Medicine and Health Sciences Commons^™

Assessing The Reliability Of The Pairwise Variability Index For Differential Diagnosis Of Apraxia Of Speech, Celeste Sinko

University Honors Theses

Differential diagnosis of apraxia of speech (AOS) from other speech and language disorders is a prevailing challenge in the field of speech language pathology. Presently, existing measures for assessing AOS consist of perceptual rating scales, such as the Apraxia of Speech Rating Scale developed by Duffy, Strand, Clark, and Josephs. While perceptual rating scales are the current gold standard for assessment and diagnosis of AOS, they require a high degree of clinical expertise, and are susceptible to rater bias and rater drift. Thus, there exists a need for quantitative, objective measures for differential diagnosis of AOS. The purpose of this …

Addressing Stroke Care Disparities Through Patient Education, Christina Annerino

Honors Capstones

It has been found across current studies and evaluations of stroke care and patient outcomes that there is a disparity in disability and mortality between male and female patients who have experienced stroke. The aforementioned studies did not identify the cause of this disparity, although a number of hypotheses for this phenomenon were provided. This study then conducted a preliminary survey of 130 participants, both men and women, aged 18-80 years old, to evaluate potential barriers to accessing stroke care and receiving treatment effectively. Preliminary survey data demonstrated consistent gaps in knowledge related to stroke risks, stroke symptoms, and when …

Filling The Gap: Educating Caregivers And Patients Post Stroke In An Acute Care Setting, Gabrielle A. Blecke

Occupational Therapy Capstone Presentations

Background: According to the U.S. Department of Health and Human Services (2022), every 40 seconds someone in the United States experiences a cerebrovascular accident (CVA), also known as stroke. A recent study suggests that 63% of these individuals will need informal caregiving from family, friends, or loved-ones throughout their rehabilitation process in order to safely transition home. Research suggests that patients and caregivers post stroke are not receiving enough education to prevent concerns such as caregiver burden, decreased caregiver wellness, and decreased patient outcomes, all which are within the scope of occupational therapy. Methods: Experiences at MyMichigan Midland Hospital drove …

Cva In Patient With Systemic Sclerosis On Aspirin Therapy: A Case Report, Rahyan Mahmud, Bianna Koutsenko, Kenneth Goich, Usaid Hasan

Rowan-Virtua Research Day

Introduction

Systemic sclerosis is an autoimmune disorder characterized by microvascular damage and multiorgan fibrosis. These patients have a higher risk of cerebrovascular events, but it is difficult to develop strategies for prevention due to limited understanding of underlying pathophysiology.

Case Presentation

A 76-year-old female with a history of systemic sclerosis presented to the emergency department with acute onset slurred speech, facial droop, and left arm pain with a National Institutes of Health (NIH) Stroke Scale of 1. She was outside the thrombolytic window. Other history includes hypertension and hyperlipidemia; both were well controlled. MRI confirmed right frontal lobe ischemic stroke …

A Stroke Or Not A Stroke? A Case Of Chronic Hemiplegic Migraines, Bum J. Kim, Matthew Orap, Bret Farrow-Cypel, Naseer Ahmed

Rowan-Virtua Research Day

Hemiplegic migraine (HM) is a rare subtype of migraine with both familial and sporadic patterns. These migraines present episodically with reversible attacks of unilateral motor weakness. Patients may experience visual changes, sensory loss, impaired level of consciousness, ataxia, and speech changes. Symptoms can last from hours to days and can mimic acute stroke.

The patient is a 45-year-old male with a past medical history of hypertension and possible cerebral vascular accident use who presents to the emergency department complaining of left extremity numbness and weakness. Neuroimaging showed no acute findings and CT angiogram showed no large vessel occlusion. Tenecteplase was …

Spatiotemporal Gait Parameter Consistency Across Two Days Of Treadmill Walking In Stroke Survivors, Alejandro Aguirre Ramirez, Samantha N. Jeffcoat, Natalia Sanchez, Andrian Kuch

Student Scholar Symposium Abstracts and Posters

Retraining impaired gait is essential in post-stroke recovery. This project aims to determine between day variability of spatiotemporal gait measures in treadmill walking post-stroke to differentiate between changes due to the intervention and measurement errors due to between day test-retest variability. Six individuals post-stroke performed a two-minute walk test at a self-selected speed (SSS) for two consecutive days. SSS was assessed through the six-minute walk test. Reflective markers were placed on anatomical landmarks (van den Bogert et al. 2013). The heel markers were used for step detection. We calculated spatiotemporal parameters: stride length, stride time, step length, stance time, and …

