April stroke current awareness by Musgrove Park Hospital Library

Library Services Musgrove Park and Somerset Partnership

Current Awareness Stroke This monthly Current Awareness Bulletin is produced by the Library, Musgrove Park Academy to provide staff with a range of stroke-related resources to support practice. It includes recently published guidelines and research articles, news and policy items.

This guide provides a selection of resources relevant to the subject area and is not intended to be a comprehensive list. All websites have been evaluated and details are correct at the time of publications. Details correct at time of going to print. Please note that resources are continuously updated. For further help or guidance, please contact a member of library staff.

This guide has been compiled by: Jess Pawley Senior Library Assistant Musgrove Park Hospital Library Service jessica.pawley@tst.nhs.uk

Issue 8 April 2016

Contents Click on a section title to navigate contents Page Recent journal articles

Books

Reports, publications and resources

Twitter

Training & Networking Opportunities, Conferences, Events

Literature search service

Library contact details: Library Musgrove Park Academy Musgrove Park Hospital Taunton Somerset TA1 5DA Tel: 01823 34 (2433)

Email: library@tst.nhs.uk Blog: http://librarymph.wordpress.com @musgrovesompar

RECENT JOURNAL ARTICLES BACK TO TOP This is a list of journal articles on the topic of stroke. Some articles are available in the library or online via an OpenAthens password by following the full-text link. If you would like an article which is not available as full-text then please contact library staff. Please note that abstracts are not always available for all articles.

MUSGROVE STAFF ONLY Click on the image to access full-text-available from 1970 to current using your OpenAthens password

Title: Multimodal Interventions to Enhance Adherence to Secondary Preventive Medication after Stroke: A Systematic Review and Meta-Analyses Citation: Cardiovascular Therapeutics, April 2016, vol./is. 34/2(85-93), 1755-5914;1755-5922 (01 Apr 2016) Author(s): Al Alshaikh S., Quinn T., Dunn W., Walters M., Dawson J. Abstract: Introduction: Nonadherence to secondary preventative medications after stroke is common and is associated with poor outcomes. Numerous strategies exist to promote adherence. We performed a systematic review and meta-analysis to describe the efficacy of strategies to improve adherence to stroke secondary prevention. Methods: We created a sensitive search strategy and searched multiple electronic databases (MEDLINE, EMBASE, CINAHL, PsycINFO, CENTRAL, and Web of Knowledge) for studies of interventions that aimed to enhance adherence to secondary preventative medication after stroke. We assessed quality of included studies using the Cochrane tool for assessing risk of bias. We performed narrative review and performed meta-analysis where data allowed. Results: From 12,237 titles, we included seventeen studies in our review. Eleven studies were considered to have high risk of bias, 3 with unclear risk, and 3 of low risk. Meta-analysis of available data suggested that these interventions improved adherence to individual medication classes (blood pressure-lowering drugs - OR, 2.21; 95% CI (1.63, 2.98), [P < 0.001], lipid-lowering drugs - OR, 2.11; 95% CI (1.00, 4.46), [P = 0.049], and antithrombotic drugs - OR, 2.32; 95% CI (1.18, 4.56, [P = 0.014]) but did not improve adherence to an overall secondary preventative medication regimen (OR, 1.96; 95% CI (0.50, 7.67), [P = 0.332]). Conclusion: Interventions can lead to improvement in adherence to secondary preventative medication after stroke. However, existing data is limited as several interventions, duration of follow-up, and various definitions were used. These findings need to be interpreted with caution.

Title: Depression after minor stroke: The association with disability and quality of life - A 1year follow-up study Citation: International Journal of Geriatric Psychiatry, April 2016, vol./is. 31/4(425-431), 08856230;1099-1166 (01 Apr 2016) Author(s): Shi Y.Z., Xiang Y.T., Yang Y., Zhang N., Wang S., Ungvari G.S., Chiu H.F.K., Tang W.K., Wang Y.L., Zhao X.Q., Wang Y.J., Wang C.X.

