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STROKE LENGTH, STROKE FREQUENCY AND VELOCITY OF MALE AND FEMALE SWIMMERS IN THE BUTTERFLY.Stevens, Margaret Gail. January 1983 (has links)
No description available.
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The effects of lateralized stimulation on unilateral visuo-spatial neglectSullivan, Carol-Anne Maria January 1999 (has links)
No description available.
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Studies in the care of Northumberland patients with hypertensionAylett, Malcolm January 2000 (has links)
No description available.
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Identification and dissection of cardiovascular and cerebrovascular quantitative trait loci in the stroke-prone spontaneously hypertensive ratJeffs, Baxter January 1998 (has links)
No description available.
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Lightning-earth flash return strokeHoole, P. R. P. January 1987 (has links)
No description available.
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The prevalence of atrial fibrillation in the UK and of suitability for warfarin treatment amongst those with atrial fibrillationSudlow, Christopher Mark January 1999 (has links)
No description available.
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Emotion regulation, executive functioning and quality of life following stroke : a research portfolioYule, Mhairi January 2013 (has links)
Systematic review Executive dysfunction is commonly reported following stroke with most research in this area focused on frontal lobe lesions. A systematic review was carried out to evaluate the evidence of executive dysfunction following stroke as compared to control groups. It was found that executive functions are consistently impaired following stroke and is not limited to frontal lobe lesions. Processing speed, mental flexibility, attention and working memory impairments were found to be the most common executive functioning impairments following stroke. Given the impact executive dysfunction may have on successful rehabilitation, relationships, return to work and quality of life, a comprehensive assessment of such difficulties is important following stroke to aid in the development of appropriate and effective rehabilitation strategies. Future research should use larger samples and a wide range of measures to assess different aspects of executive functioning. Introduction Mood disorders and psychological distress are common following stroke, and depression and emotional lability have been studied extensively. There has, however, been little research into difficulties in emotion regulation following stroke and whether this is associated with emotional or cognitive difficulties. The current study investigated emotion regulation difficulties following stroke and their relationship with quality of life, executive functions, anxiety and depression. Method Fifty participants who had suffered a stroke and forty five age matched controls completed the Difficulties in Emotion Regulation Scale, the Hospital Anxiety and Depression Scale, the World Health Organization Quality of Life assessment – Brief version and the National Adult Reading Test. In addition individuals with stroke completed four measures of executive functioning – Color Trails Test, Verbal Fluency, Brixton Spatial Anticipation Test and the Hayling Sentence Completion Test. Results Individuals with stroke had significantly greater difficulties in emotion regulation compared to age matched controls and this was significantly associated with lower self reported quality of life and increased levels of both anxiety and depression. No significant associations were found between emotion regulation and executive functions or between executive dysfunction and lower self reported quality of life. Discussion The current study found evidence that individuals who have suffered a stroke have more difficulties in emotion regulation than an age matched control group. This is clinically important as emotion regulation difficulties are found in mood disorders and it may be that such difficulties precipitate and/or maintain depression following stroke. The absence of an association between difficulties in emotion regulation and executive functioning suggests that other factors may influence such difficulties, such as the trauma of having a stroke. Future research should explore emotion regulation difficulties further following stroke, particularly investigating whether the course of these difficulties changes over time and if they are linked to type of stroke or lesion location.
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Exploring discrepant views of the quality of life of stroke survivors : a means of investigating adjustment to strokeTodman, Jonathan January 2009 (has links)
Objectives: Reviews have suggested that stroke patients and family members frequently hold different impressions of the patient’s quality of life. Understanding such differences may be particularly useful for clinicians who wish to help clients adjust to the effects of a stroke. The aim of this study was to investigate how the responses of stroke survivors and their family members differ when indicating the stroke survivors’ quality of life, and whether such differences are associated with greater time elapsed since the stroke onset. Design and Method: A related-subject design and a correlational design were utilised in this study. People who had suffered a stroke within five years were compared with nominated members of their family. All participants indicated the perceived quality of life of the stroke survivor using the WHOQOL-BREF. The time elapsed since their stroke was recorded and the participants’ mood was assessed. Results: No significant differences were found between the stroke survivors and the family members’ views of the stroke survivors’ quality of life. However, agreement between these groups was found to be low in the Social domain of the WHOQOLBREF. Greater time since the stroke onset was found to correlate with greater discrepancy between groups in the Social domain, but not in the other domains. Conclusions: The results suggest that families’ adjustment to stroke does not conclude when improvement in function slows. Instead, a stroke continues to affect families years after the initial stroke. These findings may be interpreted within the context of quality of life response shift, where changes in the stroke survivors’ evaluation of their social lives may not be identified by their families. This may reflect a common trajectory following stroke. The methodological limitations of this study and suggestions for future research are discussed.
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To establish the effect of task oriented group circuit training for people affected by stroke in the public healthcare sector in RSABallington, Megan Claire 19 March 2013 (has links)
Stroke remains a serious public health problem in low, middle and high income countries worldwide. In
low and middle income countries there has been a greater than 100% increase in stroke incidence.
