scholarly journals Training in Swallowing Prevents Aspiration Pneumonia in Stroke Patients with Dysphagia

2006 ◽  
Vol 34 (3) ◽  
pp. 303-306 ◽  
Author(s):  
JY Huang ◽  
DY Zhang ◽  
Y Yao ◽  
QX Xia ◽  
QQ Fan
Keyword(s):  
Acute Stroke ◽  
Family Member ◽  
Aspiration Pneumonia ◽  
Oral Feeding ◽  
Stroke Patients ◽  
Information Group ◽  
Group A ◽  
Experienced Nurse ◽  
Group B

This study investigated the frequency of aspiration pneumonia in conscious stroke patients fed by a family member and examined the effect of introducing training in swallowing techniques by nurses. A total of 96 consecutive patients presenting with dysphagia due to acute stroke were included in the study. Patients presenting between January 2000 and July 2003 ( n = 48) were fed orally by a family member given general nursing information (group A), whereas those presenting between August 2003 and March 2005 ( n = 48) were fed orally by an experienced nurse trained in specific swallowing techniques (group B). All patients were examined daily for the presence of aspiration pneumonia. The incidence of aspiration pneumonia was 33.3% in group A and 6.3% in group B ( P < 0.05). The incidence of aspiration pneumonia in dysphagic stroke patients who are orally fed is still high. Training in swallowing during oral feeding offers clear protection against pneumonia in conscious stroke patients.

scholarly journals Effects of Proprioceptive Neuromuscular Facilitation (PNF) Techniques on Bed Mobility, Transfer and Early Trunk Control in Acute Stroke Patients

2021 ◽  
pp. 540-545
Author(s):  
Binash Afzal ◽  
Tehreem Mukhtar ◽  
Ghazal Awais Butt ◽  
Asifa Bashir ◽  
Sadiaa Manzoor ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Stroke Patients ◽  
Trunk Control ◽  
Proprioceptive Neuromuscular Facilitation ◽  
Post Test ◽  
Group A ◽  
Group B ◽  
Age Range ◽  
Bed Mobility ◽  
Written Informed Consent

Aims: The aim of this study was to observe the effects of Proprioceptive neuromuscular facilitation (PNF) Techniques to improve bed mobility, transfer and early trunk control in Stroke patients. Study Design: Assessor blinded Randomized Control Trail. Place and Duration of the Study: Physiotherapy department of Shalamar hospital Lahore, Pakistan from March 2019 to September 2020. Methodology: A total of 50 acute stroke patients with severity level NIHSS>21 were recruited and randomly allocated into 2 groups (males: 29, females: 21; age range: 50 to 65) after obtaining written informed consent. Patients were assessed at baseline 0 week and after 6 week of post treatment on Trunk impairment scale (TIS) and ICU mobility scale. Results: It showed that PNF base trunk control exercises exhibited significant improvement in Trunk impairment scale(TIS) in Group A as compared with Group B at post-test, 18.44±3.176 vs 16.12±2.35 (p=0.004) respectively. ICU Mobility scale significantly improves at post-test in Group A as compared to Group B, 7.52 ±2.583 vs 5.84±1.434 (p=0.007) respectively. Conclusion: This study concluded that PNF based trunk exercise showed more improvement in Group A (Trunk stability exercises using PNF techniques) when compared with conventional training.

scholarly journals EFFICACY OF ROLLING BOARD PERTURBATION TRAINING ON BALANCE AMONG HEMIPARETIC STROKE PATIENTS - A COMPARATIVE STUDY

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Dr. Senthil kumar ◽  
Dr. Franklin Shaju M.K m k ◽  
Dr. Vijaya Senthil Kumar kumar ◽  
Dr. A. velmurugan
Keyword(s):  
Public Health Problem ◽  
Berg Balance Scale ◽  
Major Public Health Problem ◽  
Stroke Patients ◽  
Perturbation Training ◽  
Before And After ◽  
Group A ◽  
Hemiparetic Stroke ◽  
Conventional Physiotherapy ◽  
Group B