Abstract: Objective Minor stroke is characterized by mild neurological functional impairment and relatively good outcome. Little is known about the association between post-stroke depression (PSD) and outcomes of minor stroke. The aim of this study was to investigate the association between PSD and disability and quality of life (QoL) at 1 year after minor ischemic stroke. Methods Patients with first-ever minor ischemic stroke (n = 747) were followed up at 14 +/- 2 days, 3 months, 6 months, and 1 year after stroke. Depressive symptoms were assessed at each follow-up. Patients diagnosed with depression at 14 +/- 2 days formed the early-onset PSD group; those who were diagnosed with depression at any subsequent follow-ups for the first time constituted the late-onset PSD group. The outcomes of minor stroke including disability (modified Rankin score >2) and QoL (Short Form-36 Health Survey) were assessed at the 1-year follow-up. Results A total of 198 (26.5%) patients were diagnosed with PSD over the 1-year follow-up; 136 and 62 patients were allocated to the early-onset PSD group and late-onset PSD group, respectively. Both early-onset and late-onset PSD were independently associated with disability and poor physical and mental health at 1 year after stroke. Recovery from depression (n = 112) within 1 year decreased the adverse impacts of PSD on functional outcome and QoL. Conclusions Post-stroke depression was independently associated with disability and poor QoL at 1 year after first-ever minor ischemic stroke. Recovery from PSD decreased but did not eliminate the adverse impacts of PSD on outcomes of minor stroke.

Title: Care-limiting decisions in acute stroke and association with survival: analyses of UK national quality register data. Citation: International journal of stroke : official journal of the International Stroke Society, Apr 2016, vol. 11, no. 3, p. 321-331, 1747-4949 (April 2016) Author(s): Parry-Jones, Adrian R, Paley, Lizz, Bray, Benjamin D, Hoffman, Alex M, James, Martin, Cloud, Geoffrey C, Tyrrell, Pippa J, Rudd, Anthony G, SSNAP Collaborative Group Abstract: Prognosis after intracerebral hemorrhage (ICH) is poor and care-limiting decisions may worsen outcomes. To determine whether in current UK stroke practice, key acute care decisions are associated with stroke subtype (ICH/ischemic) and whether these decisions are independently associated with survival. We extracted data describing all stroke patients included in a UK quality register between 1 April 2013 and 31 March 2014. Key care decisions in our analyses were transfer to higher level care on admission and palliation in the first 72 h. We used multivariable regression models to test for associations between stroke subtype (ICH/ischemic), key care decisions, and survival. A total of 65,818 patients were included in the final analysis. After ICH (n = 7020/65,818, 10.7%), 10.5% were palliated on the day of admission and 19.3% by 72 h (vs. 0.7% and 3.3% for ischemic stroke). Although a greater proportion were admitted directly to higher level care after ICH (3.7% vs. 1.5% for ischemic stroke), ICH was not independently associated with the decision to admit to higher level care (adjusted odds ratio (OR): 1.12, 95% confidence interval (95%CI): 0.95-1.31, p = 0.183). However, ICH was strongly associated with the decision to commence palliative care on the day of admission (OR: 7.27, 95%CI: 6.31-8.37, p < 0.001). Palliative care was independently associated with risk of death by 30 days regardless of stroke subtype. When compared to ischemic stroke, patients with ICH are much more likely to commence palliative care during the first 72 h of their care, independent of level of consciousness, age, and premorbid health. 2016 World Stroke Organization.

Title: Influence of visual feedback on dynamic balance control in chronic stroke survivors Citation: Journal of Biomechanics, March 2016, vol./is. 49/5(698-703), 0021-9290;1873-2380 (21 Mar 2016) Author(s): Walker E.R., Hyngstrom A.S., Schmit B.D.

Abstract: Chronic stroke survivors have an increased incidence of falls during walking, suggesting changes in dynamic balance control post-stroke. Despite this increased incidence of falls during walking, balance control is often studied only in standing. The purpose of this study was to quantify deficits in dynamic balance control during walking, and to evaluate the influence of visual feedback on this control in stroke survivors. Ten individuals with chronic stroke, and ten neurologically intact individuals participated in this study. Walking performance was assessed while participants walked on an instrumented split-belt treadmill with different types of visual feedback. Dynamic balance control was quantified using both the extent of center of mass (COM) movement in the frontal plane over a gait cycle (COM sway), and base of support (step width). Stroke survivors walked with larger COM sway and wider step widths compared to controls. Despite these baseline differences, both groups walked with a similar ratio of step width to COM sway (SW/COM). Providing a stationary target with a laser reference of body movement reduced COM sway only in the stroke group, indicating that visual feedback of sway alters dynamic balance control post-stroke. These results demonstrate that stroke survivors attempt to maintain a similar ratio of step width to COM movement, and visual cues can be used to help control COM movement during walking post-stroke.

