Leading stroke charity funds first study into long-term impact of Covid-19 on strokes

The Stroke Association is funding the world’s first study to determine the longterm impact of Covid-19 on stroke survivors. Since the start of the Covid-19 pandemic there have been widespread reports of adults with the virus also having strokes[1]. The charity announces this new study today, amid concerns that the virus may be causing more severe strokes in patients[2] whom doctors are struggling to treat.

It is thought that the virus could be increasing the chance of blood clots forming in the brain and blocking blood flow[3]. The Stroke Association is funding this vital research to investigate the difference the virus could make to stroke recoveries, which are already at risk due to disruption to stroke services caused by the pandemic[4] .

The study will establish which differences in patients with and without the virus may influence their needs for treatment and care, including how to avoid the risk of having further strokes.

Researchers at University College London Hospitals NHS Foundation Trust (UCLH) will follow up to 4,000 stroke survivors, with and without Covid-19 from across 13 emergency stroke units. Stroke recovery, rehabilitation and health will be tracked for up to 18 months after their stroke. Researchers will collect and assess comprehensive, specialist medical information from stroke patients, including brain scans, blood samples and measures of disability. The findings will help to understand how Covid-19 impacts stroke recovery and which treatments might best support survivors’ recoveries.

Dr Richard Perry, lead researcher at UCLH, said: “Research that compares stroke in patients with and without Covid-19 is essential to understand if Covid-19 results in more severe strokes, where survivors will need more support to recover from its devastating effects. While redeployed to stroke wards at the start of the pandemic, I would see patients admitted with unusual strokes, who would then go on to have a positive Covid-19 test.

“The findings from this study will inform decisions about the

most effective treatment and the rehabilitation needs of this group of patients, including prevention of recurrent stroke. We already know that from the moment a person has a stroke or mini-stroke they are at substantial increased risk of further strokes[5] .

“We’ve come a long way since the start of the pandemic. I’m incredibly proud of stroke doctors and researchers throughout the UK who generously gave their time to contribute to the early stages of our study on the impact of Covid-19 on stroke, when we had no resources and were entirely dependent on their goodwill. This much-needed funding means we can continue the urgent work.”

Stroke is a sudden brain attack, stroke strikes every five minutes, and there are more than 1.2 million stroke survivors living in the UK. However, this is set to rise; it is predicted that the number of stroke survivors aged 45 and over could rise to 1.4 million in 2025, and 2.1 million in 2035[6] .

[1] Mao L, Jin H, Wang M, et al. Neurologic

Manifestations of Hospitalized Patients

With Coronavirus Disease 2019 in Wuhan,

China. JAMA Neurol. 2020;77(6):683–690. doi:10.1001/jamaneurol.2020.1127 Ischemic Stroke. Stroke 2020;51:e254–e258

[3] Beyrouti R, Adams ME, Benjamin L, et al.

Characteristics of ischaemic stroke associated with COVID-19. J Neurol Neurosurg Psychiatry

E. 2020. doi:10.1136/jnnp2020-323586. Association 2020.

[5] Mohan et al, 2011, Risk and cumulative risk of stroke recurrence

[6] Patel et al., 2020, Economic impact of stroke in the UK.

Dr Rubina Ahmed, Research Director at the Stroke Association, said: “Stroke is a leading cause of adult disability in the UK and the second biggest killer in the world. It’s extremely concerning that we’re seeing strokes happening in ways we have not seen before. This research is absolutely critical in understanding and treating stroke after Covid-19, to help reduce the devastating effects and ultimately improve lives. Covid-19 is here to stay, so it’s vital we can prevent and treat strokes linked with the virus.

“The pandemic has shattered our fundraised income and is threatening research that drives life-changing breakthroughs in stroke care. As a result of the pandemic, we have had to halve our budget for stroke research. Research improves treatment and care for people affected by stroke so they can live their best lives possible, and that’s why stroke research is worth saving. Now more than ever, we need the public’s support. If you can, please help us find a way through the research funding crisis by donating today, so that we can fund more lifesaving research.”

In February, the Stroke Association announced the world’s largest study to confirm if Covid-19 increases the risk of stroke and by how much. Together with the new research announced today, the two studies will help doctors to prevent and best treat Covid-19 strokes in the people who are most at risk.

Over the past 30 years the Stroke Association has played a crucial role in supporting stroke research in the UK. Research helps stroke survivors rebuild their lives, but the pandemic has hit research hard. By saving stroke research, more stroke survivors can live life to the full.

Find out how stroke research helps rebuild lives at: stroke.org.uk/rebuildinglives or to donate, please visit: stroke.org.uk/saveresearch

Hi, I’m Paul, Your Resident Health Coach...

Paul is a successful and multi-award nominated health coach working for PT Health Coaching, based in Darwen. With over 15 years experience in the field of health, fitness and wellbeing, Paul takes a holistic approach to helping people make positive lifestyle changes.

