Stroke Horizon Scanning Bulletin Volume 7 Issue 4

Researchers contribute to patient resource for stroke survivors self-management

Source: Glasgow Caledonian University

Follow this link for the abstract

Date of publication: 29^th June 2015

Publication type: News

In a nutshell:

Glasgow Caledonian University (GCU) researchers have provided their expertise in stroke self-management to a new website for anyone who has had a stroke, to help them gain control of their lives and set goals for rehabilitation, and health and wellbeing.Selfhelp4stroke (www.selfhelp4stroke.org) has been launched with expertise and input from healthcare professionals, researchers, and stroke survivors with an interest in stroke and self-management.

Length of publication: Online article

Southend Stroke Service Benefits from Realistic 3D Simulation Training

Source: Disruptive magazine

Follow this link for full text

Date of publication: 23^rd June 2015

Publication type: News

In a nutshell:

Southend University Hospital has founded an innovative interventional stroke service at Anglia Ruskin University that is being supported by 3D Systems‘ ANGIO Mentor Suite simulator. According to both parties, the simulator has enabled the efficient and realistic team training necessary for effective endovascular stroke treatment, which requires the specific and precise mechanical opening of the brain artery in the affected area. The hospital found that by operating dedicated training courses in a realistic cath lab environment with the virtual reality simulator, it enhanced the clinical teams’ understanding of high-risk stroke procedures, strengthened collaboration and improved communication skills. This in turn resulted in better outcomes.

 

Length of publication: online article

Blood pressure control to prevent decline in cognition after stroke

Source: Journal of Vascular Health and Risk Management

Follow this link for the full text

Date of publication: 9^th June 2015

Publication type: Journal Article

In a nutshell:

Treatment of hypertension post-stroke preserves cognition through prevention of recurrent stroke, but it is not clear whether it prevents cognitive decline through other mechanisms. We aimed to describe changes in blood pressure from baseline to 1 year post-stroke and to evaluate the association between achieved blood pressure targets and cognitive function, mild cognitive impairment (MCI), and dementia.

We included patients with first-ever stroke, and defined achieved blood pressure goals as systolic blood pressure (SBP) in the categories ≤125 mmHg, ≤140 mmHg, and ≤160 mmHg, SBP reduction of ≥10 mmHg, and diastolic blood pressure (DBP) reduction of ≥5 mmHg. The main outcome variables were cognitive assessments 1 year post stroke. Secondary outcomes were diagnoses of MCI or dementia.

Forty-one of 166 patients (25%) reached SBP ≤125 mmHg after 1 year, 92/166 (55%) reached SBP ≤140 mmHg, and 150/166 (90%) reached SBP ≤160 mmHg. SBP was reduced by ≥10 mmHg in 44/150 (29%) and DBP by ≥5 mmHg in 57/150 (38%). We did not find any statistically significant associations between cognitive test performances and different blood pressure goals (P=0.070–1.0). Nor was there any significant association between achieved goal blood pressure or blood pressure reduction after 1 year and the diagnoses of MCI or dementia (P=0.32–0.56)

Treatment of hypertension is important for primary and secondary prevention of stroke. Showing a potential beneficial effect of blood pressure control on cognitive function, however, probably needs longer follow-up.

Length of publication: Online article

Old benefit as much as young patients with stroke from high-intensity neurorehabilitation: cohort analysis

Source: Journal of Neurology, Neurosurgery & Psychiatry

Follow this link for the full text

Date of publication: June 2015

Publication type: Journal Article

In a nutshell: 

In current clinical practice, old patients with stroke are less frequently admitted to neurorehabilitation units following acute care than younger patients based on an assumption that old age negatively impacts the benefit obtained from high-intensity neurorehabilitation. Our objective was to test this assumption empirically in a large sample of patients with stroke.

Functional recovery during 4 weeks of inpatient neurorehabilitation was assessed with the Barthel Index (BI) in 422 middle-aged (<65 years), 1399 old (65–80 years) and 473 very old (>80 years) patients with stroke. Overall functional recovery, recovery patterns and the relationship between therapy intensity and recovery were statistically compared between the three age groups.

 

Overall functional recovery was statistically equivalent in middle-aged, old and very old patients (average improvement in BI total score: middle-aged: 15 points; old: 15 points; very old: 14 points). A novel item-wise logistic regression analysis (see Pedersen, Severinsen & Nielsen, 2014, Neurorehabil Neural Repair) revealed that this was true for 9 of the 10 everyday functions assessed by the BI. Furthermore, functional recovery was predicted by the amount of therapy (R=0.14; p=0.0001), and age did not moderate this relationship between therapy intensity and recovery (p=0.70). Old and even very old patients with stroke benefit from specialised inpatient neurorehabilitation and high amounts of therapy in the same degree as younger patients. Contrary to current clinical practice, old age should not be a criterion against admission to a neurorehabilitation unit following acute stroke treatment.

Length of publication: Online article

Further dissemination

If you think anyone would benefit from receiving this posting or from subscribing to this blog please email them the link to this blog and suggest they sign up to the blogs email newsletter to stay up-to-date with new content.