scholarly journals The Effectivity of Mirror Therapy on Arm Motoric Improvement in Acute Ischemic Stroke Patients

2019 ◽  
Vol 7 (1) ◽  
pp. 6
Author(s):  
Jumraini Tammasse ◽  
Machyono Andi Kurnia Bintang
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Standard Therapy ◽  
Cerebrovascular Diseases ◽  
Control Group ◽  
Mirror Therapy ◽  
Stroke Patients ◽  
Motor Action ◽  
Significant Difference ◽  
Experimental Group

Cerebrovascular diseases (stroke) ranked the second cause of death worldwide. This research aimed at investigating the effectiveness of mirror therapy on artery therapy by ARAT (ARAT) score. The research was carried out by the clinical trials study towards 32 acute ischemic stroke patients who were divided into an experimental group got the combination of mirror therapy and standard therapy, and the control group only got the standard therapy. The level of the motor action was tested by Action Research Arm Test (ARAT) score. The research then compared the ARAT score difference between the two groups. The result of the research reveals that the ARAT score differences on the group who gets the combination of mirror therapy and standard therapy (15.56±4.38) higher than the group who only gets the standard therapy (7.69±1, 66). By using T-test, it is obtained the significant difference of P <0.05 (0.001).

scholarly journals Effect of proprioceptive sensation and feedback required for motor learning on function, activity, and daily life behavior of patients after nerve injury

2021 ◽  
Vol 11 (3) ◽  
pp. 474-481
Author(s):  
Jung-Ho Lee
Keyword(s):  
Upper Extremity ◽  
Daily Activities ◽  
Control Group ◽  
Mirror Therapy ◽  
Stroke Patients ◽  
Proprioceptive Sensation ◽  
Significant Difference ◽  
Upper Extremity Function ◽  
Function Activity ◽  
Experimental Group

Purpose: This study investigated the effects of modified mirror therapy and taping therapy for providing feedback on upper extremity function, activity, and daily activities of stroke patients. Methods: This study was conducted with 20 stroke patients and randomly assigned 10 subjects to the experimental group and 10 to the control group. In the experimental group, after proprioceptive neuromuscular stimulation treatment, the mirror therapy program was implemented. In the control group, upper extremity taping was performed before proprioceptive neuromuscular facilitation treatment. In this study, a prior evaluation using JTT, FIM, and MAL was performed before intervention to evaluate the patient's function and daily life behavior. Post-tests were performed after the last treatment. Results: In the paired-sample T-test used for within-group comparison of JTTs, FIM, and MAL, there was a significant difference between pre- and post-test for all groups. But there was no statistically significant difference between experimental group 1 and experimental group 2 in an independent t-test conducted to compare the effect sizes of treatments. Conclusion: In other words, by applying mirror therapy and taping therapy that can increase proprioceptive sensation and feedback information in stroke patients, upper extremity function and daily activities can be increased.

scholarly journals Effect of DLBS1033 on Functional Outcomes for Patients with Acute Ischemic Stroke: A Randomized Controlled Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Rizaldy Taslim Pinzon ◽  
Raymond R. Tjandrawinata ◽  
Vincent Ongko Wijaya ◽  
Vanessa Veronica
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Hospital Discharge ◽  
Standard Therapy ◽  
Functional Outcomes ◽  
Standard Care ◽  
Control Group ◽  
Stroke Management ◽  
Once Daily ◽  
Experimental Group

Background. There are still some unmet needs for stroke management and safety. DLBS1033 is a protein fraction extracted from the earthworm Lumbricus rubellus that has shown fibrinolytic and fibrinogenolytic activities, reduces blood viscosity, and inhibits platelet aggregation that it can be considered an add-on therapy and potential medical breakthrough in acute ischemic stroke management. Objective. This study is aimed at measuring the benefit of DLBS1033 in acute ischemic stroke management. Methods. This was a randomized, open-label trial at a referral stroke center from November 2019 to December 2020. Subjects who met the inclusion criteria were randomly divided into a control group and an experimental group. The control group received standard therapy consisting of aspirin 100 mg once daily, atorvastatin 20 mg once daily, and vitamin B12 100 mg three times daily. The experimental group received standard therapy and DLBS1033 three times daily. The functional outcomes were measured using the National Institutes of Health Stroke Scale (NIHSS), Barthel Index (BI), and modified Rankin Scale (mRS) at baseline, hospital discharge, and day 30. Results. Collected data from 180 subjects was analyzed. The NIHSS scores’ improvements were significantly greater in the experimental group compared to the control group at both hospital discharge ( − 5.57 ± 2.16 vs. − 3.64 ± 2.65 ; p < 0.001 ) and day 30 ( − 6.62 ± 2.64 vs. − 5.14 ± 2.41 ; p = 0.001 ). Compared with the control group, the improvements in the BI scores were significantly better in the experimental group, at both hospital discharge ( 10.69 ± 5.36 vs. 6.64 ± 5.04 ; p < 0.001 ) and day 30 ( 10.9 ± 8.19 vs. 8.56 ± 7.45 ; p = 0.003 ). The distribution of mRS scores was improved in both groups during 30 days of follow-up and was more favorable in the experimental group. In both groups, a favorable outcome ( mRS < 2 ) was achieved better at day 30 (86.7% vs. 80%; p = 0.302 ) than at baseline (0% vs. 6.7%; p = 0.028 ) and at hospital discharge (58.9% vs. 43.3%; p = 0.085 ). There was no clinically significant adverse event related to the study product. Conclusions. DLBS1033 in addition to the standard care was more effective in improving functional status compared to standard care alone in acute ischemic stroke patients with a similar safety profile.

