Background: Stroke is among the leading causes of disability of worldwide. Gait dysfunction is common in stroke survivors, and substantial advance is yet to be made in stroke rehabilitation practice to improve the clinical outcome of gait recovery. The role of the upper limb in gait recovery has been emphasized in the literature. Recent studies proposed that four limbs coordinated interventions, coined the term "interlimb-coordinated interventions," could promote gait function by increasing the neural coupling between the arms and legs. A high-quality review is essential to examine the clinical improvement and neurophysiological changes following interlimb-coordinated interventions in patients with stroke.
Methods: Systematic review and meta-analysis will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The literature will be retrieved from the databases of OVID, MEDLINE, PubMed, Web of Science, EMBASE, and PsycINFO. Studies published in English over the past 15 years will be included. All of the clinical studies (e.g., randomized, pseudorandomized and non-randomized controlled trials, uncontrolled trials, and case series) that employed interlimb intervention and assessed gait function of patients with stroke will be included. Clinical functions of gait, balance, lower limb functions, and neurophysiologic changes are the outcome measures of interest. Statistical analyses will be performed using the Comprehensive Meta-Analysis version 3.
Discussion: The findings of this study will provide insight into the clinical benefits and the neurophysiological adaptations of the nervous system induced by interlimb-coordinated intervention in patients with stroke. This would guide clinical decision-making and the future development of targeted neurorehabilitation protocol in stroke rehabilitation to improve gait and motor function in patients with stroke. Increasing neuroplasticity through four-limb intervention might complement therapeutic rehabilitation strategies in this patient group. The findings could also be insightful for other cerebral diseases.
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http://dx.doi.org/10.3389/fneur.2022.959917 | DOI Listing |
JAMA Intern Med
January 2025
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Importance: Evidence on cardiovascular benefits and safety of sodium-glucose cotransporter 2 (SGLT-2) inhibitors is mainly from placebo-controlled trials. Therefore, the comparative effectiveness and safety of individual SGLT-2 inhibitors remain unknown.
Objective: To compare the use of canagliflozin or dapagliflozin with empagliflozin for a composite outcome (myocardial infarction [MI] or stroke), heart failure hospitalization, MI, stroke, all-cause death, and safety outcomes, including diabetic ketoacidosis (DKA), lower-limb amputation, bone fracture, severe urinary tract infection (UTI), and genital infection and whether effects differed by dosage or cardiovascular disease (CVD) history.
JAMA Neurol
January 2025
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Importance: Trials have not demonstrated superiority of alteplase or tenecteplase vs standard care in patients with mild stroke and have raised safety concerns. Prourokinase is an alternative fibrinolytic that may have a favorable safety profile, and the benefit-risk profile of prourokinase in mild stroke is unknown.
Objective: To investigate the efficacy and safety of prourokinase in mild ischemic stroke within 4.
Ultrasound J
January 2025
Health Sciences North Research Institute, Sudbury, ON, Canada.
The duration of mechanical systole-also termed the flow time (FT) or left ventricular ejection time (LVET)-is measured by Doppler ultrasound and increasingly used as a stroke volume (SV) surrogate to guide patient care. Nevertheless, confusion exists as to the determinants of FT and a critical evaluation of this measure is needed. Using Doppler ultrasound of the left ventricular outflow tract velocity time integral (LVOT VTI) as well as strain and strain rate echocardiography as grounding principles, this brief commentary offers a model for the independent influences of FT.
