Active clinical trials for "Stroke"

The purpose of this study is to determine whether intensive, focused training of the affected upper extremity after stroke results in long-term functional gains in moderately-to-severely paralyzed patients, more than 6 months after their vascular accident. During the course of therapy, user's attempts to move and complete exercises are assisted by neuromuscular electrical stimulation.

Main idea perception of written stories and in pictures among impaired right hemisphere patients Abstract The right hemisphere is considered to complement the language processing abilities of the opposite hemisphere; it is responsible for the processing of secondary and unusual characteristics of linguistic stimulates. This processing enables, among other functions, the comprehension of metaphors and humor. Additionally, it enables the execution of inferring from spoken and written discourse. Studies which deal with common impairments among right-hemisphere-damaged (RHD) individuals, found that inference processing of written stories and narrative sequences presented in pictures was impaired. This impairment could damage the ability to create global coherence, which is an important component of central theme comprehension of different types of narrative. Another important component is superstructures, schemas which aid creating, remembering and producing the main ideas of spoken and written discourse. Other studies consider impairment in creating global coherence, or Theory of Mind impairment, as the source of central theme comprehension impairment among RHD individuals. Discourse is an integral part of interpersonal communication, and of proper social conduct. The themes chosen for conversation reflect the functional role of discourse from semantic and pragmatic points of view. The aim of the current study is to deepen the current knowledge concerning central theme comprehension among RHD individuals following cerebrovascular accident (CVA), in two genres of written discourse (classic stories and stories with a twist), and in situations represented by single pictures. Unlike written stories, the extraction of the central theme out of a single picture requires focusing on a single situation and relying on non-linguistic visual information. Differences concerning central theme comprehension in the different discourse genres and in the pictures might be able to assist in selecting diagnostic and therapeutic tools designed to work on high cognitive-linguistic abilities, which are usually impaired among RHD individuals. In later stage, these tools are meant to help improving RHD individuals' spontaneous narrative skills. The study will include 20 RHD adults following CVA, and 20 healthy adults without any known damage to the right hemisphere. The two groups will be matched concerning sex, age, educational level and socio-economic status. The subjects will perform the study tests during three sessions, 60 minutes each. The screening tests will include language diagnosis - Western Aphasia Battery (WAB), and reading test no. 37 included in the Psycholinguistic Assessments of Language Processing in Aphasia's battery (PALPA). Patients diagnosed with aphasia will be excluded from research. The research tests will include: central theme comprehension test in stories and pictures, including classic stories, stories with a twist, and pictures of different situations (each will be accompanied by a multiple-choice question concerning the central theme), sub- exanimations taken from "Frigbi" battery designed to evaluate memory and phonological memory capacity, Raven's Progressive Colored Matrices test designed to evaluate pre-morbid abilities (non-linguistic), Theory of Mind (T.O.M) evaluation test, and tests designed to evaluate central coherence impairment: Navon Figures test for evaluation of global visual perception impairment, and Rey-Osterrieth Complex Figure Test (RCFT) - Recall Form test for evaluation of visual-perceptive organizational ability, and non-verbal memory. The performances of the two groups will be compared in each test using statistical tests. In addition, the interaction between all variables will be measured.

Individuals with stroke show abnormal movement pattern of upper limb. The movement pattern needs to be corrected. There are several methods to train normal movement. Exercise with technology is an active movement and affects sensory and cognitive systems. It may benefit to individuals with stroke in training.

The purpose of this study is to assess whether repeated enhanced and prolonged ECG monitoring after ischemic stroke results in a higher detection of atrial fibrillation (/flutter) compared to usual care (at least 24 hour of cardiac monitoring).

The study aimed to demonstrate the relationship between secondary prevention medication persistence and clinical prognosis of ischemic stroke patients at 3,6,12 months

To perform an exploratory single center randomized study that will form the basis for a larger scale, more definitive randomized clinical trial to determine the optimal time after stroke for intensive motor training. The investigators will perform a prospective exploratory study of upper extremity (UE) motor training delivered at higher than usual intensity at three different time points after stroke: early (initiated within 30 days) subacute/outpatient (initiated within 2-3 months) chronic (initiated within 6-9 months) The control group will not receive the therapy intervention during the 1-year study. Outcome measures will be assessed at baseline, pre-treatment, post-treatment, 6 months and one year after stroke onset. Compared to individuals randomized during the outpatient (2-3 months after stroke onset) or chronic (6-9 months after stroke onset) time points, participants randomized to early intensive motor training will show greater upper extremity motor improvement measured at one year post stroke.

This is a randomized follow-up study after discharge from a stroke unit after a first stroke. The patients are randomized either to follow-up at a special out-patient stroke unit or with their general practitioners. The hypothesis is that follow-up with specialists is superior to follow-up with general practitioners. Endpoints are mortality, recurrent stroke and handicap measured with different scales.

Atrial fibrillation (AF) is a common and treatable cause of ischemic stroke, but it can be paroxysmal and asymptomatic, and therefore difficult to detect. Patients with stroke routinely undergo 24 hours of continuous cardiac telemetry during hospitalization for stroke as a means of excluding AF. Small studies indicate that extending the duration of monitoring with portable outpatient telemetry devices detects more cases of AF. However, these studies are small and lack control groups, and cannot demonstrate that prolonged cardiac monitoring detects more cases of AF than routine clinical follow-up. The investigators therefore propose a pilot study to determine the feasibility of randomizing patients to prolonged cardiac monitoring or routine clinical follow-up. The investigators will enroll 40 consecutive adult patients seen at the University of California at San Francisco (UCSF) Neurovascular service with cryptogenic stroke or high-risk TIA (ABCD2 score 4 or greater). Enrolled patients will be randomized in a 1:1 fashion. Group A will be assigned to wear an ambulatory cardiac event monitor for 21 days. Group B will be discharged home without a monitor and will serve as controls during routine clinical follow-up. The investigators' primary outcome will be feasibility, defined as more than 80% of randomized patients completing full clinical follow-up and more than 70% of cardiac monitoring if applicable. The investigators' secondary outcomes will be diagnoses of AF at 90 days and 1 year and diagnoses of recurrent stroke at 1 year.

This study will compare the Adaptive Physical Activity program (APA) to a less vigorous group exercise program, (Sittercise) to see if APA leads to greater improvements in walking endurance, quality of life, and participation in social activities.

The purpose of the trial is to determine if extended-release dipyridamole + aspirin [Aggrenox, Asasa ntin] is superior to clopidogrel [Plavix], and if telmisartan [Micardis, Gliosartan, Kinzal, Kinzalm ono, Predxal, Pritor, Samertan, Telmisartan] is superior to placebo, in the presence of background antihypertensive therapy, in prevention of a second stroke in patients who have recently suffered a stroke and therefore are at high risk of suffering another one.