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2024

Stroke

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Full-Text Articles in Medicine and Health Sciences

Spontaneous Spinal Epidural Hematoma Presenting As A Stroke Alert: A Case Report, Christian Flores Do, Monisha Bindra Md, Mph, Adam Sigal Md, Michael Romeo Do Sep 2024

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

Transformative Medicine

Introduction

Spinal epidural hematoma (SEH) is a rare pathologic entity that accounts for less than 1% of all space-occupying spinal canal lesions [2,8]. Even more rare are spontaneous spinal epidural hematomas (SSEH), defined as a SEH without a known traumatic or inciting cause, with a reported incidence of 0.1 cases per 100,000 annually [1,2]. Currently, there is a paucity of literature regarding this topic [2,3]. SSEH can easily be missed or misdiagnosed if clinicians do not hold a high level of clinical suspicion.

Case Description

A 69-year-old female with no history of anticoagulation use or preceding trauma presented to the …


Utrgv Som Stroke Prevention Education Program, Briana Gonzalez Digrazia, Mia Rose Schmolze, Chantal Uzoma, Paul Digrazia, Maria Camila Gonzalez Tovar Sep 2024

Utrgv Som Stroke Prevention Education Program, Briana Gonzalez Digrazia, Mia Rose Schmolze, Chantal Uzoma, Paul Digrazia, Maria Camila Gonzalez Tovar

Research Colloquium

Purpose: The UTRGV SOM Stroke Prevention Education Program is a patient education initiative for uninsured patients in Hidalgo County, where the prevalence of the five major risk factors for strokes, like diabetes and hypertension, are especially high. Texas Medical Association student members collaborated with the UTRGV SOM Area Health Education (AHEC) Scholars program, which aims to help reduce the significant shortage of primary health care providers in rural and medically underserved communities in the Rio Grande Valley.

TMA and AHEC students from multiple disciplines like medicine, dietetics, nutrition, and exercise studies offered specific techniques (i.e. home workout programs and culturally …


Pre-Hospital Stroke Time Intervals In The Rio Grande Valley, Kelsey Baker, Elio E. Garcia Sosa Sep 2024

Pre-Hospital Stroke Time Intervals In The Rio Grande Valley, Kelsey Baker, Elio E. Garcia Sosa

Research Colloquium

Background and Introduction: Stroke continues to be a significant cause of mortality in the United States. Despite advancements in acute stroke treatments such as thrombolytic therapy and endovascular procedures, many patients remain unable to benefit from these interventions due to delays in receiving treatment. Healthcare professionals have made substantial efforts to improve 'door to needle' times, the interval between a patient's arrival at the hospital and the administration of thrombolytic therapy, yielding promising outcomes. However, a critical gap persists: the time interval from the onset of stroke symptoms to when patients actually present at a healthcare facility. This study aims …


Milvexian Vs Apixaban For Stroke Prevention In Atrial Fibrillation: The Librexia Atrial Fibrillation Trial Rationale And Design, Sneha S Jain, Kenneth W Mahaffey, Karen S Pieper, Wataru Shimizu, Tatjana Potpara, Christian T Ruff, Hooman Kamel, Basil S Lewis, Jan H Cornel, Peter R. Kowey, Jay Horrow, John Strony, Alexei N Plotnikov, Danshi Li, Stephen Weng, Julia Donahue, C Michael Gibson, P Gabriel Steg, Roxana Mehran, Jeffrey I Weitz, S Claiborne Johnston, Graeme J Hankey, Robert A Harrington, Carolyn S P Lam Aug 2024

