Hemispheric Coherence Analysis of Wide Band EEG Signals for Characterization of Post-Stroke Patients with Dementia

Post-stroke dementia (PSD) is a type of vascular dementia (VaD) that might be occurred in post-stroke patients. Memory, language and behavior tests can be used for the analysis of cognitive impairment caused by PSD. Often a supporting clinical examination such as an electroencephalogram (EEG) is used to support the diagnosis or analyze the characteristic changes that occur in the brain. Conventional analysis or visual inspection of EEG signals can be very difficult, since the nature of the signal tends to be non-stationer. Therefore, this study proposes a quantitative analysis for the characterization of EEG signals in stroke survivors with dementia. It is thought that it has different characteristics with the normal subject so that this study can be used as a reference in supporting dementia detection in post-stroke survivors. The quantitative analysis used in this study is coherence analysis. Coherence analysis was performed on EEG signals recorded from six poststroke patients with dementia and then compared with ten normal healthy subjects. Analysis of coherence between brain areas includes inter and intra-hemispheric coherence. Validation was carried out by using the independent t-test where the confidence level was 95%, indicating that the p-value <0.05 had a significant difference. The test results show that in general the coherence of the electrode pairs in patients with dementia is lower than in the normal healthy group. It is notably, i) In interhemispheric, the C3-C4, T3-T4, and T5-T6 pairs generate significant differences, ii) the highest decrease in intrahemispheric coherence was found in C3-T5 with p = 0.0005. The coherence study presented in this paper is expected to be used for early detection of PSD in the future.

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Application Of Mirror Therapy On Upper Extremity Motor Recovery In Post-Stroke Patients

Jurnal Keterapian Fisik ◽

10.37341/jkf.v0i0.293 ◽

2021 ◽

pp. 136-144

Author(s):

Roh Hastuti Prasetyaningsih ◽

Hendri Kurniawan

Keyword(s):

Upper Extremity ◽

Motor Recovery ◽

The Body ◽

P Value ◽

Mirror Therapy ◽

Research Subjects ◽

Hand Rehabilitation ◽

Stroke Patients ◽

Post Stroke ◽

Significant Difference

Background: Stroke is a health problem for both developed and developing countries, including Indonesia. Paralysis in stroke is mainly due to damage to the internal capsule. This damage requires neuroplasticity involving a number of parts of the brain to restore. One therapy that is beneficial for neuroplasticity is Mirror Therapy (MT). MT is a rehabilitation tool that aims to restore some of the pathological conditions in which the body representation is affected, including post-stroke motor impairment. Methods: This research is a quantitative pre-experimental design with the type one group pretest-postest. The research subjects were 15 post-stroke patients in residency of Semarang. Research data were collected in August-September 2020. Sample selection with purposive sampling technique who conform inclusion criteria. The Fulg-Meyer Upper Extremity Assessment (FMA-UE) as an aoutcame measure that be avowed valid and reliabel. Data analysis using Paired Sample T-Test because of normally distributed. Results: Statistically the results represent a significant difference in the UE motor ability of post-stroke patients between baseline and after mirror therapy intervention, with a mean difference (5,14) and p value = 0.000 (ρ < 0,05). Application of MT effect on upper extremity motor recovery in post-stroke patients. Conclusions: MT program is an effective intervention for UE motor recovery and motor function improvement in post- stroke patients. MT program can be used as a standardized of hand rehabilitation intervention in hospital, clinics and homes.

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LACK OF EMPHASIS ON PSYCHOLOGICAL REHABILITATION FOR STROKE PATIENTS

Pakistan Journal of Rehabilitation ◽

10.36283/pjr.zu.1.1/009 ◽

2012 ◽

Vol 1 (1) ◽

pp. 2

Author(s):

Samina Masood Haider

Keyword(s):

Emotional Difficulties ◽

Stroke Survivors ◽

Stroke Patients ◽

Post Stroke ◽

Post Stroke Depression ◽

The Many ◽

Over Time

It has been observed that most of the patients are not aware of the dilapidating affects of post stroke depression on their recovery, survival and a return to normal activities of life. The lack of emphasis on psychological rehabilitation for stroke patients is a source of concern for me and I would like to bring to your attention about the facts regarding the implications of proper psychological rehabilitation is not undertaken. Stroke survivors report a range of emotional difficulties, most common being fear, anxiety, frustration, anger, sadness and a sense of grief for their physical and mental losses. Usually these feelings may fade over time however, some patients may struggle with adjusting to the many changes following stroke. When this happens these feelings can develop into depression. It is estimated that approximately one-third of stroke1 survivors develop post-stroke depression (PSD)

