Efficacy of Multi Unani regimen in functional independence recovery of post stroke patients and #8211; A black-box design

Spatula DD ◽  
2016 ◽  
Vol 6 (1) ◽  
pp. 41
Author(s):  
Mohd Shahid ◽  
Iram Naaz ◽  
Noor Ahmed ◽  
Sabiha Fatima ◽  
Mansoor Siddiqui
Keyword(s):  
Functional Independence ◽  
Black Box ◽  
Stroke Patients ◽  
Post Stroke

scholarly journals Postural Assessment Scale for Stroke Patients in Acute, Subacute and Chronic Stage: A Construct Validity Study

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 365
Author(s):  
Cecilia Estrada-Barranco ◽  
Roberto Cano-de-la-Cuerda ◽  
Vanesa Abuín-Porras ◽  
Francisco Molina-Rueda
Keyword(s):  
Construct Validity ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Assessment Scale ◽  
Validity Study ◽  
Stroke Patients ◽  
Chronic Stage ◽  
Post Stroke ◽  
Valid Instrument ◽  
Postural Assessment

(1) Background: Observational scales are the most common methodology used to assess postural control and balance in people with stroke. The aim of this paper was to analyse the construct validity of the Postural Assessment Scale for Stroke Patients (PASS) scale in post-stroke patients in the acute, subacute, and chronic stroke phases. (2) Methods: Sixty-one post-stroke participants were enrolled. To analyze the construct validity of the PASS, the following scales were used: the Functional Ambulatory Category (FAC), the Wisconsin Gait Scale (WGS), the Barthel Index (BI) and the Functional Independence Measure (FIM). (3) Results: The construct validity of the PASS scale in patients with stroke at acute phase was moderate with the FAC (r = −0.791), WGS (r = −0.646) and FIM (r = −0.678) and excellent with the BI (r = 0.801). At subacute stage, the construct validity of the PASS scale was excellent with the FAC (r = 0.897), WGS (r = −0.847), FIM (r = −0.810) and BI (r = −0.888). At 6 and 12 months, the construct validity of the PASS with the FAC, WGS, FIM and BI was also excellent. (4) Conclusions: The PASS scale is a valid instrument to assess balance in post-stroke individuals especially, in the subacute and chronic phases (at 6 and 12 months).

scholarly journals Sarcopenic Obesity and Activities of Daily Living in Stroke Rehabilitation Patients: A Cross-Sectional Study

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 255
Author(s):  
Tatsuya Matsushita ◽  
Shinta Nishioka ◽  
Shiori Taguchi ◽  
Anna Yamanouchi ◽  
Ryusei Nakashima ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Older Patients ◽  
Functional Independence ◽  
The Body ◽  
Sarcopenic Obesity ◽  
Fat Percentage ◽  
Stroke Patients ◽  
Post Stroke ◽  
Simple Obesity

Reports investigating the relationship between sarcopenic obesity and activities of daily living in older patients with stroke were limited. This study aimed to examine the prevalence of sarcopenic obesity and its association with activities of daily living in older post-stroke patients in convalescent rehabilitation wards. This study was performed in older post-stroke patients admitted to convalescent rehabilitation wards between January 2017 and March 2019. Sarcopenia was diagnosed based on the skeletal muscle mass index and hand grip strength according to the criteria of the 2019 Asian Working Group for Sarcopenia. Obesity was diagnosed according to the body fat percentage; ≥27% in men, ≥38% in women. The primary outcome was the Functional Independence Measure (FIM) score upon admission, which was analyzed using multiple linear regression. In total, 376 participants (women 44%; mean age 77.5 years) were analyzed and classified as normal (22%), simple obesity (17%), sarcopenia without obesity (32%), and sarcopenic obesity (28%). The presence of sarcopenic obesity was independently associated with the FIM score (95% CI, −16.157 to −5.353), whereas simple obesity and sarcopenia without obesity were not. In conclusion, sarcopenic obesity was independently associated with lower activities of daily living capability in older patients with stroke.