Milvexian Vs Apixaban For Stroke Prevention In Atrial Fibrillation: The Librexia Atrial Fibrillation Trial Rationale And Design, Sneha S Jain, Kenneth W Mahaffey, Karen S Pieper, Wataru Shimizu, Tatjana Potpara, Christian T Ruff, Hooman Kamel, Basil S Lewis, Jan H Cornel, Peter R. Kowey, Jay Horrow, John Strony, Alexei N Plotnikov, Danshi Li, Stephen Weng, Julia Donahue, C Michael Gibson, P Gabriel Steg, Roxana Mehran, Jeffrey I Weitz, S Claiborne Johnston, Graeme J Hankey, Robert A Harrington, Carolyn S P Lam

Department of Medicine Faculty Papers

BACKGROUND: Direct oral anticoagulants are the standard of care for stroke prevention in eligible patients with atrial fibrillation and atrial flutter; however, bleeding remains a significant concern, limiting their use. Milvexian is an oral Factor XIa inhibitor that may offer similar anticoagulant efficacy with less bleeding risk.

METHODS: LIBREXIA AF (NCT05757869) is a global phase III, randomized, double-blind, parallel-group, event-driven trial to compare milvexian with apixaban in participants with atrial fibrillation or atrial flutter. Participants are randomly assigned to milvexian 100 mg or apixaban (5 mg or 2.5 mg per label indication) twice daily. The primary efficacy objective is to …


The Effect Of Phonomotor Treatment In A Telepractice Model: An Experimental Study, Jessica Mulch Aug 2024

The Effect Of Phonomotor Treatment In A Telepractice Model: An Experimental Study, Jessica Mulch

Masters Theses & Specialist Projects

This study provides an investigation into the effectiveness of a modified version of Phonomotor Treatment (PMT) for treating apraxia of speech (AOS) in a telepractice model. A single-subject design was utilized to provide treatment to a participant with post-stroke apraxia of speech and aphasia. Treatment occurred two hours a day, five days a week, for four weeks. Targets were selected specifically for the participant after initial probing and testing. Data was taken to measure the chosen targets for acquisition, maintenance, and generalization. The data collected includes pre-treatment (before starting treatment), post-treatment (directly after treatment), and follow-up (10 weeks after the …


Displace Study Shows Poor Quality Of Transcranial Doppler Ultrasound For Stroke Risk Screening In Sickle Cell Anemia, Kimberly A Davidow, Robin E Miller, Shannon M Phillips, Alyssa M Schlenz, Martina Mueller, Monica L Hulbert, Lewis L Hsu, Neha Bhasin, Robert J Adams, Julie Kanter Jul 2024

Displace Study Shows Poor Quality Of Transcranial Doppler Ultrasound For Stroke Risk Screening In Sickle Cell Anemia, Kimberly A Davidow, Robin E Miller, Shannon M Phillips, Alyssa M Schlenz, Martina Mueller, Monica L Hulbert, Lewis L Hsu, Neha Bhasin, Robert J Adams, Julie Kanter

2020-Current year OA Pubs

Children with sickle cell anemia (SCA) are at increased risk of stroke when compared with their age-based counterparts. The Stroke Prevention Trial in Sickle Cell Anemia (STOP) previously demonstrated that with the use of transcranial Doppler ultrasound (TCD; Sickle Stroke Screen) and chronic red cell transfusion, the risk of stroke is reduced by over 90%. The STOP criteria detailed the type and method of measurement required; the time-averaged mean maximum velocity (TAMMV). Unfortunately, it has been difficult to adhere to the appropriate TAMMV measurements. The objectives of this study were to assess the quality of TCD and transcranial Doppler imaging …


Occupational Therapy In Stroke: A Case Study Using The Bobath Frame Of Reference And Task Oriented Approach, Reza Nur Arsyi, Afifah Fadhilah Nursyam, Muhammad Luthfi, Hermito Gidion, Ayleen Alicia Kosasi, Erna Faryza Mohd Poot, Rosilah Wahab, Nur Atiqah Azman Jun 2024

Occupational Therapy In Stroke: A Case Study Using The Bobath Frame Of Reference And Task Oriented Approach, Reza Nur Arsyi, Afifah Fadhilah Nursyam, Muhammad Luthfi, Hermito Gidion, Ayleen Alicia Kosasi, Erna Faryza Mohd Poot, Rosilah Wahab, Nur Atiqah Azman