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Efektivitas Alih Baring Tiap 2 Jam Terhadap Pencegahan Ulkus Dekubitus pada Pasien Pasca Stroke dengan Tirah Baring Lama di Bangsal Saraf RSUD Arifin Achmad Pekanbaru

Jurnal Ilmu Kedokteran ◽

10.26891/jik.v4i2.2010.133-140 ◽

2017 ◽

Vol 4 (2) ◽

pp. 133

Author(s):

Bevi Dewi Citra ◽

Hermes C. Sitompul ◽

Tuti Restuastuti

Keyword(s):

Intervention Study ◽

Preventive Intervention ◽

Decubitus Ulcer ◽

Medical Rehabilitation ◽

Neurological Deficits ◽

Stroke Patients ◽

Cross Sectional ◽

Post Stroke ◽

Rehabilitation Programs ◽

Significant Difference

Neurological deficits on stroke patients can caused immobility. Decubitus ulcer is one of immobilty’s complication.Two hours repositioning is one of medical rehabilitation programs in decubitus prevention. The aim of this study is todescribe effectiveness of two hours repositioning to prevent decubitus ulcer, especially on post-stroke patients. Thisstudy was a preventive intervention study with cross-sectional approach. Sample consists of 32 patients. Group Iconsists of 16 patients with repositioning intervention. On the otherhand, group II consists of 16 patients withoutrepositioning intervention. Then, this two groups were compared and were looked for the effectiveness. from thisstudy, we knew that prevalence of decubitus ulcer on post-stroke patients are 19.4% with the effectiveness of two hoursrepositioning is 87.5%. There was significant difference between these two groups to prevent decubitus. it occurred ongeriatric patients with percentage of 75%. Its Proportion for female: male are 2:1. It is commonly occurred on firstweek hospitalization, especially grade 2 (33.3%). It is mostly located on sacrum (100%).

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Association among depression, cognitive impairment and executive dysfunction after stroke

Dementia & Neuropsychologia ◽

10.1590/s1980-57642012dn06030007 ◽

2012 ◽

Vol 6 (3) ◽

pp. 152-157 ◽

Cited By ~ 13

Author(s):

Luisa Terroni ◽

Matildes F.M. Sobreiro ◽

Adriana B. Conforto ◽

Carla C. Adda ◽

Valeri D. Guajardo ◽

...

Keyword(s):

Cognitive Impairment ◽

Neuropsychological Tests ◽

Executive Dysfunction ◽

Stroke Survivors ◽

Stroke Patients ◽

Adequate Treatment ◽

Post Stroke ◽

Quantitative Studies ◽

Post Stroke Depression ◽

The Relationship

ABSTRACT The relationship between depression and cognitive impairment, frequent after stroke, is complex and has not been sufficiently elucidated. Objective: To review the relationship between post-stroke depression and cognitive impairment. Methods: We performed a PubMed database search spanning the last ten years, using the terms post-stroke depression, cognitive dysfunction, cognitive impairment and neuropsychological tests. Our target studies were original quantitative studies that investigated the relationship between post-stroke depression (PSD) and cognitive impairment in stroke patients. Articles published in English, Spanish, Italian and Portuguese were considered. Selection criteria were the use of neuropsychological tests to assess cognitive function, and of either instruments to diagnose major depression, or scales to assess depressive symptoms, within the first three months after stroke. Results: Six original quantitative studies fulfilled the criteria. The prevalence of PSD within the first three months after stroke ranged from 22% to 31%. Incidence ranged from 25% to 27% and was evaluated in only two studies. PSD was associated with increased cognitive impairment. Cognitive impairment was reported in 35.2% to 87% of the patients. Post-stroke cognitive deficits were reported mostly in executive function, memory, language, and speed of processing. Conclusion: Executive dysfunction and depression occur in stroke survivors, are frequently coexistent, and also associated with worse stroke prognosis. Healthcare professionals need to address and provide adequate treatment for depression and executive dysfunctions in stroke patients early in the first three months after stroke. Future studies should evaluate the efficacy of programs evaluating the early detection and treatment of PSD and executive dysfunction in stroke survivors.