The effect of addition protein, phosphatidylcholine, phosphatidylserine, and inulin on GFAP levels of acute ischemic stroke patients at Dr. Kariadi Hospital, Semarang

2021 ◽  
Vol 9 (2) ◽  
pp. 184-197
Author(s):  
Diah Retno Wahyuningrum ◽  
Retnaningsih Retnaningsih ◽  
Martha Irene Kartasurya
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
G Protein ◽  
Intervention Group ◽  
Circulatory System ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Stroke Patients ◽  
Significant Difference ◽  
Enteral Formula

Background: The occurrence of ischemia causes a loss of energy to switch to anaerobic processes resulting in acidosis due to reduced Adenosina Triphosphate (ATP). This condition makes neuron cells apoptotic. Apoptotic of several biochemical substrates in the brain, such as Glial Fibrillary Acidic Protein (GFAP) exit into the circulatory system which is associated with dysbiosis through immunological pathways.Objectives: To determine the effect of giving enteral formula containing protein, phosphatidylcholine, phosphatidylserine, and inulin on GFAP levels in patients with acute ischemic stroke Dr. Kariadi Hospital.Materials and Methods: This study was done in a single-blind RCT. Eighteen ischemic stroke patients were randomly divided into intervention (9 subjects) and control groups (9 subjects). The intervention group received 69 g of the powdered enteral formula three times a day for seven days. The formula contained protein (15 g), phosphatidylcholine (128 mg),  phosphatidylserine (32 mg), and inulin (3 g). The subject who had diabetes mellitus received for 14 days at a dose of 34.5 g per day (7.5 g protein with additions 64mg phosphatidylcholine, 16mg phosphatidylserine, 1.5 g inulin). The control group received the standard enteral formula from the hospital, which contains (11.8 g protein without additions protein, phosphatidylcholine, phosphatidylserine, and inulin). GFAP levels by ELISA method (Enzyme-linked immunosorbent Assay) at pre and post-intervention.Results: There was a trend of decreasing GFAP levels before and after in the intervention group towards a better direction from 8.37±4.25 to 8.30±4.9 compared with the control group which experienced an increasing trend from 5.4±1.8 to 7.5±4. There was no significant difference in GFAP levels after intervention between groups (p = 0.7).Conclusions: The addition of protein, phosphatidylcholine, phosphatidylserine, and inulin had no significant effect on GFAP levels.

The relationship between serum and liquor IL-1β, IL-6, TNFa, IL-10 levels and clinical, cognitive and functional characteristics in acute ischemic stroke

2016 ◽  
Vol 94 (9) ◽  
pp. 657-662 ◽  
Author(s):  
Aleksey A. Kulesh ◽  
E. M. Kuklina ◽  
V. V. Shestakov
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Processing Speed ◽  
Cerebrovascular Diseases ◽  
Control Group ◽  
Cerebral Stroke ◽  
Main Process ◽  
Stroke Patients ◽  
Functional Characteristics ◽  
Visual Spatial