Title: Do Physically Active Patients Have Better Functional Outcome after Stroke? A Systematic Review Citation: Journal of Stroke and Cerebrovascular Diseases, March 2016, vol./is. 25/3(527-532), 10523057;1532-8511 (01 Mar 2016) Author(s): Tumasz M.T., Trocoli T., De Oliveira M.F., Campos R.R., Botelho R.V. Abstract: Background and Purpose Stroke is one of the major causes of mortality and, among survivors, disability. Physical activity has a protective effect maybe due to a major control of risk factors, such as hypertension, diabetes mellitus, and body weight. However, the effect of prestroke physical activity and the poststroke functional outcomes needs clarification. Methods We made a systematic review of the literature to elucidate this effect through electronic search in the MEDLINE/PubMed database. Prisma statement was used as a basis for this systematic review and analysis of the risk of bias was made according to the Grading of Recommendations, Assessment, Development and Evaluation. Three studies were finally analyzed in this review. Results The largest of the studies (Rist et al) revealed no association between prior physical activity and functional outcome after stroke. The second major study (Stroud et al) showed only a slight association. Only the smallest of the 3 studies (Krarup et al) showed a protective effect of physical activity. Conclusions The evidence of the protective effect of physical activity is still conflicting. Better longitudinal studies are still needed to see the real effect of physical activity on functional outcome after stroke.

Title: Motor imagery training on muscle strength and gait performance in ambulant stroke subjects - A randomized clinical trial Citation: Journal of Clinical and Diagnostic Research, March 2016, vol./is. 10/3(YC01-YC04), 2249782X;0973-709X (01 Mar 2016) Author(s): Kumar V.K., Chakrapani M., Kedambadi R. Abstract: Introduction: The ultimate goal of physiotherapy in stroke rehabilitation is focused towards physical independence and to restore their functional ability during activities of daily living (ADLs). Motor imagery (MI) is an active process during which a specific action is reproduced within working memory without any actual movements. MI training enhances motor learning, neural reorganization and cortical activation in stroke. The efficacy of MI training involving lower extremity mobility tasks need to be assessed. Aim: To evaluate the effects of combining motor imagery with physical practice

in paretic Lower Extremity Muscles Strength and Gait Performance in Ambulant Stroke subjects. Materials and Methods: A Randomized Clinical Trial was conducted in Department of Physical Therapy, Tertiary Care Hospitals, Mangalore, India which includes 40 hemi paretic subjects (>3 months post-stroke) who were ambulant with good imagery ability in both KVIQ-20 > 60 and Time dependent MI screening test were recruited and randomly allocated into task-oriented training group (n=20) and task-oriented training group plus MI group (n=20). Subjects in both groups underwent task orientated training for lower extremity 45-60 minutes, 4 days per week for 3 weeks. In addition, the experimental group received 30 minutes of audio-based lower extremity mobility tasks for MI practice. Isometric muscle strength of Hip, Knee and Ankle using a hand-held dynamometer and self-selected 10 m gait speed were assessed before and after 3 weeks of intervention. Results: Both the groups had found a significant change for all the outcome measures following 3 weeks of interventions with p <.05. The experimental group had shown a significant improvement in paretic hip muscles (both flexors and extensors), knee extensors and ankle dorsiflexors and gait speed compare to control group with p <.05 between group analyses. Conclusion: Additional task specific MI training improves paretic muscle strength and gait performance in ambulant stroke patients.

