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Zeng H, Cai A, Zhao W, Wu J, Ding Y, Zeng X. Factors and predictive model for malnutrition in poststroke disabled patients: A multicenter cross-sectional study. Nutrition 2024; 123:112423. [PMID: 38583267 DOI: 10.1016/j.nut.2024.112423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/10/2024] [Accepted: 03/07/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Although malnutrition has been shown to influence the clinical outcome of poststroke disabled patients, the associated factors and the prediction model have yet to be uncovered. OBJECTIVES This study aims to assess the current prevalence and factors associated with malnutrition in poststroke disabled patients and establish a prediction model. METHODS A multicenter cross-sectional survey among Chinese poststroke disabled patients (≥18 y old) was conducted in 2021. Information on patients' basic data, medical history, Barthel Index, dysphagia, and nutritional status was collected. A multivariable logistic regression model was used to identify the factors that influence malnutrition. Nomogram was developed and internal validation was conducted using 5-fold cross-validation. External validation was performed using the data from a preliminary survey. Receiver operating characteristic (ROC) analysis, calibration curves, and decision curve analysis (DCA) were used to analyze the predictive value of the nomogram. RESULTS Four hundred fifty-seven cases were enrolled, with the prevalence of malnutrition as 71.77%. Age (aOR = 1.039, 95% CI: 1.006-1.078), pulmonary infection (aOR = 4.301, 95% CI: 2.268-14.464), dysphagia (aOR = 24.605, 95% CI: 4.966-191.058), total intake volume (aOR = 0.997, 95% CI: 0.995-0.999), Barthel Index (aOR = 0.965, 95% CI: 0.951-0.980), and nasogastric tube (aOR = 16.529, 95% CI: 7.418-52.518) as nutrition support mode (compared to oral intake) were identified as the associated factors of malnutrition in stroke-disabled patients (P < 0.05). ROC analysis showed that the area under the curve (AUC) for nomogram was 0.854 (95% CI: 0.816-0.892). Fivefold cross-validation showed the mean AUC as 0.829 (95% CI: 0.784-0.873). There were no significant differences between predicted and actual probabilities. The DCA revealed that the model exhibited a net benefit when the risk threshold was between 0 and 0.4. CONCLUSIONS Age, pulmonary infection, dysphagia, nutrition support mode, total intake volume, and Barthel Index were factors associated with malnutrition in stroke-related disabled patients. The nomogram based on the result exhibited good accuracy, consistency and values.
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Affiliation(s)
- Hongji Zeng
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Ang Cai
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Weijia Zhao
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Junfa Wu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China; National Center for Neurological Disorders, Shanghai, China
| | - Yu Ding
- Department of Neurology, The Second Medical Center, PLA General Hospital, Beijing, China
| | - Xi Zeng
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, China.
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Kinoshita M, Oyanagi K, Matsushima A, Kondo Y, Hirano S, Ishizawa K, Ishihara K, Terada S, Inoue T, Yazawa I, Washimi Y, Yamada M, Nakayama J, Mitsuyama Y, Ikeda SI, Sekijima Y. Adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP): Estimation of pathological lesion stage from brain images. J Neurol Sci 2024; 461:123027. [PMID: 38805875 DOI: 10.1016/j.jns.2024.123027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 04/06/2024] [Accepted: 05/01/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP) is a disease responsible for cognitive impairment in adult humans. It is caused by mutations in the colony stimulating factor 1 receptor gene (CSF1R) or alanyl-transfer (t) RNA synthetase 2 (AARS2) gene and affects brain white matter. Settlement of stages of the pathological brain lesions (Oyanagi et al. 2017) from the findings of brain imaging will be inevitably essential for prognostication. METHODS MRI images of eight patients with ALSP were analyzed semiquantitatively. White matter degeneration was assessed on a scale of 0 to 4 (none, patchy, large patchy, confluent, and diffuse) at six anatomical points, and brain atrophy on a scale 0 to 4 (none, slight, mild, moderate, and severe) in four anatomical areas. The scores of the two assessments were then summed to give total MRI scores of 0-40 points. Based on the scores, the MRI features were classified as Grades (0-4). Regression analysis was applied to mutual association between mRS, white matter degeneration score, brain atrophy score, the total MRI score and disease duration. RESULTS White matter degeneration score, brain atrophy score, and the total MRI score were significantly correlated with the disease duration. MRI Grades (2-4) based on the total MRI scores and the features of the images were well correlated with the pathological lesion stages (II - IV); i.e., 'large patchy' white matter degeneration in the frontal and parietal lobes (MRI Grade 2) corresponded to pathological Stage II, 'confluent' degeneration (Grade 3) to Stage III, and 'diffuse' degeneration (Grade 4) to Stage IV. CONCLUSION MRI Grades (2-4) resulted from the total MRI scores were well correlated with the pathological lesion Stages (II - IV).
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Affiliation(s)
- Michiaki Kinoshita
- Department of Neurology, Azumino Red Cross Hospital, 5685 Toyoshina, Azumino, Nagano 399-8292, Japan.
| | - Kiyomitsu Oyanagi
- Division of Neuropathology, Department of Brain Disease Research, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
| | - Akira Matsushima
- Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan; Department of Neurology, JA Nagano Kouseiren Kakeyu-Misayama Rehabilitation Center Kakeyu Hospital, 1308 Kakeyu-onsen, Ueda, Nagano 386-0396, Japan.
| | - Yasufumi Kondo
- Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
| | - Shigeki Hirano
- Department of Neurology, Chiba University School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
| | - Keisuke Ishizawa
- Departments of Neurology and Pathology, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan.
| | - Kenji Ishihara
- Department of Neurology, Asahi Neurology Rehabilitation Hospital, 789-1 Kurigasawa, Matsudo, Chiba 270-0022, Japan
| | - Seishi Terada
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-chou, Kita-ku, Okayama 700-8558, Japan.
| | - Teruhiko Inoue
- Psychogeriatric Center, Daigo Hospital, 1270 Nagata, Mimata-chou, Kitamorokata-gun, Miyazaki 889-1911, Japan.
| | - Ikuru Yazawa
- Faculty of Health and Medical Sciences, Tokoha University, 1230 Miyakoda-chou, Kita-Ku, Hamamatsu, Shizuoka 431-2102, Japan
| | - Yukihiko Washimi
- National Center for Geriatrics and Gerontology Hospital, 7-430 Morioka-chou, Obu, Aichi 474-8511, Japan.
| | - Mitsunori Yamada
- Division of Neuropathology, Department of Brain Disease Research, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
| | - Jun Nakayama
- Department of Molecular Pathology, Shinshu University Graduate School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
| | - Yoshio Mitsuyama
- Psychogeriatric Center, Daigo Hospital, 1270 Nagata, Mimata-chou, Kitamorokata-gun, Miyazaki 889-1911, Japan.