Single Case Experimental Design Examining Cognitive Behavioural Therapy For Post-Stroke Depression, Liam Alexander Mackenzie Myles, Emma Jones

Journal of Mind and Medical Sciences

Background. Post-stroke depression (PSD) is common in older-age adults and is typically treated with cognitive-behavioural therapy (CBT). However, research has ascertained mixed findings regarding the efficacy of CBT for PSD in older-age adults, with limited evidence in people from global majority backgrounds. Materials and Methods. This case study used single case experimental design methodology to examine the effectiveness of CBT for PSD in a black, older-age man. The effects of health conditions, cohort beliefs, transitions in role investments, socio-cultural context and early experiences on the client’s thoughts, emotions, physical sensations and behaviours were formulated, before behavioural activation was used to …

Updating Data On Cognitive Impairment In Stroke Patients, Denisa Floriana Vasilica Pîrșcoveanu, Carmen Valeria Albu, Elena-Anca Târtea, Iulia Cristina Mărginean, George Alexandru Iacob, Elena Pinoșanu, Anca Maria Țucă, Cristina Maria Mărginean, Raluca Elena Sandu, Mircea Pîrșcoveanu

Journal of Mind and Medical Sciences

Vascular cognitive impairments are the expression of complex interactions between vascular etiology, risk factors (brain diseases, white matter lesions, etc.) and cellular changes at the brain level. Consequently, vascular cognitive impairment is highly dependent on the location, extent (volume of brain tissue affected) and number of lesions. Memory impairment is not necessarily characteristic of vascular cognitive decline, usually having an evolution with episodic exacerbations and multiple cerebrovascular attacks (cumulative effect), thus producing a gradual deterioration. In recent years, the concept of mild cognitive impairment has emerged as a potential form of predementia, but which can progress to different types of …

Brain Matters: Cognitive-Behavioral Therapy And Antidepressants For Post-Stroke Depression, Lindsey Anne Smith

MSN Capstone Projects

Stroke is the leading cause of death and disability in the United States, and approximately one-third of these patients will develop post-stroke depression, which is associated with higher rates of morbidity and mortality (American Stroke Association, 2022). Even though post-stroke depression is prevalent, it often goes undertreated. The combination of antidepressants and cognitive-behavioral therapy has shown to be an effective method of treating post-stroke depression. There are cognitive-behavioral exercises that nurses can implement, such as group therapy, acceptance therapy, and cognitive retraining, a method of coaching the patient to replace negative thoughts with positive ones (Byun et al., 2021). With …

Spontaneous Spinal Epidural Hematoma Presenting As A Stroke Alert: A Case Report, Christian Flores Do, Monisha Bindra Do, Adam Sigal Md, Michael A. Romeo Do

Tower Health Research Day

No abstract provided.

Respite Care And Relief For Brain Injury Survivors And Their Caregivers, Sydney Bradley

OTD Capstone Projects

This doctoral capstone was completed through a partnership with Neuro Therapy Nashville. Neuro Therapy Nashville (NTN) is an outpatient interdisciplinary clinic that provides services to brain injury survivors including stroke, traumatic brain injury, Parkinson’s, etc. Their mission is work in collaboration with patients to regain as much normal function as possible and return to better, more productive lives through a positive, hopeful and expectant environment. The primary purpose of this project was to create and develop three different programs to provide respite and relief for the brain injury survivors and their caregivers. The process of the project involved collaboration with …

Use Of Medication Management Strategies To Increase Medication Compliance In Person’S Who Have Suffered A Stroke, Mason Pace, Rebecca King

Spring 2024 Virtual OTD Capstone Symposium

The provided research provides education to increased independence in person with stroke for the occupation of medication adherence. Various exercises and education provided in the research to increase independence in persons with stroke.

Real-World Comparison Of Standard Versus Reduced Dose Apixaban In Stroke Prevention And Bleeding Risk In Atrial Fibrillation Patients With Chronic Kidney Disease: A Retrospective Analysis Of Trinetx Data., Sameh Gomaa, Joseph Hellman, Olutoyin Lawal, Edward Hovick, Slawomir Kusmirek

Tower Health Research Day

No abstract provided.

Measuring Fibrinogen To Shorten Post-Alteplase Administration Window, Ahmad Hamid, Jennifer A. Ross, Mandy J. Binning

Tower Health Research Day

No abstract provided.