Introduction. Inflammation is probably the main process that links cardiovascular risk factors with damage to blood vessels and neurons. Elucidation of mechanisms of this relationship is an important issue. Materials and methods. 70 acute stroke patients were studied to assess their neuropsychological (MMSE, MoCA, FAB, Clock Drawing Test, Shulte Tables and Verbal Fluency) and functional status (mRS, RivermeadMobility Index). The serum and liquor IL-1β, IL-6, TNFa and IL-10 levels were analyzed. Control group included subjects without cerebrovascular diseases. Results. Stroke patients had higher IL-10 serum concentration than controls. No difference was found for other cytokines. There was correlation between serum and liquor cytokines levels. We found positive correlation between IL-1β, IL-6 and IL-10 levels. High IL-1β concentration was associated with vascular riskfactors, cardioembolic stroke, enhanced severity of cerebral stroke, low processing speed, impaired executive and visual-spatial functions and higher grade of mRS on discharge. The same pattern was revealed for IL-6 and IL-10. IL-6 level was related to mRS without relation to NIHSS on admission. High TNFa concentration was linked with vascular riskfactors, low MMSE score and processing speed. Discussion. Despite the antagonistic effects of IL-1β, IL-6 and IL-10 on inflammation, associations of these cytokines with anamnestic, clinical, neuropsychological and functional characteristics were similar in acute ischemic stroke. Probably, this fact indicates that during the acute ischemic brain damage process the immune response develops at the same time in pro- and anti-inflammatory directions. Its magnitude correlates with the damage severity and is associated with the effects of vascular riskfactors before stroke.

scholarly journals Effect of Simvastatin in Serum Interleukin-6 Level in Patients with Acute Ischemic Stroke

2021 ◽  
Vol 56 (3) ◽  
pp. 165
Author(s):  
Maria Lettisia Meo ◽  
Abdulloh Machin ◽  
Didik Hasmono
Keyword(s):  
Ischemic Stroke ◽  
Treatment Group ◽  
Acute Ischemic Stroke ◽  
University Hospital ◽  
Neurological Deficits ◽  
Control Group ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Permanent Disability ◽  
Significant Difference

Acute ischemic stroke is the leading cause of death and causing permanent disability in adults worldwide. In acute ischemic stroke, IL-6 levels positively correlated to more severe neurological deficits, more extensive brain damage and worse prognoses. The use of statin was associated with milder initial stroke severity, better functional outcome and lower mortality. This clinically randomized controlled trial study was aimed to analyze the serum levels of IL 6 in acute ischemic stroke patients who treated with Simvastatin 20 mg compare to placebo. Samples were taken using consecutive sampling method from hospitalized acute ischemic stroke patients in Neurology Department of Dr. Soetomo Teaching Hospital Surabaya and Airlangga University Hospital Surabayafrom August to November 2017. Total of 44 patients met the inclusion criteria, consisting of 22 patients in treatment group and 22 patients in control group.There were no significant difference in the characteristic of the patients in both groups (p>0.05). Averages of serum IL-6 in the control and the treatment group are 38.594±74.313 and 17.760±25.253(p=0,438) while averages of serum IL-6 post in the control group and the treatment are 46.586±103.484 and 15.275±17.183 (p=0,589). There were no significant level escalation in pre and post of control group (p = 0.205) and also no significant level reduction in pre and post of treatment group (p = 0.411), while the average difference in the control group (-7.992 + 78.912 pg/ml) and in the treatment group (2.485 + 23.738 pg/ml).

scholarly journals Effect of Simvastatin in Serum Interleukin-6 Level in Patients with Acute Ischemic Stroke

2020 ◽  
Vol 56 (3) ◽  
pp. 165
Author(s):  
Maria Lettisia Meo ◽  
Abdulloh Machin ◽  
Didik Hasmono
Keyword(s):  
Ischemic Stroke ◽  
Treatment Group ◽  
Acute Ischemic Stroke ◽  
University Hospital ◽  
Neurological Deficits ◽  
Control Group ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Permanent Disability ◽  
Significant Difference

Acute ischemic stroke is the leading cause of death and causing permanent disability in adults worldwide. In acute ischemic stroke, IL-6 levels positively correlated to more severe neurological deficits, more extensive brain damage and worse prognoses. The use of statin was associated with milder initial stroke severity, better functional outcome and lower mortality. This clinically randomized controlled trial study was aimed to analyze the serum levels of IL 6 in acute ischemic stroke patients who treated with Simvastatin 20 mg compare to placebo. Samples were taken using consecutive sampling method from hospitalized acute ischemic stroke patients in Neurology Department of Dr. Soetomo Teaching Hospital Surabaya and Airlangga University Hospital Surabaya from August to November 2017. Total of 44 patients met the inclusion criteria, consisting of 22 patients in treatment group and 22 patients in control group. There were no significant difference in the characteristic of the patients in both groups (p>0.05). Averages of serum IL-6 in the control and the treatment group are 38.594±74.313 and 17.760±25.253 (p=0,438) while averages of serum IL-6 post in the control group and the treatment are 46.586±103.484 and 15.275±17.183 (p=0,589). There were no significant level escalation in pre and post of control group (p=0.205) and also no significant level reduction in pre and post of treatment group (p=0.411), while the average difference in the control group  (-7.992 ± 78.912 pg/ml) and in the treatment group (2.485 ± 23.738 pg/ml).