IS TIME YOUR BARRIER?

Most of my clients at some point on their coaching journey will explain that time is a barrier. I’ve used it myself: “I just don’t have time” or, “I’m a bit busy at the moment, maybe later.” Based on a YouGov survey of 2000 adults, we spend 218 minutes per day procrastinating, the equivalent of 55 days per year of lost time. Just 10 minutes a day (Monday to Friday) looking at social media equates to 43.3 hours per year (a working week) lost.

The Swedes are second on the OCED index for work-life balance. They spend more than 15 hours per day in leisure or sleeping. It makes sense that they are ranked as one of the happiest nations in the world.

How nice would it feel to not have time as a barrier? Think about this for a second… If you had 2 hours to do whatever you wanted to do, right now… what would you choose to do? Take a nap? Go for a walk? Read a book? Meet a friend? The thing about managing your time more effectively is, you can do the things that you really want to do, instead of wishing you could.

WHAT STRATEGIES CAN I USE TO MANAGE MY TIME MORE EFFECTIVELY AND IMPROVE MY PRODUCTIVITY?

THE POMODORO TECHNIQUE

The Pomodoro Technique is a time management method developed by Francesco Cirillo in the late 1980s. The technique uses a timer to break down work into intervals, traditionally 25 minutes in length, separated by short 5 minute breaks. Each interval is known as a pomodoro, from the Italian word for ‘tomato’, after the tomato-shaped kitchen timer that Cirillo used as a university student. Here’s what to do:

• Pick the task, job, or chore that you want to complete.

Something big, something small, something you’ve been putting off for a million years: it doesn’t matter. What

matters is that it’s something that deserves your full, undivided attention.

• Set the timer for 25 minutes. Make a small oath to yourself:

I will spend 25 minutes on this task, and I will not interrupt myself. You can do it! After all, it’s just 25 minutes.

• Work on the task until the timer rings. Immerse yourself in the task for the next 25 minutes. If you suddenly realise you have something else you need to do, write the task down on a sheet of paper.

• When the timer rings put a checkmark on a piece of paper.

Congratulations! You’ve spent an entire, interruption-less

Pomodoro on a task.

• Take a short break (5 mins). Breathe, meditate, grab a cup of coffee, go for a short walk or do something else relaxing (i.e., not work-related). Your brain will thank you later.

• Every 4 pomodoros you complete, take a longer break: Once you’ve completed four pomodoros, you can take a longer break. 20 minutes is good. Or 30. Your brain will use this time to assimilate new information and rest before the next round of Pomodoros. This is how you do it:

You can use project management software, a pen and paper, or a whiteboard and sticky notes.

• Determine the number of stages in your project or task and create the columns. For example, you can create four columns, and move tasks within a project across these stages:

• Backlog - you brainstorm and define all your tasks here. You then decide what tasks you’re supposed to move to the To Do column, and what tasks can wait their turn.

• To Do - these are the tasks you’ll work on.

EAT THAT FROG

Sounds rather odd, right? Mark Twain once said, “Eat a live frog first thing in the morning and nothing worse will happen to you the rest of the day.” Now, although the prospects of eating an actual live frog are daunting, we can interpret these “frogs” as the tasks we dread. In that sense, “Eating that frog” means you have to do the task you dread first, before all other tasks. Once you have “eaten” your “frog”, you can rest assured that the worst is behind you, so you’re likely to take on a positive approach about the rest of your day. Here’s how to do it:

• Label your tasks to identify your “frog” (an extremely important task, an extremely difficult task or both).

• Work on your “frog” first thing in the morning (why - in a new study, researchers found your brain slows down throughout the day due to a lack of sleep, and that causes delayed behavioural responses, as well as trouble with memory associations and visual perception.)

• Once done, shift your focus to less crucial tasks in your schedule • In Progress - tasks you are currently working on.

• Done - tasks you’ve finished.

Ultimately, if you can remove the biggest time wasters in your life: interruptions, your mobile phone, your TV, background noise, you can get more done. The more you get done the less you have to worry about. The less you have to worry about, the more leisure time you have, free from worry of the impending work to come.

Remember, getting stuff done isn’t about working harder, it’s about working smarter. In fact, during the writing of this article I used an app called Forest App. It uses the pomodoro technique above and plants a little tree in your forest for every 25 minute piece of work you complete.

KANBAN

A visual time management technique that helps you follow the progress with your projects - you track how the tasks move across differently labelled columns. This technique was developed in the 1940s in Japan by Taiichi Ohno, for Toyota Automotive, to help increase their productivity, and effectiveness in manufacture.

“Until you value yourself, you will not value time. Until you value your time, you will do nothing with it.” M. Scott Peck, psychiatrist & author.

Until next time...

Paul is a Health and wellbeing coach and consultant for individuals and organisations and is Lancashire Magazine’s resident Health Coach. To find out more or to get some support contact him on: Tel: 07495 89298 Email: paul@pthealthcoaching.com