| | - Shu-Ichi Ikeda
- Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
| | - Yoshiki Sekijima
- Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
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Fernandes JB, Fernandes S, Domingos J, Castro C, Romão A, Graúdo S, Rosa G, Franco T, Ferreira AP, Chambino C, Ferreira B, Courela S, Ferreira MJ, Silva I, Tiago V, Morais MJ, Casal J, Pereira S, Godinho C. Motivational strategies used by health care professionals in stroke survivors in rehabilitation: a scoping review of experimental studies. Front Med (Lausanne) 2024; 11:1384414. [PMID: 38813377 PMCID: PMC11133544 DOI: 10.3389/fmed.2024.1384414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 05/02/2024] [Indexed: 05/31/2024] Open
Abstract
Introduction Cognitive and motor impairments are common among stroke survivors. Physical therapy is often used to improve the functional capacity of stroke survivors. However, limited adherence to rehabilitation programs is a challenge. Motivation plays a crucial role in the success of rehabilitation programs as it influences individual adherence to treatment and overall health outcomes. This review aims to identify current trends in motivational strategies used by healthcare professionals for stroke survivor rehabilitation. Methods Following the framework developed by Arksey and O'Malley, a scoping review was conducted. We performed a literature search using MEDLINE, CINAHL, the Cochrane Central Register of Controlled Trials, Nursing & Allied Health, and MedicLatina databases. Results A total of 906 papers were identified. After selecting and analyzing the articles, 17 papers were included in this review. Health professionals use various strategies to motivate stroke survivors. These approaches include establishing a therapeutic alliance, improving patients' health literacy, defining realistic goals, fostering problem-solving skills, personalizing the rehabilitation program, showcasing success stories, utilizing persuasive techniques, offering encouragement and compliments, providing emotional support, and effectively managing symptoms. Conclusion The knowledge gathered in this review can guide healthcare professionals in helping patients overcome barriers to rehabilitation, improve their motivation, and ultimately enhance their recovery outcomes.
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Affiliation(s)
- Júlio Belo Fernandes
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
- Nurs* Lab, Almada, Portugal
| | - Sónia Fernandes
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
- Nurs* Lab, Almada, Portugal
| | - Josefa Domingos
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
| | - Cidália Castro
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
- Nurs* Lab, Almada, Portugal
| | - Ana Romão
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
- Nurs* Lab, Almada, Portugal
| | - Susana Graúdo
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, Hospital Garcia de Orta, Almada, Portugal
| | - Gonçalo Rosa
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
- Nurs* Lab, Almada, Portugal
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, Hospital Garcia de Orta, Almada, Portugal
| | - Tânia Franco
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, Hospital Garcia de Orta, Almada, Portugal
| | - Ana Patrícia Ferreira
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, Hospital Garcia de Orta, Almada, Portugal
| | - Claudine Chambino
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, Hospital Garcia de Orta, Almada, Portugal
| | - Bruno Ferreira
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, Hospital Garcia de Orta, Almada, Portugal
| | - Susana Courela
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, Hospital Garcia de Orta, Almada, Portugal
| | - Maria José Ferreira
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, Hospital Garcia de Orta, Almada, Portugal
| | - Isabel Silva
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, Hospital Garcia de Orta, Almada, Portugal
| | - Vera Tiago
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, ACeS Almada-Seixal, UCC Seixal, Seixal, Portugal
| | - Maria João Morais
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, ACeS Almada-Seixal, UCC Seixal, Seixal, Portugal
| | - Joana Casal
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, ACeS Almada-Seixal, UCC Seixal, Seixal, Portugal
| | - Silvia Pereira
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, ACeS Almada-Seixal, UCC Seixal, Seixal, Portugal
| | - Catarina Godinho
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, ACeS Almada-Seixal, UCC Seixal, Seixal, Portugal
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Teodoro J, Fernandes S, Castro C, Fernandes JB. Current Trends in Gait Rehabilitation for Stroke Survivors: A Scoping Review of Randomized Controlled Trials. J Clin Med 2024; 13:1358. [PMID: 38592172 PMCID: PMC10932333 DOI: 10.3390/jcm13051358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 02/23/2024] [Accepted: 02/24/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Stroke stands as a significant global health concern, constituting a leading cause of disability worldwide. Rehabilitation interventions are crucial in aiding the recovery of stroke patients, contributing to an overall enhancement in their quality of life. This scoping review seeks to identify current trends in gait rehabilitation for stroke survivors. METHODS The review followed the methodological framework suggested by Arksey and O'Malley. Electronic databases, such as CINAHL Complete, MEDLINE Complete, and Nursing & Allied Health Collection, were systematically searched in November 2023. Inclusion criteria comprised papers published in either English or Portuguese from 2013 to 2023. RESULTS From the initial search, a total of 837 papers were identified; twenty-one papers were incorporated into this review. Thirteen distinct categories of gait rehabilitation interventions were identified, encompassing diverse approaches. These categories comprise conventional rehabilitation exercises, traditional gait training with integrated technology, and gait training supported by modern technologies. CONCLUSIONS Although traditional rehabilitation exercises have historically proven effective in aiding stroke survivors, a recent trend has emerged, emphasizing the development and integration of innovative therapeutic approaches that harness modern technologies.
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Affiliation(s)
- Joana Teodoro
- Department of Nursing, Hospital Garcia de Orta, 2805-267 Almada, Portugal;
- Nurs* Lab, 2829-511 Almada, Portugal; (S.F.); (C.C.)
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal
| | - Sónia Fernandes
- Nurs* Lab, 2829-511 Almada, Portugal; (S.F.); (C.C.)
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal
| | - Cidália Castro
- Nurs* Lab, 2829-511 Almada, Portugal; (S.F.); (C.C.)
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal
| | - Júlio Belo Fernandes
- Nurs* Lab, 2829-511 Almada, Portugal; (S.F.); (C.C.)
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal
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Oshvandi K, Torabi M, Khazaei M, Khazaei S, Yousofvand V. Impact of Hope on Stroke Patients Receiving a Spiritual Care Program in Iran: A Randomized Controlled Trial. JOURNAL OF RELIGION AND HEALTH 2024; 63:356-369. [PMID: 36435926 PMCID: PMC9702748 DOI: 10.1007/s10943-022-01696-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/11/2022] [Indexed: 06/16/2023]
Abstract
This study sought to examine the effect of a spiritual program on the hope of stroke patients in Iran. The present study was a randomized controlled trial that included 108 stroke patients referred to Besat Hospital, Hamadan, Iran, in 2021. Participants were randomized to either the intervention group (n = 54) or control group (n = 54). The data were collected before the intervention by using the demographic information form, Snyder's Adult Hope Scale (AHS), the Modified Rankin Scale (MRS), and after the intervention, the Snyder's Adult Hope Scale (AHS). The intervention group received four sessions of 45-60 min (one session per week) that included a spiritual needs assessment, religious care, spiritual supportive care, and evaluation of benefits. After the intervention, a significant between-group difference was observed (p < 0.001). There was also a significant increase in the mean of hope scores in the intervention group from baseline to follow-up (within-group difference) (p < 0.001), while there was no significant difference between baseline and follow-up in the control group (p = 0.553). (IRCT 20160110025929N36 and date: 2021/09/27).
