Active clinical trials for "Stroke"

Stem cell theray in old stroke patients is a study to treat stroke patients approved before in our hospital. We recruit these patients who received stem cell therapy and completed the study. We adopted movement-related cortical potential,and cortico-cortical inhibition to assess the stroke patients with or without stem cell therapy. Further analyzing the correlation of the motor related cortical potential and cortico-cortical inhibition among them. We wanted to find out if there are changes in cortical excitability in subjects with chronic stroke after stem cell therapy.

Stroke is the most common cause for motor disability in the grown-up population in the Western world. In Sweden > 80 % are above 65 years of age at onset (1).Areas in the brain, controlling the movement in the upper extremity (UE) are often damaged at a stroke, which leads to impaired function. This impairment of the UE often leads to limitations in activities of daily living and reductions in the level of social activities; therefore, interventions that will improve function are needed to reduce the consequences for the person living with stroke. The time course of recovery of the UE is not clear and therefore the optimal timing of the intervention for the person and its content (ways of intervention) uncertain. The investigators have developed objective assessments of motor performance with new technology (kinematic analysis and virtual reality with haptics). Since having an impaired UE often results in reduced capacity in daily living and social activities, this might lead to decreased participation. To complement the traditional focus on body function, there is a need for assessments of the person's activity level and participation, as well as self-perceived function. The results from this study will lay the ground for an intervention study focusing on improved function in the upper extremity.

our research team will develop a new CADL scale for stroke patients over the next three years. In the first year, we had established a CADL item bank of 50 items. The investigators will administer the 50 items on 300 patients with stroke living in the community. Then we will select 10 to 15 items from the item bank for the CADL scale based on the International Classification of Functioning, Disability and Health (ICF), the opinions of an expert panel, and Rasch analysis. It is anticipated that the CADL scale will have unidimensionality, an interval level of measurement, soundly psychometric characteristics, a reduced number of items, and ease of administration. In the second and third years, we will compare the psychometric properties of the CADL scale and the combined BI and FAI scale. The psychometric properties investigated will include reliability (e.g. inter-rater reliability, intra-rater reliability, and internal consistency), validity (e.g. concurrent validity, convergent validity, predictive validity and discriminant validity), and responsiveness. A total of 150 patients will be recruited. Both the CADL scale and the combined BI and FAI scale will be used on patients from the initial stage (within one month) to six months after hospital discharge. The results will be useful for researchers and clinicians to determine whether the CADL scale is better than the combined BI and FAI scale in stroke patients.

This study is going to comprehensively examine the psychometric properties of the three depression scales (Hamilton depression scale (HAMD), Hospital anxiety and depression scale (HADS), and Beck Depression Inventory (BDI)) in stroke patients over a period of three years.

Tripping over obstacles is one of the common movements in daily life and is the most frequently mentioned cause of falls in the elderly. Indeed, crossing obstacles is a more complex motor skill than walking, and ensuring sufficient clearance of an obstacle during locomotion requires accurate movement and appropriate modifications of the swing limb. However, little is known about the obstacle crossing deficits that following stroke, especially in good outcome and function independently strokes. It is still a mystery about motor control and motor plastic of central nerve system. The purpose of the study was to observe and quantify certain characteristics of the performance of subjects following stroke with good outcome to understand the damage of central nerve system how to affect motor control. The present study investigated selected spatial-temporal characteristics, kinematic variables and kinetic variables of the gait pattern to define further the problems in obstacle crossing following strokes. To quantify the deficits, we compared results from a group of subjects with stroke with a group of healthy subjects matched for age, gender, and height.

The purpose of this study is to explore the severity of malnutrition and inflammation in Taiwanese hemodialysis patients.

A total of 144 stroke patients 6 -24 months post onset who are between 45 and 75 years old will be recruited. A randomized-blocks pretest and posttest control group design will be applied. Four groups will be involved in this project and the subjects will be stratified on two variables: impairment level of the hand and side of lesion. Randomization will be done in blocks of six and each block randomization scheme is within each stratum. Treatment regimens will be designed to ensure that patients in 4 groups receive equivalent intensity of treatment (5 days/week for 1.5 hours/day for 4 consecutive weeks) directly supervised by senior occupational therapists. Brain and movement reorganization will be evaluated with fMRI and kinematic instrument, respectively before and after the 4-week intervention period. Clinical measures on motor impairment, daily function and quality of life will be assessed before, immediately and six months after intervention. Two examiners blind to group allocation will collaborate to provide both fMRI and kinematic evaluations and one of them will administer clinical measures. Before being allowed to work with subjects, the examiner competence will be assessed by principle investigator and co-principle investigators. Multivariate analyses of covariance will be used to examine change in brain activation, kinematic variables and clinical measures as a function of intervention while controlling for pretest data, age and onset post stroke. Multiple regression models will be established to examine the possible predictor(s) for functional outcome of each rehabilitation approach. Canonical correlation analyses will be conducted to quantify the relationship between brain/motor reorganization and clinical measures.

The aim of the study is to monitor if specialized stroke nurses as team partners in the ED can reduce hospital acquired infections. The study is designed as pre- post-intervention study in which specialized SU nurses partner with ED nursing staff to asses and screen stroke admissions in the ED.

Rationale: Over 20.000 people suffer an ischemic stroke in the Netherlands each year. Large artery occlusions are easy to identify and can be treated with endovascular clot removal. 70% of patient will however suffer from a more distal occlusion resulting in small volume stroke or a transient ischemic attack (TIA). Small ischemic lesions are hard to detect with current acute stroke protocols. TIA and small volume stroke patients, are at an increased risk for recurrent stroke, making immediate diagnosis critical. Because thrombo-embolic sources often cause these strokes, identifying and treating the underlying aetiology has the potential to radically lower the risk of recurrence and improve the outcome of these patients. Objectives: 1) To identify clinical and imaging predictors of recurrent stroke; 2) To improve early detection of small volume stroke with admission computed tomography perfusion (CTP) in patients with suspected acute ischemic stroke with small volume stroke or no ischemia on admission imaging. Study design: Prospective, multicenter cohort study. Study population: All patients who visited the University Medical Center (UMC) Utrecht, the Amsterdam University Medical Centers (Amsterdam UMC), location Academic Medical Center (AMC) or the St. Antonius Hospital and who underwent a CT-scan of the brain within 9 hours after onset of stroke symptoms with an age ≥18 years. Within 36 months, 720 patients will be enrolled in the study. Of these patients, 300 patients will be included for the follow-up magnetic resonance imaging (MRI). Main study parameters/endpoints: The main study endpoints are: 1) Stroke recurrence rate at 2 years; 2) Presence and volume of acute ischemic lesions on follow-up diffusion weighted imaging MRI.

wide range of diagnoses may present like stroke, called stroke mimics as well as transient ischemic attacks .