From Textbooks To Clinical Practice: Selecting And Implementing Outcomes Measures In Stroke Rehabilitation, Stacie Mae Larreau Christensen, Monica Dial

Posters and Presentations: Physical Therapy

No abstract provided.

An Occupational Therapy Approach To Improving Adl/Iadl Performance In Diabetic Adults With Stroke And Upper Extremity Pathologies, Halle Thomas, Cassandra Nelson

Spring 2024 Virtual OTD Capstone Symposium

This capstone presentation depicts the impact of diabetic management with an occupational therapy approach on upper extremity motor function for the adult stroke population. This program utilizes dietary management, a home exercise program, and task modification strategies to improve ADL and IADL performance.

A Multitrait Genetic Study Of Hemostatic Factors And Hemorrhagic Transformation After Stroke Treatment, Cristina Gallego-Fabrega, Gerard Temprano-Sagrera, Jara Cárcel-Márquez, Elena Muiño, Natalia Cullell, Miquel Lledós, Laia Llucià-Carol, Jesús M Martin-Campos, Tomás Sobrino, José Castillo, Mònica Millán, Lucía Muñoz-Narbona, Elena López-Cancio, Marc Ribó, Jose Alvarez-Sabin, Jordi Jiménez-Conde, Jaume Roquer, Silvia Tur, Victor Obach, Juan F Arenillas, Tomas Segura, Gemma Serrano-Heras, Joan Marti-Fabregas, Marimar Freijo-Guerrero, Francisco Moniche, Maria Del Mar Castellanos, Alanna C Morrison, Nicholas L Smith, Paul S De Vries, Israel Fernández-Cadenas, Maria Sabater-Lleal

Journal Articles

BACKGROUND: Thrombolytic recombinant tissue plasminogen activator (r-tPA) treatment is the only pharmacologic intervention available in the ischemic stroke acute phase. This treatment is associated with an increased risk of intracerebral hemorrhages, known as hemorrhagic transformations (HTs), which worsen the patient's prognosis.

OBJECTIVES: to investigate the association between genetically determined natural hemostatic factors' levels and increased risk of HT after r-tPA treatment.

METHODS: Using data from genome-wide association studies on the risk of HT after r-tPA treatment and data on 7 hemostatic factors (factor [F]VII, FVIII, von Willebrand factor [VWF], FXI, fibrinogen, plasminogen activator inhibitor-1, and tissue plasminogen activator), we performed …

Optimization Of Baseline Values For The Bionik Inmotion Arm/Hand Rehabilitation Robot, Marysol Cabello, Diego Rojano, Daniel Salinas, Ramiro Oquita, Victoria Cuello, Kelsey Potter-Baker

Research Symposium

Background: Clinical studies utilizing the Bionik InMotion Arm/Hand robot are increasing in recent years. However, there is a lack of standardized values from healthy participants that can be used to compare to patients with stroke or other neurodegenerative disorders. We aim to create this standardized set of values by employing the new Bionik InMotion Arm/Hand robot on healthy participants. Establishing normative values will allow our lab, and other laboratories, to have a baseline that can be used to track rehabilitation progress in patients with neurological disorders, such as stroke. Creating this standardization may also allow for more tailored rehabilitative approaches …

Comprehensive Quality Assessment For Aphasia Rehabilitation After Stroke: Protocol For A Multicentre, Mixed-Methods Study, Sam Harvey, Marissa Stone, Sally Zingelman, David A. Copland, Monique F. Kilkenny, Erin Godecke, Dominique A. Cadilhac, Joosup Kim, Muideen T. Olaiya, Miranda L. Rose, Caterina Breitenstein, Kirstine Shrubsole, Robyn O'Halloran, Annie J. Hill, Deborah Hersh, Kathryn Mainstone, Penelope Mainstone, Carolyn A. Unsworth, Emily Brogan, Kylie J. Short, Clare L. Burns, Caroline Baker, Sarah J. Wallace

Research outputs 2022 to 2026

INTRODUCTION: People with aphasia following stroke experience disproportionally poor outcomes, yet there is no comprehensive approach to measuring the quality of aphasia services. The Meaningful Evaluation of Aphasia SeRvicES (MEASuRES) minimum dataset was developed in partnership with people with lived experience of aphasia, clinicians and researchers to address this gap. It comprises sociodemographic characteristics, quality indicators, treatment descriptors and outcome measurement instruments. We present a protocol to pilot the MEASuRES minimum dataset in clinical practice, describe the factors that hinder or support implementation and determine meaningful thresholds of clinical change for core outcome measurement instruments. METHODS AND ANALYSIS: This research …

