Cerebral Damage after Stroke: The Role of Neuroplasticity as Key for Recovery

Muhammad, Mubarak; Hassan, Tasneem M.

doi:10.5772/intechopen.95512

Cited by 5 publications

(4 citation statements)

References 93 publications

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“…Another is the surgical drainage of the haematoma, which also has theoretical advantages such as reduction in intracranial pressure and reduction in excitotoxicity and neurotoxicity of blood products [ 39 , 40 ]. These factors may create a favourable environment for acute neuroplasticity, augmented further by intensive early rehabilitation, leading to improved functional gains [ 41 ]. Moreover, the lower FIM score on admission for the surgical group provided greater room for improvement compared to the non-surgical group, potentially explaining the similar FIM gains after rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

Inpatient Rehabilitation Outcomes after Primary Severe Haemorrhagic Stroke: A Retrospective Study Comparing Surgical versus Non-Surgical Management

Ong,

Seah,

Chua

2023

Life

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Background: Haemorrhagic stroke, accounting for 10–20% of all strokes, often requires decompressive surgery as a life-saving measure for cases with massive oedema and raised intracranial pressure. This study was conducted to compare the demographics, characteristics and rehabilitation profiles of patients with severe haemorrhagic stroke who were managed surgically versus those who were managed non-surgically. Methods: A single-centre retrospective study of electronic medical records was conducted over a 3-year period from 1 January 2018 to 31 December 2020. The inclusion criteria were first haemorrhagic stroke, age of >18 years and an admission Functional Independence Measure (FIM™) score of 18–40 upon admission to the rehabilitation centre. The primary outcome measure was discharge FIM™. Secondary outcome measures included modified Rankin Scale (mRS), rehabilitation length of stay (RLOS) and complication rates. Results: A total of 107 patients’ records were analysed; 45 (42.1%) received surgical intervention and 62 (57.9%) patients underwent non-surgical management. Surgically managed patients were significantly younger than non-surgical patients, with a mean age of [surgical 53.1 (SD 12) vs. non-surgical 61.6 (SD 12.3), p = 0.001]. Admission FIM was significantly lower in the surgical vs. non-surgical group [23.7 (SD6.7) vs. 26.71 (SD 7.4), p = 0.031). However, discharge FIM was similar between both groups [surgical 53.91 (SD23.0) vs. non-surgical 57.0 (SD23.6), p = 0.625). Similarly, FIM gain (surgical 30.1 (SD 21.1) vs. non-surgical 30.3 (SD 21.1), p = 0.094) and RLOS [surgical 56.2 days (SD 21.5) vs. non-surgical 52.0 days (SD 23.4), p = 0.134) were not significantly different between groups. The majority of patients were discharged home (surgical 73.3% vs. non-surgical 74.2%, p = 0.920) despite a high level of dependency. Conclusions: Our findings suggest that patients with surgically managed haemorrhagic stroke, while older and more dependent on admission to rehabilitation, achieved comparable FIM gains, discharge FIM and discharge home rates after ~8 weeks of rehabilitation. This highlights the importance of rehabilitation, especially for surgically managed haemorrhagic stroke patients.

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Section: Discussionmentioning

confidence: 99%

Inpatient Rehabilitation Outcomes after Primary Severe Haemorrhagic Stroke: A Retrospective Study Comparing Surgical versus Non-Surgical Management

Ong,

Seah,

Chua

2023

Life

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“…Even though we expect the neuroplastic changes within six months following a stroke to enhance functional recovery [61], post-six months, functional improvements are not impossible [62]. Moreover, after six months of post-stroke intense practice simulating practical tasks, functional improvements are inevitable in stroke patients [42,63].…”

Section: Discussionmentioning

confidence: 99%

Impact of Constraint-Induced Movement Therapy (CIMT) on Functional Ambulation in Stroke Patients—A Systematic Review and Meta-Analysis