Title: Novel echocardiographic indicator for potential cardioembolic stroke Citation: European Journal of Neurology, March 2016, vol./is. 23/3(613-620), 1351-5101;1468-1331 (01 Mar 2016) Author(s): Kim Y., Kim T.J., Park J.-B., Lee S., Kim Y.-J., Lee J.S., Lee S.-H. Abstract: Background and purpose: In many cardioembolic strokes (CSs), the specific embolic source is uncertain. Despite the high mortality of CS, not enough attention is paid to its potential source. Although atrial fibrillation (AF) is the most common source of embolism, more complex and dynamic multiplicities may influence CS. The aim of this study was to evaluate novel indicators of transthoracic echocardiography (TTE) that have additional value for detecting CS. Methods: In total, 1878 patients with acute ischaemic stroke who had TTE during admission were identified. Of the patients with undetermined etiology, 93 patients with incomplete evaluations were excluded. Thereafter, two stroke neurologists reviewed all of the magnetic resonance images to assess cardioembolic lesion patterns. The patients were classified into two groups: potential cardioembolic stroke (PCS) and non-PCS. Results: Amongst a total of 1601 patients, 518 (32.4%) had PCS. About half of the patients with PCS had AF. Patients with PCS were more likely to have larger left ventricular (LV) end-diastolic diameters, larger LV end-systolic diameters, larger left atrial sizes, increased E/A ratios and reduced LV ejection fractions. After adjusting for multiple clinical and TTE variables including AF, an E/A ratio >1.5 had a significant predictive value for PCS (odds ratio 2.89, 95% confidence interval 1.57-5.31, P < 0.01). Conclusion: An E/A ratio >1.5 is independently associated with PCS after adjusting for multiple covariates including AF and provides incremental prognostic information for detecting PCS.

Title: Communication partner training of enrolled nurses working in nursing homes with people with communication disorders caused by stroke or Parkinsonâ&#x20AC;&#x2122;s disease. Citation: Disability & Rehabilitation, 2016, vol./is. 38/12(1187-1203), 09638288 Author(s): Eriksson, Karin, Forsgren, Emma, Hartelius, Lena, Saldert, Charlotta Language: English Publication type: Academic Journal Source: CINAHL ________________________________________________________________________________ Title: Assessing the impact of upper limb disability following stroke: a qualitative enquiry using internet-based personal accounts of stroke survivors.

Citation: Disability & Rehabilitation, 2016, vol./is. 38/10(945-951), 09638288 Author(s): Poltawski, Leon, Allison, Rhoda, Briscoe, Simon, Freeman, Jennifer, Kilbride, Cherry, Neal, Debbie, Turton, Ailie J., Dean, Sarah ________________________________________________________________________________ Title: Choral singing therapy following stroke or Parkinson’s disease: an exploration of participants’ experiences. Citation: Disability & Rehabilitation, 2016, vol./is. 38/10(952-962), 09638288 Author(s): Fogg-Rogers, Laura, Buetow, Stephen, Talmage, Alison, McCann, Clare M., Leão, Sylvia H. S., Tippett, Lynette, Leung, Joan, McPherson, Kathryn M., Purdy, Suzanne C. ________________________________________________________________________________ Title: A systematic review of studies investigating the care of stroke survivors in long-term care facilities. Citation: Disability & Rehabilitation, 2016, vol./is. 38/8(715-723), 09638288 Author(s): Teo, Keith, Slark, Julia ________________________________________________________________________________

BOOKS BACK TO TOP If you are unable to find a book, or require a book that is not on this list, please ask library staff who will be able to locate the book for you using interlibrary loan. Please note that some books detailed below may not be available in your local library and would need to be ordered for you. Some books from our electronic book collection- click on book cover and log in with your OpenAthens password to browse free online or to request access. Stroke: Pathophysiology, Diagnosis and Management Albers, GW et al th 2015, 6 ed

Management of Post-Stroke Complications Birns, J et al 2015

From the back of the book: Comprehensive, expert clinical guidance enables you to recognize the clinical manifestations of stroke, use the latest laboratory and imaging studies to arrive at a diagnosis, and generate an effective medical and surgical treatment plan. Abundant fullcolor CT images and pathology slides help you make efficient and accurate diagnoses. Data from late-breaking endovascular trials equips you with recent findings. Includes comprehensive coverage of advances in molecular biology of cell death; risk factors and prevention; advances in diagnostics and stroke imaging; and therapeutic options, including a thorough review of thrombolytic agents and emerging data for endovascular therapy. Highlights new information on genetic risk factors; primary prevention of stroke; infectious diseases and stroke; recovery interventions such as robotics, brain stimulation, and telerehabilitation; and trial design. Details advances in diagnostic tests, such as ultrasound, computed tomography (including CT angiography and CT perfusion), MRI (including MR perfusion techniques), and angiography.