Jurnal Fisioterapi Terapan Indonesia or Indonesian Journal of Applied Physiotherapy

Stroke is a sudden neurological disorder caused by vascular injury to the brain, leading to significant functional limitations. This case study examines the use of occupational therapy interventions, specifically the Bobath and Task Oriented approaches, for a 43-year-old male with left hemiparesis to enhance independence in motorcycling. The patient experienced various limitations, including vestibular function, range of motion, muscle tone and strength, postural control, and fine motor skills. Using the Ashworth scale and the Canadian Occupational Performance Measure (COPM) for assessment, occupational therapy interventions showed progress in several aspects, although the primary goal has not yet been fully achieved. This …


Verbal Learning And Memory Deficits Across Neurological And Neuropsychiatric Disorders: Insights From An Enigma Mega Analysis., Eamonn Kennedy, Spencer W Liebel, Hannah M Lindsey, Shashank Vadlamani, Pui-Wa Lei, Maheen M Adamson, Martin Alda, Silvia Alonso-Lana, Tim J Anderson, Celso Arango, Robert F Asarnow, Mihai Avram, Rosa Ayesa-Arriola, Talin Babikian, Nerisa Banaj, Laura J Bird, Stefan Borgwardt, Amy Brodtmann, Katharina Brosch, Karen Caeyenberghs, Vince D Calhoun, Nancy D Chiaravalloti, David X Cifu, Benedicto Crespo-Facorro, John C Dalrymple-Alford, Kristen Dams-O'Connor, Udo Dannlowski, David Darby, Nicholas Davenport, John Deluca, Covadonga M Diaz-Caneja, Seth G Disner, Ekaterina Dobryakova, Stefan Ehrlich, Carrie Esopenko, Fabio Ferrarelli, Lea E Frank, Carol E Franz, Paola Fuentes-Claramonte, Helen Genova, Christopher C Giza, Janik Goltermann, Dominik Grotegerd, Marius Gruber, Alfonso Gutierrez-Zotes, Minji Ha, Jan Haavik, Charles Hinkin, Kristen R Hoskinson, Daniela Hubl, Andrei Irimia, Andreas Jansen, Michael Kaess, Xiaojian Kang, Kimbra Kenney, Barbora Keřková, Mohamed Salah Khlif, Minah Kim, Jochen Kindler, Tilo Kircher, Karolina Knížková, Knut K Kolskår, Denise Krch, William S Kremen, Taylor Kuhn, Veena Kumari, Junsoo Kwon, Roberto Langella, Sarah Laskowitz, Jungha Lee, Jean Lengenfelder, Victoria Liou-Johnson, Sara M Lippa, Marianne Løvstad, Astri J Lundervold, Cassandra Marotta, Craig A Marquardt, Paulo Mattos, Ahmad Mayeli, Carrie R Mcdonald, Susanne Meinert, Tracy R Melzer, Jessica Merchán-Naranjo, Chantal Michel, Rajendra A Morey, Benson Mwangi, Daniel J Myall, Igor Nenadić, Mary R Newsome, Abraham Nunes, Terence O'Brien, Viola Oertel, John Ollinger, Alexander Olsen, Victor Ortiz García De La Foz, Mustafa Ozmen, Heath Pardoe, Marise Parent, Fabrizio Piras, Federica Piras, Edith Pomarol-Clotet, Jonathan Repple, Geneviève Richard, Jonathan Rodriguez, Mabel Rodriguez, Kelly Rootes-Murdy, Jared Rowland, Nicholas P Ryan, Raymond Salvador, Anne-Marthe Sanders, Andre Schmidt, Jair C Soares, Gianfranco Spalleta, Filip Španiel, Scott R Sponheim, Alena Stasenko, Frederike Stein, Benjamin Straube, April Thames, Florian Thomas-Odenthal, Sophia I Thomopoulos, Erin B Tone, Ivan Torres, Maya Troyanskaya, Jessica A Turner, Kristine M Ulrichsen, Guillermo Umpierrez, Daniela Vecchio, Elisabet Vilella, Lucy Vivash, William C Walker, Emilio Werden, Lars T Westlye, Krista Wild, Adrian Wroblewski, Mon-Ju Wu, Glenn R Wylie, Lakshmi N Yatham, Giovana B Zunta-Soares, Paul M Thompson, Mary Jo Pugh, David F Tate, Frank G Hillary, Elisabeth A Wilde, Emily L Dennis Jun 2024

