Stroke Horizon Scanning Bulletin Volume 8 Issue 1

World class stroke care is achievable: Latest quarterly Sentinel Stroke National Audit Programme (SSNAP) results

Source: Royal College of Physicians  

Follow this link for the full text

Date of publication: 24^th March 2016

Publication type: News article

In a nutshell:

Presented at the International Stroke Conference 2016, the final results from the PISTE trial (Pragmatic Ischaemic Stroke Thrombectomy Evaluation) add new evidence for the effectiveness of mechanical clot retrieval (thrombectomy) treatment in the UK.

Although the trial was stopped early, the results are consistent with previously published trials and suggest that treatment with thrombectomy was effective within an NHS setting, and beneficial in the group of severely affected, ischaemic stroke patients who received it.

Length of publication: Online article

Some important notes:  Find information on the conference here

Using Puppets to Teach Schoolchildren to Detect Stroke and Call 911

Source: Journal of School Nursing

Follow this link for the abstract

Date of publication: 23^rd March 2016

Publication type: Journal Article

In a nutshell:

To overcome barriers to improved outcomes, we undertook an intervention to teach schoolchildren how to detect a stroke and call emergency medical services (EMS). We obtained permission from parents and guardians to use an 8-min puppet show to instruct the fourth, fifth, and sixth graders about stroke detection, symptomatology, and calling EMS. A pretest and three posttests—one immediately following the presentation, one at 3 months, and a third at 6 months—were administered. Responses from 282 students were evaluable. Significant improvements (p < .001) in knowledge were found through all posttests in identifying what parts of the body stroke affected and through the first two posttests in recognizing symptoms stroke victims experienced. Students demonstrated at pretest a high awareness of EMS and 911 (97.5%) and showed slight, but not significant, improvement over time.

tLength of publication: Online article

Some important notes:  Please contact your local NHS library for the full text of this article. Follow this link to find your local NHS library.

Electrical brain stimulation could boost benefits of stroke rehabilitation

Source: The Guardian

Follow this link for the full text

Date of publication: 16^th March  2016

Publication type: News article

In a nutshell:

Electrical brain stimulation could benefit stroke patients by boosting the effects of rehabilitation therapy, new research suggests.

Writing in the journal Science Translational Medicine, the authors reveal that patients who were given electrical brain stimulation during a rehabilitation programme performed better on a range of tasks than those taking part in the rehabilitation programme.

“It is an exciting message because there is so much frustration about people not reaching their true recovery potential,” said Professor Heidi Johansen-Berg, an author of the study from the University of Oxford, highlighting the fact that the cost of programmes and limited availability of therapists often restricts the amount of rehabilitation offered to patients.

Length of publication: Online article

Some important notes:  Original article is available as a PDF here .

Does the use of Nintendo Wii SportsTMimprove arm function? Trial of WiiTM in Stroke: A randomized controlled trial and economics analysis

Source: Clinical Rehabilitation

Follow this link for the abstract

Date of publication: 14^th March 2016

Publication type: Journal Article

In a nutshell:

A total of 240 participants aged 24–90 years with arm weakness following a stroke within the previous six months. Participants were randomly assigned to exercise daily for six weeks using the Wii^TM or arm exercises at home. Primary outcome was change in the affected arm function at six weeks follow-up using the Action Research Arm Test. Secondary outcomes included occupational performance, quality of life, arm function at six months and a cost effectiveness analysis.

 

The study was completed by 209 participants (87.1%). There was no significant difference in the primary outcome of affected arm function at six weeks follow-up (mean difference −1.7, 95% CI −3.9 to 0.5, p = 0.12) and no significant difference in secondary outcomes, including occupational performance, quality of life or arm function at six months, between the two groups. No serious adverse events related to the study treatment were reported. The cost effectiveness analysis showed that the Wii^TM was more expensive than arm exercises £1106 (SD 1656) vs. £730 (SD 829) (probability 0.866). The trial showed that the Wii^TM was not superior to arm exercises in home-based rehabilitation for stroke survivors with arm weakness. The Wii^TM was well tolerated but more expensive than arm exercises.

Length of publication: Online article

Some important notes:  Please contact your local NHS library for the full text of this article. Follow this link to find your local NHS library.

Description of a novel telemedicine-enabled comprehensive system of care: drip and ship plus drip and keep within a system of stroke care delivery

Source: Journal of telemedicine and telecare

Follow this link for the abstract

Date of publication: 16^th March 2016

Publication type: Journal Article

In a nutshell:

United States (US) and worldwide telestroke programs frequently focus only on emergency room hyper-acute stroke management. This article describes a comprehensive, telemedicine-enabled, stroke care delivery system that combines “drip and ship” and “drip and keep” models with a comprehensive stroke center primary hub at Ochsner Medical Center in New Orleans, advanced stroke-capable regional hubs, and geographically-aligned, “stroke-ready” spokes. The primary hub provides vascular neurology expertise via telemedicine and monitors care for patients remaining at regional hubs and spokes using a multidisciplinary team approach. By 2014, primary hub telestroke consults grew to ≈1000/year with 16 min average door to consult initiation and 20 min to completion, and 29% of ischemic stroke patients received recombinant tissue-type plasminogen activator (rtPA), increasing 275%. Most patients remained in hospitals close to home, but neurointensive care and interventional procedures were common reasons for primary hub transfer. Given the time sensitivity and expert consultation needed for complex acute stroke care delivery paradigms, telestroke programs are effective for fulfilling unmet care needs. Combining drip and ship and drip and keep management allows more patients to stay “local,” limiting primary hub transfer unless more advanced services are required. Post admission telestroke management at spokes increases personnel efficiency and can positively impact stroke outcomes.

Length of publication: Online article

Some important notes:  Please contact your local NHS library for the full text of this article. Follow this link to find your local NHS library.

Robot rehabilitation

Source:  Stroke Association

Follow this link for full text

Date of publication: 4^th March 2016

Publication type: News

In a nutshell:

A prestigious seminar was held at Northwick Park Hospital, London. The theme was the exciting area of robot assisted rehabilitation after stroke, and specifically the RATULS (Robot Assisted Training for the Upper Limb after Stroke) trial.

The guest speaker was Dr Hermano Igo Krebs, Principal Research Scientist and Lecturer at MIT (Massachusetts Institute of Technology) in the USA. He is also a co-investigator on the UK based RATULS trial, and co-founder of the company who make the robots used in RATULS (Interactive Motion Technology).

 

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.