtained. MRI scan was performed on day 5±1. DT data was normalized to MNI Space and Q-Space diffeomorphic reconstruction was performed using DSI-studio. CST was reconstructed based on quantitative anisotropy (QA) using the CST region (JHU white matter atlas) as seeding region and cerebral peduncle as region of interest (ROI). Fractional Anisotropy (FA) and QA were analyzed in the seeding and ROI region and in the posterior limb of the internal capsule (PLIC). Dichotomized modified Rankin Scale on day 90 (favorable outcome = mRS 0-2) was assessed as primary outcome variable. Results: 33 patients, mean age 70.7 y (standard deviation (SD) 12.9), 12 male, 21 with lobar hemorrhage, mean ICH volume on admission 16.5 (SD 11.3) cm 3 were included. 16 patients had a favorable outcome on day 90 (median mRS 3 (IQR 1-3.5). Mean number of reconstructed CST fiber pathways ipsilateral to ICH was higher in patients with favorable outcome (11343 (SD 8201)) than in patients with unfavorable outcome (4868 (SD 3221), p=0.008). Median QA and FA values in the PLIC ipsilateral to ICH were also higher in patients with favorable outcome (QA: 18.9 (IQR 16.2-23.3) vs. 14.6 (IQR 11.7 - 17.7), p=0.016, FA: 0.49 (IQR 0.45-0.53) vs. 0.41 (IQR 0.38-0.49), p=0.026). Conclusion: Higher FA- and QA-values in the PLIC and higher numbers of CST fiber pathways ipsilateral to ICH seem to be associated with a favorable outcome. DT Imaging may turn out as a useful quantitative predictive marker in the acute phase of ICH.


2021 ◽  
Vol 2 (3) ◽  
pp. 220-233
Author(s):  
Indah Ameilia ◽  
Dhea Anandha Aulia ◽  
Eka Anintyas Pandini ◽  
Yasyinta Ayu Qoriah ◽  
Fadiya Yasmin Robbani

Latar Belakang: Fenomena peningkatan populasi lansia menjadi isu penting bagi dunia. Saat ini, semakin banyak masalah penurunan kemampuan fisik lansia yang dapat memengaruhi kemandirian Activity of Daily Living (ADL) pada lansia. Sehingga, diberikan intervensi Pilates Exercise yang dapat menjaga fungsional fisik demi mewujudkan lansia yang lebih mandiri. Tujuan: Untuk mengetahui efektivitas Pilates Exercise terhadap peningkatan Activity of Daily Living (ADL) pada lansia. Metode: Jenis penelitian ini Systematic Literature Review dengan variabel bebas “Pilates Exercise” dan variabel terikat “Activity of Daily Living (ADL)”. Sampel penelitian pada lansia sehat dan tidak memiliki masalah kesehatan kronis. Pengumpulan data dilakukan secara online melalui 3 search engine dengan kata kunci yang dikembangkan berdasarkan PICOS. Waktu pengumpulan data tanggal 30 Mei 2021. Hasil: Didapatkan 9 literatur dengan desain Clinical Trial dan Randomized Controlled Trial, menghasilkan adanya peningkatan Activity of Daily Living (ADL) yang diukur dengan Barthel Index, Katz Scale, IADL Scale, Senior Fitness Test (SFT) Battery, dan GDLAM Index. Kesimpulan: Secara keseluruhan, penelitian ini melihat adanya peningkatan Activity of Daily Living (ADL) pada lansia dengan intervensi Pilates Exercise.


2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Xianfang Yue ◽  
Hua Zhou

Objective: To investigate the clinical effect of Xingnaojing injection combined with craniocerebral hypothermia apparatus in the treatment of acute hemorrhagic stroke. Methods: Seventy-two patients with acute hemorrhagic stroke admitted to our hospital from March 2018 to September 2019 were randomly divided into two groups, with 36 cases in each group. The control group (n=36) was treated with craniocerebral hypothermia apparatus, and the observation group (n=36) was treated with Xingnaojing injection combined with craniocerebral hypothermia apparatus. The clinical efficacy, the National Institutes of Health Stroke Scale (NIHSS) score and the activity of daily living (MBI score) after 1 month of treatment were compared. Results: The effective rate of treatment in the observation group was higher than that in the control group (P < 0.05); NIHSS score was decreased in both groups (P < 0.05); MBI score was increased in both groups, and the change range of the observation group was greater than that of the control group, showing statistically significant differences (P < 0.05). Conclusion: Xingnaojing injection combined with craniocerebral hypothermia apparatus can improve the clinical efficacy, the neurological impairment and activity of daily living in the treatment of acute hemorrhagic stroke, which is worthy of clinical application.


Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2070
Author(s):  
Sung-Ho Jang ◽  
Chang-Hoon Bae ◽  
Jae-Woon Kim ◽  
Hyeok-Gyu Kwon

Some studies have reported that a core vestibular projection (CVP) injury is associated with dizziness following a brain injury using diffusion tensor tractography (DTT). On the other hand, there has been no DTT study on dizziness caused by a CVP injury in patients with mild traumatic brain injury (TBI). In this study, DTT was used to examine the relationship between dizziness and CVP injury in patients with mild TBI. Forty-three patients with mild TBI and twenty-nine normal subjects were recruited. The patients were classified into two groups based on the dizziness score: group A, patients with a dizziness score less than 2 on the sub-item score for dizziness in the Rivermead Post-concussion Symptoms Questionnaire; group B, patients with a dizziness score above 2. The tract volume (TV) in group B was significantly lower than group A and the control group (p < 0.05). By contrast, the TV in group A was similar to the control group (p > 0.05). Regarding the correlation, the dizziness score of all patients showed a strong negative correlation with the TV of the CVP (r = −0.711, p < 0.05). DTT revealed the CVP injury in patients with dizziness after mild TBI. In addition, the severity of dizziness of these patients was closely related to the injury severity of the CVP.


2021 ◽  
Vol 3 (2) ◽  
pp. 15-20
Author(s):  
Nanjar Widiastuti ◽  
Tri Sumarni ◽  
Reni Dwi Setyaningsih

Abstrak Activity of daily living (ADL) adalah aktivitas pokok bagi perawatan diri. Activity of daily living meliputi antara lain: ke toilet, makan, berpakaian (berdandan), mandi, dan berpindah tempat. Pengkajian ADL penting untuk mengetahui tingkat ketergantungan lansia dalam rangka menetapkan level bantuan bagi lansia tersebut dan untuk menyusun rencana perawatan jangka panjang. Tujuan dari penelitian ini adalah untuk mengetahui gambaran tingkat kemandirian lansia dalam pemenuhan ADL yang tinggal di rojinhome Thinsaguno Ie Itoman Okinawa Jepang. Jenis penelitian ini adalah deskriptif observasional. Sampel dalam penelitian ini adalah seluruh lansia di rojinhome Thinsaguno Ie Itoman Okinawa Jepang sejumlah 34 responden. Penentuan sampel menggunakan teknik total sampling. Alat ukur yang digunakan adalah lembar checklist Barthel Index. Penelitian ini menggunakan analisis data univariat yang ditampilkan dalam distribusi frekuensi. Hasil penelitian menunjukan rata-rata umur yaitu 83,23 tahun dan paling dominan pada rentang umur old (75-90 tahun) yaitu 70,6%. Jenis kelamin sebagian besar perempuan yaitu 64,7%, tingkat kemandirian sedang dalam ADL yaitu 38,2%. Tingkat kemandirian lansia  berdasarkan umur paling dominan pada rentang umur old (75-90 tahun) dengan tingkat kemandirian sedang (29,4%). Tingkat kemandirian lansia berdasarkan jenis kelamin paling dominan pada jenis kelamin perempuan dengan ketergantungan sedang (23,5%). Kata kunci: lansia, activity of daily living, tingkat kemandiria Abstract Activity of daily living (ADL) is a staple activity for self-care. Activity of daily living includes, among others: toileting, eating, dressing, showering, and moving places. ADL assessment is important to determine the level of dependence of the elderly in order to determine the level of assistance for the elderly and to develop a long-term care plan. The purpose of this study was to describe the level of independence of the elderly in fulfilling the ADL at rojinhome of Thinsaguno Ie Itoman Okinawa, Japan. The type of this research is descriptive observational with cross sectional approach. The sample in this research were all 34 elderly people at rojinhome Thinsaguno Ie Itoman Okinawa Japan. Determination of the sample using total sampling technique. The measuring instrument used is the Barthel Index checklist sheet. This study uses univariate data analysis which is displayed in the frequency distribution. The results showed that the average age was 83.23 years and the most dominant in the old age range (75-90 years) was 70.6%. The gender of most of the women was 64.7%, the level of independence was moderate in ADL, namely 38.2%. The level of elderly independence based on age is the most dominant in the old age range (75-90 years) with a moderate level of independence (29.4%). The level of independence of the elderly based on sex was the most dominant in the female sex with moderate dependence (23.5%). Keywords: elderly, activity of daily living, level of independence