scholarly journals Functional recovery in post-stroke patients on hemodialysis during the convalescent phase: a comparison with those not undergoing hemodialysis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Takeki Ishida ◽  
Kenichi Kono ◽  
Yuusuke Nishida ◽  
Masahiro Yoshida
Keyword(s):  
Functional Recovery ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Hemodialysis Patients ◽  
Stroke Patients ◽  
Post Stroke ◽  
Rehabilitation Hospital ◽  
Convalescent Phase ◽  
The Difference ◽  
Impaired Motor Function

Abstract Background Low physical fitness is often found in patients undergoing hemodialysis. It may be possible that the recovery of impaired motor function with rehabilitative training might be affected when the patient is on hemodialysis. So far, however, no researcher has clinically investigated this issue in post-stroke patients. The purpose of this study is to clarify the difference of functional recovery during the convalescent phase between post-stroke patients with and without hemodialysis. Methods A cohort of 82 post-stroke hemiparetic patients who were admitted to our rehabilitation hospital, were subjected. On the day of admission and discharge, some clinical parameters including Functional Independence Measure (FIM) and Functional Ambulation Category (FAC) were evaluated for each patient. The changes during the hospitalization and the values at the discharge in these parameters were statistically compared between the patients with and without hemodialysis. Results The FIM motor score at the discharge was significantly lower in hemodialysis patients than non-hemodialysis patients (64.7 ± 21.2 points in hemodialysis patients and 81.8 ± 28.0 points in non-hemodialysis patients, p < 0.05). In addition, the frequency of FAC at the discharge of ≥ 3 was significantly lower in hemodialysis patients than non-hemodialysis patients (40.0% in hemodialysis patients and 72.2% in non-hemodialysis patients, p < 0.05). Conclusion In patients undergoing hemodialysis seem to experience a worse functional recovery during the convalescent phase compared to those not undergoing hemodialysis. We might have to modify the rehabilitative program during the convalescent phase after stroke if the patient was on hemodialysis.

scholarly journals Influence of Physical Therapy and Cholinergic Medication on the Life Quality Parameters in Post-Stroke with the arm Motor Dysfunction

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Iriah Festus Uwa-Agbonikhena
Keyword(s):  
Quality Of Life ◽  
Physical Therapy ◽  
Functional Independence ◽  
Motor Dysfunction ◽  
Stroke Patients ◽  
Post Stroke ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Motor dysfunction makes the greatest contribution to the patient’s functional independence and has a significant impact on the quality of life (QOL) of post-stroke patients. The objective of the research was to evaluate the impact of different physical therapy approaches and choline alphoscerate on the functional independence and quality of life in patients in 1 year after ischemic stroke. Materials and methods. There were 104 patients examined in 1-year period after first anterior circulation ischemic stroke. Neurological status, functional independence and QOL were assessed according to the National Institute of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Functional Independence Measurement (FIM) and Stroke Specific Quality of Life Scale (SS-QOL). Patients in Group 1 received secondary stroke prevention therapy and performed the exercises complex for general muscle function improvement for 2 months; patients in Group 2 also performed the exercise complex for hand motility improvement for 2 months; patients in Group 3 received choline alphoscerate 400 mg twice a day for 2 months in addition to the abovementioned physical therapy. Results. 2 months of physical therapy in Group 1 resulted in increase of “Transfer” and subtotal motor scores. A significant increase in the “Self-care”, “Transfer” and therefore subtotal motor and total scores was observed in the patients in Group 2 and Group 3; the motor subtotal and total scores in Group 3 were 11.4% and 11.6 % higher than the same indices in Group 1, respectively. The most significant improvement of QOL parameters was observed in patients in Group 3, whose total score increased by 36.8% from the baseline (p<0.05), and exceeded the same index of Group 1 by 17.1% (p<0.05). Conclusions. Adding of hand exercise into the physical therapy complex for post-stroke patients contributes to better upper extremity motor performance and therefore functional independence. Stimulation of cholinergic neurotransmission with the choline alphoscerate may also increase the efficacy of physical therapy and contribute to patients’ general mobility, upper extremity function and QOL.

scholarly journals Does cognition influence the functional impairment degree of post-stroke patients?

