Outcomes from ischemic stroke subtypes classified by the Oxfordshire Community Stroke Project: a systematic review.

BACKGROUND: Stroke is a highly heterogeneous disorder with distinct subtypes, each presenting specific clinical aspects. Information on prognosis of ischemic stroke subtypes help to improve clinical management and rehabilitation treatments. AIM: Summarize findings of studies on outcome in stroke subtypes categorized by use of the Oxfordshire Community Stroke Project (OCSP) classification. DESIGN: Systematic review. SETTING: Not applicable. POPULATION: Adult post-stroke patients. METHODS: Systematic literature research of five databases was undertaken to identify relevant studies. Outcomes were examined in terms of impairment, activity restriction and participation restriction. Quality of Life and mortality was also examined for each study. RESULTS: Sixteen studies met inclusion criteria. Most studies measure outcome in terms of activity limitations and participation restriction. Only one study measures impairment. TACI group have poor outcomes in comparison with other groups. Outcomes of LACI, PACI and POCI groups are controversial. CONCLUSION: Stroke subtype is a factor influencing outcome. However, differences among groups, overall in terms of impairment, should be further investigated. CLINICAL REHABILITATION IMPACT: Different prognosis of stroke subtypes may imply different rehabilitation managements.

[Effects of two types of treatment for shoulder subluxation in hemiplegics: a pilot study]. / Effetti di due tipi di trattamento della sublussazione di spalla in pazienti emiplegici: uno studio pilota.

PURPOSE: The aim of this pilot study is to compare the effects of a new sling, a special type of strapping and their association to treat shoulder subluxation. MATERIALS AND METHODS: The effectiveness of a modified version of a sling, a special type of strapping and their association to treat shoulder subluxation has been compared in three hemiplegic patients. Shoulder subluxation has been diagnosed by palpation, then assessed by radiographic measurements in sitting position with the plane of the scapula method (at 30 degrees to the coronal plane). The distance between the inferior acromial surface and the horizontal line crossing through the central point of the humeral head (in millimeters) has been taken as measurement of subluxation. RESULTS: All the patients showed a reduction of the acromial-humeral distance when the sling was applied with strapping. When sling or strapping alone was applied, a slight difference was measured in each patient. CONCLUSIONS: The association of sling and strapping seems to be an effective strategy to treat shoulder subluxation in hemiplegic patients in sub-acute stage. The tools described in the paper give a better cost/benefit ratio in comparison with others described in literature and widely used in clinical practice. Hawever, further investigations are necessary to confirm these results.