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Affiliation(s)
- Khodayar Oshvandi
- Department of Medical Surgical Nursing, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Torabi
- Chronic Diseases (Home Care) Research Centre, Malayer School of Nursing, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mojtaba Khazaei
- Besat Educational and Medical Center, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Salman Khazaei
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Vahid Yousofvand
- Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
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Wong MNK, Cheung MKT, Ng YM, Yuan HL, Lam BYH, Fu SN, Chan CCH. International Classification of Functioning, Disability, and Health-based rehabilitation program promotes activity and participation of post-stroke patients. Front Neurol 2023; 14:1235500. [PMID: 38020626 PMCID: PMC10657202 DOI: 10.3389/fneur.2023.1235500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Background The International Classification of Functioning, Disability, and Health (ICF) model has been applied in post-stroke rehabilitation, yet limited studies explored its clinical application on enhancing patients' Activity and Participation (ICF-A&P) level. Purpose This study gathered evidence of the effects of an ICF-based post-stroke rehabilitation program (ICF-PSRP) in enhancing community reintegration in terms of ICF-A&P of post-stroke patients. Methods Fifty-two post-stroke patients completed an 8 to 12 weeks multidisciplinary ICF-PSRP after setting personal treatment goals in an outpatient community rehabilitation center. Intake and pre-discharge assessments were administered for primary outcomes of Body function (ICF-BF; e.g., muscle strength) and ICF-A&P (e.g., mobility), and secondary outcomes of perceived improvements in ability (e.g., goal attainment and quality of life). Results There were significantly higher levels in the ICF-BF and ICF-A&P domains, except cognitive function under the ICF-BF. Improvements in the primary outcomes predicted corresponding secondary outcomes. Firstly, expressive and receptive functions (ICP-BF) were mediated by the everyday language (ICF-A&P) which predicted patients' satisfaction with the language-related quality of life. Secondly, upper extremity function (ICP-BF) was mediated by the lower extremity mobility (ICF-A&P) predicting work and productivity-related quality of life. Content analyses showed that combined ICF-BF and ICF-A&P contents throughout the ICF-PSRP contributed to the positive treatment effects. Conclusion The ICF-PSRP was effective in promoting body function, and activity and participation levels of post-stroke patients. Positive treatment effects are characterized by goal-setting process, cross-domain content design, and community-setting delivery.Clinical trial registration: https://clinicaltrials.gov/study/NCT05941078?id=NCT05941078&rank=1, identifier NCT05941078.
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Affiliation(s)
- Mabel Ngai-Kiu Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Department of Psychology, The Education University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Mike Kwun-Ting Cheung
- Centre on Research and Advocacy, The Hong Kong Society of Rehabilitation, Hong Kong, Hong Kong SAR, China
| | - Yuk-Mun Ng
- Rehabilitation Division, The Hong Kong Society for Rehabilitation, Hong Kong, Hong Kong SAR, China
| | - Huan-Ling Yuan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Bess Yin-Hung Lam
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, Hong Kong SAR, China
| | - Siu Ngor Fu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Chetwyn Che Hin Chan
- Department of Psychology, The Education University of Hong Kong, New Territories, Hong Kong SAR, China
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Lee EJ, An HY, Lim J, Park KI, Choi SY, Jeong HY, Kang DW, Yang W, Kim JM, Ko SB, Lee SH, Yoon BW, Koh Y, Jung KH. Clonal Hematopoiesis and Acute Ischemic Stroke Outcomes. Ann Neurol 2023; 94:836-847. [PMID: 37532684 DOI: 10.1002/ana.26754] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/27/2023] [Accepted: 07/29/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVE The effect of clonal hematopoiesis of indeterminate potential (CHIP) on the manifestation and clinical outcomes of acute ischemic stroke (AIS) has not been fully elucidated. METHODS Patients with AIS were included from a prospective registry coupled with a DNA repository. Targeted next-generation sequencing on 25 genes that are frequently mutated in hematologic neoplasms was performed. The prevalence of CHIP was compared between patients with AIS and age-matched healthy individuals. A multivariate linear or logistic regression model was used to assess the association among CHIP and stroke severity, hemorrhagic transformation, and functional outcome at 90 days. RESULTS In total, 380 patients with AIS (mean age = 67.2 ± 12.7 years; 41.3% women) and 446 age-matched controls (mean age = 67.2 ± 8.7 years; 31.4% women) were analyzed. The prevalence of CHIP was significantly higher in patients with AIS than in the healthy controls (29.0 vs 22.0%, with variant allele frequencies of 1.5%, p = 0.024). PPM1D was found to be most significantly associated with incident AIS (adjusted odds ratio [aOR] = 7.85, 95% confidence interval [CI] = 1.83-33.63, p = 0.006). The presence of CHIP was significantly associated with the initial National Institutes of Health Stroke Scale (NIHSS) score (β = 1.67, p = 0.022). Furthermore, CHIP was independently associated with the occurrence of hemorrhagic transformation (65/110 clonal hematopoiesis positive [CH+] vs 56/270 CH negative [CH-], aOR = 5.63, 95% CI = 3.24-9.77, p < 0.001) and 90-day functional disability (72/110 [CH+] vs 99/270 [CH-], aOR = 2.15, 95% CI = 1.20-3.88, p = 0.011). INTERPRETATION CH was significantly associated with incident AIS. Moreover, particularly, sequence variations in PPM1D, TET2, and DNMT3A represent a new prognostic factor for AIS. ANN NEUROL 2023;94:836-847.
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Affiliation(s)
- Eung-Joon Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Hong Yul An
- Genome Opinion Incorporation, Seoul, South Korea
| | - Jiwoo Lim
- Genome Opinion Incorporation, Seoul, South Korea
| | - Kyung-Il Park
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
- Department of Neurology, Seoul National University Healthcare System Gangnam Center, Seoul, South Korea
| | - Su-Yeon Choi
- Division of Cardiology, Department of Internal Medicine, Seoul National University Healthcare System Gangnam Center, Seoul, South Korea
| | - Han-Yeong Jeong
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Dong-Wan Kang
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Wookjin Yang
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Jeong-Min Kim
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Sang-Bae Ko
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Seung-Hoon Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Byung-Woo Yoon
- Department of Neurology, Uijeongbu Eulji Medical Center, Uijeongbu-si, South Korea
| | - Youngil Koh
- Genome Opinion Incorporation, Seoul, South Korea
- Division of Hematology and Oncology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Keun-Hwa Jung
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
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Kong E, Park D, Chang MC. Prediction of motor outcome based on brain perfusion single photon emission computed tomography in corona radiata infarct. Int J Neurosci 2023:1-7. [PMID: 37812028 DOI: 10.1080/00207454.2023.2269476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/06/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND There is limited information on brain perfusion single-photon emission computed tomography (SPECT) findings related to motor outcomes in patients with stroke. We aimed to investigate whether brain SPECT can be used to determine motor outcomes after corona radiata infarction. METHODS Eighty-nine patients were recruited in this study. Brain SPECT and diffusion tensor tractography (DTT) were conducted to evaluate the state of the corticospinal tract (CST) within 7-30 days of corona radiata infarct. Motor outcome was measured 6 months after infarct onset and was evaluated using the modified Brunnstrom classification (MBC) and functional ambulation category (FAC) for motor function of the upper and lower extremities, respectively. The presence of hypoperfusion on brain SPECT was evaluated in the frontal lobe, temporal lobe, parietal lobe, basal ganglia, thalamus, and cerebellum on both the ipsilesional and contralesional sides. Statistical analysis was performed using multivariate logistic regression, comparing patients in which CST was spared versus interrupted. RESULTS Hypoperfusion in the contralesional cerebellum was indicative of poor recovery in both the upper and lower extremities after corona radiata infarction when the CST was interrupted. Additionally, when the CST was preserved, hypoperfusion in the ipsilesional thalamus was indicative of poor recovery of the lower extremities. CONCLUSION Brain SPECT evaluation was shown to be a useful tool for predicting motor outcomes in patients with corona radiata infarcts.
