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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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Efficacy and Safety of Botulinum Toxin Type A for Limb Spasticity after Stroke: A Meta-Analysis of Randomized Controlled Trials. Inconsistent data have been reported for the effectiveness of intramuscular botulinum toxin type A (BTXA) in patients with limb spasticity after stroke. This meta-analysis of available randomized controlled trials (RCTs) aimed to determine the efficacy and safety of BTXA in adult patients with upper and lower limb spasticity after stroke.An electronic search
The Effects of Virtual Reality Training on Function in Chronic Stroke Patients: A Systematic Review and Meta-Analysis. The aim of this study was to perform a meta-analysis to examine whether virtual reality (VR) training is effective for lower limb function as well as upper limb and overall function in chronic stroke patients.Three databases, OVID, PubMed, and EMBASE, were used to collect articles. The search terms used were "cerebrovascularaccident (CVA)," "stroke", and "virtual reality (...) ), joint range of motion, gait, balance, and kinematics.The VR training was effective in improving the function in chronic stroke patients, corresponding to a moderate effect size. Moreover, VR training showed a similar effect for improving lower limb function as it did for upper limb function.
Add-On Effects of Chinese Herbal Medicine for Post-Stroke Spasticity: A Systematic Review and Meta-Analysis. Background: Treatment for post-stroke spasticity (PSS) remains a major challenge in clinical practice. Chinese herbal medicine (CHM) is often administered to assist in routine care (RC) in the treatment of PSS, with increasing numbers of clinical research and preclinical studies suggesting that it has potential benefits. Therefore, we conducted a systematic review and meta-analysis
Assistive Technology for the Upper Extremities After Stroke: Systematic Review of Users' Needs. Technical innovations have the potential to compensate for loss of upper-limb motor functions after stroke. However, majority of the designs do not completely meet the needs and preferences of the end users. User-centered design methods have shown that the attention to user perspectives during development of assistive technology leads to devices that better suit the needs of the users.To get more (...) insight into the factors that can bring the design of assistive technology to higher levels of satisfaction and acceptance, studies about user perspectives on assistive technology for the upper limb after stroke are systematically reviewed.A database search was conducted in PubMed, EMBASE, CINAHL, PsycINFO, and Scopus from inception to August 2017, supplemented with a search of reference lists. Methodological quality of the included studies was appraised. User perspectives of stroke survivors, carers
of HRT. The secondary aim was to perform a meta-regression with mean age at trial baseline as the covariate for various outcomes.Younger initiation trials were defined as those with mean age of participants <60 years and older initiation trials were those with mean age >60 years. The primary endpoints included all-cause mortality, cardiac mortality, coronary heart disease (CHD) events (a composite of cardiac mortality and nonfatal myocardial (MI)), and a composite of stroke, transientischemicattack (...) (TIA) and systemic embolism.Thirty-one RCTs were identified comparing HRT users to nonusers (n = 40,521). There was significant heterogeneity of treatment effect between younger versus older HRT initiators for all-cause mortality (Chi2 = 9.74, p = 0.002, I2 = 89.7%), cardiac mortality (Chi2 = 4.04, p = 0.04, I2 = 75.2%), and CHD events (Chi2 = 3.06, p = 0.08, I2 = 67.3%). Both groups experienced an increase in stroke, TIA and systemic embolism (1112/18,774 in the HRT group versus 734/18,070
another.The purpose of this article is to compare the efficacy and safety of first-line contact aspiration and stent-retriever thrombectomy in stroke patients with anterior circulation large-artery occlusion.We undertook a systematic review of studies of patients treated for large-artery occlusion, with the latest devices of either strategy, within six hours of stroke onset. We determined rates of final complete reperfusion (defined as modified Thrombolysis In CerebralInfarction score = 3 (...) First-line contact aspiration vs stent-retriever thrombectomy in acute ischemicstroke patients with large-artery occlusion in the anterior circulation: Systematic review and meta-analysis. In acute ischemicstroke patients with large-artery occlusion, uncertainties remain about whether clinically important outcomes are comparable between first-line contact aspiration and stent-retriever thrombectomy, although two trials have investigated whether one strategy should be preferred over
Acupuncture is effective in improving functional communication in post-stroke aphasia : AÂ systematic review and meta-analysis of randomized controlled trials. In this meta-analysis the authors evaluated the effectiveness of acupuncture in improving functional communication and language function in post-stroke aphasia (PSA) patients.Data sources: MEDLINE, EMBASE, CENTRAL, AMED, SinoMed, CNKI, VIP, and Wanfang databases, ICTRP, ISRCTN, EUCTR, ClinicalTrials.gov, and Stroke Trials Registries (...) . A search was carried out for randomized controlled trials (RCTs) investigating the effects of acupuncture compared with no treatment or placebo acupuncture on post-stroke aphasia (PSA). The searched records were independently screened by two authors, who extracted the data, and assessed risk of bias of the included RCTs. Data aggregation and risk of bias evaluation were conducted on Review Manager Version 5.3. The protocol was registered in the PROSPERO database (CRD42016037543).A total of 28 RCTs
