The The Effectiveness of Early Mobilization Time on Balance and Functional Ability after Ischemic Stroke

BACKGROUND: Early mobilisation (EM) after-ischemic stroke is a motor learning intervention aimed to restore nerve cells and to improve balance and functional ability. Unfortunately, the study of when this intervention began has not been widely studied. AIM: On this study was compared the effect of EM started at 24 hours and 48 hours after an ischemic stroke on balance and functional ability. MATERIAL AND METHODS: Randomized controlled trial involving 40 patients on 2 groups meeting predefined inclusion criteria. The levels of balance were measured using the Berg Balance Scale, and the functional ability was measured using the Barthel Index, at 5th and 7th day. RESULTS: A significant difference was observed in both balance (p = 0.038) and functional ability (p = 0.021) obtained on the 7th day of assessment between both groups. A significant difference on the 5th day was observed only in the functional ability (p = 0.002) and not in the balance (p = 0.147), between the groups. CONCLUSION: EM started at 24 hours after the ischemic stroke has been found to have a better impact on balance and functional ability compared to that at 48 hours.

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Acupuncture versus Rehabilitation in the Treatment of Ischemic Stroke Recovery: A Randomized Controlled Trial

10.21203/rs.2.177/v1 ◽

2019 ◽

Author(s):

Lixia Li ◽

Weifeng Zhu ◽

Guohua Lin ◽

Chuyun Chen ◽

Donghui Tang ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Ischemic Stroke ◽

Controlled Trial ◽

Stroke Recovery ◽

Control Group ◽

Acupuncture Points ◽

Randomized Controlled ◽

Modified Ashworth Scale ◽

Significant Difference ◽

Ashworth Scale

Abstract Background: Acupuncture is a treatment for ischemic stroke recovery, but evidence of its effectiveness remains limited. Methods: A total of 497 patients with ischemic stroke were randomized into Arm 1 (159 cases), Arm 2 (173 cases) and a control group (165 cases). In the control group, rehabilitation training was provided. In Arm 1 and Arm 2, acupoint schemes were determined by the consensus of acupuncture experts and previous clinical research. Arm 1 was based on an acupoint summary of ancient literature, and Arm 2 was based on the summary of effective acupuncture points in modern RCT literature. The treatment was given with conventional acupuncture at the appropriate position. After acupuncture, the needles were left in for 30 minutes, and checked every 10 minutes. The three groups received treatment once a day, 5 times a week, for 2 weeks. The primary outcome were the National Institute of Health stroke scale (NIHSS), and the secondary outcomes were the Barthel index (BI) and modified Ashworth scale (MAS). Outcomes were observed in patients both before and after treatment. Results: After 2 weeks of treatment, there was no significant difference between Arm 1 and the control group for either the BI scores or the modified Ashworth scale scores (P>0.05). However, the NIHSS scores of Arm 1 were lower than those of the control group (P=0.017); the BI scores were higher in Arm 2 than they were in the control group (P=0.020). Conclusion: The clinical efficacy of Arm 1 and Arm 2 (acupuncture groups) was superior to that of the control group. Trial Registration: Chinese Clinical Trial Registry: ChiCTR-IOR-16008627, Registered 11 June 2016, http://www.chictr.org.cn/index.aspx. Keywords: Acupuncture; ischemic stroke; randomized controlled trial (RCT)

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Effectiveness of physiotherapy interventions in brain plasticity, balance and functional ability in stroke survivors: A randomized controlled trial

Neurorehabilitation ◽

10.3233/nre-203210 ◽

2020 ◽

Vol 47 (4) ◽

pp. 463-470

Author(s):

Umi Budi Rahayu ◽

Samekto Wibowo ◽

Ismail Setyopranoto ◽

M. Hibatullah Romli

Keyword(s):