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Affiliation(s)
- Eunjung Kong
- Department of Nuclear Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Donghwi Park
- Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Min Cheol Chang
- Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea
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Yousofvand V, Torabi M, Oshvandi K, Kazemi S, Khazaei S, Khazaei M, Azizi A. Impact of a spiritual care program on the sleep quality and spiritual health of Muslim stroke patients: A randomized controlled trial. Complement Ther Med 2023; 77:102981. [PMID: 37640165 DOI: 10.1016/j.ctim.2023.102981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 08/23/2023] [Accepted: 08/25/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVES Stroke patients often experience poor sleep quality and spiritual health due to complications and limitations. In this situation, implementing spiritual care may reduce these problems. Therefore, this study aimed to examine the effect of a spiritual care program on sleep quality and spiritual health of Muslim stroke patients. METHODS This was a two-group randomized clinical trial conducted in Hamadan, Iran, in 2021, with 117 stroke patients. The samples were selected by convenience sampling and assigned to experimental (N = 59) and control (N = 58) groups based on random permutation blocks. The data were collected using the demographic information form, the Pittsburgh Sleep Quality Index, the Paloutzian and Ellison Spiritual Well-Being Scale, and the Modified Rankin Scale before and one month after the intervention. The experimental group received five daily sessions of spiritual care for 45-60 min based on standard and local methods, including patient orientation and identification of spiritual needs, religious care, supportive spiritual care, and beneficial evaluations. Data were analyzed by chi-square test, Fisher's exact test, independent t-test, and paired t-test at 0.05 significance level in SPSS 21. RESULTS The socio-demographic characteristics were similar between the groups (p > 0.05). At baseline, there was no significant difference in sleep quality and spiritual health between the experimental and control groups (p > 0.05). However, after the intervention, the sleep quality and spiritual health of patients in the experimental group improved significantly compared with the control group (p < 0.05). CONCLUSION The spiritual care program improved sleep quality and spiritual health of stroke patients; therefore, nurses should consider these aspects to provide holistic care.
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Affiliation(s)
- Vahid Yousofvand
- Department of Medical-Surgical Nursing, Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Torabi
- Chronic Diseases (Home Care) Research Centre, Malayer School of Nursing, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Khodayar Oshvandi
- Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Saeid Kazemi
- Department of Islamic Education, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Salman Khazaei
- Department of Epdemiology, Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mojtaba Khazaei
- Department of Neurology, Besat Educational and Medical Center, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Azim Azizi
- Department of Medical -Surgical Nursing, Chronic Diseases (Home Care) Research Centre, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
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Saraiva J, Rosa G, Fernandes S, Fernandes JB. Current Trends in Balance Rehabilitation for Stroke Survivors: A Scoping Review of Experimental Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6829. [PMID: 37835099 PMCID: PMC10572981 DOI: 10.3390/ijerph20196829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/15/2023] [Accepted: 09/23/2023] [Indexed: 10/15/2023]
Abstract
Balance impairment is a common consequence of a stroke, which can significantly hinder individuals' participation in daily activities, social interactions, and leisure pursuits and their ability to return to work. Rehabilitation is vital for minimizing post-stroke sequelae and facilitating the recovery of patients. This review aims to identify current trends in balance rehabilitation of stroke survivors. This Scoping review followed Arksey and O'Malley's methodological framework. The literature search was conducted in electronic databases, including CINAHL Complete, MEDLINE Complete, and Nursing & Allied Health Collection. The search was performed in March 2023, and the inclusion criteria were articles published in English or Portuguese between 2013 and 2023. A total of 446 articles were identified. After selecting and analyzing the reports, fourteen publications were included in this review. Seven distinct categories of balance rehabilitation interventions were identified, covering various approaches. These categories included conventional rehabilitation exercises, gym-based interventions, vibration therapy, rhythmic auditory stimulation training, boxing therapy, dual-task training, and technology-based rehabilitation interventions. Each of these methods presents unique benefits and can significantly impact the recovery of balance in stroke survivors, enhancing their overall well-being and functional capacity.
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Affiliation(s)
- Júlia Saraiva
- Department of Nursing, Hospital Garcia de Orta, 2805-267 Almada, Portugal;
- Nurs* Lab, Caparica, 2829-511 Almada, Portugal; (S.F.); (J.B.F.)
| | - Gonçalo Rosa
- Department of Nursing, Hospital Garcia de Orta, 2805-267 Almada, Portugal;
- Nurs* Lab, Caparica, 2829-511 Almada, Portugal; (S.F.); (J.B.F.)
| | - Sónia Fernandes
- Nurs* Lab, Caparica, 2829-511 Almada, Portugal; (S.F.); (J.B.F.)
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, 2829-511 Almada, Portugal
| | - Júlio Belo Fernandes
- Nurs* Lab, Caparica, 2829-511 Almada, Portugal; (S.F.); (J.B.F.)
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, 2829-511 Almada, Portugal
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Fernandes JB, Domingos J, Família C, Veríssimo J, Castanheira P, Menezes C, Vicente C, Santos C, Marvão E, Coelho J, Mestre J, Teodoro J, Saraiva J, Cavaco M, Sousa N, Godinho C. Adapted Portuguese folk dance intervention for subacute rehabilitation post-stroke: study protocol. Front Public Health 2023; 11:1200093. [PMID: 37663853 PMCID: PMC10470121 DOI: 10.3389/fpubh.2023.1200093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
Dance can be an innovative, well-accepted, and effective therapy for stroke survivors. The present protocol aims to assess the feasibility of adapted Portuguese folk dance as a post stroke rehabilitative activity. We will use a mixed-methods pilot study convenience sampling to recruit 16 stroke survivors with mild-moderate lower limb paresis from a rehabilitation center in Lisbon and Tagus Valley. In addition to usual care, participants will attend 3 days per week 1-h dance exercise for 8 weeks. The dance style used for this intervention will be an adaptation of the Portuguese folk dance. Assessment will be conducted before and immediately after the program intervention. Acceptability will be assessed by four key domains (enrollment, retention, satisfaction, and recommendation to others). Safety will be assessed based on the number and type of adverse events. Feasibility will be assessed based on balance performance and functional mobility. Quantitative data will be analyzed through descriptive statistics for sample characterization, followed by inferential statistics to evaluate differences in the balance recovery and functional mobility scores between the initial and final assessment. Qualitative data will be analyzed using an inductive process of content analysis. The Portuguese folk dance program has the potential to improve balance outcomes and functional mobility. Our results will help validate Portuguese folk dance as a tool for rehabilitation settings for stroke survivors. The potential of our program to enhance balance outcomes and functional mobility among stroke survivors bears implications for aging and public health initiatives. Positive results from this study could pave the way for integrating dance-based rehabilitative activities into standard stroke rehabilitation protocols, catering to older stroke survivors' specific needs and preferences.