Verbal Learning And Memory Deficits Across Neurological And Neuropsychiatric Disorders: Insights From An Enigma Mega Analysis., Eamonn Kennedy, Spencer W Liebel, Hannah M Lindsey, Shashank Vadlamani, Pui-Wa Lei, Maheen M Adamson, Martin Alda, Silvia Alonso-Lana, Tim J Anderson, Celso Arango, Robert F Asarnow, Mihai Avram, Rosa Ayesa-Arriola, Talin Babikian, Nerisa Banaj, Laura J Bird, Stefan Borgwardt, Amy Brodtmann, Katharina Brosch, Karen Caeyenberghs, Vince D Calhoun, Nancy D Chiaravalloti, David X Cifu, Benedicto Crespo-Facorro, John C Dalrymple-Alford, Kristen Dams-O'Connor, Udo Dannlowski, David Darby, Nicholas Davenport, John Deluca, Covadonga M Diaz-Caneja, Seth G Disner, Ekaterina Dobryakova, Stefan Ehrlich, Carrie Esopenko, Fabio Ferrarelli, Lea E Frank, Carol E Franz, Paola Fuentes-Claramonte, Helen Genova, Christopher C Giza, Janik Goltermann, Dominik Grotegerd, Marius Gruber, Alfonso Gutierrez-Zotes, Minji Ha, Jan Haavik, Charles Hinkin, Kristen R Hoskinson, Daniela Hubl, Andrei Irimia, Andreas Jansen, Michael Kaess, Xiaojian Kang, Kimbra Kenney, Barbora Keřková, Mohamed Salah Khlif, Minah Kim, Jochen Kindler, Tilo Kircher, Karolina Knížková, Knut K Kolskår, Denise Krch, William S Kremen, Taylor Kuhn, Veena Kumari, Junsoo Kwon, Roberto Langella, Sarah Laskowitz, Jungha Lee, Jean Lengenfelder, Victoria Liou-Johnson, Sara M Lippa, Marianne Løvstad, Astri J Lundervold, Cassandra Marotta, Craig A Marquardt, Paulo Mattos, Ahmad Mayeli, Carrie R Mcdonald, Susanne Meinert, Tracy R Melzer, Jessica Merchán-Naranjo, Chantal Michel, Rajendra A Morey, Benson Mwangi, Daniel J Myall, Igor Nenadić, Mary R Newsome, Abraham Nunes, Terence O'Brien, Viola Oertel, John Ollinger, Alexander Olsen, Victor Ortiz García De La Foz, Mustafa Ozmen, Heath Pardoe, Marise Parent, Fabrizio Piras, Federica Piras, Edith Pomarol-Clotet, Jonathan Repple, Geneviève Richard, Jonathan Rodriguez, Mabel Rodriguez, Kelly Rootes-Murdy, Jared Rowland, Nicholas P Ryan, Raymond Salvador, Anne-Marthe Sanders, Andre Schmidt, Jair C Soares, Gianfranco Spalleta, Filip Španiel, Scott R Sponheim, Alena Stasenko, Frederike Stein, Benjamin Straube, April Thames, Florian Thomas-Odenthal, Sophia I Thomopoulos, Erin B Tone, Ivan Torres, Maya Troyanskaya, Jessica A Turner, Kristine M Ulrichsen, Guillermo Umpierrez, Daniela Vecchio, Elisabet Vilella, Lucy Vivash, William C Walker, Emilio Werden, Lars T Westlye, Krista Wild, Adrian Wroblewski, Mon-Ju Wu, Glenn R Wylie, Lakshmi N Yatham, Giovana B Zunta-Soares, Paul M Thompson, Mary Jo Pugh, David F Tate, Frank G Hillary, Elisabeth A Wilde, Emily L Dennis

