ABSTRACT
BACKGROUND The criterion standard treatments for ischemic stroke patients, starting from systemic thrombolysis and/or undergoing endovascular recanalization therapy to intensive rehabilitation, are the best options available nowadays, but still cannot achieve total recovery. Neuroprotective and neurotrophic agents seem to be promising therapeutic targets in stroke, even in ischemic and/or hemorrhagic stroke, either in the acute stage or to support neuro-recovery in subacute to chronic stages. Therefore, new therapies are needed as adjuvants in the rehabilitation phase for promoting the recovery and monitoring adverse effects of treatment. CASE REPORT We describe a patient with an acute occlusion of the right middle cerebral artery who was treated with recombinant tissue-plasminogen activator (rtPA), underwent mechanical thrombectomy, and was then enrolled in a 1-month rehabilitation program. After the post-stroke recovery plateau, the patient received 10 days of 30 mL intravenous Cerebrolysin® to support further neuro-recovery, together with long-term rehabilitation. We utilized clinical standard assessment tools, including National Institutes of Health Stroke Scale (NIHSS), modified Rankin scale (mRS), modified Barthel Index (MBI), and function of ambulation, to evaluate the outcome of the patient, together with the adverse events monitoring. After Cerebrolysin® administration, the patient demonstrated improvement in all assessment scores at 1, 3, and 6 months. CONCLUSIONS Postoperative treatment with Cerebrolysin® in our patient with subacute ischemic stroke, after plateau recovery in the rehabilitation phase, together with the standard acute stroke regimen, improved the patient's recovery outcomes. No serious adverse effects were observed.
Subject(s)
Brain Ischemia , Ischemic Stroke , Stroke , Amino Acids , Brain Ischemia/drug therapy , Fibrinolytic Agents/therapeutic use , Humans , Stroke/drug therapy , Thrombolytic Therapy , Tissue Plasminogen Activator/therapeutic use , Treatment OutcomeABSTRACT
OBJECTIVE: The aim of this study was to evaluate the effectiveness of Cognitive Sensory Motor Training Therapy (Perfetti's method) vis-à-vis conventional occupational therapy in the recovery of arm function after acute stroke. DESIGN: Prospective randomized controlled trial. SETTING: Two rehabilitation centers in Bangkok, Thailand. SUBJECTS: Forty first-time acute stroke patients without severe cognitive or language impairment. INTERVENTION: All subjects were randomly divided into two groups; one was treated using Perfetti's method and the other using conventional occupational therapy. Each group underwent therapy for 30 minutes, five times a week for four weeks. MAIN MEASURES: The primary variable was arm function as assessed by the Action Research Arm Test; secondary variables were the extended Barthel Index and the box and block test score. RESULTS: The intention-to-treat analysis revealed no statistically significant differences between the two groups at the end of treatment for any variable. CONCLUSIONS: There was no evidence of a difference between Cognitive Sensory Motor Training Therapy of Perfetti's method and conventional occupational therapy with respect to the restoration of hand and arm function after a stroke.
Subject(s)
Arm , Exercise Therapy/methods , Occupational Therapy/methods , Paresis/rehabilitation , Proprioception , Stroke Rehabilitation , Acute Disease , Adult , Aged , Female , Humans , Male , Middle Aged , Recovery of Function , ThailandABSTRACT
OBJECTIVE: The objective of the present study was to determine the correlation between the scores of the Action Research Arm Test (ARAT) and the Box and Block Test (BBT), commonly used tests of upper extremity (UE)function. MATERIAL AND METHOD: Forty first-time subacute stroke patients without severe cognitive, language, or motion impairment were administered the ARAT and BBT before and after participating in a 4-week rehabilitation program. Their scores were analyzed by Wilcoxon sign-rank testing and by Spearman's rank correlation, standardized response mean, and scatter-plot analysis. RESULTS: The ARAT and the BBT scores have a high level of responsiveness to change and are highly correlated. The BBThas afloor effect compared with the ARAT while the ARAT has a small ceiling effect compared with the BBT CONCLUSION: The ARAT and the BBT scores have excellent concurrent validity and are highly responsive to change, indicating that the BBT can effectively assess UE function.
