scholarly journals Early rehabilitation after haemorrhagic stroke in a patient with a history of heart transplantation. A case study

2016 ◽  
Vol 16 (4) ◽  
pp. 208-211
Author(s):  
Anna Grygielska ◽  
◽  
Elżbieta Miller ◽  
◽  
Keyword(s):  
Heart Rate ◽  
Heart Transplantation ◽  
Functional Status ◽  
Barthel Index ◽  
Stroke Rehabilitation ◽  
Haemorrhagic Stroke ◽  
National Institutes Of Health ◽  
Exercise Heart Rate ◽  
Post Stroke ◽  
History Of

Introduction: Stroke is the most common form of central nervous system condition. An average of about 80 heart transplantations are performed in Poland yearly. A transplanted heart is prone to tachycardia. Early, complex post-stroke rehabilitation requires physical effort from the patient. Case report: We present a clinical case of a patient with left-sided hemiparesis after a haemorrhagic stroke and on immunosuppressive treatment after heart transplantation (2005). Methods: The outcomes of rehabilitation therapy were assessed based on the following scales: the Barthel Index, a modified Rankin Scale, the Rivermead Motor Index, the National Institutes of Health Stroke Scale, the Mini–Mental State Examination, and the Geriatric Depression Scale. Moreover, pre- and post-exercise heart rate monitoring was performed. Results: As a result of comprehensive rehabilitation treatment, functional status improvement was observed in all estimated scales. The highest change was reported for Barthel Index (50%) and National Institutes of Health Stroke Scale (30%). Heart rate was between 75 and 180 bpm. Conclusions: A patient with a history of heart transplantation shows good tolerance of physical exercise despite tachycardia. Early post-stroke rehabilitation significantly improves functional status.

scholarly journals Comparison of heart rate recovery between normotensive young adults with and without a parental history of hypertension

2020 ◽  
Vol 11 (3) ◽  
pp. 31-36
Author(s):  
Satyajit Bagudai ◽  
Hari Prasad Upadhyay
Keyword(s):  
Heart Rate ◽  
Young Adults ◽  
Heart Rate Recovery ◽  
Step Test ◽  
Exercise Heart Rate ◽  
Parental History ◽  
Recovery Index ◽  
Significant Difference ◽  
History Of ◽  
The Difference

Introduction: Studies have reported that off springs of hypertensive parents are more likely to develop hypertension. Affection of target organ starts even before the diagnosis of hypertension. Autonomic dysfunction may be the initial cardiac effects in the pathogenesis of hypertension. Till now very few studies have been done to find the early outcomes in the cardiac autonomic functions in the normotensive siblings of hypertensive patients. Heart rate recovery after exercise is a useful marker for cardiac autonomic function. Since the etio-pathogenesis of hypertension is expected to affect the autonomic cardiovascular parameters even before the prehypertensive stage, the following study was carried out to analyze the heart rate recovery, in the descendent non- hypertensive young adults with and without parental history of hypertension. Aim and objective: This research study was aimed to study the quantify and compare the difference (if any) of heart rate recovery in response to 3minute step test between non hypertensive children of non- hypertensive and hypertensive parents within an age group of 18-22 years. Material &Methods: A total of 63 normotensive students were divided into one hypertensive parents(HP) group containing students with parental history of hypertension) and one non hypertensive parents group (NHP) having students without parental history of hypertension). Each student was subjected to 3 minute Master step test. Recordings of heart rate were made before and after exercise. Heart rate recovery index (HRRI) of 1minute (HRRI1), as well as in 2, 3 and 4 minute (HRRI2, HRRI3, HRRI4) were calculated and analyzed. Results: The resting (basal) heart rate as well as 1st minute heart rate recovery index (HRRI1) was not significantly different in the two groups. Likewise, the 2nd minute (HRRI2), 3rd minute (HRRI3), and 4th minute HRRI (HRR4) respectively were also not significantly different between the two groups. Conclusion: This study concluded that there is no significant difference in heart rate recovery among non-hypertensive young adults, with and without parental history of hypertension.

scholarly journals 86 Haemorrhagic Stroke: What's in a Bleed?

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Imelda Noone ◽  
Mary Kate Meagher ◽  
Naomi Davey ◽  
Diarmuid O'Shea ◽  
Tim Cassidy
Keyword(s):  
Atrial Fibrillation ◽  
Intracerebral Haemorrhage ◽  
Haemorrhagic Stroke ◽  
Amyloid Angiopathy ◽  
Stroke Patients ◽  
Post Stroke ◽  
Significant Difference ◽  
History Of ◽  
Cerebral Amyloid