Student and Faculty Publications

Deficits in memory performance have been linked to a wide range of neurological and neuropsychiatric conditions. While many studies have assessed the memory impacts of individual conditions, this study considers a broader perspective by evaluating how memory recall is differentially associated with nine common neuropsychiatric conditions using data drawn from 55 international studies, aggregating 15,883 unique participants aged 15–90. The effects of dementia, mild cognitive impairment, Parkinson’s disease, traumatic brain injury, stroke, depression, attention-deficit/hyperactivity disorder (ADHD), schizophrenia, and bipolar disorder on immediate, short-, and long-delay verbal learning and memory (VLM) scores were estimated relative to matched healthy individuals. Random forest …


A Single-Center, Assessor-Blinded, Randomized Controlled Clinical Trial To Test The Safety And Efficacy Of A Novel Brain-Computer Interface Controlled Functional Electrical Stimulation (Bci-Fes) Intervention For Gait Rehabilitation In The Chronic Stroke Population, Piyashi Biswas, Lucy Dodakian, Po T. Wang, Christopher A. Johnson, Jill See, Vicky Chan, Cathy Chou, Wendy Lazouras, Alison L. Mckenzie, David J. Reinkensmeyer, Danh V. Nguyen, Steven C. Cramer, An H. Do, Zoran Nenadic Jun 2024

A Single-Center, Assessor-Blinded, Randomized Controlled Clinical Trial To Test The Safety And Efficacy Of A Novel Brain-Computer Interface Controlled Functional Electrical Stimulation (Bci-Fes) Intervention For Gait Rehabilitation In The Chronic Stroke Population, Piyashi Biswas, Lucy Dodakian, Po T. Wang, Christopher A. Johnson, Jill See, Vicky Chan, Cathy Chou, Wendy Lazouras, Alison L. Mckenzie, David J. Reinkensmeyer, Danh V. Nguyen, Steven C. Cramer, An H. Do, Zoran Nenadic

Physical Therapy Faculty Articles and Research

Background

In the United States, there are over seven million stroke survivors, with many facing gait impairments due to foot drop. This restricts their community ambulation and hinders functional independence, leading to several long-term health complications. Despite the best available physical therapy, gait function is incompletely recovered, and this occurs mainly during the acute phase post-stroke. Therapeutic options are limited currently. Novel therapies based on neurobiological principles have the potential to lead to long-term functional improvements. The Brain-Computer Interface (BCI) controlled Functional Electrical Stimulation (FES) system is one such strategy. It is based on Hebbian principles and has shown promise …


Small Rma Signatures Of Acute Ischemic Stroke In L1cam Positive Extracellular Vesicles, Bharti Manwani, Nivetha Brathaban, Abiya Baqai, Yashee Munshi, Hilda W Ahnstedt, Mengqi Zhang, Kajsa Arkelius, Ted Llera, Edilberto Amorim, Fanny M Elahi, Neel S Singhal Jun 2024

Small Rma Signatures Of Acute Ischemic Stroke In L1cam Positive Extracellular Vesicles, Bharti Manwani, Nivetha Brathaban, Abiya Baqai, Yashee Munshi, Hilda W Ahnstedt, Mengqi Zhang, Kajsa Arkelius, Ted Llera, Edilberto Amorim, Fanny M Elahi, Neel S Singhal

