Search

INTRODUCTION: La coronaropathie serait fréquente chez les survivants d´accident vasculaire cérébral (AVC). L´objectif de l´étude était de déterminer la prévalence de la coronaropathie chez les survivants d´AVC suivis au centre hospitalier universitaire départemental Borgou-Alibori (CHUD/B-A). METHODES: il s´est agi d´une étude transversale menée du 1er mars au 31 août 2019. Elle a inclus tous les patients victimes d´AVC, d´âge = 18 ans, reçus dans l´unité de neurologie du CHUD/B-A entre janvier 2012 et juillet 2019, ayant survécu à la phase aiguë, et chez qui le consentement éclairé écrit ou celui d´un tuteur (patients sévèrement handicapés) a été obtenu. Un entretien individuel, des mesures anthropométriques, un examen physique, un électrocardiogramme et une revue du dossier médical ont été effectués. La présence de coronaropathie a été définie par un antécédent documenté, des anomalies ST/T et/ou Q évocatrices (critères de Minnesota) ou un questionnaire de dépistage de l´angine de poitrine positif. Les facteurs associés à la coronaropathie ont été recherchés par une régression logistique. RESULTATS: un total de 101 patients était inclus avec un âge moyen de 57,2±10,5 ans. Le délai médian depuis la survenue de l´AVC était de 11 mois [2,0-23,5]. Les AVC ischémiques prédominaient (57,4%). La prévalence de la coronaropathie était estimée à 49,5%. Les facteurs associés à la coronaropathie étaient la non-scolarisation (p=0,036), l´obésité (p=0,036) et le tabagisme ancien (p=0,044). CONCLUSION: cette étude montre une fréquence élevée de coronaropathie chez les survivants d´AVC. Il est important de dépister la coronaropathie dans cette cible afin d´optimiser la prise en charge.

High-intensity interval training (HIIT) has been shown to benefit stroke patients when implemented three months post-stroke. This study examined HIIT's feasibility and clinical effectiveness in the early post-stroke stage in Benin. This was a prospective interventional study comprising an HIIT programme executed on a recumbent bike, three times/week, 20–30 min/session for 6 weeks, added to a conventional physiotherapy. The primary outcomes were feasibility, credibility and expectancy assessed with credibility and expectancy questionnaire. A maximal exercise test, 6-min walking test (6MWT), 10-m walking test (10mWT), Berg balance scale (BBS) and five repetitions sit-to-stand test (5 R-STS) were performed before and after the training programme. Ten outpatients, with a median age [P25-P75]: 63.5[56.7–71.2] years; time since stroke: 15.0[9.7–21.0] days, started and completed all training sessions without serious adverse events. High scores were observed on the Credibility subscale at admission (27.0[25.7–27.0]), which remained so after intervention (26.5[25.7–27.0]). Expectancy subscale scores were high at admission (25.5[24.0–27.0]) and post-training (25.5[24.5–27.0]). Peak workload (p < 0.001), BBS (p < 0.001), 6MWT (p < 0.001), 10mWT (p < 0.001) and 5 R-STS (p = 0.004) were all improved. HIIT is feasible and safe in the early subacute post-stroke stage and is perceived by patients as highly credible, meeting their expectations of recovery. [ABSTRACT FROM AUTHOR]

Objective: Modern clinical rehabilitation practice aligned to the International Classification of Functioning, Disability and Health and the Convention on the Rights of Persons with Disabilities highlights the importance of attention to participation in the rehabilitation formulation. This systematic review investigates the efficacy of rehabilitation interventions evaluated in common neurological disorders reported to influence participation outcomes. Data sources: PubMed, Web of Science and PsycINFO databases were searched from inception to 25 April 2023. Only randomised controlled trials were considered for inclusion. Review methods: The data were extracted by two independent reviewers in the following categories: characteristics of the included study publications, description of intervention and outcome measures. Results: A total of 1248 unique article records were identified through the databases. Twenty-eight randomized controlled trials were included with 15 publications having participation as a primary outcome measure. Articles were related to multiple sclerosis (N = 4), spinal cord injury (N = 2), stroke (N = 16) and traumatic brain injury (N = 6). Four publications showed significant differences in pre- and post-intervention within experimental groups. All four articles described participation as primary outcome measure. Conclusion: There is a limited evidence of the identified rehabilitation interventions to improve participation in common neurological conditions. However, there was a paucity of articles involving individual with Parkinson's disease that met the inclusion criteria. [ABSTRACT FROM AUTHOR]

