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      The effect of premorbid features on post-stroke rehabilitation outcome

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          Abstract

          Background: A wide variety of factors influence stroke prognosis, including age, stroke severity, stroke mechanism, infarct location, comorbid conditions, clinical findings, and related complications. The aim of this study was to detect the prognostic determinants in patients with acute stroke for guiding rehabilitation.

          Methods: Patients with ischemic acute stroke were included in the study. Patients’ age, sex, education level, and marital status, premorbid personality traits, comorbidities such as current smoking status and alcohol consumption, regular exercise habits, and sleeping disorder were recorded. Motor assessment and daily activity skills were evaluated according to the Brunnstrom staging and Functional Independence Measure (FIM), respectively.

          Results: A total of 85 patients were studied. All patients’ motor and functional stages were significantly improved with the rehabilitation. The improvements in the upper extremity motor levels were less in whom over 76 years and smokers, in patients who had 4 and more comorbidities and sleep disorders. The functional improvement was less in whom over 76 years and men, and in patients who had 4 and more comorbidities and sleep disorders.

          Conclusion: The significant post-stroke predictor of insufficiency in functioning was having 4 or more risk factors.

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          Most cited references20

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          Sex differences in stroke care and outcomes: results from the Registry of the Canadian Stroke Network.

          Stroke is an important cause of death and disability in women as well as men. However, little is known about sex differences in stroke care and outcomes. The Registry of the Canadian Stroke Network (RCSN) captured data on patients with stroke seen at acute care hospitals across Canada. We used data from phase 1 (July 2001 to February 2002) and phase 2 (June to December 2002) of the RCSN to compare stroke presentation, management, and 6-month outcomes in women and men using multivariable regression techniques to adjust for age and other factors. The study sample included 3323 patients, with 1527 women. Stroke symptoms at presentation were similar in women and men, except that women were more likely to present with headaches and were less likely to have brain stem or cerebellar symptoms. There were no sex differences in the use of neuroimaging, thrombolysis, antithrombotic therapy, or consultations. Women were less likely than men to receive care on an acute stroke unit, but this difference was no longer significant after adjustment for age and other factors. Women were more likely than men to be discharged to long-term care and had greater disability at 6 months. Mortality and quality of life at 6 months were similar in women and men. Among patients participating in the RCSN, there were no major sex differences in stroke presentation or management. Compared with men, women were more often institutionalized and had a slightly worse functional status at 6 months after stroke.
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            Measurement in neurological rehabilitation.

            The measurement of impairment and disability can improve patient care and is now essential in clinical audit. Practical, useful measures are slowly being developed, both for use in specific diseases and for more general use. This review discusses both new measures and new work on more well-established measures.
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              Stroke knowledge and awareness: an integrative review of the evidence.

              the recognition of stroke symptoms by the public and activation of the emergency medical services (EMS) are the most important factors in instigating pre-hospital stroke care. Studies have suggested that poor recognition of the warning signs of stroke is the main cause of delay in accessing the EMS. an integrative review of published studies about stroke knowledge and awareness was performed by searching online bibliographic databases, using keywords, from 1966 to 2008. Studies were included in the review if they focussed on risk factors, signs and symptoms, action and information. Each study was reviewed by two researchers (SJ and MJ). we identified 169 studies of which 39 were included in the review. The ability to name one risk factor for stroke varied between studies, ranging from 18% to 94% when asked open-ended questions and from 42% to 97% when asked closed questions. The ability to name one symptom ranged from 25% to 72% when asked open-ended questions and from 95% to 100% when asked closed questions. When asked what action people would take if they thought they were having a stroke, between 53% and 98% replied that they would call the EMS. People generally obtained information about stroke from family and friends. Older members of the population, ethnic minority groups and those with lower levels of education had consistently poor levels of stroke knowledge. generally, levels of knowledge about recognising and preventing stroke were poor. Nevertheless, most participants stated they would contact the EMS at the onset of stroke symptoms.
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                Author and article information

                Journal
                Iran J Neurol
                Iran J Neurol
                IJNL
                Iranian Journal of Neurology
                Tehran University of Medical Sciences (Tehran, Iran )
                2008-384X
                2252-0058
                5 January 2018
                : 17
                : 1
                : 38-46
                Affiliations
                [1]Department of Physical Medicine and Rehabilitation, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
                Author notes
                Corresponding Author: Ozgur Zeliha Karaahmet Email: drozguroz@ 123456gmail.com
                Article
                IJNL-17-38
                6121201
                1757f58e-2f21-458f-8e53-47f02e81f842
                Copyright © 2015 Iranian Neurological Association, and Tehran University of Medical Sciences

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 13 August 2017
                : 18 October 2017
                Categories
                Original Article

                stroke,rehabilitation,cerebral infarction,prognosis,rehabilitation outcome

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