Displaying publications 1 - 20 of 32 in total

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  1. Manaf H, Justine M, Goh HT
    Motor Control, 2017 Jan;21(1):42-57.
    PMID: 26595318 DOI: 10.1123/mc.2015-0040
    Attentional loadings deteriorate straight walking performance for individuals poststroke, but its effects on turning while walking remain to be determined. Here we compared turning kinematics under three attentional loading conditions (single, dual-motor, and dual-cognitive task) between stroke survivors and healthy controls. Nine chronic stroke survivors and 10 healthy controls performed the Timed Upand- Go test while their full-body kinematics were recorded. Onset times of yaw rotation of the head, thorax and pelvis segments and head anticipation distance were used to quantify turning coordination. Results showed that stroke survivors reoriented their body segments much earlier than the controls, but they preserved the similar segmental reorientation sequence under the single-task condition. For the healthy controls, attentional loading led to an earlier axial segment reorientation, but the reorientation sequence was preserved. In contrast, the dual-cognitive task condition led to a disrupted reorientation sequence in stroke. The results indicate that turning coordination was altered in individuals poststroke, especially under the dual-task interference.
    Matched MeSH terms: Stroke/physiopathology*
  2. Kumar SN, Joseph LH, Pharmy Jalil A
    Clin Neurophysiol, 2015 Jul;126(7):1453-4.
    PMID: 25468242 DOI: 10.1016/j.clinph.2014.09.031
    Matched MeSH terms: Stroke/physiopathology*
  3. Mohammad AH, Al-Sadat N, Siew Yim L, Chinna K
    Biomed Res Int, 2014;2014:302097.
    PMID: 25276774 DOI: 10.1155/2014/302097
    This study aims to test the translated Hausa version of the stroke impact scale SIS (3.0) and further evaluate its psychometric properties. The SIS 3.0 was translated from English into Hausa and was tested for its reliability and validity on a stratified random sample adult stroke survivors attending rehabilitation services at stroke referral hospitals in Kano, Nigeria. Psychometric analysis of the Hausa-SIS 3.0 involved face, content, criterion, and construct validity tests as well as internal and test-retest reliability. In reliability analyses, the Cronbach's alpha values for the items in Strength, Hand function, Mobility, ADL/IADL, Memory and thinking, Communication, Emotion, and Social participation domains were 0.80, 0.92, 0.90, 0.78, 0.84, 0.89, 0.58, and 0.74, respectively. There are 8 domains in stroke impact scale 3.0 in confirmatory factory analysis; some of the items in the Hausa-SIS questionnaire have to be dropped due to lack of discriminate validity. In the final analysis, a parsimonious model was obtained with two items per construct for the 8 constructs (Chi-square/df < 3, TLI and CFI > 0.9, and RMSEA < 0.08). Cross validation with 1000 bootstrap samples gave a satisfactory result (P = 0.011). In conclusion, the shorter 16-item Hausa-SIS seems to measure adequately the QOL outcomes in the 8 domains.
    Matched MeSH terms: Stroke/physiopathology*
  4. Sanchez-Bezanilla S, Hood RJ, Collins-Praino LE, Turner RJ, Walker FR, Nilsson M, et al.
    J Cereb Blood Flow Metab, 2021 09;41(9):2439-2455.
    PMID: 33779358 DOI: 10.1177/0271678X211005877
    There is emerging evidence suggesting that a cortical stroke can cause delayed and remote hippocampal dysregulation, leading to cognitive impairment. In this study, we aimed to investigate motor and cognitive outcomes after experimental stroke, and their association with secondary neurodegenerative processes. Specifically, we used a photothrombotic stroke model targeting the motor and somatosensory cortices of mice. Motor function was assessed using the cylinder and grid walk tasks. Changes in cognition were assessed using a mouse touchscreen platform. Neuronal loss, gliosis and amyloid-β accumulation were investigated in the peri-infarct and ipsilateral