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Introduction: Stroke is characterized by neurological deficits resulting fromacute focal injury to the central nervous system, originating from blood vessels such as cerebral infarction, cerebral hemorrhage and subarachnoid hemorrhage. This study explores the effectiveness of a mind body therapy, specifically the HENS application on Android in reducing stress in post stroke patients. Method: The study employs a quasi-experimental design with a pre-test and post-test with control group. The sampling technique in the study was convenience sampling with a sample size of 48 poststroke patients (24 for each intervention and control group). The HENS application was given to the intervention group. Data was collected using the DASS-42 questionnaire to measure stress level. Paired t-Test and Independent t-Test were used in this study to determine differences in one pre-post paired group and to analyze the changes after intervention between two different groups (post-post intervention) Result: The results revealed significant changes in stress levels before and after the six-day intervention with the HENS Application. The intervention group showed a p value=0.000 indicating a significant reduction in stress levels. In contrast, p value for the control group's was 0.853, suggesting no significant change without treatment. Conclusion: The HENS application has the potential to provide post-stroke patients with independent support for managing stress. It offers clear and useful guidelines for implementing HENS techniques which can improve confidence of post stroke patients in independently managing stress. [ABSTRACT FROM AUTHOR]

The imbalance in oxidative stress in acute stroke has been extensively studied; on the contrary, its investigation in the subacute phase is limited. The aim of this study was to analyse the variation in the systemic oxidative status in subacute post-stroke patients before (T0) and after a six-week rehabilitation treatment (T1) and to investigate the relationship between systemic oxidative status and rehabilitation outcomes. We enrolled 109 subjects in two different centres, and we analysed their serum hydroperoxide levels (d-ROMs), biological antioxidant power (BAP), thiol antioxidant components (-SHp), and relative antioxidant capacity (OSI and SH-OSI indices). Activity of Daily Living (ADL), hand grip strength, and walking endurance were evaluated using the modified Barthel Index, the Hand Grip test, and the 6-min walk test, respectively. At T0, most of the patients showed very high levels of d-ROMs and suboptimal levels of the BAP, OSI, and SH-OSI indices. Comparing the T1 and T0 data, we observed an improvement in the rehabilitation outcomes and a significant decrease in d-ROMs (549 ± 126 vs. 523 ± 148, p = 0.023), as well as an improvement in the OSI and SH-OSI indices (4.3 ± 1.3 vs. 4.7 ± 1.5, p = 0.001; 11.0 ± 0.4 vs. 1.2 ± 0.4, p < 0.001). In addition, significant correlations were seen between the oxidative stress parameters and the rehabilitation outcomes. These results suggest monitoring the systemic oxidative stress status in post-stroke patients in order to plan a tailored intervention, considering its relationship with functional recovery. [ABSTRACT FROM AUTHOR]

Stroke is damage to brain tissue due to disruption of blood flow to the brain. One impact in stroke patients is weakness on one side of the body or hemiparesis. The management of stroke includes physical rehabilitation. However, many post-stroke patients still do not comply with physical rehabilitation, so education is needed about the importance of complying with physical rehabilitation to accelerate recovery and restore movement function in post-stroke patients. The purpose of this study is to develop Stroke Care Education and analyze its effectiveness on adherence to physical rehabilitation in post-stroke patients. The design of this study used Research and Development (R&D) and a quasy experiment with a pretest-posttest control group design which was carried out for 21 days. The sampling technique used purposive sampling which consisted of 60 respondents who were divided into the intervention and control groups. The intervention group was given YouTube-based Stroke Care Education twice a day (20 minutes), while the control group was given a leaflet. The measurement method used a level of adherence questionnaire, namely the Morinsky Medication Adherence Scale (MMAS) with low, medium, and high measurement values. The data were analyzed using the Wilcoxon test and the Mann-Whitney test. The results of this study YouTube-based Stroke Care Education is suitable for use for post-stroke patients with a validity test result value of 87.5%. The statistical test results showed an increase in adherence to physical rehabilitation in the intervention group compared to the control group, from an average score of 4.40 to 7.57. Meanwhile, in the control group, it increased from 3.77 to 4.23 with a value of p = 0.000. In conclusion, YouTube-based Stroke Care Education is effective in increasing adherence to physical rehabilitation in post-stroke patients.

Stroke adalah salah satu penyebab kematian dan kecacatan yang akan berdampak terhadap ekonomi dan kualitas hidup. Tujuan dari penelitian ini adalah untuk mengukur kualitas hidup pasien post stroke dan membandingkan nilai kualitas hidupnya dengan kualitas hidup populasi masyarakat Indonesia. Metode penelitian yang digunakan adalah non-eksperimental cross-sectional dan teknik pengambilan sampel menggunakan non-probability sampling. Data kualitas hidup masyarakat Indonesia diperoleh dari artikel yang telah dipublikasi sebelumnya. Data kualitas hidup pasien post stroke diperoleh dari hasil pengisian kuesioner di salah satu rumah sakit khusus di Sumatra Barat dan data lainnya diperoleh dari rekam medis pasien. Penilaian kualitas hidup menggunakan kuesioner EQ-5D-5L dan EQ-VAS versi bahasa Indonesia. Sebanyak 109 pasien post stroke terlibat dalam penelitian. Nilai rata-rata utilitas pasien post stroke dengan menggunakan EQ-5D-5L adalah 0,47±0,16dan rata-rata skor EQ-VAS adalah 76,88±10,81. Nilai rata-rata kualitas hidup pasien post stroke dibawah nilai rata-rata kualitas hidup masyarakat Indonesia yaitu 0,91±0,11 (EQ-5D-5L) dan 79,39±14,01 (EQ-VAS). Dapat disimpulkan terdapat perbedaan yang signifikan kualitas hidup pasien post stroke dengan masyarakat umum Indonesia (nilai p< 0,001) dengan menggunakan kuesioner EQ-5D-5L dan kualitas hidup masyarakat Indonesia lebih baik dibandingkan pasien post stroke.