Randomized Controlled Trial ◽

Functional Ability ◽

Brain Injuries ◽

Functional Performance ◽

Brain Plasticity ◽

Controlled Trial ◽

Berg Balance Scale ◽

Stroke Patients ◽

Randomized Controlled ◽

The Impact

BACKGROUND: Brain injuries such as strokes cause damage and death of the neuron cells. Physiotherapy interventions help to improve patient’s performance and ability. However, this is only theorized but the impact of the physiotherapy intervention on brain plasticity is not known. OBJECTIVE: The present study aimed to investigate the effect of physiotherapy interventions on brain neuroplasticity by evaluating the brain plasticity regeneration, balance and functional ability. METHODS: A randomized controlled trial was conducted with 64 stroke patients from three hospitals in the Surakarta region, Indonesia. Control groups (n = 32) received conventional physiotherapy and intervention groups (n = 32) received neurorestoration protocol, which both lasted for seven days. Efficacy of the interventions were measured on brain-derived neurotropic factor serum analysis, Berg Balance Scale and Barthel Index, respectively. RESULTS: Both groups showed improvements in all parameters but only balance and functional performance had a statistically significant outcome. CONCLUSION: Neurorestoration protocol that combined several established physiotherapy interventions was effective in improving balance and functional ability of stroke patients in only a seven days period.

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The Effectiveness of Mometasone Spray and Triamcinolone Acetonide Gel in Preventing Sore Throat, Cough, and Hoarse after Intubation

Journal of Anesthesiology and Clinical Research ◽

10.37275/jacr.v2i1.144 ◽

2021 ◽

Vol 2 (1) ◽

pp. 135-147

Author(s):

Zentika. I. Fajri ◽

Fredi Heru Irwanto ◽

A Miarta ◽

Theodorus

Keyword(s):

Randomized Controlled Trial ◽

General Anesthesia ◽

Sore Throat ◽

Triamcinolone Acetonide ◽

Endotracheal Intubation ◽

Controlled Trial ◽

Inclusion Criteria ◽

Open Label ◽

Randomized Controlled ◽

Significant Difference

Background: Endotracheal intubation is a procedure performed by inserting an endotracheal tube into the airway. With endotracheal intubation, there can be several complications ranging from mild to severe. Sore throat, coughing, and hoarseness were several endotracheal intbation complications. From several studies, it was found that the incidence of POST was 21-65%. This study aimed to determine the efficacy between 0.1% triamcinolone acetonide gel and 100 mcg mometasone spray in reducing sore throat, cough, and hoarseness due to endotracheal intubation. Method: A Randomized Controlled Trial, Open-Label was carried out on patients undergoing endotracheal intubation with general anesthesia in RSMH operating room from September 2020 - November 2020. Seventy-two study subjects met the inclusion criteria and were divided into two groups, namely the triamcinolone acetonide gel group, and the mometasone spray group. Analyzing data was SPSS version 23. Result: There were no difference between age, sex, ASA PS classification, and length of operation between the two groups (p> 0.05). Mometasone spray 100 mcg and triamcinolone acetonide gel 0.1% had the same effectiveness to reduce endotracheal intubation such as sore throat, cough, and hoarseness within 24 hours of endotracheal intubation (p> 0.05). There was a significant difference in the incidence of sore throat between two groups in the first hour (p = 0.039). Conclusion: There was no statistically significant difference between the efficiency of mometasone spray 100 mcg and triamcinolone acetonide gel 0.1% on a sore throat, cough, and hoarseness within 24 hours of endotracheal intubation (p > 0.05).

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Effect of leg wrapping technique on prevention of spinal induced hypotension and fetal acidosis during cesarean section: Randomized controlled trial

Journal of Nursing Education and Practice ◽

10.5430/jnep.v10n2p70 ◽

2019 ◽

Vol 10 (2) ◽

pp. 70

Author(s):

Samah Nasser Abd El-Aziz El-Shora ◽

Amina Mohamed Rashad El-Nemer

Keyword(s):