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Gothenburg Very Early Supported Discharge study (GOTVED): a randomised controlled trial investigating anxiety and overall disability in the first year after stroke

BMC Neurology ◽

10.1186/s12883-019-1503-3 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Lena Rafsten ◽

Anna Danielsson ◽

Asa Nordin ◽

Ann Björkdahl ◽

Asa Lundgren-Nilsson ◽

...

Keyword(s):

Multidisciplinary Team ◽

Controlled Trial ◽

Stroke Care ◽

Secondary Outcome ◽

Outpatient Rehabilitation ◽

Control Group ◽

Stroke Patients ◽

Post Stroke ◽

Early Supported Discharge ◽

Significant Difference

Abstract Background and purpose Early supported discharge (ESD) has been shown to be efficient and safe as part of the stroke care pathway. The best results have been seen with a multidisciplinary team and after mild to moderate stroke. However, how very early supported discharge (VESD) works has not been studied. The aim of this study was to investigate whether VESD for stroke patients in need of ongoing individualized rehabilitation affects the level of anxiety and overall disability for the patient compared with ordinary discharge routine. Methods A randomized controlled trial was performed with intention to treat analyses comparing VESD and ordinary discharge from hospital. All patients admitted at the stroke care unit at Sahlgrenska University Hospital of Gothenburg between August 2011 and April 2016 were screened. Inclusion occurred on day 4 using a block randomization of 20 and with a blinded assessor. Assessments were made 5 days post-stroke and 3 and 12 months post-stroke. Patients in the VESD group underwent continued rehabilitation in their homes with a multidisciplinary team from the stroke care unit for a maximum of 1 month. The patients in the control group had support as usual after discharge when needed such as home care service and outpatient rehabilitation. The primary outcome was anxiety as assessed by the Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A). The secondary outcome was the patients’ degree of overall disability, measured by the modified Rankin Scale (mRS). Results No significant differences were found between the groups regarding anxiety at three or 12 months post-stroke (p = 0.811). The overall disability was significantly lower in the VESD group 3 months post-stroke (p = 0.004), compared to the control group. However, there was no significant difference between the groups 1 year post-stroke. Conclusions The VESD does not affects the level of anxiety compared to ordinary rehabilitation. The VESD leads to a faster improvement of overall disability compared to ordinary rehabilitation. We suggest considering coordinated VESD for patients with mild to moderate stroke in addition to ordinary rehabilitation as part of the service from a stroke unit. Trial registration Clinical Trials.gov: NCT01622205. Registered 19 June 2012 (retrospectively registered).

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Quantitative Analysis of Intrinsic Muscle Stiffness in Biceps Brachii of Post-stroke Patients

XXVI Brazilian Congress on Biomedical Engineering - IFMBE Proceedings ◽

10.1007/978-981-13-2119-1_53 ◽

2019 ◽

pp. 343-346

Author(s):

Silvana Galvão ◽

Denise Xerez ◽

Renato de Lima ◽

Alexandre V. Pino ◽

Liliam Fernandes de Oliveira ◽

...

Keyword(s):

Quantitative Analysis ◽

Biceps Brachii ◽

Muscle Stiffness ◽

Stroke Patients ◽

Intrinsic Muscle ◽

Post Stroke

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Changes in PHQ-9 depression scores in acute stroke patients shortly after returning home

PLoS ONE ◽

10.1371/journal.pone.0259806 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0259806

Author(s):

Brent Strong ◽

Michele C. Fritz ◽

Liming Dong ◽

Lynda D. Lisabeth ◽

Mathew J. Reeves

Keyword(s):