hippocampal regions at 7, 28 and 84 days post-stroke. Our findings showed persistent impairment in cognitive function post-stroke, whilst there was a modest spontaneous motor recovery over the investigated period of 84 days. In the peri-infarct region, we detected a reduction in neuronal loss and decreased neuroinflammation over time post-stroke, which potentially explains the spontaneous motor recovery. Conversely, we observed persistent neuronal loss together with concomitant increased neuroinflammation and amyloid-β accumulation in the hippocampus, which likely accounts for the persistent cognitive dysfunction. Our findings indicate that cortical stroke induces secondary neurodegenerative processes in the hippocampus, a region remote from the primary infarct, potentially contributing to the progression of post-stroke cognitive impairment.
    Matched MeSH terms: Stroke/physiopathology*
  5. Hamza AM, Al-Sadat N, Loh SY, Jahan NK
    Biomed Res Int, 2014;2014:350281.
    PMID: 24982864 DOI: 10.1155/2014/350281
    This study aims to identify the predictors in the different aspects of the health-related quality of life (HRQoL) and to measure the changes of functional status over time in a cohort of Nigerian stroke survivors. A prospective observational study was conducted in three hospitals of Kano state of Nigeria where stroke survivors receive rehabilitation. The linguistic-validated Hausa versions of the stroke impact scale 3.0, modified Rankin scale, Barthel index and Beck depression inventory scales were used. Paired samples t-test was used to calculate the amount of changes that occur over time and the forward stepwise linear regression model was used to identify the predictors. A total of 233 stroke survivors were surveyed at 6 months, and 93% (217/233) were followed at 1 year after stroke. Functional disabilities were significantly reduced during the recovery phase. Motor impairment, disability, and level of depression were independent predictors of HRQoL in the multivariate regression analysis. The involvement of family members as caregivers is the key factor for those survivors with improved functional status. Thus, to enhance the quality of poststroke life, it is proposed that a holistic stroke rehabilitation service and an active involvement of family members are established at every possible level.
    Matched MeSH terms: Stroke/physiopathology
  6. Manaf H, Justine M, Ting GH, Latiff LA
    Top Stroke Rehabil, 2014 Mar-Apr;21(2):128-36.
    PMID: 24710973 DOI: 10.1310/tsr2102-128
    Little is known about the effects of attentional loading on performance of turning during walking in individuals with stroke.
    Matched MeSH terms: Stroke/physiopathology*
  7. Gan CS, Wang CW, Tan KS
    Genet. Mol. Res., 2012;11(1):147-52.
    PMID: 22370881 DOI: 10.4238/2012.January.27.1
    Cerebral ischemia or ischemic stroke is mainly attributed to vascular and circulation disorders. Among protein biomarkers, RNA profiles have also been identified as markers of ischemic stroke. MicroRNA-145 expression is ostensibly recognized as marker and modulator of vascular smooth muscle cell phenotype; however, expression levels in ischemic stroke had not been investigated. Employing real-time quantitative PCR, we examined the expression profile of circulatory microRNA-145 in healthy control subjects (N = 14) and ischemic stroke patients (N = 32). Circulatory microRNA-145 expression was significantly higher in ischemic stroke patients than in control subjects. This demonstrates that hemostatic mechanisms are affected by ischemic stroke. We conclude that circulating microRNA-145 has potential as a biomarker for ischemic stroke.
    Matched MeSH terms: Stroke/physiopathology
  8. Nordin NAM, Aziz NA, Sulong S, Aljunid SM
    NeuroRehabilitation, 2019;45(1):87-97.
    PMID: 31450518 DOI: 10.3233/NRE-192758
    BACKGROUND: The benefits of engaging informal carers or family in the delivery of therapy intervention for people with stroke have not been well researched.