Student and Faculty Publications

L1CAM-positive extracellular vesicles (L1EV) are an emerging biomarker that may better reflect ongoing neuronal damage than other blood-based biomarkers. The physiological roles and regulation of L1EVs and their small RNA cargoes following stroke is unknown. We sought to characterize L1EV small RNAs following stroke and assess L1EV RNA signatures for diagnosing stroke using weighted gene co-expression network analysis and random forest (RF) machine learning algorithms. Interestingly, small RNA sequencing of plasma L1EVs from patients with stroke and control patients (n = 28) identified micro(mi)RNAs known to be enriched in the brain. Weighted gene co-expression network analysis (WGCNA) revealed small RNA …


Application Of Intravenous Laser Irradiation Of Blood (Ilib) In Physical Medicine: A Narrative Review, Ya-Chi Chuang, Yuan-Yang Cheng Jun 2024

Application Of Intravenous Laser Irradiation Of Blood (Ilib) In Physical Medicine: A Narrative Review, Ya-Chi Chuang, Yuan-Yang Cheng

Rehabilitation Practice and Science

Intravenous laser irradiation of blood (ILIB) involves a type of intravascular treatment which applies a helium-neon laser possessing a wavelength of 632.8nm. Since its first use in 1981 by Russian scientists, it is now widely applied in the treatment of various diseases, including chronic musculoskeletal pain, wound healing, spinal cord injury, stroke, traumatic brain injury, coronary artery disease, type 2 diabetes mellitus, rheumatoid arthritis and acute kidney injury. The underlying mechanism for ILIB may be associated with its anti-oxidative (through regulating the reactive oxygen species systems) and anti-inflammatory effects (by reducing the production of inflammatory cytokines). Moreover, positive effects on …


Design And Implementation Of A Vision-Based Deep-Learning Protocol For Kinematic Feature Extraction With Application To Stroke Rehabilitation, Juan Diego Luna Inga Jun 2024

Design And Implementation Of A Vision-Based Deep-Learning Protocol For Kinematic Feature Extraction With Application To Stroke Rehabilitation, Juan Diego Luna Inga

Master's Theses

Stroke is a leading cause of long-term disability, affecting thousands of individuals annually and significantly impairing their mobility, independence, and quality of life. Traditional methods for assessing motor impairments are often costly and invasive, creating substantial barriers to effective rehabilitation. This thesis explores the use of DeepLabCut (DLC), a deep-learning-based pose estimation tool, to extract clinically meaningful kinematic features from video data of stroke survivors with upper-extremity (UE) impairments.

To conduct this investigation, a specialized protocol was developed to tailor DLC for analyzing movements characteristic of UE impairments in stroke survivors. This protocol was validated through comparative analysis using peak …


Neurorehabilitation With Vagus Nerve Stimulation: A Systematic Review, Radha Korupolu, Alyssa Miller, Andrew Park, Nuray Yozbatiran May 2024

Neurorehabilitation With Vagus Nerve Stimulation: A Systematic Review, Radha Korupolu, Alyssa Miller, Andrew Park, Nuray Yozbatiran

Student and Faculty Publications

OBJECTIVE: To systematically review vagus nerve stimulation (VNS) studies to present data on the safety and efficacy on motor recovery following stroke, traumatic brain injury (TBI), and spinal cord injury (SCI).

METHODS: Data sources: PubMed, EMBASE, SCOPUS, and Cochrane.

STUDY SELECTION: Clinical trials of VNS in animal models and humans with TBI and SCI were included to evaluate the effects of pairing VNS with rehabilitation therapy on motor recovery.

DATA EXTRACTION: Two reviewers independently assessed articles according to the evaluation criteria and extracted relevant data electronically.

