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Latest & greatest articles for stroke
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on stroke or other clinical topics then use Trip today.
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Left Atrial Enlargement and the Risk of Stroke: A Meta-Analysis of Prospective Cohort Studies. Background: The association between left atrial size and the risk of stroke has not been fully understood. We performed a meta-analysis of prospective cohort studies to determine whether left atrial enlargement (LAE) is associated with an increased risk of stroke. Methods: We searched PubMed, EMBASE, Web of Science, and the Cochrane Library through May 2019. Prospective cohort studies were included (...) if they reported hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) of stroke with respect to LAE. All meta-analyses were performed using a random-effects model. Results: Six studies involving 66,007 participants and 3,549 stroke events were included. Compared with patients without LAE, those with LAE had an increased risk of stroke (adjusted HR 1.68, 95% CI 1.36-2.07). There was also a graded association with stroke relating to LAE (adjusted HR for mild LAE 1.50, 95% CI 0.98-2.28; moderate
Effect of Intensive and Standard Lipid-Lowering Therapy on the Progression of Stroke in Patients With Coronary Artery Syndromes: A Meta-Analysis of Randomized Controlled Trials. This meta-analysis demonstrated the effect of intensive versus standard statins on the risk of stroke in patients with coronary artery syndromes (CAS). PubMed, Embase, the Cochrane library, and clinicaltrials.gov were searched, and the retrieved studies were undertaken for randomized controlled trials (RCTs) throughout (...) September 2018. Studies that were designed as RCTs and recruited at least 1000 CAS patients followed up greater than 1 year were eligible for this study. The summary relative risk with the 95% confidence interval was used as an effect estimate and calculated using the random-effects model. Five RCTs comprising a total of 39,612 coronary syndrome patients with reported 1236 stroke events were included in this meta-analysis. The summary result indicated a 14% reduction in the risk of stroke in CAS
Systematic Review on Fractal Dimension of the Retinal Vasculature in Neurodegeneration and Stroke: Assessment of a Potential Biomarker. Introduction: Ocular manifestations in several neurological pathologies accentuate the strong relationship between the eye and the brain. Retinal alterations in particular can serve as surrogates for cerebral changes. Offering a "window to the brain," the transparent eye enables non-invasive imaging of these changes in retinal structure and vasculature. Fractal (...) dimension (FD) reflects the overall complexity of the retinal vasculature. Changes in FD could reflect subtle changes in the cerebral vasculature that correspond to preclinical stages of neurodegenerative diseases. In this review, the potential of this retinal vessel metric to serve as a biomarker in neurodegeneration and stroke will be explored. Methods: A literature search was conducted, following the PRISMA Statement 2009 criteria, in four large bibliographic databases (Pubmed, Embase, Web Of Science
First aid cooling techniques for heat stroke and exertional hyperthermia: A systematic review and meta-analysis. Heat stroke is an emergent condition characterized by hyperthermia (>40 °C/>104 °F) and nervous system dysregulation. There are two primary etiologies: exertional which occurs during physical activity and non-exertional which occurs during extreme heat events without physical exertion. Left untreated, both may lead to significant morbidity, are considered a special circumstance (...) for cardiac arrest, and cause of mortality.We searched Medline, Embase, CINAHL and SPORTDiscus. We used Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods and risk of bias assessments to determine the certainty and quality of evidence. We included randomized controlled trials, non-randomized trials, cohort studies and case series of five or more patients that evaluated adults and children with non-exertional or exertional heat stroke or exertional hyperthermia, and any
The effectiveness of various cytotherapeutic strategies for the treatment of ischemicstroke: a Bayesian network meta-analysis of randomized controlled trials. Cytotherapy is a potential treatment for ischemicstroke (IS) patients but lacks uniform procedures. We aimed to assess the impact of the time of intervention, cell type, dose, and route of administration on the clinical effects by network meta-analysis.We searched public electronic databases through July 7, 2019. Bayesian network meta