    OBJECTIVES: To assess the effectiveness of a home-based carer-assisted in comparison to hospital-based therapist-delivered therapy for community-dwelling stroke survivors.

    METHODS: An assessor blinded randomised controlled trial was conducted on 91 stroke survivors (mean age 58.9±10.6 years, median time post-onset 13.0 months, 76.5% males) who had completed individual rehabilitation. The control group received hospital-based group therapy delivered by physiotherapists as out-patients and the test group was assigned to a home-based carer-assisted therapy. Targeted primary outcomes were physical functions (mobility, balance, lower limb strength and gait speed). A secondary outcome index was health-related quality of life. An intention-to-treat analysis was used to evaluate outcomes at week 12 of intervention.

    RESULTS: Both therapy groups improved significantly in all the functional measures; mobility (p  0.05).

    CONCLUSIONS: The home-based carer-assisted therapy is as effective as the hospital-based therapist-delivered training in improving post-stroke functions and quality of life.

    Matched MeSH terms: Stroke/physiopathology
  9. Omar NH, Mohd Nordin NA, Chai SC, Abdul Aziz AF
    Med J Malaysia, 2020 03;75(2):146-151.
    PMID: 32281596
    INTRODUCTION: There is scarcity of research information on upper limb (UL) functionality among Malaysian post-stroke population despite the increasing number of stroke survivors. This study intends to evaluate functionality among stroke survivors residing in the community, with a specific focus on the UL.

    METHODS: This cross-sectional study involved 65 stroke survivors with UL dysfunction (mean (SD) age = 64.83 (8.05) years, mean (SD) post-stroke duration 41.62 (35.24) months) who attended community-based rehabilitation program. Upper limb functionality was assessed using the UL items of Stroke Specific Quality of Life Scale (SSQOL), the Lawton Instrumental Activities of Daily Living (IADL) Scale and the Jebsen-Taylor Hand Function Test (JTHFT). The stroke survivors' performance in completing JTHFT using their affected dominant hand was compared with standard norms.

    RESULTS: The three most affected UL daily living tasks were writing (64.7%, n=42), opening a jar (63.1%, n=41) and putting on socks (58.5%, n=38). As for IADL, the mean (SD) score of Lawton scale was 3.26 (2.41), with more than 50% unable to handle finance, do the laundry and prepare meals for themselves. Performances of stroke survivors were much slower than normal population in all tasks of JTHFT (p<0.05), with largest speed difference demonstrated for 'stacking objects' task (mean difference 43.24 secs (p=0.003) and 24.57 (p<0.001) in males and females, respectively.

    CONCLUSION: UL functions are significantly impaired among stroke survivors despite undergoing rehabilitation. Rehabilitation professionals should prioritize highly problematic tasks when retraining UL for greater post-stroke functionality.

    Matched MeSH terms: Stroke/physiopathology*
  10. Abdul Rahman H, Khor KX, Yeong CF, Su EL, Narayanan AL
    Biomed Mater Eng, 2017;28(2):105-116.
    PMID: 28372264 DOI: 10.3233/BME-171660
    BACKGROUND: Clinical scales such as Fugl-Meyer Assessment (FMA) and Motor Assessment Scale (MAS) are widely used to evaluate stroke patient's motor performance. However, there are several limitations with these assessment scales such as subjectivity, lack of repeatability, time-consuming and highly depend on the ability of the physiotherapy. In contrast, robot-based assessments are objective, repeatable, and could potentially reduce the assessment time. However, robot-based assessments are not as well established as conventional assessment scale and the correlation to conventional assessment scale is unclear.

    OBJECTIVE: This study was carried out to identify important parameters in designing tasks that efficiently assess hand function of stroke patients and to quantify potential benefits of robotic assessment modules to predict the conventional assessment score with iRest.

    METHODS: Twelve predictive variables were explored, relating to movement time, velocity, strategy, accuracy and smoothness from three robotic assessment modules which are Draw I, Draw Diamond and Draw Circle. Regression models using up to four predictors were developed to describe the MAS.