Female Enrollment In Rehabilitation Trials: A Systematic Review Of Reporting Sex And Female Participation In Randomized Controlled Trials Of Poststroke Upper Extremity Rehabilitation Over 50 Years, Sarvenaz Mehrabi, Amber Harnett, Marcus Saikaley, Jamie L Fleet, Janice J Eng, Mark Bayley, Robert Teasell

Physical Medicine and Rehabilitation Publications

OBJECTIVE: To systematically assess the reporting of sex and the percentage of female participants in randomized controlled trials (RCTs) examining interventions for the post-stroke rehabilitation of upper extremity (UE) motor disorders.

DATA SOURCES: CINAHL, Embase, PubMed, Scopus and Web of Science were searched from 1960 to April 1, 2021. Additional articles were identified using the Evidence-Based Review of Stroke Rehabilitation.

STUDY SELECTION: Studies were eligible for inclusion if they (1) were RCTs or crossovers published in English, (2) ≥50% of participants were diagnosed and affected by stroke, (3) included adults ≥18 years old, and (4) applied an intervention to the …

Moving Toward Elucidating Alternative Motor Pathway Structures Post-Stroke: The Value Of Spinal Cord Neuroimaging, Ramiro Oquita, Victoria Cuello, Sarvani Uppati, Sravani Mannuru, Daniel Salinas, Michael R. Dobbs, Kelsey Potter-Baker

School of Medicine Publications and Presentations

Stroke results in varying levels of motor and sensory disability that have been linked to the neurodegeneration and neuroinflammation that occur in the infarct and peri-infarct regions within the brain. Specifically, previous research has identified a key role of the corticospinal tract in motor dysfunction and motor recovery post-stroke. Of note, neuroimaging studies have utilized magnetic resonance imaging (MRI) of the brain to describe the timeline of neurodegeneration of the corticospinal tract in tandem with motor function following a stroke. However, research has suggested that alternate motor pathways may also underlie disease progression and the degree of functional recovery post-stroke. …

Brain Artery Diameters And Risk Of Dementia And Stroke, Jesus D. Melgarejo, Kursat Gurel, Cassidy Rose Compton, Minghua Liu, Vanessa Guzman, Stephanie Assuras, Bonnie E. Levin, Mitchell S. V. Elkind, M. Kamran Ikram, Maryam Kavousi

School of Medicine Publications and Presentations

Introduction: We tested the association of brain artery diameters with dementia and stroke risk in three distinct population-based studies using conventional T2-weighted brain magnetic resonance imaging (MRI) images.

Methods: We included 8420 adults > 40 years old from three longitudinal population-based studies with brain MRI scans. We estimated and meta-analyzed the hazard ratios (HRs) of the brain and carotids and basilar diameters associated with dementia and stroke.

Result: Overall and carotid artery diameters > 95th percentile increased the risk for dementia by 1.74 (95% confidence interval [CI], 1.13-2.68) and 1.48 (95% CI, 1.12-1.96) fold, respectively. For stroke, meta-analyses yielded HRs of 1.59 …

Remnant Cholesterol Traits And Risk Of Stroke: A Multivariable Mendelian Randomization Study, Zhiyuan Wu, Yue Jiang, Zheng Guo, Pingan Li, Yulu Zheng, Yutao Wang, Haiping Zhang, Lois Balmer, Xingang Li, Lixin Tao, Qi Zhang, Bo Gao, Xiuhua Guo

Research outputs 2022 to 2026

Observational epidemiological studies have reported a relationship between remnant cholesterol and stroke. However, the results are inconclusive, and causality remains unclear due to confounding or reverse causality. Our objective in this study was to investigate the causal relevance of remnant cholesterol and the risk of stroke and its subtypes using the Mendelian randomization (MR) approach. Genome-wide association studies (GWASs) including 115,082 European individuals (UK Biobank) were used to identify instruments for remnant cholesterol, including intermediate-density lipoprotein (IDL) cholesterol and very-low-density lipoprotein (VLDL) cholesterol. Summary-level data for total stroke, intracerebral hemorrhage, subarachnoid hemorrhage, ischemic stroke (IS), and IS subtypes were obtained …