Background of the study: Stroke is a major public health problem that ranks in the top four causes of death in most of the countries and is responsible for a large proportion of the burden of neurologic disorders. Patients with stroke have poor balance because they cannot control dynamically the size of the base of support or the location of the line of gravity. Perturbation training undergoes the maximal sway possible without losing his balance. Objective of the study: The objective of the study is to find the effects of rolling board perturbation training on balance among hemiparetic stroke patients. Methodology: Thirty clinically diagnosed hemiparetic stroke patients were selected based on the inclusion and exclusion criteria. They were randomly allocated into two groups (Group A and Group B) consists of 15 subjects each. Group A received conventional physiotherapy alone and group B received rolling board perturbation training along with conventional physiotherapy. Intervention lasted for 4 weeks, three days in a week and one hour per day. Balance was measured before and after 4 weeks of intervention by berg balance scale. Conclusion: Both conventional physiotherapy alone and rolling board perturbation training along with conventional physiotherapy significantly improved balance among hemiparetic stroke patients. When comparing both rolling board perturbation training along with conventional physiotherapy is more effective than conventional physiotherapy alone in improving balance among hemiparetic stroke patients.

Abstract P855: Importance of Compliance in Dysphagia Screening in Acute Stroke Care

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Patty Noah ◽  
Melanie Henderson ◽  
Rebekah Heintz ◽  
Russell Cerejo ◽  
Christopher T Hackett ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Aspiration Pneumonia ◽  
Hemorrhagic Stroke ◽  
Oral Intake ◽  
Stroke Care ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Acute Stroke Care ◽  
Chi Square ◽  
Stroke Center

Introduction: Dysphagia occurs in up to two thirds of stroke patients and can lead to serious complications such as aspiration pneumonia, which is also linked to increased morbidity and mortality. Evidence-based guidelines recommend a bedside dysphagia assessment before oral intake in stroke patients regardless of initial stroke severity. Several studies have described registered nurses’ competency in terms of knowledge and skills regarding dysphagia screening. We aimed to examine the rate of aspiration pneumonia compared to the rate of dysphagia screening. Methods: A retrospective analysis of prospectively collected data at a single tertiary stroke center was carried out between January 2017 and June 2020. Data comparison was completed utilizing ICD-10 diagnosis codes to identify aspiration pneumonia in ischemic and hemorrhagic stroke patients. The data was reviewed to compare the compliance of a completed dysphagia screen prior to any oral intake to rate of aspiration pneumonia. Chi square tests were used to assess proportion differences in completed dysphagia screen and proportion of aspiration pneumonia diagnosis in the ischemic and hemorrhagic stroke patients. Results: We identified 3320 patient that met inclusion criteria. 67% were ischemic strokes, 22% were intracerebral hemorrhages and 11% were subarachnoid hemorrhages. Compliance with dysphagia screening decreased from 94.2% (n=1555/1650) in 2017-2018 to 74.0% (n=1236/1670) in 2019-2020, OR=0.17 (95%CI 0.14 - 0.22), p < 0.0001. Aspiration pneumonias increased from 58 (3.5%) in 2017-2018 to 77 (4.6%) in 2019-2020, but this difference was not statistically significant, OR=0.75 (95%CI 0.53 - 1.07), p = 0.11. Conclusion: We noted that the decrease in compliance with completing a dysphagia screen in patients with acute stroke prior to any oral intake was associated with a higher trend of aspiration pneumonia.

Abstract TP52: Endovascular Therapy in Patients Over 80 Years of Age With Acute Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Janhavi M Modak ◽  
Syed Daniyal Asad ◽  
Jussie Lima ◽  
Amre Nouh ◽  
Ilene Staff ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Symptom Onset ◽  
Time Window ◽  
Extended Time ◽  
Stroke Patients ◽  
Stroke Outcomes ◽  
Stroke Treatment ◽  
Group A ◽  
Group B