Randomized Controlled Trial ◽

Cesarean Section ◽

Controlled Trial ◽

Intervention Group ◽

Cost Effective ◽

Control Group ◽

Induced Hypotension ◽

Randomized Controlled ◽

Significant Difference ◽

Wrapping Technique

Background and aim: Hypotension during cesarean section (CS) under spinal anesthesia has been a subject of scientific study for more than 50 years and the search for the most effective strategy to achieve hemodynamic stability remains challenging. Aim: The study was carried out to apply leg wrapping technique for the prevention of spinal-induced hypotension (SIH) during CS.Methods: Randomized Controlled Trial design was utilized at cesarean delivery operating room Mansoura General Hospital in El-Mansoura City during the period from May 2018 to November 2018. A purposive sample of 88 pregnant women, assigned randomly to an intervention group (n = 44) in which their legs wrapped with elastic crepe bandage and control group (n = 44) in which no wrapping was done. Data collected for maternal, neonatal hemodynamic and signs of hypotension, the feasibility of application and cost analysis.Results: There was a statistically significant difference in the incidence of SIH and Ephedrine use among both groups (18.20% in leg wrapping group whereas 75% in control group). In addition, neonatal acidosis and NICU admission were less among leg wrapping group (11.40%, 9.10% respectively). Economically, leg wrapping technique was cost effective compared to the cost of the hospital regimen for treating SIH and admission to (NICU).Conclusion and recommendations: Leg wrapping technique was cost effective and an efficient method for decreasing SIH, neonatal acidosis and Ephedrine administration. It is recommended to apply leg wrapping technique in maternal hospitals' protocol of care for decreasing SIH during CS.

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Interest of a standardized hypnotic message for the reduction of pain and anxiety in cancer patients treated by capsaicin patch for neuropathic pain: a randomized controlled trial

BMC Complementary Medicine and Therapies ◽

10.1186/s12906-021-03329-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rémi Etienne ◽

Myriam Laurent ◽

Aline Henry ◽

Antoine Bioy ◽

Julia Salleron ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Neuropathic Pain ◽

Rating Scales ◽

Controlled Trial ◽

Standard Group ◽

Randomized Controlled ◽

Significant Difference ◽

Numerical Rating ◽

Reduction Of Pain ◽

The Impact

Abstract Background Neuropathic pain is characterized by spontaneous painful symptoms. Medical therapies include the use of a capsaicin 8% patch (Qutenza®, Grünenthal Gmbh, Germany), and patients may experience a sharp burning sensation at application and removal of the patch. This study aimed to evaluate the impact of playing a standardized hypnosis recording during application, on the pain and anxiety induced by capsaicin treatment. Methods In a randomized, controlled trial, we assessed the benefits of the intervention firstly on pain and secondly on anxiety, as measured using numerical rating scales. All patients had application of the capsaicin patch, including the possibility for the patient to apply a cold patch. Participants were randomly assigned to one of 3 groups, namely the “Standard group” (no intervention), “Hypnosis group”, in which a standardized hypnotic message was played during application, or the “Music group” in which relaxing music was played during application of the patch. Results Sixty-nine patients were included. Overall, there was no significant difference in pain scores between groups (p = 0.355). Compared to standard application, anxiety was significantly lower in the hypnosis group after application (p = 0.007), with no significant difference between the standard and music arms (p = 0.271), or between the hypnosis and music arms (p = 0.423). Conclusions Listening to a standardized hypnotic message during application of a capsaicin patch was found to significantly lower anxiety. These findings indicate that the use of a hypnotic message can reduce discomfort and warrant its evaluation in other indications of pain or anxiety during treatment procedures. Trial registration NCT02822625.