From the back of the book: This book highlights the underlying importance of post-stroke complications during recovery, allowing healthcare professionals managing stroke patients to understand their frequency and identify which patients are at risk of developing such complications. Complications are categorised into neurological and non-neurological, and the time-frame for these complications both in the short-term and long-term are discussed. The common practices in managing poststroke complications and the skills required in their prevention are described, as is the evidence base from clinical trials around their management. The book concludes with a discussion of new developments and research priorities for the future. Management of PostStroke Complications is aimed at members of the multidisciplinary stroke team, stroke physicians, neurologists, general practitioners, stroke specialists in training, and medical students.

Taunton and SomPar NHS staff - Have you visited the EBL eBook catalogue? Follow the links below and login via OpenAthens to read online books free for 5-10 minutes each day, send requests for eBook loans or purchase suggestions Taunton & Somerset eBook catalogue

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COCHRANE SYSTEMATIC REVIEWS

Reviews from March 2016 Physical fitness training for stroke patients Transcranial direct current stimulation (tDCS) for improving activities of daily living, and physical and cognitive functioning, in people after stroke

GUIDELINES

National Clinical Guideline for Stroke, 4 edition 2012 NICE Guidelines Mechanical clot retrieval for treating acute ischaemic stroke- NICE interventional procedure guidance [IPG548] Published date: February 2016 Secondary prevention after a myocardial infarction- NICE quality standard [QS99] Published date: September 2015 Cardiovascular risk assessment and lipid modification- NICE quality standard [QS100] Published date: September 2015 Edoxaban for preventing stroke and systemic embolism in people with non-valvular atrial fibrillationNICE technology appraisal guidance [TA355] Published date: September 2015

UPTODATE & DYNAMED PLUS BACK TO TOP What’s new from our clinical decision-making tools on the topic of stroke. UpToDate –Access for Musgrove Staff only DynaMed Plus – Access for Somerset Partnership Staff only Please contact library staff for details on how to access these resources; you will need an Athens password if accessing from home.

REPORTS, PUBLICATIONS AND RESOURCES

NICE Pathway on Stroke UK Stroke Forum- hosted by Stroke Association Stroke Association website- contains information about support groups, conferences, fundraising, research and professional advice including toolkits and posters. The Sentinel Stroke National Audit Programme- 2 reports Post-acute organisational audit Presents the findings on the organisation of care for stroke survivors once they leave hospital. The audit highlights the number and location of post-acute stroke services across the UK and outlines what a patient might expect in accessing these services. Is stroke care improving? The second SSNAP annual report The second annual SSNAP report reveals today that despite steady progress in stroke care, further work needs to be done to ensure that patients have access to key interventions and assessments when they are admitted to hospital. Raconteur Report- Understanding Stroke Stroke is one of the biggest health issues people face today, taking a life every 13 minutes and costing the nation an estimated ÂŁ9 billion a year in health and social costs. Yet the condition ranks low in terms of public perception and research funding, and the UK lags behind some other nations in improving patient outcomes. This report highlights the need to raise research funding, along with awareness of the condition, and identifies key risk factors. It also showcases major technological and medical breakthroughs.

TOPIC ALERTS AND UPDATES

ABSTRACTS AVAILABLE VIA LINKS BELOW - FOR FULL-TEXT PLEASE ASK LIBRARY STAFF

Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies Heart Published Online First: 18 April 2016 FREE FULL TEXT