Effect and Safety of Naomaili Granules (脑脉利颗粒) for the Treatment of Acute Ischemic Stroke: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial

2020 ◽  
Author(s):  
Xiaogang Li ◽  
Dongjing Song ◽  
Peiyang Zhou ◽  
Huagang Wang ◽  
Chengfang Zhou ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Acute Ischemic Stroke ◽  
Western Medicine ◽  
Treatment Plan ◽  
Integrated Treatment ◽  
Acute Stage ◽  
Control Group ◽  
Significant Difference ◽  
Experimental Group

Abstract Background: It is of vital importance for the treatment and prognosis of Acute Stroke to find effective Chinese medicine that can be combined with western medicine in the acute stage. The purpose of this study is to investigate the effect and safety of Naomaili Granules (脑脉利颗粒, NML) for the treatment of acute stroke, hoping to provide a new idea and drug choice for the integrated treatment of Chinese and Western medicine in the acute stage of ischemic stroke, and at the same time to improve the treatment plan in the acute stage of ischemic stroke from the perspective of TCM syndromes. Methods: A total of 187 patients with acute ischemic stroke were randomly divided into the NML group (93 cases) and the placebo group (94 NML mimics), 1 bag (10g/bag), thrice daily for 20 days. Basic medications during the trial: Aspirin enteric-coated tablets, 1 tablet (0.1g/tablet), once a day. After treatment, the modified Rankin scale, the incidence of cardiovascular events and TCM Syndrome effect were the main efficacy indicators. Meanwhile, adverse events (AEs) were evaluated during the whole clinical trial. Results: In the FAS 90 days after the onset, the experimental group was 70.00%, and the control group was 45.24%. There was a statistically significant difference between the two groups. The incidence of acute cardio-cerebrovascular events was 1 case (1.08%) in the experimental group and 0 in the control group after 20 days of FAS treatment. Conclusion: The combined application of NML in the acute stage of ischemic stroke can effectively improve the prognosis of patients, and improve the independent survival ability of patients, and its safety is reliable, providing a new way of thinking and medication choice for the treatment of acute ischemic stroke with integrated traditional Chinese and western medicine.Trial registration: ChiCTR, ChiCTR2000033619. Registered 7 June 2020 - Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=54619

scholarly journals Hyperglycemia as a Prognostic Factor In Acute Ischemic Stroke Patients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A E E Abdelhamid ◽  
H A El-Gendy ◽  
M A E Nosseir ◽  
M A Mohamed
Keyword(s):  
Ischemic Stroke ◽  
Hospital Stay ◽  
Acute Stroke ◽  
Acute Ischemic Stroke ◽  
Motor Deficit ◽  
Control Group ◽  
P Value ◽  
Motor Power ◽  
Stroke Patients ◽  
Significant Difference

Abstract Background Hyperglycemia is encountered in 20% to 40% of acute stroke patients, with or without a pre-morbid diagnosis of diabetes mellitus. Hyperglycemia is a risk factor for infarct expansion and poor outcome through the first 72 hours of hospitalization in both diabetics and non-diabetics. Aim of the Work to study the glycemic status after acute ischemic stroke and assess its role in influencing stroke out-come as regards the duration of hospital stay, motor deficit outcome and mortality. Patients and Methods This retrospective study was conducted in Elzaiton specialized hospital and Ain Shams University from June 2016 to June 2017 on 80 patients after approval of local medical ethical committee. Patients with acute ischemic stroke without other major comorbidities within 24 hours of onset of symptoms were evaluated. Results The study revealed that hospital stay mean was 12.04 ± 9.61 (in control group) and 21.36 ± 12.49 (in uncontrolled group), with p-value &lt; 0.022 S. A highly statistically significant difference between controlled and uncontrolled according to increase motor power at ICU admission in controlled a highly statistically significant difference between controlled and uncontrolled according to increase motor power discharge in controlled group. A highly statistically significant difference was found between both groups as regards outcome (mortality). Conclusion Hyperglycemia is common among acute stroke patients and is associate with less favorable outcome as regards mortality, hospital stay and functional outcome and euglycemic control is recommended in these patients.

scholarly journals Triglyceride glucose index influences platelet reactivity in acute ischemic stroke patients