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Methylprednisolone or dexamethasone, which one is superior corticosteroid in the treatment of hospitalized COVID-19 patients: a triple-blinded randomized controlled trial

BMC Infectious Diseases ◽

10.1186/s12879-021-06045-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Keivan Ranjbar ◽

Mohsen Moghadami ◽

Alireza Mirahmadizadeh ◽

Mohammad Javad Fallahi ◽

Vahid Khaloo ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Clinical Status ◽

Intervention Group ◽

Length Of Hospital Stay ◽

Ordinal Scale ◽

Control Group ◽

Randomized Controlled ◽

Group Data ◽

Significant Difference

Abstract Background Although almost a year has passed since the Coronavirus disease 2019 (COVID-19) outbreak and promising reports of vaccines have been presented, we still have a long way until these measures are available for all. Furthermore, the most appropriate corticosteroid and dose in the treatment of COVID-19 have remained uncertain. We conducted a study to assess the effectiveness of methylprednisolone treatment versus dexamethasone for hospitalized COVID-19 patients. Methods In this prospective triple-blinded randomized controlled trial, we enrolled 86 hospitalized COVID-19 patients from August to November 2020, in Shiraz, Iran. The patients were randomly allocated into two groups to receive either methylprednisolone (2 mg/kg/day; intervention group) or dexamethasone (6 mg/kg/day; control group). Data were assessed based on a 9-point WHO ordinal scale extending from uninfected (point 0) to death (point 8). Results There were no significant differences between the groups on admission. However, the intervention group demonstrated significantly better clinical status compared to the control group at day 5 (4.02 vs. 5.21, p = 0.002) and day 10 (2.90 vs. 4.71, p = 0.001) of admission. There was also a significant difference in the overall mean score between the intervention group and the control group, (3.909 vs. 4.873 respectively, p = 0.004). The mean length of hospital stay was 7.43 ± 3.64 and 10.52 ± 5.47 days in the intervention and control groups, respectively (p = 0.015). The need for a ventilator was significantly lower in the intervention group than in the control group (18.2% vs 38.1% p = 0.040). Conclusion In hospitalized hypoxic COVID-19 patients, methylprednisolone demonstrated better results compared to dexamethasone. Trial registration The trial was registered with IRCT.IR (08/04/2020-No. IRCT20200204046369N1).

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Infectious Disease Team Review Using Antibiotic Switch and Discharge Criteria Shortens the Duration of Intravenous Antibiotic: A Single-Center Cluster-Randomized Controlled Trial in Thailand

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa539 ◽

2020 ◽

Vol 7 (12) ◽

Author(s):

Thanyarak Wongkamhla ◽

Buddharat Khan-asa ◽

Sasima Tongsai ◽

Nasikarn Angkasekwinai

Keyword(s):

Infectious Disease ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Cluster Randomized Controlled Trial ◽

Defined Daily Dose ◽

Randomized Controlled ◽

Days Of Therapy ◽

Significant Difference ◽

Cluster Randomized ◽

Discharge Criteria

Abstract Background Strategies have been recommended to optimize early antibiotic (ATB) switching from intravenous (IV) to oral ATB. This study aimed to determine whether infectious disease (ID) team review using ATB switch and discharge criteria would shorten the duration of IV ATB and length of hospital stay (LOS). Methods This cluster-randomized controlled trial was conducted in 8 general medical wards as cluster units at Siriraj Hospital during January–October 2019. The ID team review with checklist criteria was performed on the third, fifth, and seventh day of IV-ATB treatment to determine (1) the suitability of switching to oral ATB or outpatient parenteral ATB therapy and (2) early discharge for patients receiving IV-ATB versus control. The primary outcomes were LOS and the duration or days of therapy (DOT) or defined daily dose (DDD) of IV-ATB therapy. Results Four wards each were randomly assigned to the intervention and control groups (46 patients/cluster, 184 patients/arm). No significant difference was observed between intervention and controls for median duration of IV-ATB therapy (7 vs 7 days) and LOS (9 vs 10 days). A significantly shorter duration of IV ATB was observed in patients without sepsis in the intervention group when measured by DOT (7 vs 8 days, P = .027) and DDD (7 vs 9, P = .017) in post hoc analysis. Conclusions Infectious disease team review using checklist criteria did not result in a shorter duration of IV-ATB and LOS in overall patients. Further study is needed to determine whether faster culture turnaround time or advanced testing will reduce the duration of IV-ATB therapy.

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