Systematic review and meta-analysis of the prevalence of cognitive impairment no dementia in the first year post-stroke. Increasing attention is being paid to interventions for cognitive impairment (CI) post-stroke, including for CI that does not meet dementia criteria. The aim of this paper was to conduct a systematic review and meta-analysis of the prevalence of cognitive impairment no dementia (CIND) within one year post-stroke.Pubmed, EMBASE and PsychInfo were searched for papers published (...) in English in 1995-2017. Included studies were population or hospital-based cohort studies for first-ever/recurrent stroke, assessing CIND using standardised criteria at 1-12 months post-stroke. Abstracts were screened, followed by full text review of potentially relevant articles. Data were extracted using a standard form, and study quality was appraised using the Crowe Critical Appraisal Tool. A pooled prevalence of CIND with 95% confidence intervals (CI) was estimated using random-effects meta
Association of Elevated Blood Pressure Levels with Outcomes in Acute IschemicStroke Patients Treated with Intravenous Thrombolysis: A Systematic Review and Meta-Analysis. Although arbitrary blood pressure (BP) thresholds exist for acute ischemicstroke (AIS) patients eligible for intravenous thrombolysis (IVT), current international recommendations lack clarity on the impact of mean pre- and post-IVT BP levels on clinical outcomes.Eligible studies involving IVT-treated AIS patients were
Stroke aetiological classification reliability and effect on trial sample size: systematic review, meta-analysis and statistical modelling. Inter-observer variability in stroke aetiological classification may have an effect on trial power and estimation of treatment effect. We modelled the effect of misclassification on required sample size in a hypothetical cardioembolic (CE) stroke trial.We performed a systematic review to quantify the reliability (inter-observer variability) of various (...) stroke aetiological classification systems. We then modelled the effect of this misclassification in a hypothetical trial of anticoagulant in CE stroke contaminated by patients with non-cardioembolic (non-CE) stroke aetiology. Rates of misclassification were based on the summary reliability estimates from our systematic review. We randomly sampled data from previous acute trials in CE and non-CE participants, using the Virtual International Stroke Trials Archive. We used bootstrapping to model
Aldehyde dehydrogenase 2 rs671G>A polymorphism and ischemicstroke risk in Chinese population: a meta-analysis. Introduction: Recently, molecular epidemiological studies have suggested that aldehyde dehydrogenase 2 (ALDH2) rs671 G>A polymorphism may be a risk factor for ischemicstroke (IS). However, the results reported have not been consistent. Methods: We conducted the meta-analysis to explore the precise association between ALDH2 rs671 G>A polymorphism and IS risk. Five online databases
Completeness of reporting of randomised controlled trials including people with transientischaemicattack or stroke: A systematic review. To assess the adherence of stroke randomised controlled trials to Consolidated Standards Of Reporting Trials reporting guidelines and investigate the factors that are associated with completeness of reporting.We took a random sample from the Cochrane Stroke Group's Trial Register of transientischaemicattack or stroke randomised controlled trials, published (...) in English in 1997-2016 inclusive. Two reviewers assessed the published report of the final primary results of stroke randomised controlled trials with a 10-point truncated Consolidated Standards Of Reporting Trials reporting checklist to investigate adherence over time, univariable associations and independent associations with total Consolidated Standards Of Reporting Trials reporting score in a multiple linear regression model.In this random sample of 177 stroke randomised controlled trials, the mean
Overview of systematic reviews with meta-analyses on acupuncture in post-stroke cognitive impairment and depression management. Background: Acupuncture has been using as an alternative non-pharmacological therapy in the management of post stroke depression and cognitive impairment but its effectiveness and safety remain controversial. We conducted an overview of systematic reviews with meta-analyses to evaluate the evidence on the effect of acupuncture in the treatment of stroke (...) with conventional medicine intervention. Methods: Systematic reviews summarized the treatment effects of acupuncture for post stroke cognitive impairment and post stroke depression were considered eligible. Methodological quality of included systematic reviews was assessed using A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR 2). Results: Four systematic reviews on post stroke cognitive impairment and ten systematic reviews on post stroke depression with good methodological quality were included. Meta
Clopidogrel and aspirin after ischemicstroke or transientischemicattack: an updated systematic review and meta-analysis of randomized clinical trials. Recurrent stroke is common immediately following a transientischemicattack (TIA) or ischemicstroke. Dual antiplatelet therapy (DAPT) with clopidogrel and aspirin may provide greater protection against subsequent stroke than monotherapy. Electronic databases were searched for randomized clinical trials (RCTs) comparing DAPT with monotherapy (...) between the two groups and included recurrent TIA (RR 0.88; 95% CI 0.72-1.07), myocardial infarction (RR 1.04; 95% CI 0.84-1.29), vascular death (RR 0.99; 95% CI 0.82-1.19), and any death (RR 1.12; 95% CI 0.88-1.42). Similar findings were observed in patients who presented with minor stroke/TIA. Conclusions: Among patients who presented with ischemicstroke/TIA, short-course clopidogrel plus aspirin immediately following the index event appears to be more effective than and as safe as monotherapy