View Article and Find Full Text PDFRadiology
January 2025
From the Dept of Diagnostic and Interventional Neuroradiology, Univ Medical Ctr Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany (L.M., G.B., P.S., J.F., C.P.S.); Dept of Diagnostic and Interventional Neuroradiology, Hosp Bremen-Mitte, Bremen, Germany (M.A., P.P.); Interventional Neuroradiology Section, Dept of Radiology, Donostia Univ Hosp, Donostia-San Sebastián, Spain (Á.L., J.Á.L.); Clinic for Radiology, Section for Interventional Radiology, Univ of Münster and Univ Hosp Münster, Münster, Germany (W.S., H.K., C.P.S.); Dept of Neuroradiology, Westpfalz-Klinikum, Kaiserslautern, Germany (W.N.); Dept of Neuroradiology, Otto-von-Guericke-Universitätsklinikum Magdeburg, Magdeburg, Germany (D.B., M.T.); Inst for Diagnostic and Interventional Radiology and Neuroradiology, Univ Hosp Essen, Essen, Germany (H.S., C.D.); Dept of Neuroradiology, Univ of Cologne, Cologne, Germany (C.K., C.Z.); Dept of Neuroradiology, Univ Hosp Aachen, Aachen, Germany (C.W., M. Möhlenbruch); Dept of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical Univ Munich, Munich, Germany (M.R.H.P., C.M.); Inst of Neuroradiology, Univ Hosps, LMU Munich, Munich, Germany (H.Z.); Dept of Diagnostic and Interventional Neuroradiology, Univ Medical Ctr Goettingen, Goettingen, Germany (M. Ernst, A.J.); Interventional Neuroradiology, Dept of Radiology, Hosp Clínico San Carlos, Madrid, Spain (M.M.G., C.P.G.); Dept of Neuroradiology, Hosp Universitario La Paz, Madrid, Spain (P.N., A.F.P.); Div of Neurology, Dept of Medicine (L.Y., B.T.), and Div of Interventional Radiology, Dept of Diagnostic Imaging (A.G.), National Univ Health System, Singapore; Yong Loo Lin School of Medicine, National Univ of Singapore, Singapore (L.Y., B.T., A.G.); Inst of Neuroradiology, Charité Universitätsmedizin Berlin, Berlin, Germany (E.S., M. Miszczuk); Dept of Neuroradiology, Clinic and Policlinic of Radiology, Univ Hosp Halle/Saale, Halle, Germany (S.S.); Dept of Radiology and Neuroradiology, Stadtspital Zürich, Zürich, Switzerland (P.S.); Dept of Diagnostic and Interventional Neuroradiology, Univ Hosp Basel, Basel, Switzerland (P.S., M.P.); Depts of Interventional Neuroradiology (J.Z.P.) and Neurology (G.P.), Hosp Clínico Universitario Virgen de la Arrixaca, Murcia, Spain; Dept of Neuroradiology, Karolinska Univ Hosp and Dept of Clinical Neuroscience, Karolinska Inst, Stockholm, Sweden (F.A., T.A.); Dept of Medical Imaging, AZ Groeninge, Kortrijk, Belgium (T.A.); Dept of Radiology, Comenius Univ's Jessenius Faculty of Medicine and Univ Hosp, Martin, Slovakia (K.Z.); Dept of Radiology, Aretaieion Univ Hosp, National and Kapodistrian Univ of Athens, Athens, Greece (P.P.); Dept of Neuroradiology, Univ Hosp Marburg, Marburg, Germany (A.K.); Dept of Neuroradiology, Univ Hosp of Bonn, Bonn, Germany (F.D.); and Dept of Neuroradiology, Alfried Krupp Krankenhaus, Essen, Germany (M. Elsharkawy).
Background Symptomatic acute occlusions of the internal carotid artery (ICA) below the circle of Willis can cause a variety of stroke symptoms, even if the major intracranial cerebral arteries remain patent; however, outcome and safety data are limited. Purpose To compare treatment effects and procedural safety of endovascular treatment (EVT) and best medical treatment (BMT) in patients with symptomatic acute occlusions of the ICA below the circle of Willis. Materials and Methods This retrospective, multicenter cohort study from 22 comprehensive stroke centers in Europe and Asia includes patients treated between January 1, 2008, and December 31, 2022.
View Article and Find Full Text PDFJ Neurophysiol
February 2025
Department of Rehabilitation Medicine, Tianjin Medical University General Hospital, Tianjin, China.
Vagus nerve stimulation (VNS) has been commonly employed for the functional rehabilitation of stroke patients. This study aimed to investigate the therapeutic effects of transcranial direct current stimulation on the vagus nerve (TDCSVN) in improving dysphagia in stroke patients. Patients experiencing dysphagia following a stroke were diagnosed with dysphagia by a water swallow test.
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