The imbalance in oxidative stress in acute stroke has been extensively studied; on the contrary, its investigation in the subacute phase is limited. The aim of this study was to analyse the variation in the systemic oxidative status in subacute post-stroke patients before (T0) and after a six-week rehabilitation treatment (T1) and to investigate the relationship between systemic oxidative status and rehabilitation outcomes. We enrolled 109 subjects in two different centres, and we analysed their serum hydroperoxide levels (d-ROMs), biological antioxidant power (BAP), thiol antioxidant components (-SHp), and relative antioxidant capacity (OSI and SH-OSI indices). Activity of Daily Living (ADL), hand grip strength, and walking endurance were evaluated using the modified Barthel Index, the Hand Grip test, and the 6-min walk test, respectively. At T0, most of the patients showed very high levels of d-ROMs and suboptimal levels of the BAP, OSI, and SH-OSI indices. Comparing the T1 and T0 data, we observed an improvement in the rehabilitation outcomes and a significant decrease in d-ROMs (549 ± 126 vs. 523 ± 148, p = 0.023), as well as an improvement in the OSI and SH-OSI indices (4.3 ± 1.3 vs. 4.7 ± 1.5, p = 0.001; 11.0 ± 0.4 vs. 1.2 ± 0.4, p < 0.001). In addition, significant correlations were seen between the oxidative stress parameters and the rehabilitation outcomes. These results suggest monitoring the systemic oxidative stress status in post-stroke patients in order to plan a tailored intervention, considering its relationship with functional recovery.

Strokes can cause disability and death. The disability experienced causes post-stroke stress syndrome, which results in maladaptive coping strategies. Coping strategies is important because it affects the patient's outcome and recovery. The purpose of this study was to determine the factors that influence coping strategies in post-stroke patients based on the results of a literature study. Journals from several databases such as Google Scholar (n=8), ProQuest (n=5), Science Direct (n=1), PubMed (n=1), and Springer Link (n=3) were selected. The data search used several keywords and conjunctions (AND and OR). Based on specified criteria such as journals within the last 5 years (2016-2020), in English, research articles, open access, and full text, post-stroke patient population, intervention, and comparison according to research methods, journal findings, and outcomes that discuss coping strategies. Journal findings were tested for quality using the adjusted JBI and analysed using thematic analysis. The results showed that several factors influenced coping strategies in post-stroke patients such as psychological (16%), social support (13%), self-ability (13%), sequelae (10%), spiritual (9%), stroke severity (9%), material (6%), dependence (6%), rehabilitation (6%), care (3%), gender (3%), lack of information (3%), and perception of disease (3%). Coping strategies for post-stroke patients that focus on problems and emotions. [ABSTRACT FROM AUTHOR]

Dementia is a term that represents a set of symptoms that affect the ability of the brain's cognitive functions related to memory, thinking, behavior, and language. At worst, dementia is often called a major neurocognitive disorder or senile disease. One of the most common types of dementia after Alzheimer's is vascular dementia. Vascular dementia is closely related to cerebrovascular disease, one of which is stroke. Post-stroke patients with recurrent onset have the potential to develop dementia. An accurate diagnosis is needed for proper therapy management to ensure the patient's quality of life and prevent it from worsening. The gold standard diagnostic of vascular dementia is complex, includes psychological tests, complete memory tests, and is evidenced by medical imaging of brain lesions. However, brain imaging methods such as CT-Scan, PET-Scan, and MRI have high costs and cannot be routinely used in a short period. For more than two decades, electroencephalogram signal analysis has been an alternative in assisting the diagnosis of brain diseases associated with cognitive decline. Traditional EEG analysis performs visual observations of signals, including rhythm, power, and spikes. Of course, it requires a clinician expert, time consumption, and high costs. Therefore, a quantitative EEG method for identifying vascular dementia in post-stroke patients is discussed in this study. This study used 19 EEG channels recorded from normal elderly, post-stroke with mild cognitive impairment, and post-stroke with dementia. The QEEG method used for feature extraction includes relative power, coherence, and signal complexity; the evaluation performance of normal-mild cognitive impairment-dementia classification was conducted using Support Vector Machine and K-Nearest Neighbor. The results of the classification simulation showed the highest accuracy of 96% by Gaussian SVM with a sensitivity and specificity of 95.6% and 97.9%, respectively. This study is expected to be an additional criterion in the diagnosis of dementia, especially in post-stroke patients. [ABSTRACT FROM AUTHOR]