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Affiliation(s)
- Júlio Belo Fernandes
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Almada, Portugal
| | - Josefa Domingos
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Almada, Portugal
| | - Carlos Família
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Almada, Portugal
- Molecular Pathology and Forensic Biochemistry Laboratory (MPFBL), Almada, Portugal
| | - Júlio Veríssimo
- UCCI São Roque, Santa Casa da Misericórdia de Lisboa, Lisbon, Portugal
| | | | - Carla Menezes
- UCCI São Roque, Santa Casa da Misericórdia de Lisboa, Lisbon, Portugal
| | - Célia Vicente
- Department of Nursing, Hospital Garcia de Orta EPE (HGO), Almada, Portugal
| | - Claúdia Santos
- Department of Nursing, Hospital Garcia de Orta EPE (HGO), Almada, Portugal
| | - Elisabete Marvão
- Department of Nursing, Hospital Garcia de Orta EPE (HGO), Almada, Portugal
| | - Joana Coelho
- Department of Nursing, Hospital Garcia de Orta EPE (HGO), Almada, Portugal
| | - Joana Mestre
- Department of Nursing, Hospital Garcia de Orta EPE (HGO), Almada, Portugal
| | - Joana Teodoro
- Department of Nursing, Hospital Garcia de Orta EPE (HGO), Almada, Portugal
| | - Júlia Saraiva
- Department of Nursing, Hospital Garcia de Orta EPE (HGO), Almada, Portugal
| | - Marlene Cavaco
- Department of Nursing, Hospital Garcia de Orta EPE (HGO), Almada, Portugal
| | - Natacha Sousa
- ARS LVT, ACES Lisboa Norte, UCC Integrar na Saúde—ECCI Benfica, Lisbon, Portugal
| | - Catarina Godinho
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Almada, Portugal
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Szepanowski RD, Haupeltshofer S, Vonhof SE, Frank B, Kleinschnitz C, Casas AI. Thromboinflammatory challenges in stroke pathophysiology. Semin Immunopathol 2023:10.1007/s00281-023-00994-4. [PMID: 37273022 DOI: 10.1007/s00281-023-00994-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/27/2023] [Indexed: 06/06/2023]
Abstract
Despite years of encouraging translational research, ischemic stroke still remains as one of the highest unmet medical needs nowadays, causing a tremendous burden to health care systems worldwide. Following an ischemic insult, a complex signaling pathway emerges leading to highly interconnected thrombotic as well as neuroinflammatory signatures, the so-called thromboinflammatory cascade. Here, we thoroughly review the cell-specific and time-dependent role of different immune cell types, i.e., neutrophils, macrophages, T and B cells, as key thromboinflammatory mediators modulating the neuroinflammatory response upon stroke. Similarly, the relevance of platelets and their tight crosstalk with a variety of immune cells highlights the relevance of this cell-cell interaction during microvascular dysfunction, neovascularization, and cellular adhesion. Ultimately, we provide an up-to-date overview of therapeutic approaches mechanistically targeting thromboinflammation currently under clinical translation, especially focusing on phase I to III clinical trials.
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Affiliation(s)
- R D Szepanowski
- Department of Neurology, University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen, Germany
| | - S Haupeltshofer
- Department of Neurology, University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen, Germany
| | - S E Vonhof
- Department of Neurology, University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen, Germany
| | - B Frank
- Department of Neurology, University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen, Germany
| | - C Kleinschnitz
- Department of Neurology, University Hospital Essen, Essen, Germany.
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen, Germany.
| | - A I Casas
- Department of Neurology, University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen, Germany
- Department of Pharmacology and Personalised Medicine, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Chung CC, Su ECY, Chen JH, Chen YT, Kuo CY. XGBoost-Based Simple Three-Item Model Accurately Predicts Outcomes of Acute Ischemic Stroke. Diagnostics (Basel) 2023; 13:diagnostics13050842. [PMID: 36899986 PMCID: PMC10000880 DOI: 10.3390/diagnostics13050842] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 02/19/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
An all-inclusive and accurate prediction of outcomes for patients with acute ischemic stroke (AIS) is crucial for clinical decision-making. This study developed extreme gradient boosting (XGBoost)-based models using three simple factors-age, fasting glucose, and National Institutes of Health Stroke Scale (NIHSS) scores-to predict the three-month functional outcomes after AIS. We retrieved the medical records of 1848 patients diagnosed with AIS and managed at a single medical center between 2016 and 2020. We developed and validated the predictions and ranked the importance of each variable. The XGBoost model achieved notable performance, with an area under the curve of 0.8595. As predicted by the model, the patients with initial NIHSS score > 5, aged over 64 years, and fasting blood glucose > 86 mg/dL were associated with unfavorable prognoses. For patients receiving endovascular therapy, fasting glucose was the most important predictor. The NIHSS score at admission was the most significant predictor for those who received other treatments. Our proposed XGBoost model showed a reliable predictive power of AIS outcomes using readily available and simple predictors and also demonstrated the validity of the model for application in patients receiving different AIS treatments, providing clinical evidence for future optimization of AIS treatment strategies.
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Affiliation(s)
- Chen-Chih Chung
- Department of Neurology, Taipei Medical University—Shuang Ho Hospital, New Taipei City 235, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City 110, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University—Shuang Ho Hospital, New Taipei City 235, Taiwan
| | - Emily Chia-Yu Su
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei City 110, Taiwan
- Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei City 110, Taiwan
| | - Jia-Hung Chen
- Department of Neurology, Taipei Medical University—Shuang Ho Hospital, New Taipei City 235, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City 110, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University—Shuang Ho Hospital, New Taipei City 235, Taiwan
| | - Yi-Tui Chen
- Smart Healthcare Interdisciplinary College, National Taipei University of Nursing and Health Sciences, Taipei City 112, Taiwan
- Department of Health Care Management, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei City 112, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei City 103, Taiwan
| | - Chao-Yang Kuo
- Smart Healthcare Interdisciplinary College, National Taipei University of Nursing and Health Sciences, Taipei City 112, Taiwan
- Correspondence: ; Tel.: +886-2-28227101 (ext. 1385)
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14
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Wu Y, Dai Z, Xiao W, Wang H, Huang Y, Si M, Fu J, Chen X, Jia M, Leng Z, Cui D, Mak WWS, Su X. Perceived stigma among discharged patients of COVID-19 in Wuhan, China: A latent profile analysis. Front Public Health 2023; 11:1111900. [PMID: 37026126 PMCID: PMC10070756 DOI: 10.3389/fpubh.2023.1111900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/03/2023] [Indexed: 04/08/2023] Open
Abstract
Background Perceived stigma has greatly influenced the life quality of the COVID-19 patients who recovered and were discharged (RD hereafter). It is essential to understand COVID-19 stigma of RD and its related risk factors. The current study aims to identify the characteristics of perceived COVID-19 stigma in RD using latent profile analysis (LPA), to explore its psycho-social influencing factors, and to determine the cut-off point of the stigma scale using receiver operating characteristic (ROC) analysis. Methods A cross-sectional study was conducted among COVID-19 RD in 13 communities in Jianghan District, Wuhan City, Hubei Province, China from June 10 to July 25, 2021, enrolling total 1,297 participants. Data were collected on demographic characteristics, COVID-19 perceived stigma, post-traumatic stress disorder (PTSD), anxiety, depression, sleep disorder, fatigue, resilience, social support, and peace of mind. LPA was performed to identify different profiles of perceived COVID-19 stigma level. Univariate analysis and multinominal logistic regression analysis were conducted to explore the influencing factors in different profiles. ROC analyses was carried out to identify the cut-off value of perceived stigma. Results Among the participants, three profiles of perceived stigma were identified: "low perceived COVID-19 stigma" (12.8%), "moderate perceived COVID-19 stigma" (51.1%), and "severe perceived COVID-19 stigma" (36.1%). Multinominal logistic regression analysis revealed that older age, living with other people, anxiety, and sleep disorder were positively associated with moderate perceived COVID-19 stigma, while higher educational level was negatively associated with moderate perceived COVID-19 stigma. Female, older age, living with other people, anxiety, and sleep disorder were positively associated with severe perceived COVID-19 stigma, while higher educational level, social support, and peace of mind were negatively associated with severe perceived COVID-19 stigma. ROC curve of the Short Version of COVID-19 Stigma Scale (CSS-S) for screening perceived COVID-19 stigma showed that the optimal cut-off value was ≥ 20. Conclusion The study focuses on the issue of perceived COVID-19 stigma and its psycho-socio influencing factors. It provides evidence for implementing relevant psychological interventions to COVID-19 RD.
