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Since a significantly greater percentage of body weight is supported by the non-paretic limb following stroke, a greater amount of fatigue may be present during daily activities. This may affect the ability of these individuals to maintain a stable upright posture. The presence of falls following a stroke has been attributed in part to this asymmetrical stance post-stroke. Therefore the purpose of this study was to assess the effect of quadriceps muscle fatigue on bi-pedal posture in individuals who had a stroke and an age-matched control group. Although individuals after stroke displayed greater postural sway under the paretic limb than the non-paretic limb or control subjects, results of this study show that sustaining an isometric knee extension of the non-paretic limb induces changes in postural control for individuals after stroke, but that these changes do not markedly differ from those of healthy age-matched controls.

Bakgrund: Årligen drabbas 30 000 personer i Sverige av stroke. Det är den vanligaste orsaken till funktionsnedsättning och de som drabbas är i behov av långa vårdtider. Den forskning som finns tillgänglig belyser främst patienters upplevelser i det tidiga skedet efter att ha drabbats av stroke. Syfte: Syftet med studien var att belysa hur personer upplever sin livsvärld efter att ha drabbats av stroke. Metod: Studien utgick från en kvalitativ ansats. Fem självbiografier valdes för att belysa personers upplevelser av att drabbas av stroke. Analysen gjordes utifrån Lundman och Graneheims kvalitativa innehållsanalys. Resultat: Det framkom att de drabbade genomgick stora förändringar i livet. De hade svårt att acceptera sitt nya jag, anpassa sig till sin nya situation och till de svårigheter som uppstod i vardagen. Omgivningens syn och förutfattade meningar hade även en stor betydelse och påverkan på personerna. Slutsats: Personer som drabbats av stroke upplevde att de fick en förändrad livsvärld. De upplevde både lidande, hälsa och välbefinnande beroende på i hur stor utsträckning de accepterat sin nya situation. Det är viktigt att som sjuksköterska ha kunskap om hur de upplever sig själva och sin vardag för att kunna möta deras livsvärld och ge en god omvårdnad.

The recommendations for stroke best practice suggest that mild stroke patients could receive their therapy within an ambulatory environment. However, a significant number of mild stroke patients continue to be admitted to inpatient rehabilitation. A retrospective chart audit was conducted for acute stroke discharges from two centres in Ontario. Stroke cases with a Projected Full FIM® > 80, we're stratified into two groups: discharged home - discharged to inpatient rehabilitation. There were 813 patients eligible for inclusion. Overall, 33% of mild stroke patients were admitted to inpatient rehabilitation. The results did not explain why so many mild stroke patients are admitted to inpatient rehabilitation. The two groups did not differ in rates of recurrent stroke or re-admission to hospital at follow-up. According to the results, milder stroke patients may effectively be managed in the community where rehabilitation services are available.

The recommendations for stroke best practice suggest that mild stroke patients could receive their therapy within an ambulatory environment. However, a significant number of mild stroke patients continue to be admitted to inpatient rehabilitation. A retrospective chart audit was conducted for acute stroke discharges from two centres in Ontario. Stroke cases with a Projected Full FIM® > 80, we're stratified into two groups: discharged home - discharged to inpatient rehabilitation. There were 813 patients eligible for inclusion. Overall, 33% of mild stroke patients were admitted to inpatient rehabilitation. The results did not explain why so many mild stroke patients are admitted to inpatient rehabilitation. The two groups did not differ in rates of recurrent stroke or re-admission to hospital at follow-up. According to the results, milder stroke patients may effectively be managed in the community where rehabilitation services are available.