Soft robotic glove with brain computer interfaces (BCI) control has been used for post-stroke hand function rehabilitation. Motor imagery (MI) based BCI with robotic aided devices has been demonstrated as an effective neural rehabilitation tool to improve post-stroke hand function. It is necessary for a user of MI-BCI to receive a long time training, while the user usually suffers unsuccessful and unsatisfying results in the beginning. To propose another non-invasive BCI paradigm rather than MI-BCI, steady-state visually evoked potentials (SSVEP) based BCI was proposed as user intension detection to trigger the soft robotic glove for post-stroke hand function rehabilitation. Thirty post-stroke patients with impaired hand function were randomly and equally divided into three groups to receive conventional, robotic, and BCI-robotic therapy in this randomized control trial (RCT). Clinical assessment of Fugl-Meyer Motor Assessment of Upper Limb (FMA-UL), Wolf Motor Function Test (WMFT) and Modified Ashworth Scale (MAS) were performed at pre-training, post-training and three months follow-up. In comparing to other groups, The BCI-robotic group showed significant improvement after training in FMA full score (10.05 ± 8.03, p = 0.001), FMA shoulder/elbow (6.2 ± 5.94, p = 0.0004) and FMA wrist/hand (4.3 ± 2.83, p = 0.007), and WMFT (5.1 ± 5.53, p = 0.037). The improvement of FMA was significantly correlated with BCI accuracy (r = 0.714, p = 0.032). Recovery of hand function after rehabilitation of SSVEP-BCI controlled soft robotic glove showed better result than solely robotic glove rehabilitation, equivalent efficacy as results from previous reported MI-BCI robotic hand rehabilitation. It proved the feasibility of SSVEP-BCI controlled soft robotic glove in post-stroke hand function rehabilitation.

Background: Poor diet quality has been found to be an independent risk factor for mortality in stroke. However, it is unknown to what extent Neurologists are trained and are comfortable enough to provide dietary counseling to stroke patients. Objective: To assess the knowledge, attitudes, and practices of neurology residents relating to dietary counseling of stroke patients. Methods: An online anonymous survey was administered to neurology residents throughout the country between August and November 2019 among a total of 109 (68%) US neurology programs. Self-reported practices and knowledge regarding stroke prevention through nutritional counseling were queried using validated questionnaires. Results: 453 responses out of a potential 672 were received. A minority of residents (12.3%) consistently offered nutritional counseling to stroke patients. 47.7% considered that it was not the neurologist's role to provide nutritional counseling to stroke patients. 83.4% of residents felt that it was the responsibility of the dietician to provide nutritional counseling, yet only 21.4%of residents consistently referred stroke patients to a dietician. 77.9% of respondents felt nutritional counseling is important for stroke patients, yet 65.6% felt they were not adequately trained to provide nutritional counseling. Conclusion: Neurologists in training believe diet to be an important part of stroke prevention, but practical knowledge and training in nutrition are suboptimal. This study suggests the need to include nutrition as an integral part of neurology training, to ensure neurologists feel empowered to be an important part of the team providing nutritional counseling to stroke patients. [ABSTRACT FROM AUTHOR]

Soft robotic glove with brain computer interfaces (BCI) control has been used for post-stroke hand function rehabilitation. Motor imagery (MI) based BCI with robotic aided devices has been demonstrated as an effective neural rehabilitation tool to improve post-stroke hand function. It is necessary for a user of MI-BCI to receive a long time training, while the user usually suffers unsuccessful and unsatisfying results in the beginning. To propose another non-invasive BCI paradigm rather than MI-BCI, steady-state visually evoked potentials (SSVEP) based BCI was proposed as user intension detection to trigger the soft robotic glove for post-stroke hand function rehabilitation. Thirty post-stroke patients with impaired hand function were randomly and equally divided into three groups to receive conventional, robotic, and BCI-robotic therapy in this randomized control trial (RCT). Clinical assessment of Fugl-Meyer Motor Assessment of Upper Limb (FMA-UL), Wolf Motor Function Test (WMFT) and Modified Ashworth Scale (MAS) were performed at pre-training, post-training and three months follow-up. In comparing to other groups, The BCI-robotic group showed significant improvement after training in FMA full score (10.05 ± 8.03, p = 0.001), FMA shoulder/elbow (6.2 ± 5.94, p = 0.0004) and FMA wrist/hand (4.3 ± 2.83, p = 0.007), and WMFT (5.1 ± 5.53, p = 0.037). The improvement of FMA was significantly correlated with BCI accuracy (r = 0.714, p = 0.032). Recovery of hand function after rehabilitation of SSVEP-BCI controlled soft robotic glove showed better result than solely robotic glove rehabilitation, equivalent efficacy as results from previous reported MI-BCI robotic hand rehabilitation. It proved the feasibility of SSVEP-BCI controlled soft robotic glove in post-stroke hand function rehabilitation. [ABSTRACT FROM AUTHOR]