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Affiliation(s)
- Yijin Wu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhenwei Dai
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Weijun Xiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hao Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yiman Huang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Mingyu Si
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jiaqi Fu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xu Chen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Mengmeng Jia
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhiwei Leng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Dan Cui
- National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
- The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China
| | - Winnie W. S. Mak
- Department of Psychology, Diversity and Well-Being Laboratory, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Xiaoyou Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- *Correspondence: Xiaoyou Su,
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The association of mindfulness and psychological well-being among individuals who have recovered from COVID-19 in Jianghan District, Wuhan, China: A cross-sectional study. J Affect Disord 2022; 319:437-445. [PMID: 36162667 PMCID: PMC9502442 DOI: 10.1016/j.jad.2022.09.062] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/28/2022] [Accepted: 09/20/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND In the global pandemic of the coronavirus disease 2019 (COVID-19), depression and post-traumatic stress disorder (PTSD) have commonly occurred among COVID-19 patients, whose experiences of infection and subsequent treatment might develop negative consequences on their mental well-being even after recovery. Despite the general recognition of efficacy of mindfulness-based interventions in reducing psychological distress among various populations, there were insufficient studies on the relationship between mindfulness and mental health among individuals who have recovered from COVID-19. OBJECTIVE The current study aims to identify the prevalence of common mental health challenges among recovered COVID-19 patients in Jianghan District, Wuhan, China and to explore the potential mechanism through which mindfulness alleviate depression and PTSD. METHODS A cross-sectional survey on mental health was conducted among a convenience sample of adults recovered from COVID-19 in Jianghan District, Wuhan, China. The study participants completed questionnaires under the assistance of trained investigators. The questionnaire included Chinese version of Five Facets of Mindfulness Questionnaire-Short Form (FFMQ-SF), Generalized Anxiety Disorder Questionnaire (GAD-7), Resilience Style Questionnaire (RSQ), Impact of Events Scale-Revised (IES-R), and Patient Health Questionnaire (PHQ-9) to measure mindfulness, anxiety, resilience, PTSD, and depression respectively. Structural equation modeling was used to explore the relationship between mindfulness and mental health outcomes of this population. RESULTS 1541 respondents (654 [42.4 %] men and 887 [57.6 %] women) completed the questionnaire between June 10 and July 25, 2021, of whom 36.2 % and 27.1 % had mild and severe levels of depressive and anxiety symptoms respectively, and 15.2 % was indicated with PTSD. The average score of mindfulness of the study participants was (3.100 ± 0.387), and that of resilience was (3.560 ± 0.877). The structural equation model fit the data well, demonstrating that mindfulness was negatively associated with depressive symptoms directly (β = -0.031, P = 0.021) or indirectly through the mediation effect of resilience (β = -0.019, P = 0.009) and anxiety symptoms (β = -0.208, P < 0.001), and was negatively associated with PTSD through the mediation effect of anxiety symptoms (β = -0.142, P < 0.001). CONCLUSION Individuals who have recovered from COVID-19 commonly experienced psychological distress. Mindfulness is associated with alleviation of depressive and PTSD symptoms directly or indirectly. Interventions based on mindfulness are suggested to improve the mental well-being of this population.
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Influencing factors of anxiety and depression of discharged COVID-19 patients in Wuhan, China. PLoS One 2022; 17:e0276608. [DOI: 10.1371/journal.pone.0276608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/10/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives
This study is intended to assess the prevalence of depression and anxiety in individuals who had recovered from COVID-19 and been discharged from hospital (RD hereafter) in Wuhan, China, and to explore the factors associated with these mental disorders.
Methods
Participants of this study were the RD who were infected at the beginning of the outbreak from 13 communities in Jianghan District of Wuhan City, Hubei Province, China by convenience sampling in mid-2021. The Generalized Anxiety Disorder Questionnaire, the Patient Health Questionnaire, the Short Version of COVID-19 Stigma Scale, the Peace of Mind Scale, the Resilience Style Questionnaire, and the Perceived Social Support Questionnaire were used to collect relevant information of the participants. Descriptive analyses, Pearson correlation analysis, and logistic regression analysis were used to describe and analyze the data and to examine the factors associated with the mental health status of this population.
Results
In total, we recruited 1601 participants from 3059 COVID-19 patients, and 1541 participants completed the questionnaire survey, with a response rate of 96.25%. Finally, 1297 participants met the inclusion and exclusion criteria in this study, of whom 28.8% and 37.9% reported mild to severe levels of anxiety and depression symptoms. Perceived better mental health status during hospitalization, higher frequency of alcohol use per week, peace of mind, higher education level, and resilience were negatively associated with anxiety, while stigma and history of psychological or emotional counseling before infection was positively associated with anxiety. More severe clinical classification of COVID-19 and stigma (AOR = 1.057, P<0.001) were both positively associated with depression, while perceived better mental health status during hospitalization (AOR = 0.564, P<0.001), higher frequency of alcohol use per week (AOR = 0.462, P = 0.004), peace of mind (AOR = 0.857, P<0.001), and social support (AOR = 0.972, P = 0.034) were negatively associated with depression.
Conclusions
Tailored interventions on reducing stigma, enhancing mindfulness and social support should be taken into account to alleviate anxiety and depression among RD.