Depressive Symptoms ◽

Acute Stroke ◽

Recovery Period ◽

Stroke Severity ◽

Stroke Survivors ◽

Stroke Patients ◽

Early Recovery ◽

Post Stroke ◽

Early Recovery Period ◽

Over Time

Introduction Post-stroke depression is a disabling condition that occurs in approximately one-third of stroke survivors. There is limited information on changes in depressive symptoms shortly after stroke survivors return home. To identify factors associated with changes in post-stroke depressive symptoms during the early recovery period, we conducted a secondary analysis of patients enrolled in a clinical trial conducted during the transition period shortly after patients returned home (MISTT). Methods The Michigan Stroke Transitions Trial (MISTT) tested the efficacy of social worker case management and access to online information to improve patient-reported outcomes following an acute stroke. Patient Health Questionnaire-9 (PHQ-9) scores were collected via telephone interviews conducted at 7 and 90 days post-discharge; higher scores indicate more depressive symptoms. Generalized estimating equations were used to identify independent predictors of baseline PHQ-9 score at 7 days and of changes over time to 90 days. Results Of 265 patients, 193 and 185 completed the PHQ-9 survey at 7 and 90 days, respectively. The mean PHQ-9 score was 5.9 at 7 days and 5.1 at 90 days. Older age, being unmarried, and having moderate stroke severity (versus mild) were significantly associated with lower 7-day PHQ-9 scores (indicating fewer depressive symptoms). However, at 90 days, both unmarried patients and those with moderate or high stroke severity had significant increases in depressive symptoms over time. Conclusions In stroke patients who recently returned home, both marital status and stroke severity were associated with depressive symptom scores; however, the relationships were complex. Being unmarried and having higher stroke severity was associated with fewer depressive symptoms at baseline, but both factors were associated with worsening depressive symptoms over time. Identifying risk factors for changes in depressive symptoms may help guide effective management strategies during the early recovery period.

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Post-stroke Hyperglycemia in Non-diabetic Ischemic Stroke is Related With Worse Functional Outcome: A Cohort Study

Annals of Rehabilitation Medicine ◽

10.5535/arm.21124 ◽

2021 ◽

Vol 45 (5) ◽

pp. 359-367

Author(s):

Jin A Yoon ◽

Yong-Il Shin ◽

Deog Young Kim ◽

Min Kyun Sohn ◽

Jongmin Lee ◽

...

Keyword(s):

Cohort Study ◽

Ischemic Stroke ◽

Glucose Level ◽

Functional Outcomes ◽

Stroke Patients ◽

Nihss Score ◽

Post Stroke ◽

Significant Difference ◽

Functional Assessments

Objective To investigate long-term and serial functional outcomes in ischemic stroke patients without diabetes with post-stroke hyperglycemia.Methods The Korean Stroke Cohort for Functioning and Rehabilitation (KOSCO) is a large, multi-center, prospective cohort study of stroke patients admitted to participating hospitals in nine areas of Korea. From KOSCO, ischemic stroke patients without diabetes were recruited and divided into two groups: patients without diabetes without (n=779) and with post-stroke hyperglycemia (n=223). Post-stroke hyperglycemia was defined as a glucose level >8 mmol/L. Functional assessments were performed 7 days and 3, 6, and 12 months after stroke onset.Results There were no significant differences in baseline characteristics between the groups, except in the age of onset and smoking. Analysis of the linear correlation between the initial National Institutes of Health Stroke Scale (NIHSS) score and glucose level showed no significant difference. Among our functional assessments, NIHSS, Fugl-Meyer Assessment (affected side), Functional Ambulatory Category, modified Rankin Scale, and Korean Mini-Mental State Examination (K-MMSE) showed statistically significant improvements in each group. All functional improvements except K-MMSE were significantly higher in patients without post-stroke hyperglycemia at 7 days and 3, 6, and 12 months.Conclusion The glucose level of ischemic stroke patients without diabetes had no significant correlation with the initial NIHSS score. The long-term effects of stress hyperglycemia showed worse functional outcomes in ischemic stroke patients without diabetes with post-stroke hyperglycemia.