Post-stroke sufferers will generally experience weakness on one side of the body, balance, vision, sensory, motor, and cognitive. In West Kalimantan, the estimated stroke sufferer in 2013 was 25,195 people. Based on data from the Public Hospital of Dr. Soedarso Pontianak shows a significant increase from January 2018 to December 2018 totaling 722 people. The research objective was to assess the effectiveness of the finger exoskeleton tool in simple motor therapy on the ability of the client's arm and hand muscles after a stroke. This study used a quantitative approach with a quasi-experimental design. Pre-test and Post-test Nonequivalent Control Group with two groups, which were the control group of 12 people and the intervention group of 12 people with finger exoskeleton tools. The statistical test used was the independent t test and paired t test. Measurement of muscle ability with the Action Research Arm Test. Analysis of the difference in total scores between before and after treatment in the intervention group using Paired T-Test obtained a p-value of 0.000 (p value

Introduction: Shoulder joint pain in hemiplegic patients is a common complication which interferes with the therapeutic exercises, influences activities of daily living, social participation and delays the recovery process. Various treatment methods have been given to prevent and manage the Hemiplegic Shoulder Pain (HSP). The purpose of present systematic review was to find the study which is most effective in HSP. Aim: To determine the most effective method used in physical therapy for the management of HSP. Materials and Methods: In the present systematic review, a search of PubMed, Physiotherapy Evidence Database (PEDro), CINHAL, Scopus database, Google Scholar, Cochrane Library Register of control trials and bibliography was conducted from January 2016 to March 2020. Randomised clinical trials were included in the review. The methodological quality of the identified Randomised Controlled Trials (RCTs) was assessed using the McMaster Critical Appraisal Tool. The RCTs which scored less than 9 out of 15 or below 64.2% on McMaster Critical Appraisal Tool were not included into the systematic review. Results: A total of 1337 citations were identified, however, only six RCTs matched the eligibility criteria and were included in the review. The identified studies were similar in design. Investigated diverse physical therapy modalities that were applied for dissimilar periods, and outcome measures assessed at different periods which shown inconsistent results. Conclusion: This systematic review found evidence for improvement in HSP in those treated with Kinesiotaping (KT) and Electromyography (EMG) triggered Neuromuscular Electrical Stimulaton (NMES) with bilateral arm training. However, more number of RCTs needed to substantiate the results.

Burkina Faso does not have specialized physical medicine and rehabilitation services, equipped, organized in coordinated interdisciplinary teams, suggesting a pejorative post-stroke functional outcome. The aims of the present study were to describe the characteristics of functional rehabilitation, to assess motor functional recovery and return to work, 3 months after stroke in a hospital, of reference in Ouagadougou, Burkina Faso, in order to contribute improving the functional future and professional reintegration of stroke patients. Patients and methods: This was a prospective cohort, observational, descriptive study, which took place from December 01, 2016 to May 30, 2018, at Tingandogo University Hospital, in Ouagadougou, Burkina Faso. The study concerned all patients aged > 18 years, having been hospitalized in said CHU for cerebral infarction or intracerebral hemorrhage (ICH) during the study period, confirmed by brain scan or encephalic MRI, having benefited from outpatient neurological follow-up and functional motor rehabilitation in the various functional rehabilitation centers and / or physiotherapy practices in the city of Ouagadougou, for at least 3 months after the stroke. The socio-demographic and clinical characteristics, the nature of the stroke, the functional outcome according to the modified Rankin score (mRS) at the end of hospitalization, then at one month and finally at three months poststroke, were analyzed. The data on motor rehabilitation were obtained thanks to the collaboration of physiotherapists and speech therapists. The data on the recovery of professional activities were entered at 3 months post-stroke, during neurological follow-up at 3 months post-stroke. Data entry and analysis were carried out using the EPI INFO software in its English version 7.2.1.0. The significance level was 5%. Results: In all 232 patients were collected, that is 146 patients (62.9%) with cerebral infarction and 86 patients (37.1%) with intracerebral hemorrhage; the average age was 60.9 +/- 14.5 years (range 26 and 99 years); the age group of 60 to 70 years, with 55 patients (23.7%) was the most represented. Male patients with 146 cases (62.9%) were the most numerous. Co-morbidities were found in 111 patients (47.8 %). On admission, the neurological deficit was severe to very severe (NIHSS> 16) in 83 patients (35.8%); a motor deficit was present in 150 patients (64.9%). The cumulative mortality rates at 3 months post-stroke were respectively 24.14% at the end of hospitalization, 26.72% at one month and 31.03% at 3 months post-stroke. Among the survivors, respectively, 77.3%, 67.1% and 43.1% of patients dependent on activities of daily living, respectively at the end of hospitalization, at one month and at 3 months after stroke. Functional motor rehabilitation was indicated in 125 patients (53.9%), however, only 101 patients (80.8%) received it. Physiotherapy was judged to be of poor quality in 42 patients (41.6%). Among the survivors, a recovery of professional activities was noted in 55 patients (41.7%) at 3 months after stroke. Conclusion : In our study, functional rehabilitation was incomplete, limited to physiotherapy alone. At 3 months poststroke, more than half of the survivors had regained autonomy in the activities of daily living, while professional reintegration only concerned about two survivors in 5. Our study underlines the interest of the implementation. of specialized PRM services, within the post-stroke care sectors. [ABSTRACT FROM AUTHOR]

