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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.
This page lists the very latest high quality evidence on stroke and also the most popular articles. Popularity measured by the number of times the articles have been clicked on by fellow users in the last twelve months.
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The relationship between early post-stroke cognition and longer term activities and participation: A systematic review. This systematic review examined whether early cognitive impairment after stroke is predictive of outcome within the "activity" and "participation" domains of the International Classification of Functioning, Disability and Health (ICF) at 6-12 months post-injury. Studies were included if cognitive functioning was assessed within 6 weeks of injury and outcome was measured (...) , early cognitive impairment predicted activities and participation 6-12 months post-stroke. This relationship was more consistent when domain-specific cognitive assessment was used. For the domain of activities, visuospatial perception/construction, visual memory, visual neglect, and attention/executive functioning predicted functioning 6-12 months post-stroke. Early domain-specific cognitive assessment may be clinically informative of longer term activities. For the domain of participation, further
Efficacy and Safety of Intravenous Thrombolysis in Patients with Unknown Onset Stroke: A Meta-Analysis. Unknown onset stroke (UOS) is usually excluded from intravenous thrombolysis concerning the unclear symptom onset time. Attempts have been done to use thrombolytic therapy in these patients. The current meta-analysis was done to examine the efficacy and safety of intravenous thrombolysis in UOS.PubMed, Web of Science, and Cochrane Library were searched for studies comparing thrombolysis
Upper limb tendon/muscle vibration in persons with subacute and chronic stroke: a systematic review and meta-analysis. Results of several recent studies suggest that tendon/muscle vibration treatment may improve motor performance and reduce spasticity in individuals with stroke. We performed a systematic review and meta-analysis to assess the efficacy of tendon/muscle vibration treatment for upper limb functional movements in persons with subacute and chronic stroke.We searched MEDLINE (Ovid (...) ), EMBASE (Ovid), and the Cochrane Central Register of Controlled Trials (Wiley) from inception to September 2017. We included randomized controlled trials comparing upper limb tendon/muscle vibration to sham treatment/rest or conventional interventions in persons with subacute and chronic stroke. Our primary outcome was upper limb functional movement at the end of the treatment period.We included eight trials, enrolling a total of 211 participants. We found insufficient evidence to support a benefit
Selective serotonin reuptake inhibitors for functional independence and depression prevention in early stage of post-stroke: A meta-analysis. The efficacy and safety of selective serotonin reuptake inhibitors (SSRIs) for functional independence and depression prevention in early stage of post-stroke (within 1 month after stroke onset) are still unclear.Relevant randomized controlled trials (RCTs) comparing early SSRIs therapy with placebo were sought from PubMed, Cochrane Library, Medline (...) -analysis.Our meta-analysis revealed that early SSRIs therapy were effective to prevent post-stroke depression. However, SSRIs did not improve patient's post-stroke functional independence. In addition to increase the occurrence of seizure and nausea, SSRIs were relatively safe.
A systematic review of the efficiency of recruitment to stroke rehabilitation randomised controlled trials. Randomised controlled trials (RCTs) that fail to meet their recruitment target risk increasing research waste. Acute stroke RCTs experience notable recruitment issues. The efficiency of recruitment to stroke rehabilitation RCTs has not been explored.To explore recruitment efficiency and the trial features associated with efficient recruitment to stroke rehabilitation RCTs.A systematic (...) review of stroke rehabilitation RCTs published between 2005 and 2015 identified in a search of the Cochrane Stroke Group (CSG) Trials Register from 35 electronic databases (e.g. Medline, CINAHL; EMBASE), clinical trial registers, and hand-searching. Inclusion criteria are stroke rehabilitation intervention, delivered by a member of the rehabilitation team, and clinically relevant environment. We extracted data on recruitment efficiency and trial features.We screened 12,939 titles, 1270 abstracts
Different Therapeutic Effects of Transcranial Direct Current Stimulation on Upper and Lower Limb Recovery of Stroke Patients with Motor Dysfunction: A Meta-Analysis. To explore the effects of transcranial direct current stimulation (tDCS) on the motor recovery of stroke patients and the effect differences between the upper limb and lower limb.Randomized control trials published until January 2019 were searched from PubMed, Embase, ScienceDirect, and Cochrane Library databases. The standardized (...) mean difference (SMD) with 95% confidence interval (CI) was estimated separately for upper and lower limb motor outcomes to understand the mean effect size.Twenty-nine studies with 664 subjects were included in this meta-analysis. The overall analyses of tDCS demonstrated significant effect size both for the upper limb (SMD = 0.26, P = 0.002) and the lower limb (SMD = 0.47, P = 0.002). Compared with acute and subacute stroke patients, chronic stroke patients obtained significant effects after tDCS