Introduction: Acute ischemic stroke treatment has undergone a paradigm shift, with patients being treated in the extended time window (6-24 hours post symptom onset). The purpose of this study is to assess outcomes in stroke patients above 80 years of age undergoing endovascular treatment (EVT) in the extended time window. Methods: Acute ischemic stroke patients presenting to Hartford Hospital between January 2017 to June 2019 were considered for the study. Stroke outcomes in patients above 80 years of age with anterior circulation ischemic strokes presenting in the extended time window (Group A, n=30) were compared to a younger cohort of patients below 80 years (Group B, n=31). Patients over 80 years treated in the traditional time window (within 6 hours of symptom onset) served as a second set of controls (Group C, n=40). Statistical analysis was performed with a significance level of 0.05 Results: For angiographic results, there were no statistically significant differences in terms of good outcomes (TICI 2b-3) among patients of Group A, when compared to Groups B or C (p>0.05). For the endovascular procedures, no significant differences were noted in the total fluoroscopy time (Median Group A 44.05, Group B 38.1, Group C 35.25 min), total intra-procedure time (Median Group A 144, Group B 143, Group C 126 min) or total radiation exposure (Median Group A 8308, Group B 8960, Group C 8318 uGy-m 2 ). For stroke outcomes, a good clinical outcome was defined as modified Rankin score of 0-2 at discharge. Significantly better outcomes were noted in the younger patients in Group B - 35.4%, when compared to 13.3% in Group A (p=0.03). Comparative outcomes differed in the elderly patients above 80 years, Group A -13.3% vs Group C - 25%, although not statistically significant (p=0.23). There was a significant difference in mortality in patients of Group A - 40% as compared to 12% in the younger cohort, Group B (p= 0.01). Conclusions: In the extended time window, patients above 80 years of age were noted to have a higher mortality, morbidity compared to the younger cohort of patients. No significant differences were noted in the stroke outcomes in patients above 80 years of age when comparing the traditional and the extended time window for stroke treatment.

Outcomes of Esophageal Replacement: Gastric Pull-Up and Colonic Interposition Procedures

2017 ◽  
Vol 28 (01) ◽  
pp. 022-029 ◽  
Author(s):  
Keren Sloan ◽  
Anna Morandi ◽  
Bhanumathi Lakshminarayanan ◽  
Sharon Cox ◽  
Alastair Millar ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Oral Feeding ◽  
Esophageal Replacement ◽  
Caustic Ingestion ◽  
Colonic Interposition ◽  
Septic Complications ◽  
Anastomotic Strictures ◽  
Group A ◽  
Group B ◽  
Gastric Pull Up

Aim No consensus exists about the optimal surgical technique for esophageal replacement. This study reports the surgical outcomes for the gastric pull-up and the colonic interposition procedures. Materials and Methods A retrospective review of children undergoing esophageal replacement surgery between January 2001 and June 2015 across four different pediatric surgery centers was conducted. Data collected included indications, epidemiology, surgical technique, complications, and outcomes. Patients were divided into group A, those that had a gastric pull-up procedure and group B, those that had a colonic interposition procedure. Results In total, 50 patients were included; 29 in group A and 21 in group B. Indications included esophageal atresia, caustic ingestion, and infective esophageal stricture. The median age at the time of surgery was 13 months. The mean length of follow-up was 5.2 years. Three patients died giving a mortality rate of 6%; 2 in group A and 1 in group B.In both groups, early postoperative complications included infective complications, such as wound infections, sepsis, and pneumonia (11), anastomotic leak (7), and respiratory complications (7). Late complications included adhesive bowel obstruction (2), anastomotic strictures (4), redundancy (1), and jejunostomy problems (1). Septic complications and anastomotic strictures occurred more frequently in group B. Further surgery was needed in eight patients; this was significantly higher in group B. Full oral feeding was achieved within 6 months in 91.5%. Conclusion The gastric pull-up and colonic interposition have comparable mortality and outcomes. The colonic interposition was associated with a higher rate of early septic complications, anastomotic strictures, and need for further surgery.

scholarly journals EFFICACY OF TENS WITH CONVENTIONAL OCCUPATIONAL THERAPY IN IMPROVING HAND FUNCTION OF STROKE SURVIVORS