Limited evidence of physical therapy on balance after stroke: A systematic review and meta-analysis. Stroke results in balance disorders and these directly affect autonomy and quality of life. The purpose of this systematic review and meta-analysis was to determine the efficacy of physical therapy (PT) on balance and postural control after stroke.We included all randomized controlled trials assessing the efficacy of PT on balance and postural control in adult patients after stroke without (...) language restriction. Medline, Embase/Scopus, Cochrane Central Register of Controlled Trials, PEDro, Pascal, and Francis databases were searched until January 2019. Primary outcomes were balance (Berg Balance scale and Postural Assessment Scale for Stroke) and postural control with postural deviation or stability measurement in sitting or standing static evaluation. A pair of independent reviewers selected studies, extracted data, and assessed risk of bias. Meta-analyses with subgroups (categories
Do thrombolysis outcomes differ between anterior circulation stroke and posterior circulation stroke? A systematic review and meta-analysis. It remains unclear whether thrombolysis outcomes can be influenced by the affected vascular territory (i.e. anterior circulation stroke vs. posterior circulation stroke) in stroke patients owing to the lack of randomized controlled trials.Using multiple comprehensive databases, we searched for observational studies of the safety and efficacy of intravenous (...) thrombolytics and intra-arterial treatment with or without intravenous thrombolytics in accordance with the affected vascular territory. We performed a systematic review and meta-analysis. We evaluated symptomatic intracerebral hemorrhage, all-type intracerebral hemorrhage, mortality, and functional outcomes at three months. The recanalization rate was assessed in the intra-arterial treatment group.Twenty-one studies including a report from our own stroke registry were included through quantitative
Editors' note: WMH and long-term outcomes in ischemicstroke: A systematic review and meta-analysis. 32123057 2020 03 03 1526-632X 94 9 2020 Mar 03 Neurology Neurology Editors' note: WMH and long-term outcomes in ischemicstroke: A systematic review and meta-analysis. 410 10.1212/WNL.0000000000009041 Siegler James E JE 3rd Galetta Steven S eng Journal Article United States Neurology 0401060 0028-3878 AIM IM 2020 3 4 6 0 2020 3 4 6 0 2020 3 4 6 0 ppublish 32123057 94/9/410 10.1212/WNL
Reader response: WMH and long-term outcomes in ischemicstroke: A systematic review and meta-analysis. 32123058 2020 03 03 1526-632X 94 9 2020 Mar 03 Neurology Neurology Reader response: WMH and long-term outcomes in ischemicstroke: A systematic review and meta-analysis. 410-411 10.1212/WNL.0000000000009042 Gupta Vinod V http://orcid.org/0000-0002-6770-5916 (New Delhi, India). eng Journal Article United States Neurology 0401060 0028-3878 AIM IM 2020 3 4 6 0 2020 3 4 6 0 2020 3 4 6 0 ppublish
Author response: WMH and long-term outcomes in ischemicstroke: A systematic review and meta-analysis. 32123059 2020 03 03 1526-632X 94 9 2020 Mar 03 Neurology Neurology Author response: WMH and long-term outcomes in ischemicstroke: A systematic review and meta-analysis. 411 10.1212/WNL.0000000000009043 Georgakis Marios K MK (Munich). Dichgans Martin M (Munich). eng Journal Article United States Neurology 0401060 0028-3878 AIM IM 2020 3 4 6 0 2020 3 4 6 0 2020 3 4 6 0 ppublish 32123059 94/9
Salvianolic Acids for Injection Combined with Conventional Treatment for Patients with Acute CerebralInfarction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. BACKGROUND This meta-analysis was conducted to evaluate the clinical effectiveness and safety of Salvianolic acids for injection (SAFI) plus conventional treatment (CT) for patients with acute cerebralinfarction (ACI) and to assess the evidence to guide clinical practice. MATERIAL AND METHODS PubMed, EMBASE (...) , and Evaluation (GRADE). RESULTS A total of 14 RCTs involving 1309 patients were included. Meta-analysis showed that SAFI plus CT was better than CT alone in improving the total effective rate (RR=1.35, 95% CI 1.25 to 1.44, P<0.00001), reducing the National Institutes of Health Stroke Scale (NIHSS) score (130 mg: WMD=-3.31, 95% CI -3.80 to -2.47, P<0.00001; 100 mg: WMD=-1.91, 95% CI -2.28 to -1.54, P<0.00001), improving the activity of daily living and cognitive function of ACI, and improving the hemorheology
