Monday, September 12, 2011

Stoke and stem cell research in Adelaide.

Esteemed strokeologist working with stem cell technology, Simon Koblar is featured in this attached, very interesting news article on the stroke and stem cell research happening in Adelaide. 
http://www.abc.net.au/news/2011-09-09/stem-cells-hold-hope-for-stroke-cure/2879332

Saturday, September 10, 2011

SAMMPRIS study

The Stenting versus Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) study, is the first stroke prevention trial to compare intracranial stenting with medical therapy and incorporate intensive medical management to the study design. Patients in the study were ages 30 to 80 years old and had experienced a recent transient ischemic attack or another type of non-disabling stroke. All patients participated in a lifestyle modification program focused on quitting smoking, increasing exercise, and controlling diabetes and cholesterol.

The results showed that patients at high risk for a second stroke had a lower risk of stroke and death when treated with aggressive medical therapy than patients who received a brain stent in addition to aggressive medical therapy.  The trial seems to indicate that stents are detrimental to patients at high risk of stroke. It was hypothesized by the trial investigators that those with stents would decrease their risk of death.

Your thoughts?

Tuesday, September 6, 2011

Circuit class or seven-day therapy for increasing intensity of rehabilitation after stroke. Protocol of the CIRCIT trial.


Circuit class or seven-day therapy for increasing intensity of rehabilitation after stroke. Protocol of the CIRCIT trial.
Susan Hillier, Coralie English, Professor Maria Crotty, Leonie Segal, Julie Bernhardt, and Adrian Esterman.

Acknowledgements and funding

Conflicts of interest: None to declare

Key words:
Stroke, rehabilitation, therapy, clinical trial

Summary
Rationale There is strong evidence for a dose-response relationship between physical therapy early after stroke and recovery of function. The optimal method of maximizing physical therapy within finite health care resources is unknown.
Aims To determine the effectiveness and cost-effectiveness of two alternative models of physical therapy service delivery (seven-day per week therapy services or group circuit class therapy over five days a week) to usual care for people receiving inpatient rehabilitation after stroke.
Design Multicenter, three-armed randomized controlled trial with blinded assessment of outcomes.
Study A total of 282 people admitted to inpatient rehabilitation facilities after stroke with an admission Functional Independence Measure score within the moderate range (total 40-80 points or motor 38-62 points) will be randomized to receive one of three interventions:
·      usual care therapy over five days a week
·      standard care therapy over seven-days a week, or
·      group circuit class therapy over five days a week.
Participants will receive the allocated intervention for the length of their hospital stay. Analysis will be by intention-to-treat.

Outcomes The primary outcome measure is walking ability (six-minute walk test) at four-weeks post-intervention with three and six-month follow-up. Economic analysis will include a costing analysis based on length of hospital stay and staffing/resource costs and a cost-utility analysis (incremental quality of life per incremental cost, relative to usual care). Secondary outcomes include walking speed and independence, ability to perform activities of daily living, arm function, quality of life and participant satisfaction.

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