2019 ◽  
Vol 8 (1) ◽  
pp. 25-30
Author(s):  
Faiza Tahir ◽  
Quratulain Khan
Keyword(s):  
Occupational Therapy ◽  
Conventional Therapy ◽  
Controlled Trial ◽  
Hand Function ◽  
Low Frequency ◽  
Optimal Recovery ◽  
Stroke Survivors ◽  
Stroke Patients ◽  
Group A ◽  
Group B

BACKGROUND AND AIM Stroke is currently the second leading cause of death and third main cause of disability throughout the world. Around 75% of stroke survivors suffered from upper limb dysfunction with limited functional activities whereas distal parts of upper extremity such as hand and forearm are mostly affected by stroke. Therefore, this study aims to determine the benefits of TENS along with conventional Occupational therapy in the rehabilitation of stroke patients to ascertain the optimal recovery of hand function. METHODOLOGY A Single-blind Randomized Controlled Trial was conducted on 76 individuals with acute phase or one-year history post-stroke. Group-A (n=38) received Low Frequency Transcutaneous Electrical Nerve Stimulation on elbow and wrist extensors (3 Hz, 400 μs)along with conventional Occupational therapy while Group-B (n=38) received conventional Occupational therapy only. Both the groups received intervention for 5 days/week of duration 45 minutes till 3 weeks. RESULTS Group-A showed significant improvement in means scores of FMA-UE and ARAT (p<0.05) in comparison to Group-B which showed moderate improvements in sensorimotor and activity capacity of hand function. CONCLUSION Conventional therapy along with TENS significantly improved the hand function in acute stroke patients as compared to the conventional therapy.

scholarly journals Comparison of early versus late enteral feeding following gut anastomosis.

2020 ◽  
Vol 27 (12) ◽  
pp. 2548-2552
Author(s):  
Zohra Jabeen ◽  
Ramlah Ghazanfor ◽  
Muhammad Usman Akram ◽  
Sara Malik ◽  
Maham Tariq ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Enteral Feeding ◽  
Oral Feeding ◽  
P Value ◽  
Age Group ◽  
Bowel Sounds ◽  
Early Oral Feeding ◽  
Group A ◽  
Group B ◽  
Mean Time

Objectives: To compare early feeding versus late enteral feeding following gut anastomosis in term of hospital stay. Study Design: Prospective Randomized Control study. Setting: Surgical Unit 1, Holy Family Hospital, Rawalpindi. Period: April to October 2017. Material & Methods: All patients, excluding paediatric age group (n= 60) undergoing emergency or non-emergency gut resection with primary anastomosis were incorporated. Two strata were devised. Group A (n=30) received early enteral feeding starting at 12th post-operative hours in form of 100-150ml fluid thrice daily. Group B endured being Nil per oral for 72hrs. Both groups were correlated for timing of return of bowel sounds and timespan of hospital stay. P value < 0.05 was considered noteworthy. Results: Overall 60 patients with 30 in each group were incorporated. They were predominantly males (55%) and belonged to middle age group (Group A=31.73+10.78 years; Group B= 36.00+10.53 years). Mean time for return of bowel sounds in both the groups was 24.40+5.88 hours and 35.20+10.88 hours respectively, which was striking (p value <0.05). Mean length of hospital stay in both the groups was also noteworthy i.e. 5.23+0.72 days and 6.40+1.67 days respectively. Conclusion: In the wake of gut anastomosis, early oral feeding at 12hours is superior to delayed oral feeding after 72hours, in terms of mean time for return of bowel sounds and period of hospital stay.

scholarly journals Cardiovascular Changes in Smoker and Nonsmoker Male Stroke Patients

2010 ◽  
Vol 14 (Number 1) ◽  
pp. 32-35
Author(s):  
N Habib ◽  
Md. R Amin ◽  
US N Begum ◽  
N Akhter ◽  
D Akther ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Descriptive Study ◽  
Stroke Patients ◽  
Medical College ◽  
Significant Difference ◽  
Group A ◽  
Altered Physiology ◽  
Group B

This descriptive study was done in the Deponment of Physiology. Dhaka Medical College, Dhaka. during the period of January 2008 to December 2008. The objective of the study was to measure pulse and blood pressure in smokers and nonsmoker adult male stroke patients and to find out changes in pulse and blood pressure among the smoker and non-smoker stroke patients. To accomplish this purpose 105 patient of over 20 years of age were selected. They were divided into two groups: Group A consisting of thirty n on-smoker and group B consisting of seven,' five smoker stroke patients. The finding showed that smoking caused no statistical significant difference 1p>0.05) in pulse and systolic blood pressure among she groups. Diastolic blood pressure was significantly higher (p<0.05) fill smokers than non-smokers. The study therefore provides the scope to understand the altered physiology of smoker stroke pollen's.