Currently, little is known on the relationships between cardiorespiratory fitness (CF), physical activity (PA), and functional outcomes after stroke, especially in low- and middle-income countries. We examine the relationships between CF, PA, and functional outcomes in one-year poststroke in Benin, a lower middle-income country. A case–control study was carried out in northern Benin. Twenty-one participants with chronic strokes were matched to 42 controls according to sex and age. PA patterns and associated energy expenditure (EE) were assessed with a BodyMedia's senseWear armband. CF was evaluated with the Physical Working Capacity at 75% of the predicted maximal heart rate index. The functional outcomes were evaluated using the modified Rankin scale (mRS) and the ACTIVLIM-Stroke scale. Both people with stroke and the healthy pairs spent much time in sedentary behavior (median [P25; P75]: 672 [460; 793] min vs 515 [287; 666] min, p = 0.006). Although people with chronic stroke performed fewer steps compared to healthy controls (median: 2767 vs 5524, p = 0.005), results showed that total EE was not statistically significant in either group (median: 7166 Kcal vs 8245 Kcal, p = 0.07). In addition, the mRS score (r = 0.47, p = 0.033) and the ACTIVLIM-Stroke measure (r = 0.52, p = 0.016) were moderately associated with the CF index of people with chronic stroke. The study showed clear trends for lower levels of PA in both people with chronic stroke and health controls. A correlation exists between CF, disability, and functional outcomes among stroke patients. [ABSTRACT FROM AUTHOR]

Rules have been developed to simplify the understanding of researchers/clinicians and standardize the linking process between concepts contained in the items on assessment measures and the International Classification of Functioning, Disability, and Health (ICF). Link the concepts of the SATISPART Stroke (SATIS-Stroke) and Participation Measurement Scale (PM-Scale) to ICF codes. Linking was performed by two evaluators with experience in the ICF taxonomy who applied the ten standard linking rules specifically developed and updated for this purpose. The level of agreement between the evaluators was determined using the Kappa coefficient with 95% confidence intervals. The SATIS-Stroke and PM-Scale address the nine domains of the ICF "Activities and Participation" component. Adequate agreement was found between the researchers during the linking process, mainly between the 1º and 3º evaluators. Identified 41 ICF codes were found among the SATIS-Stroke items and 24 ICF codes were found among the items of the PM-Scale. SATIS-Stroke addresses more issues regarding the domains of Learning and Applying Knowledge, Mobility, Self-Care, Domestic Life, and Major Life Areas, whereas the PM-Scale addresses more issues regarding the General Tasks and Demands, Communication, and Community, Social and Civic Life. Both instruments equally address issues related to Interpersonal Interactions and Relationships. [ABSTRACT FROM AUTHOR]

To review and quantify the effects of walking training for the improvement of various aspects of physical function of people with chronic stroke. We conducted a systematic search and meta-analysis of randomized controlled trials (RCTs) of chronic stroke rehabilitation interventions published from 2008 to 2020 in English or French. Of the 6476-screened articles collated from four databases, 15 RCTs were included and analyzed. We performed a meta-regression with the total training time as dependent variable in order to have a better understanding of how did the training dosage affect the effect sizes. Treadmill walking training was more effective on balance and motor functions (standardized mean difference (SMD)=0.70[0.02, 1.37], p = 0.04) and 0.56[0.15, 0.96], p = 0.007 respectively). Overground walking training improved significantly walking endurance (SMD = 0.38[0.16, 0.59], p < 0.001), walking speed (MD = 0.12[0.05, 0.18], p < 0.001), participation (SMD = 0.35[0.02, 0.68], p = 0.04) and quality of life (SMD = 0.46[0.12, 0.80], p = 0.008). Aquatic training improved balance (SMD = 2.41[1.20, 3.62], p < 0.001). The Meta-regression analysis did not show significant effect of total training time on the effect sizes. Treadmill and overground walking protocols consisting of ≥30 min sessions conducted at least 3 days per week for about 8 weeks are beneficial for improving motor impairments, activity limitations, participation, and quality of life in people with chronic stroke. Treadmill walking training is effective for improving balance and motor functions. Overground walking training improved significantly walking endurance, walking speed, participation and quality of life. Treadmill and overground walking protocols consisting of ≥30 min sessions conducted at least 3 days per week for about 8 weeks are beneficial for improving motor impairments, activity limitations, participation, and quality of life in patient with chronic stroke. [ABSTRACT FROM AUTHOR]