Stroke patients relearning how to walk with peculiar shoe

Stroke patients relearning how to walk with peculiar shoe

First published on ScienceDaily.com

A therapeutic shoe engineered to improve stroke recovery is proving successful and expected to hit the market by the end of the year. Clinical trials have been completed on the U.S. patented iStride device, which is licensed by Moterum LLC, a startup company located in the University of South Florida (USF) Research Park. Its results were just published in the Journal of NeuroEngineering and Rehabilitation.

Stroke sufferers experience muscle weakness or partial paralysis on one side of the body, which greatly impacts how they walk, known as gait. Gait asymmetry is associated with poor balance, a major cause of degenerative issues that make individuals more susceptible to falls and injuries.

The iStride device is strapped over the shoe of the good leg and generates a backwards motion, exaggerating the existing step, making it harder to walk while wearing the shoe. The awkward movement strengthens the stroke-impacted leg, allowing gait to become more symmetrical once the shoe is removed. The impaired foot wears a matching shoe that remains stationary.

“The backward motion of the shoe is generated passively by redirecting the wearer’s downward force during stance phase. Since the motion is generated by the wearer’s force, the person is in control, which allows easier adaptation to the motion,” said developer Kyle Reed, PhD, associate professor of mechanical engineering at USF. “Unlike many of the existing gait rehabilitation devices, this device is passive, portable, wearable and does not require any external energy.”

“The importance of over-ground gait training has been emphasized in previous studies,” said Seok Hun Kim, PT, PhD, research collaborator and associate professor in the School of Physical Therapy and Rehabilitation Sciences in the USF Health Morsani College of Medicine. “However, the training options available after stroke are very limited. This novel device allows gait rehabilitation in the environment of daily activities.”

The trial included six people between ages 57 and 74 who suffered a cerebral stroke at least one-year prior to the study. They all had asymmetry large enough to impact their walking ability. Each received twelve, 30-minute gait training sessions for four weeks. With guidance from a physical therapist, the patients’ gait symmetry and functional walking were measured using the ProtoKinetics Zeno Walkway system in the Human Functional Performance Laboratory at USF.

All participants improved their gait’s symmetry and speed. That includes how long it takes to stand up from a sitting position and walk, as well as how long it takes to walk to a specific location and distance traveled within six minutes. Four improved the percentage of time spent in a gait cycle with both feet simultaneously planted on the ground, known as double limb support. As far as the other two that didn’t improve, one started the study with severe impairment, while the other was highly functional. It’s also important to note that three participants joined the study limited to walking in their homes. Following the trial, two of them could successfully navigate public venues.
Read the full article here.

Image: Pixabay

World Stroke Campaign Awards: Nominations for 2019 World Stroke Day campaigns are open

World Stroke Campaign Awards: Nominations for 2019 World Stroke Day campaigns are open

World Stroke Campaign Awards recognize key achievements in raising awareness of the World Stroke Day campaign themes and messages. Nominations for 2019 World Stroke Day campaigns are open until 19th December 2019.

To apply for an award, please visit the World Stroke Campaign website, click on the relevant award category and complete the online application form.

Award winners are featured on the World Stroke Campaign website, media and social media channels and will receive free annual membership of the World Stroke Organization which facilitates free access to the International Journal of Stroke and World Stroke Academy education resources.

For more information, contact Sarah Belson, WSO International Development Manager at sarah.belson@stroke.org.uk

PRESTIGE-AF second annual meeting held in Graz, Austria on 6th December

PRESTIGE-AF second annual meeting held in Graz, Austria on 6th December

First published on https://www.prestige-af.org/

Another year, another successful annual meeting. Hosted by PRESTIGE-AF partners, Medizinische Universitat Graz (MUG), the PRESTIGE-AF consortium convened in the idyllic and picturesque town of Graz in Austria on the 6th December for one full day of intense presentations, parallel session discussions and Scientific Advisory Board feedback.

The day started early at 8am, inviting the medical students of MUG to a seminar on the PRESTIGE-AF project. Dr Thomas Gattringer who is Additive Specialist Neurological Intensive Care at MUG, focussed his talk on the diagnosis and treatment of haemorrhagic stroke. With final remarks discussing the identified gaps in treatment guidelines, Dr Gattringer provided a smooth segue for Prof Roland Veltkamp to speak about the PRESTIGE-AF study. Coordinator of PRESTIGE-AF and Chair of Stroke Medicine at Imperial College London (UK), Prof Veltkamp explained to the students what PRESTIGE-AF, as an EU-funded, international collaborative research study, hopes to achieve in closing these gaps in stroke treatment guidelines and the expected research and patient impacts.