DATA SYNTHESIS: Twenty-nine studies were included; 11 were animal models of stroke, TBI, and …


Spontaneous Spinal Cord Infarction: A Systematic Review, Maria Gharios, Vasilios Stenimahitis, Victor Gabriel El-Hajj, Omar Ali Mahdi, Alexander Fletcher-Sandersjöö, Pascal Jabbour, Magnus Andersson, Claes Hultling, Adrian Elmi-Terander, Erik Edström May 2024

Spontaneous Spinal Cord Infarction: A Systematic Review, Maria Gharios, Vasilios Stenimahitis, Victor Gabriel El-Hajj, Omar Ali Mahdi, Alexander Fletcher-Sandersjöö, Pascal Jabbour, Magnus Andersson, Claes Hultling, Adrian Elmi-Terander, Erik Edström

Department of Neurosurgery Faculty Papers

BACKGROUND AND OBJECTIVES: Spontaneous spinal cord infarction (SCInf) is a rare condition resulting in acute neurological impairment. Consensus on diagnostic criteria is lacking, which may present a challenge for the physician. This review aims to analyse the current literature on spontaneous SCInf, focusing on epidemiology, the diagnostic process, treatment strategies and neurological outcomes.

METHODS: The study was performed in accordance with a previously published protocol. PubMed, Web of Science and Embase were searched using the keywords 'spontaneous', 'spinal cord', 'infarction' and 'ischaemic'. The eligibility of studies was evaluated in two steps by multiple reviewers. Data from eligible studies were extracted …


Assessing The Reliability Of The Pairwise Variability Index For Differential Diagnosis Of Apraxia Of Speech, Celeste Sinko May 2024

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 May 2024

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 May 2024

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 …


A Stroke Or Not A Stroke? A Case Of Chronic Hemiplegic Migraines, Bum J. Kim, Matthew Orap, Bret Farrow-Cypel, Naseer Ahmed May 2024

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 …


Cva In Patient With Systemic Sclerosis On Aspirin Therapy: A Case Report, Rahyan Mahmud, Bianna Koutsenko, Kenneth Goich, Usaid Hasan May 2024

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 …


Spatiotemporal Gait Parameter Consistency Across Two Days Of Treadmill Walking In Stroke Survivors, Alejandro Aguirre Ramirez, Samantha N. Jeffcoat, Natalia Sanchez, Andrian Kuch May 2024

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 …


Genetic Complexities Of Cerebral Small Vessel Disease, Blood Pressure, And Dementia, Muralidharan Sargurupremraj, Chia-Ling Phuah, Carlos Cruchaga, Et Al. May 2024

Genetic Complexities Of Cerebral Small Vessel Disease, Blood Pressure, And Dementia, Muralidharan Sargurupremraj, Chia-Ling Phuah, Carlos Cruchaga, Et Al.

2020-Current year OA Pubs

IMPORTANCE: Vascular disease is a treatable contributor to dementia risk, but the role of specific markers remains unclear, making prevention strategies uncertain.

OBJECTIVE: To investigate the causal association between white matter hyperintensity (WMH) burden, clinical stroke, blood pressure (BP), and dementia risk, while accounting for potential epidemiologic biases.

DESIGN, SETTING, AND PARTICIPANTS: This study first examined the association of genetically determined WMH burden, stroke, and BP levels with Alzheimer disease (AD) in a 2-sample mendelian randomization (2SMR) framework. Second, using population-based studies (1979-2018) with prospective dementia surveillance, the genetic association of WMH, stroke, and BP with incident all-cause dementia was …


Pain Management Series For Stroke: Identifying Teaching Methods To Increase Clinical Self-Efficacy For Occupational Therapy Doctoral Students, Apasara Jittprasert May 2024

Pain Management Series For Stroke: Identifying Teaching Methods To Increase Clinical Self-Efficacy For Occupational Therapy Doctoral Students, Apasara Jittprasert

