Predictability of Simple Clinical Tests to Identify Shoulder Pain After Stroke

 Absolutely useless. Who the hell cares about predicting shoulder pain?  Your tyranny of low expectations is so bad it has gone negative.

Predictability of Simple Clinical Tests to Identify Shoulder Pain After Stroke

 Presented to the 4th World Congress for NeuroRehabilitation, February 12−16, 2006, Hong Kong, and the International Stroke Congress, February 16−18, 2006, Kissimmie, FL.
Author links open overlay panelBala S.RajaratnamMAppSc (PT)a
N.VenketasubramanianFRCPbPrem V.KumarFRCScJames C.GohPhDcY.-H.ChanPhDd
https://doi.org/10.1016/j.apmr.2007.05.001
Get rights and content
Abstract

Rajaratnam BS, Venketasubramanian N, Kumar PV, Goh JC, Chan Y-H. Predictability of simple clinical tests to identify shoulder pain after stroke.
Objective

To identify simple diagnostic musculoskeletal tests that can be performed early after stroke to predict patients’ likelihood of reporting early signs of hemiplegic shoulder pain.
Design

Case control.
Setting

Multicenter acute care hospitals.
Participants

A total of 152 adults after a first episode of stroke, of whom 135 met the inclusion criteria. Thirty patients were assigned to the experimental group because they reported moderate intensity of hemiplegic shoulder pain at rest. The remaining 105 patients made up the control group.
Interventions

Not applicable.
Main Outcome Measures

Therapists measured the performance of combined upper-limb movement including the hand-behind-neck (HBN) maneuver, passive pain-free ranges of shoulder motion, 3 musculoskeletal tests, and the strength of deltoid muscles during each patient’s hospital stay. The numeric rating scale (NRS) identified those who reported moderate or greater intensities of hemiplegic shoulder pain during rest and during assessment.
Results

In our study, 22.2% (95% confidence interval, 15.5−30.2) of the patients reported hemiplegic shoulder pain, on average 1 week after the onset of stroke. Positive Neer test (NRS score ≥5) during the HBN maneuver and a difference of more than 10° of passive range of external rotation between shoulders had a 98% probability of predicting the presence of hemiplegic shoulder pain (receiver operating characteristic, .994; sensitivity, 96.7%; specificity, 99.0%; positive predictive value, 96.7%; negative predictive value, 99.0%; P<.001).
Conclusions

Three diagnostic clinical tests that can be performed during a bedside evaluation increase the likelihood of determining those who complain of hemiplegic shoulder pain after an acute episode of stroke.

Costs of stroke three times higher than thought - UK

Well shit, who cares? 90% of strokes are preventable so the survivors brought this upon themselves. Why saddle the country with the costs of solving this problem? Personal responsibility and all. 

Costs of stroke three times higher than thought - UK

A report from the Stroke Association estimates that the current cost of stroke to the UK is £26 billion every year, a threefold increase from the previous estimated cost of £9 billion. The figures also predict that a growing and ageing population, increasing numbers of stroke survivors, and rising care costs are crucial factors behind the increasing financial burden of stroke over the next 20 years.

BRAIN-DERIVED NEUROTROPHIC FACTOR DELIVERED TO THE BRAIN USING POLY (LACTIDE-CO-GLYCOLIDE) NANOPARTICLES IMPROVES NEUROLOGICAL AND COGNITIVE OUTCOME IN MICE WITH TRAUMATIC BRAIN INJURY

More research needed in humans which won't occur because we have NO stroke leadership following up promising research. Oh well, Who cares? Certainly not our fucking failures of stroke associations. 

BRAIN-DERIVED NEUROTROPHIC FACTOR DELIVERED TO THE BRAIN USING POLY (LACTIDE-CO-GLYCOLIDE) NANOPARTICLES IMPROVES NEUROLOGICAL AND COGNITIVE OUTCOME IN MICE WITH TRAUMATIC BRAIN INJURY

Preview

PDF

Access options

DOI:

10.1080/10717544.2016.1199609

Igor Khalin^a*, Renad Alyautdin^b, Tin Wui Wong^c, Justin Gnanou^a, Ganna Kocherga^d & Jörg Kreuter^e

Publishing models and article dates explained

• Received: 15 May 2016
• Accepted: 7 Jun 2016
• Accepted author version posted online: 08 Jun 2016
  Published online: 08 Jun 2016

Alert me

Abstract

Currently, traumatic brain injury (TBI) is the leading cause of death or of disabilities in young individuals worldwide. The multi-complexity of its pathogenesis as well as impermeability of the blood-brain barrier (BBB) make the drug choice and delivery very challenging. The brain-derived neurotrophic factor (BDNF) regulates neuronal plasticity, neuronal cell growth, proliferation, cell survival, and long term memory. However, its short half-life and low BBB permeability are the main hurdles to be an effective therapeutic for TBI. Poly(lactic-co-glycolic acid) (PLGA) nanoparticles coated by surfactant can enable the delivery of a variety of molecules across the BBB by receptor-mediated transcytosis. This study examines the ability of PLGA nanoparticles coated with poloxamer 188 (PX) to deliver BDNF into the brain and neuroprotective effects of BNDF in mice with TBI. C57bl/6 mice were subjected to weight-drop closed head injuries under anesthesia. Using enzyme-linked immunosorbent assay, we demonstrated that the intravenous (IV) injection of nanoparticle-bound BDNF coated by PX (NP-BDNF-PX) significantly increased BDNF levels in the brain of sham-operated mice (p < 0.001) and in both ipsi- (p < 0.001) and contralateral (p < 0.001) parts of brain in TBI mice compared to controls. The present study also showed using the passive avoidance (PA) test, that IV injection of NP-BDNF-PX 3 hours post-injury prolonged the latent time in mice with TBI thereby reversing cognitive deficits caused by brain trauma. Finally, neurological severity score test demonstrated that our compound efficiently reduced the scores at day 7 after the injury indicating the improvement of neurological deficit in animals with TBI. This study shows that PLGA nanoparticles coated with PX effectively deliver BDNF into the brain, and improve neurological and cognitive deficits in TBI mice, thereby providing a neuroprotective effect.

• PDF
•