Reddy

Gular

Dixit

et al. 2022

IJERPH

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Constraint-induced movement therapy (CIMT) has been delivered in the stroke population to improve lower-extremity functions. However, its efficacy on prime components of functional ambulation, such as gait speed, balance, and cardiovascular outcomes, is ambiguous. The present review aims to delineate the effect of various lower-extremity CIMT (LECIMT) protocols on gait speed, balance, and cardiovascular outcomes. Material and methods: The databases used to collect relevant articles were EBSCO, PubMed, PEDro, Science Direct, Scopus, MEDLINE, CINAHL, and Web of Science. For this analysis, clinical trials involving stroke populations in different stages of recovery, >18 years old, and treated with LECIMT were considered. Only ten studies were included in this review, as they fulfilled the inclusion criteria. The effect of CIMT on gait speed and balance outcomes was accomplished using a random or fixed-effect model. CIMT, when compared to controlled interventions, showed superior or similar effects. The effect of LECIMT on gait speed and balance were non-significant, with mean differences (SMDs) of 0.13 and 4.94 and at 95% confidence intervals (Cis) of (−0.18–0.44) and (−2.48–12.37), respectively. In this meta-analysis, we observed that despite the fact that several trials claimed the efficacy of LECIMT in improving lower-extremity functions, gait speed and balance did not demonstrate a significant effect size favoring LECIMT. Therefore, CIMT treatment protocols should consider the patient’s functional requirements, cardinal principles of CIMT, and cardiorespiratory parameters.

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“…The most important region in the pathogenesis of acute ischemic stroke is the comparatively large component of surviving neurons in the ischemic penumbra that surround the ischemic core. These neurons are potentially at risk of neuronal demise through evolving endogenous brain mechanisms such as neuro-inflammation, oxidative stress, and apoptosis [ 9 ]. Therefore, the ultimate goal of acute treatment of ischemic stroke is to rescue the neurons in the ischemic penumbra [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…These neurons are potentially at risk of neuronal demise through evolving endogenous brain mechanisms such as neuro-inflammation, oxidative stress, and apoptosis [9]. Therefore, the ultimate goal of acute treatment of ischemic stroke is to rescue the neurons in the ischemic penumbra [10].…”

Section: Introductionmentioning

confidence: 99%

Microbiota-gut-brain axis impairment in the pathogenesis of stroke: implication as a potent therapeutic target

MUHAMMAD

Muchimapura

WATTANATHORN

2023

Bioscience of Microbiota, Food and Health

Self Cite

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The human microbiota-gut-brain axis has an enormous role in the maintenance of homeostasis and health. Over the last two decades, it has received concerted research attention and focus due to a rapidly emerging volume of evidence that has established that impairment within the microbiota-gut-brain axis contributes to the development and progression of various diseases. Stroke is one of the entities identified to be associated with microbiota-gut-brain axis impairment. Currently, there are still limitations in the clinical treatment of stroke, and the presence of a non-nervous factor from gut microbiota that can alter the course of stroke presents a novel strategy towards the search for a therapeutic silver bullet against stroke. Hence, the aim herein, was to focus on the involvement of microbiota-gut-brain axis impairment in the pathogenesis stroke as well as elucidate its implications as a potent therapeutic target against stroke. The findings of studies to date have revealed and extended the role microbiota-gut-brain axis impairment in the pathogenesis of stroke, and studies have identified from both clinical and pre-clinical perspectives targets within the microbiota-gut-brain axis and successfully modulated the outcome of stroke. It was concluded that the microbiota-gut-brain axis stands as potent target to salvage the neurons in the ischemic penumbra for the treatment of stroke. Assessment of the microbiota profile and its metabolites status holds enormous clinical potentials as a non-invasive indicator for the early diagnosis and prognosis of stroke.

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Cerebral Damage after Stroke: The Role of Neuroplasticity as Key for Recovery

Cited by 5 publications

References 93 publications

Inpatient Rehabilitation Outcomes after Primary Severe Haemorrhagic Stroke: A Retrospective Study Comparing Surgical versus Non-Surgical Management

Inpatient Rehabilitation Outcomes after Primary Severe Haemorrhagic Stroke: A Retrospective Study Comparing Surgical versus Non-Surgical Management

Impact of Constraint-Induced Movement Therapy (CIMT) on Functional Ambulation in Stroke Patients—A Systematic Review and Meta-Analysis

Microbiota-gut-brain axis impairment in the pathogenesis of stroke: implication as a potent therapeutic target

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