Role of glial fibrillary acidic protein as a biomarker in differentiating intracerebral haemorrhage from ischaemicstroke and stroke mimics: a meta-analysis. Background: Studies have suggested promising evidence that glial fibrillary acidic protein (GFAP) could be used as a blood biomarker to distinguish between ischaemicstroke (IS) and intracerebral haemorrhage (ICH) in acute stage.Objective: To determine the available evidence for GFAP as a blood biomarker for differentiating ICH from (...) IS and stroke mimics using a meta-analysis approach.Methods: Search terms were used for literature search: ("STROKE" [Mesh] OR "BIOMARKER" [Title/Abstract] OR "GFAP" [Title/Abstract])] OR "SPECIFICITY" OR "SENSTIVITY" at various search engines like PubMed, Google scholar, Trip database, clinicaltrial.gov for articles from 1990 to April 2019 using filter 'human subjects'. Data were analysed using software STATA version 13.Results: A pooled analysis including 12 studies suggested that GFAP if used
[Top-down and bottom-up approaches for the treatment of unilateral spatial neglect in stroke patients: A systematic review]. To evaluate the effectiveness of top-down and bottom-up approaches in the rehabilitation of unilateral spatial neglect in stroke patients.We carried out a systematic review of randomized controlled trials from January of 2013 to March of 2017. The following databases were searched: Scopus, Science Direct, Web of Science, Pubmed and CINHAL. The methodological quality
Acid-suppressive medications and risk of pneumonia in acute stroke patients: A systematic review and meta-analysis. We performed a systematic review and meta-analysis aiming to clarify the relationship between acid-suppressive medication (ASM) and the risk of pneumonia in acute stroke.The included studies examined patients with an acute ischemic and/or hemorrhagic stroke, assessed the relationship of one or both groups of ASM, histamine-2 receptor antagonist (H2RA) and proton-pump inhibitor (...) (adjusted RR 1.73, 95% CI 0.74-4.25, I2 68.3%), although the latter did not reach statistical significance. A comparison of the overall acid versus non-acid groups using unadjusted values yielded likewise an increased risk for pneumonia for patients receiving ASM (unadjusted RR 4.65, 95% CI 1.64-13.16, I2 93.3%).Results of this meta-analysis show an increased risk for HAP in acute stroke patients who receive ASM, particularly those exposed to PPIs. Larger, well-controlled studies in acute stroke
Comparative efficacy and safety of multiple antiplatelet therapies for secondary prevention of ischemicstroke or transientischemicattack: A network meta-analysis. Antiplatelet therapies for secondary prevention of ischemicstroke or transientischemicattack (TIA) is a highly active research topic with five critical drugs obtained by visual analysis. We aimed to compare and rank multiple antiplatelet therapies using a network meta-analysis.Relevant medical databases were searched. Eligible (...) randomized controlled trials (RCTs) which examined any comparisons involving mono- or dual antiplatelet therapies, based on aspirin, clopidogrel, dipyridamole, ticlopidine, cilostazol and placebo for patients with noncardioembolic ischemicstroke or TIA, were included. 14 outcomes were assessed. Primary outcomes were stroke recurrence, composite events (stroke recurrence, myocardial infarction and vascular death), and intracranial hemorrhage. PROSPERO registered number CRD42017069728.45 RCTs with 173,131
Effectiveness of High-Intensity Interval Training for Fitness and Mobility Post Stroke: A Systematic Review. To evaluate the evidence on the effectiveness of high-intensity interval training (HIIT) in improving fitness and mobility post stroke. TYPE: Systematic review.Medline, Embase, CINAHL, PsycINFO, and Scopus were searched for articles published in English up to January 2018.Studies were included if the sample was adult human participants with stroke, the sample size was ≥3
= 94, 5%) and for tricyclic antidepressants (TCAs) of 1.08 (95% CI 0.93-1.22, I2 = 0%). SSRI users displayed a higher risk of ischemic (1.57, 95% CI 1.06-2.09, I2 = 96.4%) than hemorrhagic stroke (1.34, 95% CI 1.15-1.53, I2 = 72.9%). Meta-RRs were lower for TCA, although with smaller heterogeneity (ischemic 1.22, 95% CI 0.97-1.46; I2 = 0%; hemorrhagic: 1.00, 95% CI 0.83-1.18, I2 = 0%). Restricting to studies on depressed individuals, both SSRI and TCA remained associated with an increased risk (...) Use of Antidepressants and Risk of Incident Stroke: A Systematic Review and Meta-Analysis. Both depression and use of antidepressants have been reported to be risk factors for stroke, but results from the literature are still not conclusive regarding the risk attributable to antidepressants rather than to the underlying disease.To estimate the risk of incident stroke associated with use of antidepressants, a meta-analysis was performed.PubMed, Medline, Cochrane, ProQuest, Scopus
Oral anticoagulation versus antiplatelet or placebo for stroke prevention in patients with heart failure and sinus rhythm: Systematic review and meta-analysis of randomized controlled trials. Previous meta-analyses of randomized controlled trials of oral anticoagulation in patients with heart failure and sinus rhythm reported reduced stroke risk and increased bleeding risk compared to antiplatelets or placebo. However, the effect estimates may be subject to imprecision, as all included trials (...) were prematurely terminated; stroke was not the primary outcome and overall results were primarily driven by a single trial. Recently, new trial data became available.To provide more accurate estimates of the effect of oral anticoagulation on stroke risk in heart failure patients with sinus rhythm by systematic review and meta-analysis of available randomized controlled trials including recently published evidence.We searched PubMed and Scopus for full-text articles of randomized controlled trials