2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Xinmin Wang ◽  
Yingjun Sun ◽  
Shugang Dong ◽  
Xiaoying Liu ◽  
Jinming Ji

Objective: To evaluate the effect of butyphthalide in the treatment of massive cerebral infarction. Methods: One hundred and twenty patients with massive cerebral infarction who were admitted to the hospital between January 2017 and December 2017 were selected and divided into a treatment group (n = 60) and a control group (n = 60) using random number table, 80 each group. Patients in the control group were given conventional cerebral infarction therapy, while patients in the treatment group were given butyphthalide injection besides the conventional treatment. The National Institutes of Health Stroke Scale (NIHSS) score, score of activity of daily living (ADL), lipoprotein-associated phospholipase A2 (LP-PLA2) and prognosis were recorded and compared between the two groups. The response rates of the two groups were recorded. Results: The total response rates of the control group and treatment group were 73.85% and 93.85% respectively at the postoperative 21st day, and the difference had statistical significance (P<0.05). The NIHSS score of the two groups obviously decreased, and the ADL score significantly increased after treatment; the differences of NIHSS score and ADL score before and after treatment in the same group had statistical significance (P<0.05). The improvement of the indexes of the treatment group was obviously superior to that of the control group, and the differences between the two groups had statistical significance (P<0.05). The level of LP-PLA2 of both groups significantly decreased at the postoperative 21st day, and the difference before and after treatment in the same group was statistically significant (P<0.05); the treatment group had a significantly lower level of LP-PLA2 than the control group, and the difference had statistical significance (P<0.05). The treatment group had significantly higher positive outcome rate and lower mortality rate than the control group at the postoperative 90th day, and the differences had statistical significance (P<0.05). The incidence of adverse events of the treatment group and control group was 8.3% (5/60) and 5.0% (3/60) respectively, suggesting no significant difference (P>0.05). Conclusion: Butyphthalide has a favourable effect in treating massive cerebral infarction. It can repair neurologic impairment, improve activity of daily living, and adjust the level of LP-PLA2, suggesting favourable application values. How to cite this:Wang X, Sun Y, Dong S, Liu X, Ji J. Butyphthalide in the treatment of massive Cerebral Infarction. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.320 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2020 ◽  
Author(s):  
Zhiling Zhao ◽  
Feng Wang ◽  
Xue Wang ◽  
Xiunan Li ◽  
Yi Ren ◽  
...  

Abstract Background: Hospitalized patients with Coronavirus Disease 2019 (COVID-19) pneumonia showed a severve loss of muscle mass and strength over admission. Therefore, early physical interventions might be conducive to prevent disability and fasten recovery. Methods: We designed a prospective, randomized controlled trial to identify the effectiveness and safety of pulmonary rehabilitation based on muscle exercise in COVID-19 patients. The study was conducted between February 7th and March 31st 2020 in Union Hospital. Patients were randomly assigned to the pulmonary rehabilitation exercise group or the control group. Primary outcome was improvement of activity of daily living (ADL). Secondary outcome was changes of muscle strength assessed by manual muscle test (MMT) and arterial blood gas analysis. Length of hospital staying (LOS) and adverse events related to physical activity were also observed.Results: A total of sixty patients were in analysis, and thirty patients were in PR group. Patients had a mean age of 54.43±10.57 years. A statistically and clinically significant increase in ADL was observed in PR group (75.00 [66.25,90.00] to 100.00 [100.00,100.00], p<0.001). We also found that the improvement of ADL was related to younger age and higher PaO2 (p<0.01). Both groups had MMT improvement and there was no statistical difference between groups. There was a significant increase in PaO2 (80.23±6.49 vs. 90.47±7.82, respectively, p<0.001) between two groups before discharge. There was no statically significant difference in LOS between study group and control group (p=0.62). None of these patients had severe complications during the study.Conclusions: The protocal of pulmonary rehabilitation based on muscle training exercise was feasible in COVID-19 patients and it might accelerate recovery in ADL as compared with the spontaneous recovery in the control group.Clinical Trial Registration: ChiCTR, ChiCTR2000032457. Registered 29 April 2020- Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=52925.


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