2020 ◽  
pp. 1-4
Author(s):  
Ozair Argentille Pereira da Silva ◽  
Gabriele Natane de Medeiros Cirne ◽  
Edson Meneses da Silva Filho ◽  
Enio Walker Azevedo Cacho ◽  
Roberta de Oliveira Cacho
Keyword(s):  
Motor Impairment ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Temporal Orientation ◽  
Stroke Patients ◽  
Post Stroke ◽  
Motor Abilities ◽  
Sociodemographic Data ◽  
Cognitive Levels ◽  
Sensory Motor

Background: The post-stroke subjects have several sequelae after the disease, which should be investigated and identified so that the clinical treatment includes these people in all aspects. Objective: To identify if there is a correlation between level of education, cognitive function, functional independence and the sensory-motor abilities of post-stroke subjects. Methods: The sample consisted of 27 post-stroke patients who were evaluated through the following scales: Mini-Mental State Exam (MMSE), Functional Independence Measure (FIM) and Fugl-Meyer Assessment (FMAA) and sociodemographic data collection. Results: A positive and statistically significant correlation was found between MMSE and FIM. When the scores were correlated with education, motor FIM (p = 0.005), total FIM (p = 0.006), temporal orientation MMSE (p = 0.03) and total MMSE (p = 0.01) were statistically significant. Furthermore, a positive correlation but not statistically significant was identified between the cognitive levels and sensory-motor impairment assessed by FMAA. Conclusion: It is concluded that the education of subjects is associated with motor function after stroke. In addition, cognitive impairments interfere with the level of post-stroke functionality, but do not have a direct influence on the degree of sensory-motor impairment.

scholarly journals A decision making algorithm for rehabilitation after stroke: A guide to choose an appropriate and safe treadmill training

2021 ◽  
pp. 1-11
Author(s):  
Fabio Vanoglio ◽  
Adriana Olivares ◽  
Gian Pietro Bonometti ◽  
Silvia Damiani ◽  
Marta Gaiani ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Judgment ◽  
Clinical Characteristics ◽  
Rating Scale ◽  
Strong Association ◽  
Functional Independence ◽  
Treadmill Training ◽  
Walking Ability ◽  
Stroke Patients ◽  
Post Stroke

BACKGROUND: Walking independently after a stroke can be difficult or impossible, and walking reeducation is vital. But the approach used is often arbitrary, relying on the devices available and subjective evaluations by the doctor/physiotherapist. Objective decision making tools could be useful. OBJECTIVES: To develop a decision making algorithm able to select for post-stroke patients, based on their motor skills, an appropriate mode of treadmill training (TT), including type of physiotherapist support/supervision required and safety conditions necessary. METHODS: We retrospectively analyzed data from 97 post-stroke inpatients admitted to a NeuroRehabilitation unit. Patients attended TT with body weight support (BWSTT group) or without support (FreeTT group), depending on clinical judgment. Patients’ sociodemographic and clinical characteristics, including the Cumulative Illness Rating Scale (CIRS) plus measures of walking ability (Functional Ambulation Classification [FAC], total Functional Independence Measure [FIM] and Tinetti Performance-Oriented Mobility Assessment [Tinetti]) and fall risk profile (Morse and Stratify) were retrieved from institutional database. RESULTS: No significant differences emerged between the two groups regarding sociodemographic and clinical characteristics. Regarding walking ability, FAC, total FIM and its Motor component and the Tinetti scale differed significantly between groups (for all, p <  0.001). FAC and Tinetti scores were used to elaborate a decision making algorithm classifying patients into 4 risk/safety (RS) classes. As expected, a strong association (Pearson chi-squared, p <  0.0001) was found between RS classes and the initial BWSTT/FreeTT classification. CONCLUSION: This decision making algorithm provides an objective tool to direct post-stroke patients, on admission to the rehabilitation facility, to the most appropriate form of TT.

scholarly journals Does botulinum toxin improve the function of the patient with spasticity after stroke?