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Comparative Efficacy of Open-chain Kinematics and Closed-chain Kinematics on Walking Proficiency and Societal Integration in Post-stroke Individuals: a Pretest- Post-test Experimental Study

10.21203/rs.3.rs-990536/v1 ◽

2021 ◽

Author(s):

Obianuju Nwaedozie ◽

Caleb Gbiri ◽

Olajide Olawale ◽

Ukamaka Mgbeojedo ◽

Caleb Adeagbo

Keyword(s):

Experimental Study ◽

Bicycle Ergometer ◽

Stroke Survivors ◽

Walking Ability ◽

Open Chain ◽

Post Stroke ◽

Gait Parameters ◽

Closed Chain ◽

Significant Difference ◽

Spatio Temporal

Abstract Background Post-stroke hemiplegic gait is a mixture of deviations and compensatory motion dictated by residual function. To improve stroke survivors' walking ability, it is necessary to evaluate different rehabilitation approaches and identify those that have a greater effect on locomotor recovery of stroke patients. Objectives This study was designed to compare the effect of open-chain kinematics (bicycle ergometry) and closed-chain kinematics (treadmill) on walking proficiency in post-stroke individuals and their societal integration. Methods This was a pretest- posttest- experimental study involving 35 ambulatory hemiplegic stroke survivors (18males and 17 females) with a mean age of 53.77±10.95 undergoing rehabilitation at the two Teaching Hospitals in Lagos. Patients went through a 10-week rehabilitation and were randomly assigned to two intervention groups. Spatio-temporal gait parameters were measured by the six-metre walkway and community integrated questionnaire was used to examine home integration, social integration and productive activities. Data were subjected to inferential and descriptive statistics. The level of significance was set at p<0.05. Results Results showed significant difference between baseline and post intervention scores for all the gait parameters in the bicycle ergometer group except for stride length (p = 0.078). There was also a significant difference in the mean change in cadence between the treadmill and bicycle ergometer group (p = 0.04). Conclusions Both open-chain and closed-chain kinematics are effective, but closed- chain is most effective in re-educating ambulation and re-gaining spatio-temporal gait parameters after stroke and should be structured into the patients’ treatment regimen to effectively improve functional capability in post-stroke individuals.

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Role of Diffusion Weighted Imaging in Enhancing MR Imaging in Recent Is-chemic Stroke Patients

AL-MUKHTAR JOURNAL OF SCIENCES ◽

10.54172/mjsc.v35i2.316 ◽

2020 ◽

Vol 35 (2) ◽

pp. 104-115

Author(s):

Hajer A. Alfadeel

Keyword(s):

Acute Stroke ◽

Spin Echo ◽

Haemorrhagic Stroke ◽

P Value ◽

Consecutive Series ◽

Stroke Patients ◽

First Line ◽

Diffusion Weighted ◽

Significant Difference

Stroke is a common cause of admission to hospitals, and imaging in acute stroke is necessary to differentiate ischemic from haemorrhagic stroke and to exclude other diagnoses. This study aimed to evaluate the role of diffusion-weighted magnetic resonance imaging (DW MRI) in the diagnosis of recent cerebral ischemic infarction in a consecutive series of patients with symptoms of acute stroke and its feasibility as first-line imaging for those patients. We report our results with DWI and apparent diffusion coefficient (ADC) mapping comparing the sensitivity of DWI with that of conventional T2 weighted and fluid-attenuated inversion recovery (FLAIR) MRI. A Prospective audit of 87 patients with clinically suspected recent stroke referred for imaging over a consecutive 20-week period was done. The data collected included patient age, time from onset of symptoms, and clinical presentation. DWI echo planar, FLAIR, and turbo spin-echo T2-weighted MRI were performed, and ADC maps were generated. Conventional MR images were assessed before DW images. DWI was considered positive for the diagnosis of new arterial stroke whenever hyperintensities with reduced ADC values were observed, and the site of infarct detected on the images was included in patients’ data. The results were 47 patients had a final diagnosis of recent ischemic cerebral infarct. With DWI, 98% of the ischemic lesions were detected, whereas with FLAIR, only 70% were detected, and with T2-weighted images, 66% of lesions were found. There was a significant difference between the results of ischemic infarcts’ detection on DWI and T2-w/FLAIR in relation to time from onset (P value = .012). In this study, I was able to image 68% (60 of 87) of the referred suspected stroke patients with DW MRI within 48 hours and 39 patients (45%) within 24 hours of the onset of symptoms. DW MRI showed high sensitivity and superiority over conventional T2 and FLAIR imaging for the detection of acute ischemic lesions in stroke patients; it also proved quite feasible as a first-line of neuroimaging.

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