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose Post-stroke pain has been identified as a significant challenge for individuals experiencing a stroke. Occupational therapists play a crucial role in the complex treatment of post-stroke pain but often face challenges due to a lack of self-efficacy in implementing treatments for stroke-related pain. This project’s purpose was to,1) to identify which teaching methods are effective for increasing clinical self-efficacy in doctoral occupational therapy students for implementing pain management treatment for individuals’ post-stroke and 2) to increase reported clinical self-efficacy levels among these students following the completion of a pain management educational program for stroke pain. Methodology This project recruited …


Can Occupational Therapy Take A Hit? A Guide To High-Intensity Training In Stroke Rehabilitation, Jared Demke May 2024

Can Occupational Therapy Take A Hit? A Guide To High-Intensity Training In Stroke Rehabilitation, Jared Demke

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Stroke has been considered a leading cause of functional impairment (Tsao et al., 2022). Recent evidence has supported a treatment approach that increases dosage (Scheets et al., 2021). High-intensity training (HIT) has shown promising evidence for functional recovery poststroke (Crozier et al., 2018). There have been minimal programs related to Occupational therapy (OT) and HIT have been created (Lamoureux, 2023). This doctoral capstone focused on program development of the OT-based HIT program. Theoretical frameworks included the Model of Human Occupation and Motor Learning Theory to provide a foundational structure.

Methods: A needs assessment was performed at the Saint George …


A Comparison Of Spinal Reflex Function And Morphological Adaptations Of The Achilles Tendon Between Individuals Chronically Post-Stroke And Healthy Controls, Migi Contreras, Mira Seekins, Johanna Mendez, Trevor Diez May 2024

A Comparison Of Spinal Reflex Function And Morphological Adaptations Of The Achilles Tendon Between Individuals Chronically Post-Stroke And Healthy Controls, Migi Contreras, Mira Seekins, Johanna Mendez, Trevor Diez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: The hallmark gait deviation in individuals with post-stroke hemiparesis is slow walking speed. Reduction in gait speed after stroke is influenced by decreased propulsive forces, which may likely be related to impaired spinal circuit function and spasticity of the paretic plantarflexors. Chronic muscle tone maladaptations in paretic ankle plantarflexors can result in altered Achilles tendon (AT) morphology, therefore leading to altered mechanical properties, force transmission capabilities and subsequent insufficient propulsive forces during walking. The purpose of this study is to characterize the chronic maladaptations in both the spinal Ia afferent loop excitability and AT morphology after stroke lesions in …


Single Case Experimental Design Examining Cognitive Behavioural Therapy For Post-Stroke Depression, Liam Alexander Mackenzie Myles, Emma Jones Apr 2024

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 Apr 2024

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 Apr 2024

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 Apr 2024

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.


Healing Right Way Randomised Control Trial Enhancing Rehabilitation Services For Aboriginal People With Brain Injury In Western Australia: Translation Principles And Activities, Neil Drew, Meaghan Mcallister, Juli Coffin, Melanie Robinson, Judith Katzenellenbogen, Elizabeth Armstrong Apr 2024

Healing Right Way Randomised Control Trial Enhancing Rehabilitation Services For Aboriginal People With Brain Injury In Western Australia: Translation Principles And Activities, Neil Drew, Meaghan Mcallister, Juli Coffin, Melanie Robinson, Judith Katzenellenbogen, Elizabeth Armstrong

Research outputs 2022 to 2026

Background. This report provides the theory, method and practice of culturally secure translation and knowledge exchange in the Healing Right Way Clinical Trial (2017–2022), outlining activities to date. Healing Right Way was a stepped wedge cluster randomised controlled trial conducted in Western Australia, aimed at enhancing rehabilitation services and quality of life for Aboriginal Australians following acquired brain injury. The trial translation plan was aspirational and action-oriented, with its implementation iterative and ongoing. Translational activities aimed to inform service and research planning for Aboriginal people with brain injury. Situated in the intercultural space, the work guards against undertaking activities that …


Respite Care And Relief For Brain Injury Survivors And Their Caregivers, Sydney Bradley Apr 2024

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 …