    RESULTS: Results show that the time given should be not too long and it would affect the trajectory error. Besides, result also shows that it is possible to use iRest in predicting MAS score.

    CONCLUSION: There is a potential of using iRest, a non-motorized device in predicting MAS score.

    Matched MeSH terms: Stroke/physiopathology*
  11. Almalki WH, Alghamdi S, Alzahrani A, Zhang W
    Drug Discov Today, 2021 03;26(3):826-835.
    PMID: 33383212 DOI: 10.1016/j.drudis.2020.12.018
    Interest is increasing in the use of nanotheranostics as diagnosis, imaging and therapeutic tools for stroke management, but movement to the clinic remains challenging.
    Matched MeSH terms: Stroke/physiopathology
  12. Ramlee MH, Beng GK, Bajuri N, Abdul Kadir MR
    Med Biol Eng Comput, 2018 Jul;56(7):1161-1171.
    PMID: 29209961 DOI: 10.1007/s11517-017-1762-3
    The provision of the most suitable rehabilitation treatment for stroke patient remains an ongoing challenge for clinicians. Fully understanding the pathomechanics of the upper limb will allow doctors to assist patients with physiotherapy treatment that will aid in full arm recovery. A biomechanical study was therefore conducted using the finite element (FE) method. A three-dimensional (3D) model of the human wrist was reconstructed using computed tomography (CT)-scanned images. A stroke model was constructed based on pathological problems, i.e. bone density reductions, cartilage wane, and spasticity. The cartilages were reconstructed as per the articulation shapes in the joint, while the ligaments were modelled using linear links. The hand grip condition was mimicked, and the resulting biomechanical characteristics of the stroke and healthy models were compared. Due to the lower thickness of the cartilages, the stroke model reported a higher contact pressure (305 MPa), specifically at the MC1-trapezium. Contrarily, a healthy model reported a contact pressure of 228 MPa. In the context of wrist extension and displacement, the stroke model (0.68° and 5.54 mm, respectively) reported a lower magnitude than the healthy model (0.98° and 9.43 mm, respectively), which agrees with previously reported works. It was therefore concluded that clinicians should take extra care in rehabilitation treatment of wrist movement in order to prevent the occurrence of other complications. Graphical abstract ᅟ.
    Matched MeSH terms: Stroke/physiopathology*
  13. Msayib Y, Harston GWJ, Tee YK, Sheerin F, Blockley NP, Okell TW, et al.
    Neuroimage Clin, 2019;23:101833.
    PMID: 31063943 DOI: 10.1016/j.nicl.2019.101833
    BACKGROUND: Amide proton transfer (APT) imaging may help identify the ischaemic penumbra in stroke patients, the classical definition of which is a region of tissue around the ischaemic core that is hypoperfused and metabolically stressed. Given the potential of APT imaging to complement existing imaging techniques to provide clinically-relevant information, there is a need to develop analysis techniques that deliver a robust and repeatable APT metric. The challenge to accurate quantification of an APT metric has been the heterogeneous in-vivo environment of human tissue, which exhibits several confounding magnetisation transfer effects including spectrally-asymmetric nuclear Overhauser effects (NOEs). The recent literature has introduced various model-free and model-based approaches to analysis that seek to overcome these limitations.

    OBJECTIVES: The objective of this work was to compare quantification techniques for CEST imaging that specifically separate APT and NOE effects for application in the clinical setting. Towards this end a methodological comparison of different CEST quantification techniques was undertaken in healthy subjects, and around clinical endpoints in a cohort of acute stroke patients.

    METHODS: MRI data from 12 patients presenting with ischaemic stroke were retrospectively analysed. Six APT quantification techniques, comprising model-based and model-free techniques, were compared for repeatability and ability for APT to distinguish pathological tissue in acute stroke.