Abstract Background The delivery of post stroke care is fragmented even in advanced public healthcare systems, globally. Primary care teams are entrusted to provide longer term care for stroke survivors in most developing countries. The integrated Care Pathway for Post Stroke patients (iCaPPS©) was designed to guide primary care teams to incorporate further rehabilitation and regular screening for post stroke complications among patients residing at home in communities, using the shared-care approach, especially in areas with limited access to specialist stroke care services. The iCaPPS© addressed coordination of rehabilitation and screening for post stroke complications which were absent in the current conventional care of patients managed at public primary care healthcentres. This study aimed to evaluate the cost effectiveness and impact of iCaPPS© on quality-adjusted- life-years (QALY) compared with current conventional monitoring at public primary care healthcentres. Methods A pragmatic healthcentre-based cluster randomised controlled trial-within trial on 151 post stroke patients from 10 public primary care facilities in Peninsular Malaysia was conducted to evaluate QALY of patients managed with iCaPPS© (n = 86) vs conventional care (n = 65) for 6 months. Costs from societal perspective were calculated, using combination of top down and activity-based costing methods. The 5-level EQ5D (EQ-5D-5 L) was used to calculate health state utility scores. Cost per QALY and incremental cost effectiveness ratio (ICER) were determined. Differences within groups were determined using Mann-Whitney tests. Results Total costs for 6 months treatment with iCaPPS© was MYR790.34, while conventional care cost MYR527.22. Median QALY for iCaPPS© was 0.55 (0,1.65) compared to conventional care 0.32 (0, 0.73) (z = − 0.21, p = 0.84). Cost per QALY for iCaPPS© was MYR1436.98, conventional care was MYR1647.56. The ICER was MYR1144.00, equivalent to 3.7% of per capita GDP (2012 prices). Conclusions Management of post stroke patients in the community using iCaPPS© costs less per QALY compared to current conventional care and is very cost effective. Trial registration Trial Registration number ACTRN12616001322426. Registered 21 September 2016. (Retrospectively registered).

Background: Stroke is currently the main cause of disability worldwide. Telerehabilitation is a rehabilitation approach that can be used to repair the damage to motor, sensory and cognitive functions. This can also substantially reduce the travel time for the health workers and therefore increase the number of patients who are consulted in a day. Method: A search using specific keywords was done in both the journal articles and in the database. In total, 119 articles were from Scopus, 45 articles were from PubMed, 87 articles were from Science Direct, 52 articles were from EBSCO and 97 articles were from Proquest. There were 15 articles that matched the inclusion criteria. Most of the available literature only refers to short-term results and most of the research is of low quality. Result: Evidence of the relative effectiveness was found in the types of videos, VR, cellphones and computer use. The location of the network support and technological progress are still obstacles that must be addressed immediately. Based on the current scientific evidence, only a few telerehabilitation methods can be recommended for wider use. Conclusion: The telerehabilitation system can provide long-term therapy, meet the patient needs and save the health resources needed to minimize the severity of the patients’ condition. The application of telerehabilitation is used by the nurses to optimize their role in improving patient health and telerehabilitation will answer the problem of penetrating the distance dimension.

Dementia is a term that represents a set of symptoms that affect the ability of the brain’s cognitive functions related to memory, thinking, behavior, and language. At worst, dementia is often called a major neurocognitive disorder or senile disease. One of the most common types of dementia after Alzheimer’s is vascular dementia. Vascular dementia is closely related to cerebrovascular disease, one of which is stroke. Post-stroke patients with recurrent onset have the potential to develop dementia. An accurate diagnosis is needed for proper therapy management to ensure the patient’s quality of life and prevent it from worsening. The gold standard diagnostic of vascular dementia is complex, includes psychological tests, complete memory tests, and is evidenced by medical imaging of brain lesions. However, brain imaging methods such as CT-Scan, PET-Scan, and MRI have high costs and cannot be routinely used in a short period. For more than two decades, electroencephalogram signal analysis has been an alternative in assisting the diagnosis of brain diseases associated with cognitive decline. Traditional EEG analysis performs visual observations of signals, including rhythm, power, and spikes. Of course, it requires a clinician expert, time consumption, and high costs. Therefore, a quantitative EEG method for identifying vascular dementia in post-stroke patients is discussed in this study. This study used 19 EEG channels recorded from normal elderly, post-stroke with mild cognitive impairment, and post-stroke with dementia. The QEEG method used for feature extraction includes relative power, coherence, and signal complexity; the evaluation performance of normal-mild cognitive impairment-dementia classification was conducted using Support Vector Machine and K-Nearest Neighbor. The results of the classification simulation showed the highest accuracy of 96% by Gaussian SVM with a sensitivity and specificity of 95.6% and 97.9%, respectively. This study is expected to be an additional criterion in the diagnosis of dementia, especially in post-stroke patients.