Measurement properties of self-report physical activity assessment tools for patients with stroke: a systematic review. Individuals with stroke demonstrate low levels of physical activity. Self-report measures of physical activity are frequently used and the choice of the best one to use for each purpose and context should take into account the measurement properties of these instruments.To summarize the measurement properties and clinical utility of self-report measures of physical activity (...) of post-stroke subjects and to evaluate both the methodological quality of the studies and the quality of the measurement properties.Searches were made in MEDLINE, EMBASE, PEDro, LILACS, and SCIELO. Two reviewers independently screened studies that investigated measurement properties or clinical utility of self-report measures of physical activity in post-stroke subjects. The studies' methodological quality, quality of the measurement properties, and clinical utility were evaluated.From the 11,826
The effect of adding trunk restraint to task-oriented training in improving function in stroke patients: A systematic review and meta-analysis. The effectiveness of trunk restraint on post-stroke arm motor function and daily function remain controversial.To evaluate the effect of adding trunk restraint to task-oriented rehabilitation of arm motor function and functional ability after stroke.Nine databases were systematically searched for randomized controlled trials studying the effects (...) of trunk restraint in post-stroke task-oriented training. Researchers assessed methodological qualities using the Physiotherapy Evidence Database scale, and extracted data related to study participants, intervention, and outcomes. The overall effectiveness was calculated using a meta-analytic method.In total, ten articles met the inclusion criteria and nine trails (n = 255 subjects) were included in quantitative analyses. Meta-analysis revealed that trunk restraint exhibited a significant improvement
[Effectiveness of Wii Fit Balance board in comparison with other interventions for post-stroke balance rehabilitation. Systematic review and meta-analysis]. Virtual reality is a booming therapeutic tool within the neurorehabilitation field. Among the different non-inmersive virtual reality systems, the most outstanding is the platform, Wii Fit Balance.To review the scientific literature published in recent years about the effectiveness of Wii Fit Balance tool. The use of this platform (...) for balance training in patients who have suffered a stroke compared to conventional therapies is going to be analyzed from a quantitative and qualitative point of view.A search of the databases has been carried out: PubMed, Lilacs, PEDro, Scopus, Web of Science and Cochrane Library. Descriptors employed were «Wii Fit Balance», «Wii», «stroke», «ictus» and «balance». Studies were analyzed methodologically by PEDro Scale. For those possible variables a meta-analysis was elaborated.Sixteen randomized
Effects of transcutaneous electrical nerve stimulation alone or as additional therapy on chronic post-stroke spasticity: systematic review and meta-analysis of randomized controlled trials. Purpose: To evaluate the effects and to compare transcutaneous electrical nerve stimulation protocols, alone or as additional therapy in chronic post-stroke spasticity through a systematic review and meta-analysis of randomized clinical trials.Methods: Search was conducted in MEDLINE, Cochrane Library (...) identified, 10 studies with 360 subjects were included in the review. Transcutaneous electrical nerve stimulation alone or as additional therapy is superior to placebo TENS to reduce post-stroke spasticity assessed with Modified Ashworth Scale (-0.52 [-0.74 to -0.30] p < 0.0001, 6 studies), especially in lower limbs (-0.58 [-0.82 to -0.34] p < 0.0001, 5 studies), which is in accordance with the studies that used other scales. Low frequency TENS showed a slightly larger improvement than high-frequency
