Central post-stroke pain syndrome (CPSP) is described by patients as sharp, stabbing, or burning pain and the experience of hyperpathia – an abnormally exaggerated subjective response to painful stimuli and allodynia – where normally non-painful stimuli evoke pain. Pharmacological therapy, magnetic stimulation, and invasive electrical stimulation are reviewed and recommendations made for the treatment of Central post-stroke pain syndrome (CPSP) in Topics in Stroke Rehabilitation, 05/08/2013. The researchers are from the Department of Neurology, Loyola University Chicago, Stritch School of Medicine, Maywood, IL, USA.
Posts Tagged ‘stroke’
7 May
Post-stroke spasticity Management
An estimated 16 million people worldwide experience first-time strokes each yea. Of these two-thirds of stroke patients are younger than 70 years of age. Stroke is therefore a leading cause of disability in adults with functional movement disability being caused by spasticity, cognitive impairment, paresis, and depression. Disabling spasticity is defined as spasticity that is severe enough to require intervention. This post-stroke spasticity occurs in 4% of stroke survivors within 1 year of first-time stroke. Post-stroke spasticity – PSS management and rehabilitation is discussed in Acta Neurologica Scandinavica, 05/07/2013 by Sunnerhagen KS et al. from the Institute of Neuroscience and Physiology – Section for Clinical Neuroscience and Rehabilitation, Gothenburg University, Göteborg, Sweden.
6 May
Home therapy to improve arm and hand function after brain injury in New Zealand
Over 30,000 New Zealanders have a traumatic brain injury (TBI) each year. Added to this only 11 per cent of people with stroke receive any rehabilitation therapy after they leave hospital.
Because of this the Health Research council of New Zealand have awarded two grants to physical therapists from The University of Auckland who will use technologies to treat and support brain injury patietns including stroke after discharge from in patient therapy. Firstly, Dr Kersten and her team will train people in the community who have had a TBI in the past to act as mentors or peer mentors for people with a recent moderate to severe TBI. Participation is considered a fundamental outcome of rehabilitation for people with TBI,” Dr Kersten says.
A second project lead by Dr Stinear will evaluate a new home-coach model of therapy for stroke survivors. In New Zealand, only 11 per cent of people with stroke receive any rehabilitation therapy after they leave hospital. This is despite research that shows rehabilitation therapy is capable of improving hand and arm function months or years after stroke. Dr James Stinear from The University of Auckland says “There are tens of thousands of people living with stroke in our community who have an untapped capacity to recover,” explains Dr Stinear and the objective of this study is to test and design a ‘home-therapy’ protocol.”
After a physiotherapist has assessed the therapy needs of a person with stroke a family member, carer, friend or other volunteer will act as a ‘home-coach’ to deliver daily therapy in the home.
5 May
New Evidence for Therapies in Stroke Rehabilitation
A report in Current Atherosclerosis Reports, 05/03/2013 looks at the evidence based in medicine for physical therapy interventions to promote Neurologic rehabilitation post stroke.
The report by Dobkin BH et al. from Department of Neurology, Geffen School of Medicine, University of California Los Angeles, CA, USA shows that persons with serious stroke do return to participation in usual self-care and daily activities as independently as is feasible. The physical and occupational therapy detailed includes progressive task-related practice of skills, exercise for strengthening and fitness, neurostimulation, and drug and biological manipulations. The group also discuss how intensive practice can induce adaptations at multiple levels of the nervous system which lead to neuroplasticity and functional improvement. The group discuss recent clinical trials to manage walking, reach and grasp, aphasia, visual field loss, and hemi-inattention.
1 May
Chronic pain syndromes after ischemic stroke
Chronic pain syndromes after ischemic stroke and are associated with increased functional dependence and cognitive decline.
Writing in Stroke, 05/01/2013 O’Donnell MJ et al from McMaster University Ontario,Canada looks at a large cohort with ischemic stroke. Of these stroke patients ~ 11% reported new chronic post stroke pain, with 3% central post stroke pain and 1.5% with peripheral neuropathic pain and 1.3% with pain from spasticity. The group concluded that Chronic pain syndromes after ischemic stroke and are associated with increased functional dependence and cognitive decline.
24 Apr
Improving functional ability in stroke patients by improving movement impairments
Do improvements in a specific task used in massed practice therapy transfer to untrained tasks. This question was answered by Schaefer SY et al. from Washington University School of Medicine, St Louis, MO, USA in Neurorehabilitation and Neural Repair, 04/24/2013. The team aimed at showing that task-specific training is a viable approach for recovering motor function after stroke and also to help design task–specific training plans to maximize therapy benefits. The group found that for stroke patients with chronic mild to moderate hemiparesis the improvements in impairments achieved during task practice did transfer to untrained upper-extremity motor tasks e.g washing, feeding and dressing.
21 Apr
Active movement training of ankle improves mobility impairments in stroke and motor function
Active movement training of the ankle improves motor function and mobility post stroke. Waldman G et al. from Feinberg School of Medicine, Northwestern University, IL, USA looked at patients at least 3 months post stroke. Writing in NeuroRehabilitation, 04/19/2013 the group studied Robot-assisted passive stretching and active movement training as a means of intensive stroke rehabilitation for motor impairments post stroke. The outcome measures looked at include reduction in spasticity measured by modified Ashworth scale, mobility by Stroke Rehabilitation Assessment of Movement (STREAM),
and the balance by Berg balance score. Additional outcome measures were isolated movement parameters including dorsiflexion passive range of motion, dorsiflexion active range of motion and dorsiflexor strength after the training.
The MediTouch can be used to give assisted active ankle stroke rehabilitation practice.
21 Apr
Self–management programmes specific to stroke survivors
Self care is about individuals taking responsibility for their own health and well-being.The experience of a stroke event may result in a disruption to the patients daily life. Stroke patients often report have fears that they will have permanent disability and this leads to major concerns over their ability to recover and be productive and engaged with family, friends and coworkers.
Lennon S et al. writing in Clinical Rehabilitation, 04/19/2013 from Physiotherapy, School of Medicine, Flinders University, Adelaide, Australia undertook a literature review to examine the evidence base underlying self–management programmes specific to stroke survivors. The group concluded that further work is needed to confirm the feasibility, acceptability, and efficacy of stroke self–management programmes