Wernicke's aphasia is a type of aphasia caused by damage to parts of the brain associated with language comprehension. Those who experience Wernicke's aphasia generally cannot understand the words said by others or themselves. This condition occurs in adults who have had a stroke due to a blockage or rupture of blood vessels in the brains of left and right hemispheres. This article discusses one model of language therapy that can be done to restore the ability of production and language competence in patients with post-stroke Wernicke's aphasia in the form of inclusive therapy. This research uses qualitative methods, using theoretical and methodological approaches (Maseleno et al., 2019). The focus of the study is a case study of one post-stroke patient suffering from Wernicke's aphasia. The results showed that people with Wernicke's aphasia still had cognitive abilities in language. The difficulty lies in syntactically and semantically speaking language production. There are three models of therapy conducted in an inclusive and integrated, ie physiological recovery post-stroke therapy, language competency restoration therapy, and motivational therapy. The therapy is carried out regularly and continuously can accelerate the process of restoring language competence for sufferers of post-stroke Aphasia Wernicke. [ABSTRACT FROM AUTHOR]

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Abstract Background Patients with acute ischemic stroke are at a higher risk of developing cognitive impairment which could be often attributed to cytokine activation. Objectives To explore the relationship between the cognitive performance and the inflammatory markers in the ischemic stroke patients at the early stage. Patients and methods A cross-sectional case-control study was performed on 44 ischemic stroke patients. The patients underwent the following battery of evaluation: (A) assessment of stroke disability by modified Rankin Scale (mRS) and National Institute of Health Stroke Scale (NIHSS). (B) neuropsychological evaluation using Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) scale, trail making test (TMT), and Controlled Oral Word Association Test (COWAT). (C) Assessment of depression was done by using Beck Depression Inventory (BDI). Measurement of the serum levels of ESR, C-reactive protein, and IL-8 was done. This study included 44 ages, sex, and educational level matched controls for comparison of neuropsychological tests and serum level of IL-8. Results The patients showed worse performance in neuropsychological tests (MMSE, MoCA, COWAT, TMT) than the controls. There was a significant negative correlation between the serum level of IL-8 and (MoCA) (r = − 0.43, p = 0.004), verbal fluency (r = − 0.56, p

Background: Stroke is a disease of brain function disorder of the nerves in the form of local and global roomates have impact to physical and physcological. Stroke is the third causes of death in Indonesia and in South Kalimantan every 9.2 per mill areas, stroke cases had happened. There are 1258 cases in 2015 hospitalized in Ulin General Hospital. Purpose: To analyze the effect of self-efficacy on towards the Independence level of post-stroke patient in general hospital neuro policlinic Ulin Banjarmasin Methods: The methodology that use in this study is descriptive analytics, the total respondents in this study is 33 respondents. Collecting the data in this study is using the Stroke Self-Efficacy and Barthel index questionare. The Data Analyzed by Kendal Tau test Result: According to this study to 33 respondent Obtained results. The respondents who have high self efficafy as 25 (75.7%), moderate self efficacy as many as seven respondents (21.2%) and has low self-efficacy is one respondents (3.0%) and to the independence levelof post-stroke patient variables who had Categorized to independence are 14 respondents (42.4%), need minimal assistance 5 respondents (15.2%), partially need assistance in three respondents (9.0%), dependece assistance is five respondents (15.2%) and total assistance in six respondents (18.2%). the analysis result by Kendal Tau get p value = 0.044. the strength of the correlation is r = 310 it was statethat signifficant there is a moderate correlation and the direction are positive correlation. Conclusion: There signifficant There is correlation between self-efficacy to the Independence level of post-stroke patient

Objective: This meta-analysis evaluated the efficacy of acupuncture in improving cognitive impairment of post-stroke patients.Design: Randomized controlled trials (RCTs) investigating the effects of acupuncture compared with no treatment or sham acupuncture on post-stroke cognitive impairment (PSCI) before December 2019 were identified from databases (PubMed, EMBASE, Ovid library, Cochrane Library, Chinese National Knowledge Infrastructure, VIP Chinese Periodical Database, Wanfang Database, and SinoMed). The literature searching and data extracting were independently performed by two investigators. Study quality was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analyses were performed for the eligible RCTs with Revman 5.3 software.Results: Thirty-seven RCTs (2,869 patients) were included in this meta-analysis. Merged Random-effects estimates of the gain of MMSE (Mini-Mental State Examination) or MoCA (Montreal Cognitive Assessment) were calculated for the comparison of acupuncture with no acupuncture or sham acupuncture. Following 2–8 weeks of intervention with acupuncture, pooled results demonstrated significant effects of acupuncture in improving PSCI assessed by MMSE (MD [95% CI] = 2.88 [2.09, 3.66], p < 0.00001) or MoCA (MD [95% CI] = 2.66 [1.95, 3.37], p < 0.00001).Conclusion: The results suggest that acupuncture was effective in improving PSCI and supported the needs of more rigorous design with large-scale randomized clinical trials to determine its therapeutic benefits.