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Ye S, Pan H, Li W, Wang B, Xing J, Xu L. High serum amyloid A predicts risk of cognitive impairment after lacunar infarction: Development and validation of a nomogram. Front Neurol 2022; 13:972771. [PMID: 36090853 PMCID: PMC9449353 DOI: 10.3389/fneur.2022.972771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 07/26/2022] [Indexed: 12/03/2022] Open
Abstract
Background Post-stroke cognitive impairment (PSCI) after lacunar infarction was worth attention in recent years. An easy-to-use score model to predict the risk of PSCI was rare. This study aimed to explore the association between serum amyloid A (SAA) and cognitive impairment, and it also developed a nomogram for predicting the risk of PSCI in lacunar infarction patients. Methods A total of 313 patients with lacunar infarction were enrolled in this retrospective study between January 2021 and December 2021. They were divided into a training set and a validation set at 70%:30% randomly. The Chinese version of the Mini-Mental State Examination (MMSE) was performed to identify cognitive impairment 3 months after discharge. Univariate and multivariate logistic regression analyses were used to determine the independent risk factors for PSCI in the training set. A nomogram was developed based on the five variables, and the calibration curve and the receiver operating characteristic (ROC) curve were drawn to assess the predictive ability of the nomogram between the training set and the validation set. The decision curve analysis (DCA) was also conducted in both sets. Results In total, 52/313 (16.61%) participants were identified with PSCI. The SAA levels in patients with PSCI were significantly higher than non-PSCI patients in the training set (P < 0.001). After multivariate analysis, age, diabetes mellitus, white blood count, cystatin C, and SAA were independent risk predictors of PSCI. The nomogram demonstrated a good discrimination performance between the training set (AUC = 0.860) and the validation set (AUC = 0.811). The DCA showed that the nomogram had a well clinical utility in the two sets. Conclusion The increased SAA is associated with PSCI in lacunar infarction patients, and the nomogram developed with SAA can increase prognostic information for the early detection of PSCI.
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Affiliation(s)
- Sheng Ye
- Department of Emergency, The Second Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Huiqing Pan
- Department of Emergency, The Second Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Weijia Li
- School of Clinical Medicine, Wannan Medical College, Wuhu, China
| | - Bing Wang
- Department of Emergency, The Second Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Jingjing Xing
- Department of Emergency, The Second Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Li Xu
- Department of Neurology, The Second Affiliated Hospital of Wannan Medical College, Wuhu, China
- *Correspondence: Li Xu
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Al Alawi AM, Al Busaidi I, Al Shibli E, Al-Senaidi AR, Al Manwari S, Al Busaidi I, Muhanna F, Al Qassabi A. Health outcomes after acute ischemic stroke:retrospective and survival analysis from Oman. Ann Saudi Med 2022; 42:269-275. [PMID: 35933604 PMCID: PMC9357299 DOI: 10.5144/0256-4947.2022.269] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Stroke mortality and related functional disability have been declining over the last two decades, but stroke continues to represent the second leading cause of cardiovascular death worldwide and the number one cause for acquired long-term disability. OBJECTIVES Assess short- and long-term health outcomes after acute ischemic stroke and analyze factors associated with poor survival and functional outcomes. DESIGN Retrospective and survival analysis SETTING: Inpatient unit at a tertiary care referral hospital. PATIENTS AND METHODS All patients admitted with acute ischemic stroke from 1 January 2017 to 31 August 2018 were included in the study. Functional status was assessed using the modified Rankin Scale (mRS). Other demographic and clinical variables were obtained from medical records. Data were analyzed by multivariable logistic regression, Cox proportional hazards, and the Kaplan-Meier method. Long-term follow-up data, including mortality and mRS was collected by follow-up phone call. MAIN OUTCOME MEASURES Functional dependency and factors associated with mortality. SAMPLE SIZE AND CHARACTERISTICS 110 with mean age of 67.0 (14.7) years; 59 patients (53.6%) were males. RESULTS Hypertension (75.5%), diabetes mellitus (54.6%), and dyslipidemia (29.1%) were common. Sixty-five patients (59.1%) had mRS >2 upon discharge including 18 patients (16.4%) who died during the hospital stay. The cumulative mortality rate was 25.4% (28/110) at 12 months and 30.0% (33/110) at 24 months. Twenty-nine stroke survivors (29/70, 41.4%) remained physically dependent (mRS >2) at the end of follow-up. Old age, atrial fibrillation, history of prior stroke, chronic kidney disease, and peripheral arterial disease were associated with increased mortality and functional dependence. CONCLUSIONS Patients in Oman with acute ischemic stroke tend to have a high comorbidity burden, and their functional dependency and mortality are higher compared to patients from developed countries. Therefore, evidence-based measures such as establishing stroke units are essential to improve the health outcomes of patients with acute ischemic stroke. LIMITATIONS Retrospective at single center. CONFLICT OF INTEREST None.
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Affiliation(s)
- Abdullah M Al Alawi
- From the Department of Medicine, College of Medicine and Health Science, Sultan Qaboos University Hospital, Muscat, Oman.,From the Internal Medicine Program, Oman Medical Speciality Board, Al-Athaiba, Muscat, Oman
| | - Ikhlas Al Busaidi
- From the Internal Medicine Program, Oman Medical Speciality Board, Al-Athaiba, Muscat, Oman
| | - Emaad Al Shibli
- From the Internal Medicine Program, Oman Medical Speciality Board, Al-Athaiba, Muscat, Oman
| | - Al-Reem Al-Senaidi
- From the Department of Medicine, College of Medicine and Health Science, Sultan Qaboos University Hospital, Muscat, Oman
| | - Shahd Al Manwari
- From the Department of Medicine, College of Medicine and Health Science, Sultan Qaboos University Hospital, Muscat, Oman
| | - Ibtisam Al Busaidi
- From the Department of Medicine, College of Medicine and Health Science, Sultan Qaboos University Hospital, Muscat, Oman
| | - Fatema Muhanna
- From the Department of Medicine, College of Medicine and Health Science, Sultan Qaboos University Hospital, Muscat, Oman
| | - Ahmed Al Qassabi
- From the Department of Medicine, College of Medicine and Health Science, Sultan Qaboos University Hospital, Muscat, Oman
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Martins SCO, Borelli WV, Secchi TL, Mantovani GP, Pille A, Mora Cuervo DL, Carbonera LA, de Souza AC, Martins MCO, Brondani R, de Almeida AG, Dal Pizzol A, dos Santos FP, Alves AC, Meier NS, Andrade GPB, Maciel PA, Weber A, Machado GD, Parrini M, Nasi LA. Disparities in Stroke Patient-Reported Outcomes Measurement Between Healthcare Systems in Brazil. Front Neurol 2022; 13:857094. [PMID: 35599734 PMCID: PMC9120355 DOI: 10.3389/fneur.2022.857094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/24/2022] [Indexed: 01/01/2023] Open
Abstract
Introduction Acute stroke interventions, such as stroke units and reperfusion therapy, have the potential to improve outcomes. However, there are many disparities in patient characteristics and access to the best stroke care. Thus, we aim to compare patient-reported outcome measures (PROMs) after stroke in two stroke centers representing the public and private healthcare systems in Brazil. Methods PROMs through the International Consortium for Health Outcomes Measures (ICHOM) were assessed at 90 days after the stroke to compare two Brazilian hospitals in southern Brazil: a public university and a private stroke center, both with stroke protocols and stroke units. Results When compared with the private setting (n = 165), patients from the public hospital (n = 175) were younger, had poorer control of risk factors, had more frequent previous strokes, and arrived with more severe strokes. Both hospitals had a similar percentage of IV thrombolysis treatment. Only 5 patients received mechanical thrombectomy (MT), all in the private hospital. Public hospital patients presented significantly worse outcomes at 3 months, including worse quality of life and functional dependence (60 vs. 48%, p = 0.03). Poor outcome, as measured by the mRS score, was significantly associated with older age, higher NIHSS score, and the presence of heart failure. However, the public practice was a strong predictor of any self-reported disability. Conclusion Patients assisted at a good quality public stroke center with the same protocol used in the private hospital presented worse disability as measured by mRS and patient-reported outcome measures, with greater inability to communicate, dress, toilet, feed, and walk.