2007 ◽  
Vol 65 (3a) ◽  
pp. 592-595 ◽  
Author(s):  
Eduardo Cardoso ◽  
Glícia Pedreira ◽  
Antônio Prazeres ◽  
Nildo Ribeiro ◽  
Ailton Melo
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin Type A ◽  
Functional Independence Measure ◽  
Botulinum Toxin Type ◽  
Functional Independence ◽  
Functional Improvement ◽  
Stroke Patients ◽  
Early Management ◽  
Post Stroke ◽  
Upper Limb Function

Post-stroke spasticity is an important cause of disability in adults, due to muscle hyperactivity, which results in limb stiffness and muscle spasm. The prognosis for these patients depends on several features such as early management and adequate physical therapy to avoid muscle shortening, pain, and their consequences. Although several papers have shown that intramuscular injections of botulinum toxin type A (BT-A) decreases spasticity in post-stroke patients, few authors have demonstrated functional improvement after this therapy. In order to assess if individualized BT-A injections improves upper limb function in post-stroke spastic patients, we prospectively followed 20 consecutive patients of 18 years of age or more with spastic hemiparesis secondary to stroke. Fulg-Meyer scale modified for upper limbs, measure of functional independence (MFI), Ashworth modified scale, and goniometry were applied in the beginning of the investigation and in the 16th and 32nd weeks. BT-A was applied at baseline and in the 16th week. All subjects were submitted to rehabilitation therapy. All patients showed improvement according to Ashworth modified scale and increase in the range of motion, which were sustained until the 32nd week (p<0.05). The assessment of the first three parameters of the Fulg-Meyer scale and the evaluations of the motor part of the Functional Independence Measure showed statistically improvement until the end of the study. We conclude that proper choice of muscles and individualized doses of BT-A can improve function in selected post-stroke patients.

scholarly journals Assessment of the correlations between gait speed in post-stroke patients and the time from stroke onset, the level of motor control in the paretic lower limb, proprioception, visual field impairment and functional independence

2016 ◽  
Vol 30 (3) ◽  
pp. 5-16
Author(s):  
Mariusz Drużbicki ◽  
Grzegorz Przysada ◽  
Justyna Podgórska-Bednarz ◽  
Andrzej Kwolek ◽  
Teresa Pop ◽  
...  
Keyword(s):  
Motor Control ◽  
Visual Field ◽  
Lower Limb ◽  
Barthel Index ◽  
Gait Speed ◽  
Functional Independence ◽  
Stroke Onset ◽  
Lower Limbs ◽  
Stroke Patients ◽  
Post Stroke

Abstract Introduction: Gait recovery is one of the main objectives in the rehabilitation of post-stroke patients. The study aim was to assess the correlations between gait speed in post-stroke hemiparetic patients and the level of motor control in the paretic lower limb, the time from stroke onset, the subjects’ age as well as the impairment of proprioception and visual field. Materials and methods: This retrospective study was performed at the Clinical Rehabilitation Ward of the Regional Hospital No. 2 in Rzeszow. The study group consisted of 600 patients after a first stroke who walked independently. The measurements focused on gait speed assessed in a 10-meter walking test, motor control in the lower limb according to Brunnström recovery stages, proprioception in lower limbs, visual field as well as functional independence according to The Barthel Index. Results: The study revealed a slight negative correlation between gait speed and the subjects’ age (r = − 0.25). No correlation was found between mean gait speed and the time from stroke onset. On the other hand, gait speed strongly correlated both with the level of motor control in the lower limb (p = 0.0008) and the incidence of impaired proprioception. Additionally, a strong statistically significant correlation between the patients’ gait speed and the level of functional independence was found with the use of The Barthel Index. Conclusions: The level of motor control in the paretic lower limb and proprioception are vital factors affecting gait speed and functional independence. Patients with a higher level of functional independence demonstrated higher gait speed.