Introduction: The incidence of recurrent strokes is increasing accompanied by the absence of intensive monitoring of physical activity that needs to be more addressed. The aims of intensively monitoring of physical activity to reduce disruption/ disability for life, to decrease the economic burden of the family, and to reduce the risk of death in stroke patients. Objectives: The purpose of this study was to determine the physical activity of patients after stroke attack. Method: We used an observational study design by case control approach, without giving certain treatment to the subjects of this study. We collected the demographic data from the participants and the International Physical Activity Questionnaire was used to measure the physical activity. The study was conducted at Aisyiyah Islamic Hospital in Malang, the average population was 30 people per month and samples were taken using purposive sampling technique. Data was collected by IPAQ questionnaire consisting of activities carried out around the house, activities at work and recreation activities and observation sheets. Results: The results showed that most physical activity of stroke sufferers was in the mild category (68.3%. Dicussion: It is recommended that respondents continue to do physical activity to reduce the prevalence of stroke recurrence.

Objective: This meta-analysis evaluated the efficacy of acupuncture in improving cognitive impairment of post-stroke patients. Design: Randomized controlled trials (RCTs) investigating the effects of acupuncture compared with no treatment or sham acupuncture on post-stroke cognitive impairment (PSCI) before December 2019 were identified from databases (PubMed, EMBASE, Ovid library, Cochrane Library, Chinese National Knowledge Infrastructure, VIP Chinese Periodical Database, Wanfang Database, and SinoMed). The literature searching and data extracting were independently performed by two investigators. Study quality was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analyses were performed for the eligible RCTs with Revman 5.3 software. Results: Thirty-seven RCTs (2,869 patients) were included in this meta-analysis. Merged Random-effects estimates of the gain of MMSE (Mini-Mental State Examination) or MoCA (Montreal Cognitive Assessment) were calculated for the comparison of acupuncture with no acupuncture or sham acupuncture. Following 2–8 weeks of intervention with acupuncture, pooled results demonstrated significant effects of acupuncture in improving PSCI assessed by MMSE (MD [95% CI] = 2.88 [2.09, 3.66], p < 0.00001) or MoCA (MD [95% CI] = 2.66 [1.95, 3.37], p < 0.00001). Conclusion: The results suggest that acupuncture was effective in improving PSCI and supported the needs of more rigorous design with large-scale randomized clinical trials to determine its therapeutic benefits. [ABSTRACT FROM AUTHOR]

Background & Aims: Stroke is a significant health problem with high prevalence and mortality worldwide. In Indonesia, it is the first leading cause of death after ischemic heart disease in 2017. As Barthel Index has been regarded as the best outcome measure used in rehabilitation of people with stroke, this study sought to determine the construct validity of the Indonesian version of the tool. Specifically, the study looked into the inter-rater reliability of the tool, the problems encountered by participants with the English version and the corresponding modifications to be incorporated in the Indonesian version. Method: Utilizing an exploratory sequential mixed method design and involving five different groups of participants with a total of 391, the study began with the forward and backward translation of the English Barthel Index followed by the validation, reliability and validity testing of the Indonesian version. Result: Results showed that inter-rater reliability is satisfactory. Some terms in the English version were modified to suit the linguistic and cultural context of Indonesia. In terms of content validity, the Indonesian version of Barthel Index is acceptable. The construct validity test revealed two major factors, namely, functional performance and physiological function. Conclusion: it thereby provides a baseline data to advance knowledge on the use standardized tool like BI, to further improve nursing practice in the stroke room, and to enhance the nursing education curriculum. [ABSTRACT FROM AUTHOR]

Background: The delivery of post stroke care is fragmented even in advanced public healthcare systems, globally. Primary care teams are entrusted to provide longer term care for stroke survivors in most developing countries. The integrated Care Pathway for Post Stroke patients (iCaPPS©) was designed to guide primary care teams to incorporate further rehabilitation and regular screening for post stroke complications among patients residing at home in communities, using the shared-care approach, especially in areas with limited access to specialist stroke care services. The iCaPPS© addressed coordination of rehabilitation and screening for post stroke complications which were absent in the current conventional care of patients managed at public primary care healthcentres. This study aimed to evaluate the cost effectiveness and impact of iCaPPS© on quality-adjusted- life-years (QALY) compared with current conventional monitoring at public primary care healthcentres.Methods: A pragmatic healthcentre-based cluster randomised controlled trial-within trial on 151 post stroke patients from 10 public primary care facilities in Peninsular Malaysia was conducted to evaluate QALY of patients managed with iCaPPS© (n = 86) vs conventional care (n = 65) for 6 months. Costs from societal perspective were calculated, using combination of top down and activity-based costing methods. The 5-level EQ5D (EQ-5D-5 L) was used to calculate health state utility scores. Cost per QALY and incremental cost effectiveness ratio (ICER) were determined. Differences within groups were determined using Mann-Whitney tests.Results: Total costs for 6 months treatment with iCaPPS© was MYR790.34, while conventional care cost MYR527.22. Median QALY for iCaPPS© was 0.55 (0,1.65) compared to conventional care 0.32 (0, 0.73) (z = - 0.21, p = 0.84). Cost per QALY for iCaPPS© was MYR1436.98, conventional care was MYR1647.56. The ICER was MYR1144.00, equivalent to 3.7% of per capita GDP (2012 prices).Conclusions: Management of post stroke patients in the community using iCaPPS© costs less per QALY compared to current conventional care and is very cost effective.Trial Registration: Trial Registration number ACTRN12616001322426. Registered 21 September 2016. (Retrospectively registered). [ABSTRACT FROM AUTHOR]

Stroke is a leading cause of death and disability and is responsible for a significant economic burden. Sarcopenia and cognitive dysfunction are common consequences of stroke, but there is less awareness of the concurrency of these conditions. In addition, few reviews are available to guide clinicians and researchers on how to approach sarcopenia and cognitive dysfunction as comorbidities after stroke, including how to assess and manage them and implement interventions to improve health outcomes. This review synthesises current knowledge about the relationship between post-stroke sarcopenia and cognitive dysfunction, including the physiological pathways, assessment tools, and interventions involved.

