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Medicina
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Stroke Rehabilitation and Recovery
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Stroke Rehabilitation and Recovery

A special issue of Medicina (ISSN 1648-9144).

Deadline for manuscript submissions: closed (30 April 2019) | Viewed by 9892

Special Issue Editor

Dr. Alessandro Picelli

E-Mail Website
Guest Editor
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37100 Verona, Italy
Interests: botulinum toxins; muscle spasticity; movement disorders; rehabilitation; ultrasound
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Current best practice in stroke management aims to reduce the initial impact of brain damage, take precautions to avoid the further burden of complications, and maximize functional recovery through extensive rehabilitation treatment. Considering stroke as a multidimensional condition depending on the part of the body or type of ability affected, a multidisciplinary management is required.

As for stroke rehabilitation, there are many approaches including medications for the management of several post-stroke conditions (e.g. spasticity, pain, depression), physical therapy (e.g. range-of-motion therapy, motor-skill exercises, mobility training, constraint-induced movement therapy), technology-assisted training (e.g. electromechanical or robotic technology, virtual reality, telerehabilitation technology, wireless technology), cognitive or emotional treatment (e.g. therapy for cognitive and communication disorders, psychological management), and others (e.g. noninvasive brain stimulation, functional electrical stimulation, alternative medicine).

I invite you to submit original research articles and reviews that will contribute to the field of stroke rehabilitation according to the issues described above. There is a particular interest in articles proposing evidence of innovative approaches as well as in those aimed at comparing the effects of different treatment protocols therapies, including cost-effectiveness analyses.

Dr. Alessandro Picelli
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • medications in stroke rehabilitation
  • physical therapy interventions in stroke rehabilitation
  • technology-assisted approaches in stroke rehabilitation
  • cognitive or emotional treatment in stroke rehabilitation
  • noninvasive brain stimulation in stroke rehabilitation

Published Papers (3 papers)

