Top Stroke Rehabil
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Despite great strides in the life-participation approach to aphasia therapy and the arduous work of several therapists to include patients in the decision-making and goal-setting process of therapy, the patient's direct perspective on the experience of treatment is seldom portrayed in academic journals. In the current article, the voices and different agendas of a stroke survivor with aphasia, her speech-language therapists, and an aspiring qualitative researcher are discussed by means of intertwined narratives, dialogues, and discourses. ⋯ The researcher explores her own reactions and thoughts about the discharge process and report writing. The narratives in this article illustrate the potentially serious impact of seemingly routine clinical procedures, such as a discharge report.
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Not only do clinicians play a role in shaping the lives of their clients, but they are shaped by the individuals they work with. This article interweaves selected aspects from the stories of 12 aphasic individuals into a story about some of the things they have taught me about my clinical life.
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Randomized Controlled Trial
Design and methods of a randomized controlled trial on early speech and language therapy in patients with acute stroke and aphasia.
Most clinicians would recommend speech and language therapy (SLT) for aphasic patients. The question of when and for how long SLT should be administered still remains controversial. The aim of this trial is to evaluate the efficacy of early SLT in patients with acute stroke and aphasia in a randomized controlled trial. This report will present design and methods and discuss feasibility. ⋯ It is feasible to conduct a randomized controlled study on very early SLT for acute aphasic patients.
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Randomized Controlled Trial Multicenter Study Comparative Study
Cortical stimulation for upper limb recovery following ischemic stroke: a small phase II pilot study of a fully implanted stimulator.
To evaluate the feasibility of a fully implanted cortical stimulator for improving hand and arm function in patients following ischemic stroke. ⋯ Evidence suggests that cortical stimulation with rehabilitation therapy produces a lasting treatment effect in upper extremity motor control and is not associated with serious neurological complications. A larger multicenter study is underway.
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Ischemic stroke affects many new patients each year. The sequelae of brain ischemia can include lasting sensorimotor and cognitive deficits, which negatively impact quality of life. Currently, treatment options for improving poststroke deficits are limited, and the development of new clinical alternatives to improve functional recovery after stroke is actively under investigation. Anti-Nogo-A immunotherapy to reduce the central nervous system inhibitory environment, cell transplantation strategies, pharmacological agents, and movement-based therapies represent emerging treatments of poststroke deficits through enhancement of neuroanatomical plasticity.