The Neural Basis of Anosognosia for Spatial Neglect After Stroke.
The Neural Basis of Anosognosia for Spatial Neglect After Stroke.
Filed under: Rehab Centers
Stroke. 2012 May 24;
Vossel S, Weiss PH, Eschenbeck P, Saliger J, Karbe H, Fink GR
BACKGROUND AND PURPOSE: The present study investigated the lesion anatomy of anosognosia for visuospatial neglect resulting from right hemispheric stroke. METHODS: In 63 patients, self-ratings of performance in paper-and-pencil tests were contrasted with external performance ratings. Lesion analysis was conducted on patient subgroups with different degrees of anosognosia but comparable visuospatial impairment. RESULTS: Independent of the severity of visuospatial neglect per se, damage to the right angular and superior temporal gyrus was associated with higher levels of anosognosia. CONCLUSIONS: Using a novel assessment of anosognosia for spatial neglect, the present study relates stroke-induced self-awareness deficits to inferior parietal and superior temporal brain damage.
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Poststroke Disposition and Associated Factors in a Population-Based Study: The Dijon Stroke Registry.
Filed under: Rehab Centers
Stroke. 2012 May 24;
Béjot Y, Troisgros O, Gremeaux V, Lucas B, Jacquin A, Khoumri C, Aboa-Eboulé C, Benaïm C, Casillas JM, Giroud M
BACKGROUND AND PURPOSE: The organization of poststroke care will be a major challenge in coming years. We aimed to assess hospital disposition after stroke and its associated factors in clinical practice. METHODS: All cases of stroke from 2006 to 2010 were identified from the population-based Stroke Registry of Dijon, France. Demographic features, risk factors, and prestroke treatments were recorded. Admission stroke severity was assessed using the National Institutes of Health Stroke Scale score. At discharge, we collected dementia, disability using the modified Rankin Scale, length of stay, and hospital disposition (home, rehabilitation, convalescent home, and nursing home). Multivariate analyses were performed using logistic regression models to identify associated factors of postdischarge disposition. RESULTS: Of the patients with 1069 stroke included, 913 survived acute care. Among them, 433 (47.4%) returned home, whereas 206 (22.6%) were discharged to rehabilitation, 134 (14.7%) were admitted to a convalescent home, and 140 (15.3%) to a nursing home. Old patients, those under anticoagulants before stroke, those with severe stroke on admission, severe disability at discharge, dementia, or prolonged length of stay were less likely to return home. Moreover, advanced age, severe initial stroke, severe disability at discharge, and dementia were associated with admission to convalescent and nursing homes rather than rehabilitation centers. CONCLUSIONS: This population-based study demonstrated that postdischarge destinations are associated with several factors. Our findings may be useful to establish health policy concerning the organization of poststroke care.
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Effects of Telerehabilitation on Physical Function and Disability for Stroke Patients: A Randomized, Controlled Trial.
Filed under: Rehab Centers
Stroke. 2012 May 24;
Chumbler NR, Quigley P, Li X, Morey M, Rose D, Sanford J, Griffiths P, Hoenig H
BACKGROUND AND PURPOSE: To determine the effect of a multifaceted stroke telerehabilitation (STeleR) intervention on physical function, and secondarily on disability, in veterans poststroke. METHODS: We conducted a prospective, randomized, multisite, single-blinded trial in 52 veterans with stroke from 3 Veterans Affairs medical centers. Veterans with a stroke in the preceding 24 months were randomized to the STeleR intervention or usual care. The STeleR intervention consisted of 3 home visits, 5 telephone calls, and an in-home messaging device provided over 3 months to instruct patients in functionally based exercises and adaptive strategies. Usual care participants received routine rehabilitation care as prescribed by their physicians. The primary outcome measures were improvement in function at 6 months, measured by both the motor subscale of the Telephone Version of Functional Independence Measure and by the function scales of the Late-Life Function and Disability Instrument. RESULTS: The 2 complementary primary outcomes (Late-Life Function and Disability Instrument Function and Telephone Version of Functional Independence Measure) improved at 6 months for the STeleR group and declined for the usual care group, but the differences were not statistically significant (P=0.25, Late-Life Function and Disability Instrument; P=0.316). Several of secondary outcomes were statistically significant. At 6 months, compared with the usual care group, the STeleR group showed statistically significant improvements in 4 of the 5 Late-Life Function and Disability Instrument disability component subscales (P<0.05), and approached significance in 1 of the 3 Function component subscales (P=0.06). CONCLUSIONS: The STeleR intervention significantly improved physical function, with improvements persisting up to 3 months after completing the intervention. STeleR could be a useful supplement to traditional poststroke rehabilitation given the limited resources available for in-home rehabilitation for stroke survivors.Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00384748. HubMed – rehab
Obesity Negatively Impacts Aerobic Capacity Improvements Both Acutely and 1-Year Following Cardiac Rehabilitation.
Filed under: Rehab Centers
Obesity (Silver Spring). 2012 May 4;
Martin BJ, Aggarwal SG, Stone JA, Hauer T, Austford LD, Knudtson M, Arena R
Cardiac rehabilitation (CR) produces a host of health benefits related to modifiable cardiovascular risk factors. The purpose of the present investigation was to determine the influence of body weight, assessed through BMI, on acute and long-term improvements in aerobic capacity following completion of CR. Three thousand nine hundred and ninety seven subjects with coronary artery disease (CAD) participated in a 12-week multidisciplinary CR program. Subjects underwent an exercise test to determine peak estimated metabolic equivalents (eMETs) and BMI assessment at baseline, immediately following CR completion and at 1-year follow-up. Normal weight subjects at 1-year follow-up demonstrated the greatest improvement in aerobic fitness and best retention of those gains (gain in peak METs: 0.95 ± 1.1, P < 0.001). Although the improvement was significant (P < 0.001), subjects who were initially classified as obese had the lowest aerobic capacity and poorest retention in CR fitness gains at 1-year follow-up (gain in peak eMETs: 0.69 ± 1.2). Subjects initially classified as overweight by BMI had a peak eMET improvement that was also significantly better (P < 0.05) than obese subjects at 1-year follow-up (gain in peak eMETs: 0.82 ± 1.1). Significant fitness gains, one of the primary beneficial outcomes of CR, can be obtained by all subjects irrespective of BMI classification. However, obese patients have poorer baseline fitness and are more likely to "give back" fitness gains in the long term. Obese CAD patients may therefore benefit from additional interventions to enhance the positive adaptations facilitated by CR. HubMed – rehab
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Chronic Migraine Sufferers Invited to Webinar about Treatment Alternative
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Migraine Treatment Centers of America is providing a free online educational session about the Omega™ migraine procedure on May 23 at Noon, CST. On May 23, Migraine Treatment Centers of America will provide a free educational webinar to chronic …
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