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Affiliation(s)
- Sheila Cristina Ouriques Martins
- Hospital Moinhos de Vento, Neurology Service and Postgraduate in Stroke Neurology, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Neurology Service, Porto Alegre, Brazil
- Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Brazilian Stroke Network, Porto Alegre, Brazil
- *Correspondence: Sheila Cristina Ouriques Martins
| | - Wyllians Vendramini Borelli
- Hospital de Clínicas de Porto Alegre, Neurology Service, Porto Alegre, Brazil
- Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Universidade Federal do Rio Grande do Sul, Pharmacology and Therapeutics Research Program, Porto Alegre, Brazil
- Wyllians Vendramini Borelli
| | - Thais Leite Secchi
- Hospital Moinhos de Vento, Neurology Service and Postgraduate in Stroke Neurology, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Neurology Service, Porto Alegre, Brazil
- Brazilian Stroke Network, Porto Alegre, Brazil
- Universidade Federal do Rio Grande do Sul, Postgraduate in Medical Sciences, Porto Alegre, Brazil
| | - Gabriel Paulo Mantovani
- Hospital de Clínicas de Porto Alegre, Neurology Service, Porto Alegre, Brazil
- Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Brazilian Stroke Network, Porto Alegre, Brazil
| | - Arthur Pille
- Hospital de Clínicas de Porto Alegre, Neurology Service, Porto Alegre, Brazil
- Brazilian Stroke Network, Porto Alegre, Brazil
- Universidade Federal do Rio Grande do Sul, Postgraduate in Medical Sciences, Porto Alegre, Brazil
| | - Daissy Liliana Mora Cuervo
- Hospital Moinhos de Vento, Neurology Service and Postgraduate in Stroke Neurology, Porto Alegre, Brazil
- Brazilian Stroke Network, Porto Alegre, Brazil
| | - Leonardo Augusto Carbonera
- Hospital Moinhos de Vento, Neurology Service and Postgraduate in Stroke Neurology, Porto Alegre, Brazil
- Brazilian Stroke Network, Porto Alegre, Brazil
| | - Ana Claudia de Souza
- Hospital Moinhos de Vento, Neurology Service and Postgraduate in Stroke Neurology, Porto Alegre, Brazil
- Brazilian Stroke Network, Porto Alegre, Brazil
- Universidade Federal do Rio Grande do Sul, Postgraduate in Medical Sciences, Porto Alegre, Brazil
| | - Magda Carla Ouriques Martins
- Hospital Moinhos de Vento, Neurology Service and Postgraduate in Stroke Neurology, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Neurology Service, Porto Alegre, Brazil
- Brazilian Stroke Network, Porto Alegre, Brazil
| | - Rosane Brondani
- Hospital de Clínicas de Porto Alegre, Neurology Service, Porto Alegre, Brazil
- Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Brazilian Stroke Network, Porto Alegre, Brazil
| | - Andrea Garcia de Almeida
- Hospital Moinhos de Vento, Neurology Service and Postgraduate in Stroke Neurology, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Neurology Service, Porto Alegre, Brazil
- Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Brazilian Stroke Network, Porto Alegre, Brazil
| | - Angélica Dal Pizzol
- Hospital Moinhos de Vento, Neurology Service and Postgraduate in Stroke Neurology, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Neurology Service, Porto Alegre, Brazil
- Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Brazilian Stroke Network, Porto Alegre, Brazil
| | - Franciele Pereira dos Santos
- Hospital Moinhos de Vento, Neurology Service and Postgraduate in Stroke Neurology, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Neurology Service, Porto Alegre, Brazil
- Brazilian Stroke Network, Porto Alegre, Brazil
| | - Ana Claudia Alves
- Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Nathalia Soares Meier
- Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | | | - Pedro Angst Maciel
- Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Alexandre Weber
- Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Gustavo Dariva Machado
- Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Kotov SV, Borisova VA, Slyunkova EV, Isakova EV, Kiselev AV, Kotov AS. [Dynamics of recovery of cognitive deficit in patients in the early recovery period of ischemic stroke]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:26-32. [PMID: 34932282 DOI: 10.17116/jnevro202112111126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Study of the effectiveness of the use of the drug Ampasse in the process of complex rehabilitation in patients in the early recovery period of ischemic stroke at the second (stationary) stage. MATERIAL AND METHODS The study included 60 patients, 28 women and 32 men, aged 43 to 76 years (mean - 58.4±9.1 years), in the recovery period after suffering a stroke in the period from 1 to 12 months (on average - 4.7±3.5 months). All patients received complex rehabilitation, patients of the 1st group received additional intravenous injections of the drug Ampasse 25 mg (5.0 ml), 15 injections. Patients of the 2nd group (n 0) did not receive Ampasse. To assess cognitive functions, the following tests were used: the Montreal Cognitive Assessment Scale (MoCA), Stroop's test, subtest 9 of the Wechsler test, Koos cubes (CC), the severity of anxiety and depression was assessed, and motor recovery was assessed by the hand motor activity test (ARAT). The assessment was carried out before the start of treatment and on the 21st day. RESULTS There was a statistically significant increase in the score on the MoCA scale, in patients of the 1st group by an average of 2 points, in the 2nd group there was no significant dynamics, a statistically significant difference was found in the proportion of patients who had an increase in the MoCA index after the course of treatment in the 1st group. compared with the 2nd (χ2 - 22.528, p<0.001). Decreased the level of rigidity according to the Stroop test in patients of the 1st group compared with the 2nd (χ2 - 8.297, p=0.004). The number of patients who showed positive dynamics in the Koos cubes test in the 1st group was statistically significantly higher (χ2- 4.344, p=0.038). A statistically significant decrease in the level of depression was revealed in patients of the 1st group. The number of patients with improved motor function of the hand was greater in the 1st group of MG (χ2 - 4.286, p<0.039). CONCLUSION In patients in complex therapy receiving intravenous administration of the drug Ampasse at a dose of 25 mg (5.0 ml) 15 administrations, a statistically significant improvement in cognitive functions was revealed according to MoCA tests, Stroop test, Koos Cubes, when compared with the comparison group. The use of Ampasse increased the effectiveness of cognitive and motor rehabilitation in patients with post-stroke disorders.
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Affiliation(s)
- S V Kotov
- Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia
| | - V A Borisova
- Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia
| | - E V Slyunkova
- Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia
| | - E V Isakova
- Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia
| | - A V Kiselev
- Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia
| | - A S Kotov
- Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia
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