Abstract Background Intracerebral haemorrhage (ICH) accounts for approximately 20% of all strokes and is a leading cause of disability and mortality. The distribution of the ICH(Lobar v Deep) may be explained by the two major aetiologies of ICH, Cerebral Amyloid Angiopathy (CAA) versus hypertensive (HBP) respectively. The aim of our study was to look at outcomes of lobar versus deep ICH stroke patients. Methods We analyzed data of all ICH’s admitted in 2018 using SPSS. Demography, classification of haemorrhage, hypertension, atrial fibrillation (AF) and anticoagulation history, pre and post stroke Rankin and subsequent outcome were analyzed. Results 373 acute strokes were admitted of which 66(18%) were ICH. Mean age was 73yrs (52-93) and 50% were male. On neuroradiology imaging, 40(60%) were lobar and 26(39%) were deep. Lobar haemorrhages were significantly more likely to be older (p = 0.0001) however, there was no significant difference in pre-stroke Rankin. Post stroke the lobar haemorrhages had both a worse outcome from disability (p = 0.005) and mortality (p = 0.0001). 17(26%) patients with a ICH also had AF with 94% were on an oral anticoagulant(OAC).17.5% of the lobar bleeds were on an OAC versus 36% of the deep ICH. Of the lobar bleeds on OAC none died versus 4 of the deep ICH (p = .001). In total, 48(72%) of patients had a history of hypertension, but only 34(51%) were on HBP medication on admission. Conclusion There were a greater proportion of patients with lobar versus deep bleeds in our cohort which may be due to the older population in our area. Mortality and disability was far greater in the lobar cohort. None of the lobar bleeds with AF who were on OAC died in contrast to the deep ICH patients. This may suggest that more aggressive hypertensive treatment is required in this subpopulation.

scholarly journals Natural History of Swallow Function during the Three-Month Period after Stroke

Geriatrics ◽  
2019 ◽  
Vol 4 (3) ◽  
pp. 42 ◽  
Author(s):  
Viridiana Arreola ◽  
Natàlia Vilardell ◽  
Omar Ortega ◽  
Laia Rofes ◽  
Desiree Muriana ◽  
...  
Keyword(s):  
Natural History ◽  
Functional Status ◽  
Spontaneous Recovery ◽  
Dynamic Condition ◽  
Oropharyngeal Dysphagia ◽  
Stroke Patients ◽  
Post Stroke ◽  
Volume Viscosity ◽  
History Of

Oropharyngeal dysphagia is a prevalent complication following stroke (PS-OD), and one that is sometimes spontaneously recovered. This study describes the natural history of PS-OD between admission and three months post-stroke, and the factors associated with its prevalence and development. PS-OD was assessed with the volume-viscosity swallow test (V-VST) in all stroke patients on admission and at the three-month follow-up. We analyzed clinical, demographic, and neuroanatomical factors of 247 older post-stroke patients (National Institute of Health Stroke Scale (NIHSS) = 3.5 ± 3.8), comparing among those with PS-OD the ones with and without spontaneous recovery. PS-OD prevalence on admission was 39.7% (34.0% impaired safety; 30.8%, efficacy) and 41.7% (19.4% impaired safety; 39.3%, efficacy) at three months. Spontaneous swallow recovery occurred in 42.4% of patients with unsafe and in 29.9% with ineffective swallow, associated with younger age and optimal functional status. However, 26% of post-stroke patients developed new signs/symptoms of ineffective swallow related to poor functional, nutritional and health status, and institutionalization. PS-OD prevalence on admission and at the three-month follow-up was very high in the study population. PS-OD is a dynamic condition with some spontaneous recovery in patients with optimal functional status, but also new signs/symptoms can appear due to poor functionality. Regular PS-OD monitoring is needed to identify patients at risk of nutritional and respiratory complications.

scholarly journals Impact of Multidisciplinary Stroke Post-Acute Care on Cost and Functional Status: A Prospective Study Based on Propensity Score Matching

2021 ◽  
Vol 11 (2) ◽  
pp. 161
Author(s):  
Chong-Chi Chiu ◽  
Jhi-Joung Wang ◽  
Chao-Ming Hung ◽  
Hsiu-Fen Lin ◽  
Hong-Hsi Hsien ◽  
...  
Keyword(s):  
Propensity Score ◽  
Functional Status ◽  
Propensity Score Matching ◽  
Acute Care ◽  
Medical Cost ◽  
Economic Burden ◽  
Stroke Rehabilitation ◽  
Stroke Patients ◽  
The Impact ◽  
Post Acute Care

Few papers discuss how the economic burden of patients with stroke receiving rehabilitation courses is related to post-acute care (PAC) programs. This is the first study to explore the economic burden of stroke patients receiving PAC rehabilitation and to evaluate the impact of multidisciplinary PAC programs on cost and functional status simultaneously. A total of 910 patients with stroke between March 2014 and October 2018 were separated into a PAC group (at two medical centers) and a non-PAC group (at three regional hospitals and one district hospital) by using propensity score matching (1:1). A cost–illness approach was employed to identify the cost categories for analysis in this study according to various perspectives. Total direct medical cost in the per-diem-based PAC cohort was statistically lower than that in the fee-for-service-based non-PAC cohort (p < 0.001) and annual per-patient economic burden of stroke patients receiving PAC rehabilitation is approximately US $354.3 million (in 2019, NT $30.5 = US $1). Additionally, the PAC cohort had statistical improvement in functional status vis-à-vis the non-PAC cohort and total score of each functional status before rehabilitation and was also statistically significant with its total score after one-year rehabilitation training (p < 0.001). Early stroke rehabilitation is important for restoring health, confidence, and safe-care abilities in these patients. Compared to the current stroke rehabilitation system, PAC rehabilitation shortened the waiting time for transfer to the rehabilitation ward and it was indicated as an efficient policy for treatment of stroke in saving medical cost and improving functional status.

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