Effects of Nutrition Therapy in Older Stroke Patients Undergoing Rehabilitation: A Systematic Review and Meta-Analysis. To systematically review evidence on the effects of nutrition therapy in older stroke patients undergoing rehabilitation and identify its effectiveness using meta-analysis.PubMed (MEDLINE), EMBASE (via Dialog), Cochrane Central Register of Controlled Trial, World Health Organization International Clinical Trials Registry Platform and Ichu-shi Web were searched for relevant (...) articles. Randomized controlled trials investigating the effects of nutrition therapy compared to control interventions in older stroke patients undergoing rehabilitation were considered eligible. The primary outcome was activities of daily living (ADL), and secondary outcomes were all-cause mortality, infections, pneumonia incidence, disability level, walking ability, fall, stroke recurrence, and quality of life. The risk of bias of each trial was assessed using the Cochrane Collaboration Tool
Meta-Analysis of Factor V, Factor VII, Factor XII, and Factor XIII-A Gene Polymorphisms and IschemicStroke. Numerous studies examined the association between factors FV, FVII, FXII, and FXIII-A gene polymorphisms and ischemicstroke, but conclusive evidence is yet to be obtained. Thus, this meta-analysis aimed to investigate the novel association of FV rs1800595, FVII rs5742910, FXII rs1801020, and FXIII-A rs5982 and rs3024477 polymorphisms with ischemicstroke risk. A systematic review (...) was performed on articles retrieved before June 2018. Relevant data were extracted from eligible studies and meta-analyzed using RevMan version 5.3. The strength of association between studied polymorphisms and ischemicstroke risk was calculated as odds ratios and 95% confidence intervals, by applying both fixed- and random-effect models. A total of 25 studies involving 6100 ischemicstroke patients and 9249 healthy controls were incorporated in the final meta-analysis model. Specifically, rs1800595
Genetic variants on chromosome 9p21 confer risks of cerebralinfarction in the Chinese population: a meta-analysis. Ischemicstroke (IS) is the leading cause of disability. Researchers have demonstrated that IS is more a multifactorial disorder than a single-factor disease. At present, no consistent conclusions have been reached on susceptibility loci for IS on chromosome 9p21. We conducted this meta-analysis to verify whether genetic loci on chromosome 9p21 reported domestically and abroad
, EMBASE, and Web of Science was performed to identify articles comparing the stroke outcomes of dialysis patients. Hazard ratios (HRs) with 95% confidence intervals (95% CIs) were extracted and synthesized to examine stroke outcomes, including ischemicstroke, hemorrhagic stroke, and overall stroke. Results: The search yielded five studies composed of 1,219,245 patients that were evaluated in the final analysis. The results showed that PD was associated with a lower risk for hemorrhagic stroke (...) compared with HD (HR = 0.78; 95% CI: 0.69-0.88; p < 0.001). For ischemicstroke, the results showed that PD was associated with a higher risk compared with HD among the non-Asian patients (HR = 1.13; 95% CI: 1.05-1.23; p = 0.002), but there were no significant differences between PD and HD for the Asian patients. Similarly, there were no significant differences between the effects of the PD and HD approaches on overall stroke risk. Conclusions: We observed that PD patients were less likely to develop
Interventional closure vs. medical therapy of patent foramen ovale for secondary prevention of stroke: updated meta-analysis. 30374773 2019 12 17 2020 02 25 1861-0692 108 4 2019 Apr Clinical research in cardiology : official journal of the German Cardiac Society Clin Res Cardiol Interventional closure vs. medical therapy of patent foramen ovale for secondary prevention of stroke: updated meta-analysis. 452 10.1007/s00392-018-1382-4 Shah Syed Raza SR North Florida Regional Medical Center (...) , University of Central Florida (Gainesville), 6500 West Newberry Road, Gainesville, FL, 32605, USA. firstname.lastname@example.org. eng Letter 2018 10 29 Germany Clin Res Cardiol 101264123 1861-0684 0 Anticoagulants IM Anticoagulants therapeutic use Cardiac Surgical Procedures methods Conservative Treatment methods Foramen Ovale, Patent complications therapy Humans Middle Aged Secondary Prevention methods Septal Occluder Device Stroke etiology prevention & control 2018 08 09 2018 10 08 2018 10 31 6 0 2019 12 18
Vessel-Wall Magnetic Resonance Imaging of Intracranial Atherosclerotic Plaque and IschemicStroke: A Systematic Review and Meta-Analysis. Introduction: Vessel-wall magnetic resonance imaging (MRI) has been suggested as a valuable tool for assessing intracranial arterial stenosis with additional diagnostic features. However, there is limited conclusive evidence on whether vessel-wall MR imaging of intracranial atherosclerotic plaques provides valuable information for predicting vulnerable (...) lesions. We conducted this systematic review and meta-analysis to evaluate which characteristics of intracranial-plaque on vessel-wall MRI are markers of culprit lesions. Methods: The MEDLINE, EMBASE, and Cochrane Library of Clinical Trials databases were searched for studies reporting the association between vessel-wall MRI characteristics of intracranial plaque and corresponding stroke events. Odds ratios (ORs) for the prevalence of stroke with intracranial-plaque MRI characteristics were pooled