In Saskatchewan, stroke is the third leading cause of death as well was the major cause of adult disability. Once a person suffers a stroke or transient ischemic attack (TIA), they are at high risk for having a secondary (or recurrent) stroke. Despite this knowledge, secondary stroke prevention is often overlooked in the care of stroke/TIA patients. With the vision of decreasing the incidence and impact of stroke in Saskatchewan, the Saskatchewan Integrated Stroke Strategy (SISS) was recently implemented. The purpose of this study is to begin the development of an evaluation measurement system for the SISS based on the guidelines and measures from the Canadian Stroke Strategy (CSS) specifically pertaining to secondary stroke prevention.<p> This multi-year cross-sectional study is an analysis of de-identified health data derived from linkage of administrative and laboratory data. Select indicators from the CSS Performance Measurement Manual involving medications use for secondary stroke prevention (antihypertensives, antilipidemics, anticoagulants) and intermediate health outcomes (serum LDL cholesterol, INR) are calculated. Regression is used to quantify the association of patient demographic and socioeconomic characteristics and geographic location of care with receipt of guideline-recommended secondary stroke prevention. The target population is Saskatchewan residents who have been hospitalized for a stroke or TIA between April 1, 2001 and March 31, 2008.<p> The results of this study indicated that secondary stroke prevention in Saskatchewan is sub-optimal in the management of hypertension, dyslipidemia, and atrial fibrillation. Although there has been some improvement over the time period, a significant number of patients are not taking the recommended medications at discharge from acute care. Similarly, a considerable number of patients are not receiving the appropriate laboratory tests within the year following their stroke event. Through regression analysis it was revealed that a number of correlates (ie. age, income, on medication before the stroke event) were significantly associated with receiving these specific elements of secondary stroke prevention, suggesting potential differences in provision of care. Finally, regional differences in secondary stroke prevention were found for a number of the outcomes, which may indicate differences in care throughout the province.<p> The findings of this study serve as a baseline for evaluation of the impact of the Saskatchewan Integrated Stroke Strategy in the area of secondary stroke prevention. The results make apparent the fact that secondary stroke prevention in Saskatchewan can be improved, and that there is much opportunity for future research in this area.

Stroke definieras som en akut neurologisk dysfunktion av vaskulärt ursprung, och är en av de vanligaste orsakerna till död och neurologiska handikapp i världen. Den drabbade lider ofta av kvarstående funktionshinder som kan påverka hälsostatus, och dessa bör behandlas med rehabilitering. Hälsa bör därför mätas post-stroke för att utvärdera rehabiliteringen. I denna fas spelar sjukvårdspersonalen en viktig roll.

Stroke är en vanlig sjukdom som många drabbas av. Inom den prehospitala akutsjukvården möter ambulanssjuksköterskan patienter drabbade av stroke. Tiden är avgörande för den fortsatta vården och att patienten kommer till rätt vårdinstans direkt. Användningen av mätinstrumentet inom den prehospitala akutsjukvården ökar patientens möjligheter till rätt vård. Syfte: undersöka vilka mätinstrument och metoder som är lämpliga för att identifiera strokesymtom hos patienter i en prehospital akutfas. Metod: artikelsökningen genomfördes i databaserna ELIN, PubMed, Cinahl, EBSCO samt via American stroke associations hemsida och utfördes under perioden februari 2009 till september 2009. I studien inkluderades 15 vetenskapliga artiklar och dessa kvalitetsgranskades utifrån en granskningsmall för kvantitativa artiklar. Resultatet presenteras i form av kategorier. Resultat: användning av mätinstrument är bra för att identifiera stroke inom prehospital akutsjukvård. Mätinstrument ska vara lätta att förstå och inte vara tidskrävande. Vid användningen fås en snabbare identifiering av stroke och patienten kan få rätt vård utan extra tidsfördröjning vilket i sin tur leder till bättre livskvalitet och mindre lidande för patienterna. Slutsats: I studien framgår inte vilket mätinstrument som passar bäst inom den prehospitala akutsjukvården men att använda ett mätinstrument är att föredra. Beaktande bör tas att inget mätinstrument kan diagnostisera stroke utan mätinstrumenten identifierar symtomen.

Since a significantly greater percentage of body weight is supported by the non-paretic limb following stroke, a greater amount of fatigue may be present during daily activities. This may affect the ability of these individuals to maintain a stable upright posture. The presence of falls following a stroke has been attributed in part to this asymmetrical stance post-stroke. Therefore the purpose of this study was to assess the effect of quadriceps muscle fatigue on bi-pedal posture in individuals who had a stroke and an age-matched control group. Although individuals after stroke displayed greater postural sway under the paretic limb than the non-paretic limb or control subjects, results of this study show that sustaining an isometric knee extension of the non-paretic limb induces changes in postural control for individuals after stroke, but that these changes do not markedly differ from those of healthy age-matched controls.