Background: Cognitive impairment is one of the most common post-stroke complications; however, neither patients nor health professionals are often aware of this complication. The impact of cognitive impairment on quality of life is reflected through basic activity daily living (bADL) and instrumental activity daily living (IADL). Prior studies concerning the correlation between cognitive impairment and activity daily living has shown contradictive results. This study was conducted in order to analyze the correlation between the cognitive functions and activity daily living in post stroke patients at Dr. Hasan Sadikin General Hospital. Methods: This cross-sectional study was carried out to 23 post-stroke patients from September–November 2015. Samples were collected through consecutive sampling at Dr. Hasan Sadikin General Hospital. Mini Mental State Examination (MMSE) was used to assess the cognitive functions and Lawton and Brody Scale to assess both bADL and IADL. Spearman correlation was selected to analyze the existing correlation between each cognitive domain and activity daily living. Results: Spearman statistical correlation showed an insignificant correlation between the cognitive functions and bADL (r2=0.181, p=0.408) and a significant correlation with IADL was obtained (r2=0.517, p=0.03). The only cognitive domain positively correlated with IADL was orientation to time and verbal recall. Conclusions: There is a correlation between cognitive functions and IADL among post-stroke patients at Dr. Hasan Sadikin General Hospital.

Background: Stroke is one of the leading causes of global disability. Post stroke rehabilitation program becomes the key to gain functional recovery. Thus it minimizes disabilities. Multiple studies have been carried out to gain greater functional outcomes for post stroke patients, including medical therapy such as supplements. However, supplement effectiveness in providing stroke recovery or prevention is still debatable. There is no data of supplement consumption among post stroke patients; therefore, the aim of this study was to determine the supplement consumption among post stroke patients. Methods: This study was a cross sectional descriptive study using primary data with a consecutive sampling method. Minimum samples for this study were 42 post stroke respondents who followed rehabilitation program. This study was conducted at Physical Medicine and Rehabilitation Clinic of Dr. Hasan Sadikin General Hospital Bandung from June until November 2013. The interviews were done after written informed consent was obtained. Descriptive statistics such as frequency distributin and proportion were used to analyze the data. Results: From 42 respondents, 23 (55%) respondents consumed the supplement. From 34 supplements recorded, 56% were herbs supplements; followed by multivitamin (29%), mineral (6%), multivitamin and mineral (6%), and other supplement (3%). The most frequent ingredients composed in the supplements were B1, B6 and B12 vitamin (7%). Conclusions: More than a half of post stroke patients at Physical Medicine and Rehabilitation Clinic Dr. Hasan Sadikin General Hospital are supplement users, with herbal supplements as the majority. The most frequent ingredients used are B1, B6 and B12 vitamin.

Purpose: A muscle synergies model was suggested to represent a simplifying motor control mechanism by the brainstem and spinal cord. The aim of the study was to investigate the feasibility of such control mechanisms in the rehabilitation of post-stroke individuals during the execution of hand-reaching movements in multiple directions, compared to non-stroke individuals.Methods: Twelve non-stroke and 13 post-stroke individuals participated in the study. Muscle synergies were extracted from EMG data that was recorded during hand reaching tasks, using the NMF algorithm. The optimal number of synergies was evaluated in both groups using the Variance Accounted For (VAF) and the Mean Squared Error (MSE). A cross validation procedure was carried out to define a representative set of synergies. The similarity index and the K-means algorithm were applied to validate the existence of such a set of synergies, but also to compare the modulation properties of synergies for different movement directions between groups. The similarity index and hierarchical cluster analysis were also applied to compare between group synergies.Results: Four synergies were chosen to optimally capture the variances in the EMG data, with mean VAF of 0.917 ± 0.034 and 0.883 ± 0.046 of the data variances, with respective MSE of 0.007 and 0.016, in the control and study groups, respectively. The representative set of synergies was set to be extracted from movement to the center of the reaching space. Two synergies had different muscle activation balance between groups. Seven and 17 clusters partitioned the muscle synergies of the control and study groups. The control group exhibited a gradual change in the activation in the amplitude in the time domain (modulation) of synergies, as reflected by the similarity index, whereas the study group exhibited consistently significant differences between all movement directions and the representative set of synergies. The study findings support the existence of a representative set of synergies, which are modulated to execute movements in different directions.Conclusions: Post-stroke individuals differently modulate the activation of synergies to different movement directions than do non-stroke individuals. The conclusion was supported by different muscle activation balances, similarity values and different classifications of synergies among groups.