Outcome after intravenous thrombolysis in patients with acute lacunar stroke: An observational study based on SITS international registry and a meta-analysis. Intravenous thrombolysis (IVT) for lacunar stroke (LS) is debated, as the underlying pathophysiological mechanism may not be thrombogenic.To investigate outcomes after IVT in LS in the SITS International Stroke Thrombolysis Register and perform a meta-analysis.LS was identified by both baseline NIHSS-subscores and discharge ICD-10 codes
Sex-specific relationship between adult height and the risk of stroke: A dose-response meta-analysis of prospective studies. Conflicting evidence exists regarding the magnitude of the association between adult height and risk of stroke, and it is unclear whether this association is different between men and women. The authors carried out a meta-analysis to assess the sex-specific effect of adult height on the risk of stroke and its subtypes. Prospective cohort studies reporting sex-specific (...) risk estimates of height with stroke or reported in a certain sex were included. Summary relative risks for 5-unit increments in height were calculated using random-effects, and dose-response relationships were performed using a restricted cubic spline model. Subgroup analyses, sensitivity analyses, and tests for publication bias were also performed. In all, 20 prospective studies were identified in this study. The summary of relative risks (95% CIs) of stroke for a 5 cm increase in adult height
Novel Oral Anticoagulants for the Prevention of Stroke in Patients with Atrial Fibrillation and Hypertension: A Meta-Analysis. Hypertension is associated with increased risk of stroke and bleeding in patients with atrial fibrillation (AF). In the present study, we aimed to investigate the influence of hypertension status in patients with AF receiving treatment with non-vitamin K antagonist oral anticoagulants (NOACs).PubMed, Embase, and Cochrane Library were searched from the inception of each (...) database to November 2017. Randomized controlled trials (RCTs) that evaluated NOACs versus warfarin in patients with AF and hypertension were identified. A meta-analysis was performed using random- or fixed-effects models according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Five trials (72,967 patients, including 51,378 patients with hypertension) were enrolled. NOACs significantly reduced the risk of stroke and systemic embolism (hazard ratio [HR
Artificial intelligence to diagnose ischemicstroke and identify large vessel occlusions: a systematic review. Acute stroke caused by large vessel occlusions (LVOs) requires emergent detection and treatment by endovascular thrombectomy. However, radiologic LVO detection and treatment is subject to variable delays and human expertise, resulting in morbidity. Imaging software using artificial intelligence (AI) and machine learning (ML), a branch of AI, may improve rapid frontline detection of LVO (...) strokes. This report is a systematic review of AI in acute LVO stroke identification and triage, and characterizes LVO detection software.A systematic review of acute stroke diagnostic-focused AI studies from January 2014 to February 2019 in PubMed, Medline, and Embase using terms: 'artificial intelligence' or 'machine learning or deep learning' and 'ischemicstroke' or 'large vessel occlusion' was performed.Variations of AI, including ML methods of random forest learning (RFL) and convolutional
Evidence of chronic stroke rehabilitation interventions in activities and participation outcomes: systematic review of meta-analyses of randomized controlled trials. Stroke is a leading cause of long-term disabilities worldwide. A great deal of meta-analyses of randomized controlled trials (RCTs) address rehabilitation in chronic stroke, several of them with focus on activities and participation, considered critical outcomes of successful rehabilitation. Nevertheless, substantial heterogeneity (...) number of participants is 815, far away from the convincing, highly suggestive, or suggestive required evidence levels. All PIs include the null value. Mobility is addressed by 87% of the identified meta-analyses, with 75% of them focusing exclusively in mobility.The findings of this study show a clear need for high quality RCTs examining the effectiveness of rehabilitation interventions addressing activities and participation. The ICF framework may contribute to a holistic approach in chronic stroke
secondary to stroke.A search of the Pubmed, clinicaltrials.gov and Cochrane databases was performed in September 2018. The articles included in this review had to meet the following criteria: randomised controlled trials with therapeutic interventions that evaluated improvement in manual dexterity, measured with the box and block test in patients older than 18 years with a residual deficit secondary to an ischaemic or haemorrhagic stroke in the previous months.Of 371 studies analysed, six were included (...) [Efficacy of Music Therapy in Functional Recovery of the Upper Limb After a Stroke: a Systematic Review and Meta-Analysis]. Formal therapeutic interventions based on music have been used in rehabilitation to stimulate the brain functions involved in movement.The objective of this study was to conduct a systematic review and meta-analysis following the PRISMA recommendations on the effectiveness of music therapy in improving the functionality of the upper limb in patients with hemiparesis