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yinping Guo ◽  
Jing Zhao ◽  
Yi Zhang ◽  
Lingshan Wu ◽  
Zhiyuan Yu ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Platelet Reactivity ◽  
Multivariate Logistic Regression Analysis ◽  
Platelet Inhibition ◽  
Inhibition Rate ◽  
Stroke Patients ◽  
Tyg Index ◽  
Significant Difference

Abstract Aim Insulin resistance was reported to increase the risk of ischemic stroke, which can be assessed by the triglyceride glucose (TyG) index. However, it remains unclear whether the TyG index influences the platelet reactivity during the treatment of ischemic patients. Methods Ischemic stroke patients receiving dual antiplatelet therapy (DAPT) within 48 h onset were consecutively included. The TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). The top quartile of TyG index was defined as insulin resistance. The platelet reactivity was assessed by thromboelastography. The platelet inhibition rate induced by arachidonic acid (AA) or adenosine diphosphate (ADP) was used to confirm the high residual on-treatment platelet reactivity (HRPR) to aspirin or clopidogrel, respectively. The association between TyG index and platelet reactivity was assessed by Kruskal–Wallis test. The independent risk factors of HRPR were determined by multivariate logistic regression analysis. Results A total of 1002 patients were included and divided into 4 groups by quartiles of the TyG index (< 2.02; 2.02–2.27; 2.27–2.52; ≥2.52). The findings demonstrated that the maximum intensity of the clot increased, but the AA-induced platelet inhibition rate decreased, depending on the TyG index quartiles. No significant difference was found in the ADP-induced platelet inhibition rate among groups. The prevalence of aspirin HRPR increased depending on the TyG index quartile. Unlike the non-insulin resistance group, the insulin resistance group was independently associated with aspirin HRPR (OR = 1.689, 95% CI 1.14 to 2.51, P = 0.009). Conclusions In acute ischemic stroke patients taking DAPT, the elevation of the TyG index is associated with enhanced platelet reactivity and higher prevalence of aspirin HRPR. Insulin resistance assessed by the TyG index could be an independent risk factor for aspirin HRPR.

Abstract P201: Octogenarian and Nonagenarian Outcomes Among Acute Ischemic Stroke Patients

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
RAJAN R GADHIA ◽  
Farhaan S Vahidy ◽  
Tariq Nisar ◽  
Destiny Hooper ◽  
David Chiu ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Acute Ischemic Stroke ◽  
Combined Treatment ◽  
Stroke Patients ◽  
Stroke Treatment ◽  
Intravenous Tissue Plasminogen Activator ◽  
Significant Difference ◽  
Acute Stroke Treatment ◽  
Iv Tpa

Objective: Most acute stroke treatment trials exclude patients above the age of 80. Given the clear benefit of revascularization with intravenous tissue plasminogen activator (IV tPA) and mechanical thrombectomy (MT), we sought to assess functional outcomes in patients treated above the age of 80. Methods: We conducted a review of all patients admitted to Houston Methodist Hospital between January 2019 and August 2020 with an acute ischemic stroke (AIS) presentation[MOU1] for whom premorbid, discharge, and 90 day modified Rankin Scale scores were available. Patients were categorized by acute stroke treatment (IV tPA, MT, both or none[MOU2] ). mRS values were assessed during admission prior to discharge and at 90 days post stroke event. A delta mRS (Discharge vs. 90-day [MOU3] ) was defined and grouped as no change, improved, or worsened to assess overall functional disability in regards to the index stroke presentation. Results: A total of 865 patients with AIS presentation were included, of whom 651 (75.3%) were <80 years and 214 (24.7%) were > 80 years of age at presentation. A total of 208 patients received IV tPA, 176 underwent revascularization with MT only, 71 had both treatments, and 552 had no acute intervention. In patients >80 yrs who had no acute stroke intervention. mRS improvement was noted in 71.4% compared to 54.1% observed in those patients <80 years. Among patients who received IV tPA, 81.5% of > 80 years improved vs. 61.6% in the younger cohort. A similar trend was noted in the MT and combined treatment groups (76.2% vs. 71.2% and 78.6% vs. 79.3%, respectively). Conclusion: Based on our cohort of acute stroke patients, there was no significant difference in outcomes (as measured by delta mRS) for octogenarians and nonagenarians when compared to younger patients. There was a trend towards improvement in the elderly patients. Chronological age by itself may be an insufficient predictor of functional outcome among stroke patients and age cutoffs for enrollment of patients in acute stroke trials may need additional considerations.

Sign in / Sign up

Export Citation Format

Share Document