The impact of HIV associated vasculopathy is recognized as contributing to the increased prevalence
of stroke in younger patients (Tipping et al., 2007) and is an independent risk factor for stroke (Cole et
al., 2004). The impact of this increased stroke incidence has not only resulted in an increase in death
rates in the developing world, but has also resulted in increases noted in long term disability as a
result of stroke.
The available resources for stroke care and rehabilitation are lacking in developing countries including
Africa, particularly in rural areas. It has also been noted that 80% of the population live in areas where
factors such as limited resources and cultural practices limit access to stroke services (Poungvarin
1998). Currently patients with stroke are discharged from hospitals in the public healthcare sector
within six to 14 days of having a stroke, because of the pressure for beds (Mudzi, 2009; Reid et al.,
2005; Hale, 2000). As a result patients are not benefitting from rehabilitation services and this leads to
suboptimal recovery post stroke and to a large number of persons living with disabilities in under
resourced communities. Because the patients with stroke are discharged so acutely after their stroke,
carers become a necessity to cope with the burden of care. These conditions result in increased
stroke survivor dependence in South Africa compared to the USA or New Zealand.
While 80% of stroke survivors who are initially unable to walk achieve independent walking
(Jorgensen et al., 1995), at three months post stroke 25%-33% still require assistance or supervision
when walking (Jorgenson et al., 1995; Duncan et al., 1994; Richards et al., 1993). Unfortunately these
independent walkers seldom achieve walking speeds that are sufficient for community ambulation
(Schmid et al., 2007; Lord and Rochester, 2005; Lord et al., 2004). Walking competency is a term
used to describe a certain level of walking ability allowing an individual to participate in the community
safely and efficiently (Salbach et al., 2004). It should also be noted that even those with mild and
moderate strokes experience limitations with higher physical functioning which impacts on their quality
of life and ability to return to work (Duncan and Lai, 1997).
The cerebral cortex has the ability to undergo functional and structural reorganization for several
weeks and even months in more severe cases post stroke. Rehabilitation post stroke facilitates this
process and can shape the reorganization of the adjacent intact cortex (Green, 2003). Further, it has been concluded that to facilitate the best possible functional outcome for people post stroke,
engagement in intensive task oriented therapy is necessary (Kwakkel et al., 2004; Van Peppen et al.,
2004). Considering these findings it is extremely concerning that there is little or no rehabilitation
provided to stroke survivors in the public healthcare sector in South Africa (Mudzi, 2009; Rhoda and
Hendry 2003; Hale and Wallner, 1996; Stewart et al., 1994).
With this in mind, the aim of this study was to determine if an out -patient based task oriented group
training programme would promote improved walking competency more than the current progressive
resistance strength group training programmes that are common practice in persons who have had an
acute stroke in the public healthcare system in South Africa. The specific objectives of this study were
to establish the effect of a low intensity, namely once a week (for six weeks), out- patient based task
programme on: walking competency, walking endurance, gait speed and health status in terms of
physical functioning in persons with sub-acute stroke. Due to the high incidence of post stroke
survivors with HIV it was important to establish if the training programme produced comparable effects
in HIV positive and HIV negative subjects.
This study used a stratified blocked randomised controlled trial design. Where group allocation was
concealed. In addition assessor blinded evaluations were conducted at baseline, post intervention and
at six months after the intervention had ceased. A total of 144 persons who had a stroke were
stratified according to their walking speed – mild (able to walk at a gait speed > 0.8m/s), moderate
(able to walk at a speed of 0.4-0.8 m/s) or severe (able to walk at a speed < 0.4m/s) – and randomly
assiged to one of three training groups. One group received task oriented group circuit training (task
group), the second group received progressive resistance strength training (strength group), and the
third group participated in one multidisciplinary education group training session (control group). The
task and strength interventions included 6 sessions, of 60 minutes each for six to 12 weeks. While the
control intervention group participated in one three hour education session, which included advice on
the importance of exercise and a 20-minute exercise session. All subjects had been discharged from
the public healthcare sector and were less than six months post stroke at inclusion into the study. The
primary objective was walking competency, which included the measurement of walking endurance,
gait speed, functional balance and mobility (Salbach et al., 2004). The task group showed an
improvement that was significantly greater than that achieved by the strength and control groups in
walking endurance, gait speed, functional mobility and balance at the follow-up. These findings
demonstrate that the provision of as little as six sessions of task training (in a developing country,
where persons with sub-acute stroke have had no previous rehabilitation) improves walking
competency to a significantly greater extent than either a strength intervention of equal intensity, or a control intervention programme consisting of one three hour education visit in the sub -acute phase
post stroke. While the strength group received a more frequent and intensive training compared with
the control group, there were no significant differences in terms of walking competency between these
two groups over the study period.
The task group showed significantly greater improvements in walking endurance, comfortable and
maximum gait speed than the strength and control groups immediately post intervention. While post
intervention, the task training led to superior gains in functional mobility and balance compared to the
control group, it was not superior to the strength group.