NHS Evidence Antidepressant use and risk of cardiovascular outcomes in people aged 20 to 64: cohort study using primary care database BMJ 2016; 352 doi: http://dx.doi.org/10.1136/bmj.i1350 (Published 22 March 2016) FREE FULL TEXT Aspirin for the Primary Prevention of Cardiovascular Events: A Systematic Evidence Review for the U.S. Preventive Services Task Force Ann Intern Med. Published online 12 April 2016 Elsevier Practice Updates Hypertension Is Associated With Increased Mortality in Children Hospitalized With Arterial Ischemic Stroke Pediatric Neurology March 2016Volume 56, Pages 25â&#x20AC;&#x201C;29 Recommendations for the Management of Strokelike Episodes in Patients With Mitochondrial Encephalomyopathy, Lactic Acidosis, and Strokelike Episodes JAMA Neurol. Published online March 07, 2016 Transcranial direct current stimulation facilitates motor learning post-stroke: a systematic review and meta-analysis J Neurol Neurosurg Psychiatry 2016;87:345-355 FREE FULL TEXT Guidelines for Urgent Management of Stroke in Children Pediatric Neurology March 2016 Volume 56, Pages 8â&#x20AC;&#x201C;17 Statin pretreatment is associated with better outcomes in large artery atherosclerotic stroke Neurology March 22, 2016 vol. 86 no. 12 1103-1111 Cost-effectiveness of endovascular thrombectomy in patients with acute ischemic stroke Neurology March 15, 2016 vol. 86 no. 11 1053-1059 Imaging Parameters and Recurrent Cerebrovascular Events in Patients With Minor Stroke or Transient Ischemic Attack JAMA Neurol. Published online March 21, 2016.

Electrical stimulation of the motor cortex enhances treatment outcome in post-stroke aphasia Brain 2016 Volume 139, Issue 4 Pp. 1152 - 1163

Medscape Topic Alerts Cocaine Use and Risk of Ischemic Stroke in Young Adults Stroke, Published online before print March 10, 2016 Ipsilesional anodal tDCS enhances the functional benefits of rehabilitation in patients after stroke Science Translational Medicine 16 Mar 2016: Vol. 8, Issue 330, pp. 330re1 Right hemisphere structures predict poststroke speech fluency Neurology. 2016 Mar 30 [Epub ahead of print] Effects of Arterial Stiffness on Brain Integrity in Young Adults From the Framingham Heart Study Stroke Published online before print March 10, 2016, Commensal microbiota affects ischemic stroke outcome by regulating intestinal ÎłÎ´ T cells th Nature Medicine Published online 28 March 2016 Transcranial direct current stimulation facilitates motor learning post-stroke: a systematic review and meta-analysis J Neurol Neurosurg Psychiatry. 2016 Apr;87(4):345-55 FREE FULL TEXT TRIP Database Characterizing Strokes and Stroke Mimics Transported by Helicopter Emergency Medical Services Prehosp Emerg Care. 2016 Apr 15:1-6. [Epub ahead of print] Impact on Outcomes of Changing Treatment Guideline Recommendations for Stroke Prevention in Atrial Fibrillation: A Nationwide Cohort Study Mayo Clin Proc. 2016 Apr 8. [Epub ahead of print] Depressive symptoms following stroke and transient ischemic attack: is it time for a more intensive treatment approach? results from the TABASCO cohort study J Clin Psychiatry. 2016 Mar 29. [Epub ahead of print]

TWITTER BACK TO TOP The latest from popular Twitter pages dedicated to stroke: Stroke Association @TheStrokeAssoc World Stroke Campaign @WStrokeCampaign Sign Against Stroke in Atrial Fibrillation @signagnststroke Different Strokes- Support for Younger Stroke Survivors @diffstrokes

TRAINING & NETWORKING OPPORTUNITIES, CONFERENCES, EVENTS BACK TO TOP

LITERATURE SEARCH SERVICE BACK TO TOP Looking for the latest evidence-based research but havenâ&#x20AC;&#x2122;t got time to trawl the databases? Do you need a literature search carried out? Do you need to find evidence to support an improvement? Do you want to know how something has been done elsewhere and whether it worked?

Library staff provide a literature search service for busy clinicians who are pressed for time.

To request a search please complete and return the appropriate form, providing as much information as possible. Alternatively if you would like an assisted search training session, where we will sit down with you and go through the steps of a literature search, then please contact the library. Musgrove staff click here to access literature search form Somerset Partnership staff click here to access literature search form

TRAINING AND ATHENS BACK TO TOP Most electronic resources are available via an Athens password. You can register for this via the Library intranet page, or from home at www.swice.nhs.uk and following the link for Athens selfregistration. Please note that registering from home will take longer as it will need to be verified that you are NHS staff/student on placement. The library offers training on how to access and use Athens resources, as well as an introductory course on critical appraisal. You can book a course through the Learning and Development intranet page, or by contacting the library directly.