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Research

10 pages, 1146 KiB  
Article
Is Anticoagulation Necessary for Severely Disabled Cardioembolic Stroke Survivors?
by Kristaps Jurjans, Baiba Vikmane, Janis Vetra, Evija Miglane, Oskars Kalejs, Zanda Priede and Andrejs Millers
Medicina 2019, 55(9), 586; https://doi.org/10.3390/medicina55090586 - 13 Sep 2019
Cited by 3 | Viewed by 2499
Abstract
Background and Objectives: Oral anticoagulants are the hallmark of cardioembolic stroke prevention, but they are frequently underused, especially in elderly patients and patients with paroxysmal atrial fibrillation. In our paper, we analyzed the long-term outcome of severely disabled cardioembolic stroke survivors depending on [...] Read more.
Background and Objectives: Oral anticoagulants are the hallmark of cardioembolic stroke prevention, but they are frequently underused, especially in elderly patients and patients with paroxysmal atrial fibrillation. In our paper, we analyzed the long-term outcome of severely disabled cardioembolic stroke survivors depending on the prescribed antithrombotic secondary prevention medication. Materials and Methods: In our study, we retrospectively collected data for ischemic stroke (IS) patients treated in P. Stradins Clinical University hospital, Riga, Latvia, from 2014 until 2017. Patients’ clinical data were collected using local stroke registry, including patients’ demographic data, vascular risk factors, clinical findings, and laboratory results. Severely disabled stroke survivors were followed up by phone at 30/90/180/365 days after discharge. Patients’ functional outcomes were assessed using the adapted version of The Rankin Focused Assessment–Ambulation. The collected data were compared in 4 groups according to prescribed secondary prevention medication. Results: A total of 682 (91.42%) patients were followed up and included in data analysis. The median age of patients was 80 (IQR = 75–85) years. Of these patients, 231 (31%) were males and 515 (69%) were females. One-year probability of survival of patients not taking any preventive medication was 53% (IQR = 29–76), while in patients taking antiplatelet agents it was 57% (IQR = 37–78), 78% (IQR = 68–88) of patients on Vitamin K antagonists (VKA) and 81% (IQR = 72–90) in patients on direct oral anticoagulants (DOACs). One year after discharge 73 (31%) had mRS 0–2, 50 (20.9%), 29 (12.1%) were still severely disabled, and 87 (36.4%) had died. Conclusions: Anticoagulant use in secondary prevention predicts better functional outcome and higher survival rate in patients with severe cardioembolic stroke due to non-valvular atrial fibrillation (NVAF), therefore severe neurological deficit must not be a reason of restriction of anticoagulation. Full article
(This article belongs to the Special Issue Stroke Rehabilitation and Recovery)
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12 pages, 496 KiB  
Article
Prediction of the Lethal Outcome of Acute Recurrent Cerebral Ischemic Hemispheric Stroke
by Olexandr Kozyolkin, Anton Kuznietsov and Liubov Novikova
Medicina 2019, 55(6), 311; https://doi.org/10.3390/medicina55060311 - 25 Jun 2019
Cited by 6 | Viewed by 2255
Abstract
Background and objectives. Stroke-induced mortality is the third most common cause of death in developed countries. Intense interest has focused on the recurrent ischemic stroke, which rate makes up 30% during first 5 years after first-ever stroke. This work aims to develop criteria [...] Read more.
Background and objectives. Stroke-induced mortality is the third most common cause of death in developed countries. Intense interest has focused on the recurrent ischemic stroke, which rate makes up 30% during first 5 years after first-ever stroke. This work aims to develop criteria for the prediction of acute recurrent cerebral ischemic hemispheric stroke (RCIHS) outcome on the basis of comprehensive baseline clinical, laboratory, and neuroimaging examinations. Materials and Methods. One hundred thirty-six patients (71 males and 65 females, median age 74 (65; 78)) with acute RCIHS were enrolled in the study. All patients underwent a detailed clinical and neurological examination using National Institutes of Health Stroke Scale (NIHSS), computed tomography of the brain, hematological, and biochemical investigations. In order to detect the dependent and independent risk factors of the lethal outcome of the acute period of RCIHS, univariable and multivariable regression analysis were conducted. A receiver operating characteristic (ROC) analysis with the calculation of sensitivity and specificity was performed to determine the prediction variables. Results. Twenty-five patients died. The independent predictors of the lethal outcome of acute RCIHS were: Baseline NIHSS score (OR 95% CІ 1.33 (1.08–1.64), p = 0.0003), septum pellucidum displacement (OR 95% CI 1.53 (1.17–2.00), p = 0.0021), glucose serum level (OR 95% CI 1.28 (1.09–1.50), p = 0.0022), neutrophil-to-lymphocyte ratio (OR 95% CI 1.11 (1.00–1.21), p = 0.0303). The mathematical model, which included these variables was developed and it could determine the prognosis of lethal outcome of the acute RCIHS with an accuracy of 86.8% (AUC = 0.88 ± 0.04 (0.88–0.93), p < 0.0001). Full article
(This article belongs to the Special Issue Stroke Rehabilitation and Recovery)
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11 pages, 869 KiB  
Article
Effects of Neck Taping in the Treatment of Hemispatial Neglect in Chronic Stroke Patients: A Pilot, Single Blind, Randomized Controlled Trial
by Valentina Varalta, Daniele Munari, Lucrezia Pertile, Cristina Fonte, Gabriella Vallies, Elena Chemello, Marialuisa Gandolfi, Angela Modenese, Nicola Smania and Alessandro Picelli
Medicina 2019, 55(4), 108; https://doi.org/10.3390/medicina55040108 - 17 Apr 2019
Cited by 9 | Viewed by 4231
Abstract
Background and objectives: Hemispatial neglect is a common consequence of stroke, with an estimated incidence of 23%. Interventions for treating hemispatial neglect may be categorized as either top-down or bottom-up processing. The aim of top-down approaches is to train the person to voluntarily [...] Read more.
Background and objectives: Hemispatial neglect is a common consequence of stroke, with an estimated incidence of 23%. Interventions for treating hemispatial neglect may be categorized as either top-down or bottom-up processing. The aim of top-down approaches is to train the person to voluntarily compensate for their neglect. Such approaches require awareness of the disorder and a high level of active participation by the patient. Differently, bottom-up approaches are based on manipulation of a patient’s sensory environment and so require less awareness of behavioral bias. In line with the latter, it is conceivable that elastic therapeutic taping applied to the left neck surface may provide bottom-up inputs that reduce hemispatial neglect symptoms. The aim of this study was to assess the effect of therapeutic neck taping on visuo-spatial abilities, neck motion, and kinesthetic sensibility in chronic stroke patients with hemispatial neglect. Materials and Methods: After randomization, 12 chronic stroke patients with hemispatial neglect received 30 consecutive days of real (treatment group) or sham (control group) neck taping. The outcomes were as follows: Stars Cancellation Test; neck active range of motion; Letter Cancellation Test; Comb and Razor Test; Cervical Joint Position Error Test evaluated before and after one month of taping. Results: Between-group comparison showed significant differences only for the Cervical Joint Position Error Test after treatment (p = 0.009). Conclusions: Our preliminary findings support the hypothesis that neck taping might improve cervicocephalic kinesthetic sensibility in chronic stroke patients with hemispatial neglect. Further studies are needed to strengthen our results and better investigate the effects of elastic therapeutic taping on visuo-spatial abilities in stroke patients with hemispatial neglect. Full article
(This article belongs to the Special Issue Stroke Rehabilitation and Recovery)
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