For subjects, with a moderate gait disability at baseline, the improvements in walking endurance and
in comfortable and maximum walking speed in the task group were significantly more than the
strength and control groups. For subjects with a severe gait deficit at baseline, the task group
improved significantly more than the control group on all measures of walking competency but not
significantly more than the strength group. There were no significant differences among the groups for
subjects with a mild gait deficit at baseline.
All three treatment intervention groups improved their score on the stroke impact scale 16 (SIS 16)
over the course of the study period. The task group improved significantly more than the control
group’s health status in terms of physical functioning measured by the SIS16. There were no
significant differences among the groups in the change scores for the measures of walking
competency between the HIV positive and HIV negative subjects throughout the study period.
The results of this study demonstrate that an extremely limited number of task training sessions
resulted in significantly greater improvements in walking competency than progressive strength
training or a multidisciplinary education training approach. However, these results must be interpreted
with caution, remembering the context of the sample population who had not received a period of inpatient
rehabilitation prior to their inclusion into the study and were 10-15 years younger than subjects
in numerous other studies. This appears to be the first study conducted with such a limited
rehabilitative intervention post stroke. As a result, further research to evaluate the effectiveness of
limited intensity task oriented training interventions for non -ambulant stroke survivors in the
developing world where resources are limited, needs to be conducted. It is important to explore the
benefits of different group based rehabilitative interventions for stroke survivors to alleviate the burden
as a result of disability as much as possible.
Key words: Stroke, Task Oriented, Rehabilitation, Walking, Walking Competency
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Adaptation of existing methods of genotyping platelet polymorphisms associated with cerebrovascular disease for use within the routine laboratory setting and determining the relative frequency in a cohort of stroke patientsMoodly, Sadhaseevan 09 November 2009 (has links)
M.Sc.(Med.), Faculty of Health Sciences, University of the Witwatersrand, 2008 / Introduction
It is widely recognised that stroke is a multi-factorial disorder in which platelets
play a crucial role in thrombus formation resulting in ischaemic stroke. Platelet
adhesion and aggregation are initiated by the interaction of various platelet
glycoproteins (GP’s) such as GPIbα, which binds to von Willebrand Factor and
GPIIb/IIIa a fibrinogen receptor. Recent studies have shown that the GP’s are
polymorphic and the polymorphisms described within GPIbα such as Kozak-
5T/C, the variable number of tandem repeats (VNTR) and the Human Platelet
antigen 2 (HPA2), have been implicated in the development of stroke, while the
PIA polymorphism of GPIIb/IIIa was found to contribute to “aspirin resistance”.
Therefore, these polymorphisms may be potentially important for early detection
and early intervention and thus setting the need to provide for a high volume
genotype testing at health care centres. One of the most used techniques to
determine platelet function is platelet aggregometry. However, the major
disadvantages of platelet aggregation is that it is influenced by a number of
environmental factors and its access is limited to tertiary health centres. Platelet
aggregation measures the functional expression of platelets, which is known to
deteriorate over time. It is for this reason that new methods at molecular level
such as polymerase chain reaction (PCR) are needed to explore the role of
genotypic expressions, which are not influenced by environmental factors.
Currently, conventional PCR is used to detect platelet polymorphisms in the
research settings and has limitations as a routine diagnostic test. Furthermore, it
is time consuming and is prone to contamination. With the recent advances in
real-time PCR it is possible to genotype large sample batches rapidly without
compromising on the quality, accuracy and precision of results. This study aims
to adapt conventional PCR methodology onto a real-time platform for detecting
platelet polymorphisms that have been implicated in both stroke and aspirin
resistance.
Materials and methods
A total of 60 caucasian patients classified as having ischaemic stroke by virtue of
MRI and Doppler analysis from the Stroke Clinic at the Johannesburg Hospital
were enrolled for this study. Healthy caucasian individuals (38), age and gender
matched were enrolled as controls. DNA samples were extracted from all the
subjects and the prevalence of the Kozak –5T/C, HPA-2, VNTR and GPIIIa PIA
polymorphisms were determined first by using conventional PCR and then the
real-time LightCycler TM PCR method.
Results
The frequency of the unfavourable alleles ( the PIA2 allele for the GPIIIa PIA
polymorphism, the T allele for the Kozak –5T/C polymorphism, the B allele for the
HPA-2 polymorphism and the C allele for the VNTR polymorphism) of the
different GP’s were higher in the stroke patients when compared to the control
subjects but did not reach statistical significance. There was complete statistical
agreement between the results obtained for the conventional PCR as compared
to the results obtained for real-time PCR except for the VNTR polymorphism, due
to the difficulty in designing and the unavailability of probes for the real-time PCR
assay. However, it is important to note that adapting the real-time PCR as a new
methodology would greatly benefit both the patients and the clinicians by
providing early detection and the possibility of early therapeutic intervention.
Conclusion
Therefore in conclusion, it is possible to perform not only conventional PCR for
platelet polymorphism but also real-time PCR on a large scale without
compromising on the quality, accuracy and precision on platelet polymorphisms
that play a significant role in stroke and aspirin resistance. However, a larger
population based study needs to be performed to confirm the findings.
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