Effects of mental imagery technique in addition to conventional physical therapy to improve hand functions in chronic stroke patient

2021 ◽  
pp. 1-15
Author(s):  
Iqra Mubeen ◽  
Ashfaq Ahmad ◽  
Waqar Afzal
Keyword(s):  
Physical Therapy ◽  
Mental Imagery ◽  
Hand Function ◽  
Chronic Stroke ◽  
P Value ◽  
Stroke Patients ◽  
Maximum Duration ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Objective: To find the effect of mental imagery and conventional physical therapy for the treatment of hand function in chronic stroke patients. Methods: A randomized controlled trial was conducted at Rana and Alvi welfare society. A sample of 50 stroke patients was selected and divided in two groups; group A (experimental) and group B (control).  Inclusion and exclusion criteria were established and patients meeting inclusion criteria were included in the study. P value was set as 0.05. Group A was treated with conventional physical therapy combined with mental imagery whereas Group B was treated with conventional physical therapy alone. Wolf motor function test and action research arm test was used as outcome measures. Results: Group A consisted of 68% of females and 32% of males and group B comprised of 44% females and 32% males. Mean age of group A and B were 59.68 + 2.37 and 58.52 + 2.46 respectively. Mean duration (in months) of stroke for group A was 16.32+3.77 (minimum and maximum duration 13 and 23 months respectively). The stroke mean duration of group B was 16.00 +2.34 (minimum and maximum duration 13 and 20 months respectively). Both groups did not show significant difference at 5th week (P=0.721) whereas a significant difference was observed at 10th week (P=0.000) Conclusion: It was concluded that mental imagery technique in combination with conventional physical therapy is significantly effective to improve hand function among chronic stroke patients in comparison to conventional physical therapy alone. Continuous...

Comparison of changes in cognitive functions of post-stroke patients with the computer-based cognitive intervention (PABLO system) and conventional cognitive intervention (Paper-Pencil method)

2021 ◽  
Vol 17 ◽  
Author(s):  
Sudhi Kulshrestha ◽  
Manju Agrawal ◽  
Ajai K Singh ◽  
Akash Ved
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Functions ◽  
Research Work ◽  
Cognitive Intervention ◽  
Stroke Patients ◽  
Post Stroke ◽  
Group A ◽  
Computer Based ◽  
Attention Memory ◽  
Group B

Background: Cognitive functions are mental series of activities that allow us to carry out any activity. The most important cognitive functions are orientation, attention, memory, executive functions, language, and visuospatial skills. Cognitive impairment is a prevalent consequence of stroke. Prognosis of stroke recovery can be estimated through the severity of cognitive impairment. The objective of this research work was to compare the changes in cognitive functions of post-stroke patients with the computer-based cognitive intervention (CBCI) using PABLO system and conventional cognitive intervention (CCI) using paper-pencil method. Methods: Total 80 stroke patients with cognitive impairment were selected and divided into two groups. The Group A received intervention through PABLO System (CBCI) and the Group B received the cognitive intervention through Paper Pencil method (CCI). Pre and post-assessment of cognitive functions like verbal fluency, language, orientation and attention, memory, visuospatial and mini mental state examination for both the groups were done by Addenbrooke Cognitive Examination-Revised (ACE-R) scale. Result: After the intervention of 4 weeks, patients of both groups showed improvement in cognitive functions. However, the group A scored higher in comparison to group B. Conclusion: Data suggest that both the interventions will bring the changes in cognitive functions post-stroke patients but CBCI may be much more effective in improving cognitive functions of stroke patients.

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