After these talks, the PRESTIGE-AF consortium gathered and work group leaders provided updates on their research progress from the past year. A well-deserved lunch brought in the afternoon parallel sessions. With one group discussing predictive modelling and the other clinical trial coordination, partners used the time to ask each other questions and clarify the particulars around the PRESTIGE-AF clinical trials including protocols, responsibilities and technical requirements.

You can read the full article here.

 

 

Living in a noisy area increases the risk of suffering a more serious stroke

Living in a noisy area increases the risk of suffering a more serious stroke

First published on ScienceDaily.com

The high levels of environmental noise we are subjected to in large cities can increase both the severity and consequences of an ischaemic stroke. More precisely, researchers from the Hospital del Mar Medical Research Institute (IMIM) and doctors from Hospital del Mar, together with researchers from the Barcelona Institute for Global Health (ISGlobal), CIBER in Epidemiology and Public Health (CIBERESP), and Brown University, in the United States, put the increased risk at 30% for people living in noisier areas. In contrast, living close to green areas brings down this risk by up to 25%. This is the first time that these factors have been analysed in relation to stroke severity. The study has been published in the journal Environmental Research.

The researchers looked at the influence of noise levels, air pollution (particularly suspended particles smaller than 2.5 microns; PM2.5), and exposure to green areas on nearly 3,000 ischaemic stroke patients treated at Hospital del Mar between 2005 and 2014. To do this, they used data from the Cartographic Institute of Catalonia, as well as models to analyse atmospheric pollutant levels, the noise map of Barcelona, and satellite images to define areas with vegetation. Also taken into account was the socioeconomic level of the place the patients lived.

Dr. Rosa María Vivanco, from the IMIM’s Neurovascular Research Group and first author of the study, points out that the study gives us initial insight into how noise levels and exposure to green spaces influences the severity of ischaemic stroke. “We have observed a gradient: the more green spaces, the less serious the stroke. And the more noise, the more serious it is. This suggests that factors other than those traditionally associated with stroke may play an independent role in the condition,” she explains. At the same time, Dr. Xavier Basagaña, one of the authors of the study and a researcher at ISGlobal, a centre supported by “la Caixa,” stresses that “exposure to green spaces can benefit human health through various mechanisms. For example, it can reduce stress, encourage social interaction, and increase levels of physical activity.” However, in this study no link was seen with atmospheric pollution. The researchers warn that one of the limitations of the work was the lack of variability in pollutant concentrations to which the study population is exposed. This made it difficult to draw conclusions, and they point out that more studies are needed in this field.

More noise, greater stroke severity

“Previous studies have demonstrated that living in places with high levels of air pollution or noise, or with fewer green areas, exposes the population to a higher risk of suffering an ischaemic stroke. This work broadens our knowledge in this field, showing that the place where we live affects not only the risk of suffering a stroke, but also its severity if it occurs,” explains Dr Gregory A. Wellenius, from the Epidemiology Department at Brown University and final author of the study. In this sense, the results indicate that patients living in noisier areas presented more severe strokes on arrival at hospital.

You can read the full article here.

More aggressive blood pressure control benefits brains of older adults

More aggressive blood pressure control benefits brains of older adults

First published on ScienceDaily.com

A major UConn School of Medicine study published in the American Heart Association’s flagship journal Circulation shows that more aggressively controlling daily blood pressure in older adults can improve brain health.

It’s been estimated that approximately two-thirds of people over the age of 75 may have damaged small blood vessels in the brain which are visible as bright white lesions on brain imaging. Prior research evidence has linked increased amounts of these white matter lesions in the brain with cognitive decline, limited mobility such as a slower walking speed, increased incidence of falls and even increased stroke risk.

The clinical trial, led by Drs. William B. White of the Calhoun Cardiology Center and Leslie Wolfson of the Department of Neurology, followed 199 hypertension patients 75 years of age and older for 3 years.

Throughout that time, researchers tracked the potential benefits of using an intensive anti-hypertensive medication treatment regimen to garner a 24-hour systolic blood pressure target of less than 130 mmHg compared to standard control (approximately 145 mmHg).

As part of the INFINITY (Intensive Versus Standard Ambulatory Blood Pressure Lowering to Prevent Functional Decline In the Elderly) study, researchers assessed the older adults’ mobility, cognitive function, their brain’s white matter progression with magnetic resonance imaging (MRI), and tracked the occurrence of any adverse events.

While the researchers did not identify any significant differences in cognitive outcomes or walking speed between the two study groups, they did observe a significant reduction in the accumulation of brain white matter disease in those receiving the intensive treatment for blood pressure control.

“The results of INFINITY demonstrate that a lower ambulatory blood pressure goal for older adults is likely to conserve future brain function and health,” said Wolfson, professor of neurology and former chair of the Department of Neurology at UConn Health.

In fact, after three years, the accrual of white matter lesions in the brain were reduced by up to 40% in the those patients receiving the intensive blood pressure therapy compared to those who were on standard therapy.

You can read the full article here.