are eligible to receive continual long-term community-based physiotherapy have already received 12 weeks of physiotherapy after being diagnosed with stroke. We excluded people who were admitted to hospital for transientischemicattack, as it is characterized as a minor and nondisabling type of stroke, 16 and focused on people who were admitted for either ischemic or (intracerebral or subarachnoid) hemorrhagic stroke. Budget Impact Analysis March 2020 Ontario Health Technology Assessment Series; Vol. 20 (...) and long-term medical attention. There are different types of stroke. The two major classifications are ischemicstroke and hemorrhagic stroke. Ischemicstroke occurs when an artery in the brain is blocked. Hemorrhagic stroke occurs when a blood vessel in the brain breaks open, interrupting blood flow in the brain. 1 Clinical Need and Target Population In Canada, approximately 62,000 people suffer a stroke annually, and about 405,000 are living with the consequences of a stroke. 2 This number
be costly, or forgo super- vised therapy and potentially not meet their rehabilita- tion and recovery potential. The 2019 update of the Canadian Stroke Best Practice Recommendations (CSBPR): Rehabilitation and Recovery following Stroke module is a comprehen- sive summary of current evidence-based recommenda- tions, focusing primarily on the management of people who have already had a moderately or severely dis- abling stroke. People with milder stroke or transientischemicattack may not require (...) for select patients with acute stroke (for instance, people with more mild strokesor transientischemicattack) butcautionisadvised, andclinical judgmentshouldbeused(Evidence Level C). (iv) Once deemed to be medically and neurologically stable, patients should receive a recommended three hours perdayof directtask-specific therapy, five days aweek, delivered by the interdisciplinary stroke team (Evidence Level C); more therapy results in better outcomes (Evidence Level A). (v) Individualized
Functional Balance and Postural Control Improvements in Patients With Stroke After Noninvasive Brain Stimulation: A Meta-analysis The postural imbalance poststroke limits individuals' walking abilities as well as increase the risk of falling. We investigated the short-term treatment effects of noninvasive brain stimulation (NIBS) on functional balance and postural control in patients with stroke.We started the search via PubMed and the Institute for Scientific Information's Web of Science (...) bias. We calculated overall and individual effect sizes using random effects meta-analysis models.The random effects meta-analysis model on the 18 qualified studies identified the significant positive effects relating to NIBS in terms of functional balance and postural control poststroke. The moderator-variable analyses revealed that these treatment effects were only significant in rTMS across patients with acute, subacute, and chronic stroke whereas tDCS did not show any significant therapeutic
The impact of a patient-directed activity program on functional outcomes and activity participation after stroke during inpatient rehabilitation-a randomized controlled trial Individuals post stroke are inactive, even during rehabilitation, contributing to ongoing disability and risk of secondary health conditions. Our aims were to (1) conduct a randomized controlled trial to examine the efficacy of a "Patient-Directed Activity Program" on functional outcomes in people post stroke during (...) inpatient rehabilitation and (2) examine differences three months post inpatient rehabilitation discharge.Randomized control trial.Inpatient rehabilitation facility.Patients admitted to inpatient rehabilitation post stroke.Patient-Directed Activity Program (PDAP) or control (usual care only). Both groups underwent control (three hours of therapy/day), while PDAP participants were prescribed two additional 30-minute activity sessions/day.Outcomes (Stroke Rehabilitation Assessment of Movement Measure
random code with an interactive web response system with stratification by site. Participants, investigators, the trial leadership, and all other personnel were masked to treatment allocation until the trial was completed and the database was locked. During the treatment period, participants in both groups were instructed to inject study drug on the same day at around the same time, each week. Strokes were categorised as fatal or non-fatal, and as either ischaemic, haemorrhagic, or undetermined (...) . Stroke severity was assessed using the modified Rankin scale. Participants were seen at 2 weeks, 3 months, 6 months, and then every 3 months for drug dispensing and every 6 months for detailed assessments, until 1200 confirmed primary outcomes accrued. The primary endpoint was the first occurrence of any component of the composite outcome, which comprised non-fatal myocardial infarction, non-fatal stroke, or death from cardiovascular or unknown causes. All analyses were done according to an intention