Spasticity Management Teams, Evaluations, and Tools: A Canadian Cross-Sectional Survey.

Objective: The objective of this study is to determine the physical evaluations and assessment tools used by a group of Canadian healthcare professionals treating adults with spasticity.

Methods: A cross-sectional web-based 19-question survey was developed to determine the types of physical evaluations, tone-related impairment measurements, and assessment tools used in the management of adults with spasticity. The survey was distributed to healthcare professionals from the Canadian Advances in Neuro-Orthopedics for Spasticity Congress database.

Optimal Muscle Selection for OnabotulinumtoxinA Injections in Poststroke Lower-Limb Spasticity: A Randomized Trial.

Objective: The aim of the study was to identify optimal muscle selection patterns for onabotulinumtoxinA treatment of poststroke lower-limb spasticity.

Design: Adults with poststroke lower-limb spasticity (ankle Modified Ashworth Scale ≥3) were randomized to onabotulinumtoxinA (300 U, mandatory ankle plantar flexors; ≤100 U, optional lower-limb muscles) or placebo. Post hoc analysis assessed the impact of muscle selection patterns on ankle Modified Ashworth Scale and physician-assessed Clinical Global Impression of Change based on change from baseline to average of weeks 4/6 versus placebo.

Hypertension Canada's 2018 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults and Children.

Hypertension Canada provides annually updated, evidence-based guidelines for the diagnosis, assessment, prevention, and treatment of hypertension in adults and children. This year, the adult and pediatric guidelines are combined in one document. The new 2018 pregnancy-specific hypertension guidelines are published separately.

A Screening Tool to Identify Spasticity in Need of Treatment.

Objective: To develop a clinically useful patient-reported screening tool for health care providers to identify patients with spasticity in need of treatment regardless of etiology.

Design: Eleven spasticity experts participated in a modified Delphi panel and reviewed and revised 2 iterations of a screening tool designed to identify spasticity symptoms and impact on daily function and sleep. Spasticity expert panelists evaluated items pooled from existing questionnaires to gain consensus on the screening tool content.

Canadian Stroke Best Practice Recommendations: secondary prevention of stroke guidelines, update 2014.

Every year, approximately 62,000 people with stroke and transient ischemic attack are treated in Canadian hospitals. The 2014 update of the Canadian Secondary Prevention of Stroke guideline is a comprehensive summary of current evidence-based recommendations for clinicians in a range of settings, who provide care to patients following stroke. Notable changes in this 5th edition include an emphasis on treating the highest risk patients who present within 48 h of symptom onset with transient or persistent motor or speech symptoms, who need to be transported to the closest emergency department with capacity for advanced stroke care; a recommendation for brain and vascular imaging (of the intra- and extracranial vessels) to be completed urgently using computed tomography/computed tomography angiography; prolonged cardiac monitoring for patients with suspective cardioembolic stroke but without evidence for atrial fibrillation on electrocardiogram or holter monitoring; and de-emphasizing the need for routine echocardiogram.

Safety of tissue plasminogen activator for acute stroke in menstruating women.

Background: Menses is a theoretical contraindication to intravenous tissue plasminogen activator (tPA) treatment. We sought to establish the safety of intravenous tPA in the treatment of acute ischemic stroke in women who are actively menstruating.

Summary Of Report: We provide a case report and review of the National Institute of Neurological Disorders and Stroke (NINDS) database for women coded as actively menstruating.

Electrodiagnostic approach to the patient with suspected peripheral polyneuropathy.

Peripheral neuropathy has a multitude of potential causes, which at times may make a clinician feel overwhelmed. This often leads to the performance of a number of costly investigations in the hope of finding an explanation or treatable cause for the neuropathy. The authors propose that by performing a thorough history and physical examination in conjunction with findings on electrodiagnostic studies, a rational and limited differential diagnosis may be generated so that a targeted and cost effective investigation may be performed.

Improving delivery of acute stroke therapy: The TLL Temple Foundation Stroke Project.

Background And Purpose: Only a small minority of acute stroke patients receive approved acute stroke therapy. We performed a community and professional behavioral intervention project to increase the proportion of stroke patients treated with approved acute stroke therapy.

Methods: This study used a quasi-experimental design.