Chronic Kidney Disease and Functional Outcomes 6 Months after Ischemic Stroke: A Prospective Multicenter Study

2015 ◽  
Vol 46 (1) ◽  
pp. 24-30 ◽  
Author(s):  
Shin Yi Jang ◽  
Min Kyun Sohn ◽  
Jongmin Lee ◽  
Deog Young Kim ◽  
Sam-Gyu Lee ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Ischemic Stroke ◽  
Kidney Disease ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Stroke Patients ◽  
Nihss Score ◽  
Disease Epidemiology ◽  
Post Stroke ◽  
Obesity Hypertension

Background: The aim of this study was to investigate whether chronic kidney disease (CKD) predicts the outcome of the Functional Independence Measure (FIM) and the Korean version of the modified Barthel Index (K-MBI) 6 months after stroke with adjustment for age, gender, education, smoking, drinking, obesity, hypertension, diabetes mellitus, dyslipidemia, the FIM or K-MBI at discharge and the National Institutes of Health Stroke Scale (NIHSS) score 7 days post stroke. Methods: This study is an interim report of the Korean Stroke Cohort for Functioning and Rehabilitation. The sample included 2,037 ischemic stroke patients aged 18 years or older. The FIM and K-MBI scores were assessed at discharge and at 6 months after the onset of stroke. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. CKD was defined as an eGFR <60 ml/min/1.73 m2. Results: Overall, the mean age was 65.5 (±12.4) years. The proportion of men was 62.6%. The proportion of CKD cases was 12.7%. The means of the 6-month FIM and K-MBI were 109.8 (±27.9) and 87.0 (±26.4), respectively. In multiple linear regressions, the 6-month FIM after stroke was significantly associated with CKD (-2.85, p < 0.05), age (-0.29, p < 0.01), the FIM at discharge (0.46, p < 0.01) and the 7-day NIHSS score (-1.71, p < 0.01). Additionally, the post-stroke 6-month K-MBI was significantly associated with CKD (-2.88, p < 0.01), age (-0.27, p < 0.01), the K-MBI at discharge (0.46, p < 0.01) and the 7-day NIHSS score (-1.55, p < 0.01). Conclusions: This nationwide hospital-based cohort study showed that CKD might predict poor 6-month FIM and K-MBI scores in ischemic stroke patients.

scholarly journals A Chinese Herbal Medicine, Tokishakuyakusan, Reduces the Worsening of Impairments and Independence after Stroke: A 1-Year Randomized, Controlled Trial

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Hirozo Goto ◽  
Nobuhiko Satoh ◽  
Yoshinori Hayashi ◽  
Hiroaki Hikiami ◽  
Yutaka Nagata ◽  
...  
Keyword(s):  
Herbal Medicine ◽  
Controlled Trial ◽  
Strength Function ◽  
Functional Independence ◽  
Lower Limbs ◽  
Favorable Effect ◽  
Control Group ◽  
Stroke Patients ◽  
Post Stroke ◽  
Significant Difference

In post-stroke patients, the recurrence of stroke and progression of impairments lead to a bedridden state and dementia. As for their treatments, only anti-hypertension and anti-coagulation therapies to prevent the recurrence of stroke are available. In Asia, post-stroke patients with impairments are often treated with herbal medicine. The present study evaluated the effectiveness of tokishakuyakusan (TS) in improving the impairment and independence in post-stroke patients. Thirty-one post-stroke patients (mean age = 81.4 years) were recruited and enrolled. Participants were randomly assigned to the TS group (n= 16) or non-treatment (control) group (n= 15) and treated for 12 months. Impairments were assessed using the Stroke Impairment Assessment Set (SIAS). Independence was evaluated using the functional independence measure (FIM). For each outcome measure, mean change was calculated every 3 months. The results were that impairments according to SIAS did not significantly change in the TS group. In contrast, SIAS significantly worsened in the control group. There was a significant difference between the two groups. In each term of SIAS, affected lower extremity scores, abdominal muscle strength, function of visuospatial perception, and so forth. in the TS group were better than those in the control group. Independence according to FIM did not change significantly in the TS group. In contrast, FIM significantly worsened in the control group. There was also a significant difference between the two groups. In conclusion, TS was considered to suppress the impairments of lower limbs and to exert a favorable effect on cerebral function for post-stroke patients.

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