What Is Task-Oriented Training? A Scoping Review, Erin Halford, Samantha Jakubiszak, Kassidy Krug, Amanda Umphress

Student Journal of Occupational Therapy

Task-Oriented Training (TOT) is an proven stroke rehabilitation intervention with significant evidence-based research that supports its effectiveness. The absence of a clear definition has led to variability in research reporting and subsequent confusion with practical implementation. A consistent definition seeks to remedy this ambiguity to facilitate knowledge translation. The objective of this study was to determine a comprehensive definition of TOT that encapsulates previous definitions and descriptions in the literature. In order to derive this definition, a two stage scoping review process was conducted across four databases searching for articles on the use of TOT in adult stroke rehabilitation therapy. …

Emerging Stroke Risk Factors: A Focus On Infectious And Environmental Determinants, Sajid Hameed, Nurose Karim, Mohammad Wasay, Narayanaswamy Venketasubramanian

Section of Neurology

This review focuses on emerging risk factors for stroke, including air pollution and climate change, gut microbiota, high altitude, and systemic infection. Up to 14% of all stroke-associated mortality is attributed to air pollution and is more pronounced in developing countries. Fine particulate matter and other air pollutants contribute to an increased stroke risk, and this risk appears to increase with higher levels and duration of exposure. Short term air pollution exposure has also been reported to increase the stroke risk. The gut microbiota is a complex ecosystem of bacteria and other microorganisms that reside in the digestive system and …

Inhibiting Metabotropic Glutamate Receptor 5 After Stroke Restores Brain Function And Connectivity, Jakob Hakon, Miriana J Quattromani, Carin Sjölund, Daniela Talhada, Byungchan Kim, Slavianka Moyanova, Federica Mastroiacovo, Luisa Di Menna, Roger Olsson, Elisabet Englund, Ferdinando Nicoletti, Karsten Ruscher, Adam Q Bauer, Tadeusz Wieloch

2020-Current year OA Pubs

Stroke results in local neural disconnection and brain-wide neuronal network dysfunction leading to neurological deficits. Beyond the hyper-acute phase of ischaemic stroke, there is no clinically-approved pharmacological treatment that alleviates sensorimotor impairments. Functional recovery after stroke involves the formation of new or alternative neuronal circuits including existing neural connections. The type-5 metabotropic glutamate receptor (mGluR5) has been shown to modulate brain plasticity and function and is a therapeutic target in neurological diseases outside of stroke. We investigated whether mGluR5 influences functional recovery and network reorganization rodent models of focal ischaemia. Using multiple behavioural tests, we observed that treatment with negative …

Effect Of Acute Care Discharge Delays On Inpatient Rehabilitation Facility (Irf) Utilization, Eric Garrard

Student Dissertations

Discharge delays present hospitals with challenges in managing costs for Medicare admissions. Meanwhile, Inpatient Rehabilitation Facilities (IRF) are subject to strict pre-admission requirements that can complicate efficient transitions of care for patients with intensive rehabilitation needs. The purpose of this retrospective quantitative correlational study was to examine any relationship between acute care discharge delays and IRF utilization. This study investigated whether length of stay (LOS) and Medicare Advantage prior authorization requirements impact IRF referrals by reviewing 3,747 medical records of acute stroke patients aged 65 years and older at a regionally integrated healthcare system over a 3-year period (2020- 2022). …

Isolated Case Of Alexia Following Cardiac Ablation: A Rare Stroke Presentation, Matthew M. Mason, Nantian Harsell, Bryan Kharbanda

Gulf Coast Division Research Symposium 2024

No abstract provided.

The Role Of Computed Tomography In Diagnosis Of A Stroke, Gabriella Gaglia

Student Research Poster Presentations 2024

A stroke can be defined as a neurological deficit attributed to an acute focal injury of the central nervous system (CNS). There are two types of strokes, and these include ischemic and hemorrhagic. An ischemic stroke is caused by a lack of blood flow to the brain. A hemorrhagic stroke is due to a burst or rupture of a blood vessel within the brain. Computed tomography (CT) is the ideal imaging study done when diagnosing strokes in patients. The importance of quickly diagnosing a stroke and determining which type the person has experienced is one reason why CT scans are …

A Stroke Of Fate: Overcoming Varicella Encephalitis’S Unexpected Consequences, Karissa Charles, Sean Gibbs

South Atlantic Division Research Day 2024

No abstract provided.