    RESULTS: Robustness analysis of six quantification techniques indicated that the multi-pool model-based technique had the smallest contrast between grey and white matter (2%), whereas model-free techniques exhibited the highest contrast (>30%). Model-based techniques also exhibited the lowest spatial variability, of which 4-pool APTR∗ was by far the most uniform (10% coefficient of variation, CoV), followed by 3-pool analysis (20%). Four-pool analysis yielded the highest ischaemic core contrast-to-noise ratio (0.74). Four-pool modelling of APT effects was more repeatable (3.2% CoV) than 3-pool modelling (4.6% CoV), but this appears to come at the cost of reduced contrast between infarct growth tissue and normal tissue.

    CONCLUSION: The multi-pool measures performed best across the analyses of repeatability, spatial variability, contrast-to-noise ratio, and grey matter-white matter contrast, and might therefore be more suitable for use in clinical imaging of acute stroke. Addition of a fourth pool that separates NOEs and semisolid effects appeared to be more biophysically accurate and provided better separation of the APT signal compared to the 3-pool equivalent, but this improvement appeared be accompanied by reduced contrast between infarct growth tissue and normal tissue.

    Matched MeSH terms: Stroke/physiopathology
  14. Rinne P, Hassan M, Fernandes C, Han E, Hennessy E, Waldman A, et al.
    Proc Natl Acad Sci U S A, 2018 01 16;115(3):E536-E545.
    PMID: 29284747 DOI: 10.1073/pnas.1715617115
    Attention control (or executive control) is a higher cognitive function involved in response selection and inhibition, through close interactions with the motor system. Here, we tested whether influences of attention control are also seen on lower level motor functions of dexterity and strength-by examining relationships between attention control and motor performance in healthy-aged and hemiparetic-stroke subjects (n = 93 and 167, respectively). Subjects undertook simple-tracking, precision-hold, and maximum force-generation tasks, with each hand. Performance across all tasks correlated strongly with attention control (measured as distractor resistance), independently of factors such as baseline performance, hand use, lesion size, mood, fatigue, or whether distraction was tested during motor or nonmotor cognitive tasks. Critically, asymmetric dissociations occurred in all tasks, in that severe motor impairment coexisted with normal (or impaired) attention control whereas normal motor performance was never associated with impaired attention control (below a task-dependent threshold). This implies that dexterity and force generation require intact attention control. Subsequently, we examined how motor and attention-control performance mapped to lesion location and cerebral functional connectivity. One component of motor performance (common to both arms), as well as attention control, correlated with the anatomical and functional integrity of a cingulo-opercular "salience" network. Independently of this, motor performance difference between arms correlated negatively with the integrity of the primary sensorimotor network and corticospinal tract. These results suggest that the salience network, and its attention-control function, are necessary for virtually all volitional motor acts while its damage contributes significantly to the cardinal motor deficits of stroke.
    Matched MeSH terms: Stroke/physiopathology*
  15. Goh HT, Chan HY, Abdul-Latif L
    J Neurol Phys Ther, 2015 Jan;39(1):15-22.
    PMID: 25427033 DOI: 10.1097/NPT.0000000000000064
    Noninvasive brain stimulation, including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), have gained popularity in the stroke rehabilitation literature. Little is known about the time course and duration of effects of noninvasive brain stimulation on corticospinal excitability in individuals with stroke. We examined the aftereffects of a single session of high-frequency rTMS (5 Hz) and anodal tDCS on corticospinal excitability in the same sample of participants with chronic stroke.
    Matched MeSH terms: Stroke/physiopathology
  16. Ramaiah SS, Mitchell P, Dowling R, Yan B
    J Stroke Cerebrovasc Dis, 2014 Mar;23(3):399-407.
    PMID: 23601372 DOI: 10.1016/j.jstrokecerebrovasdis.2013.03.012
    Evidence from recent randomized controlled studies comparing intra-arterial (IA) therapy with intravenous tissue plasminogen activator highlighted the mismatch between recanalization success and clinical outcomes in patients presenting with acute ischemic stroke. There is emerging interest in the impact of arterial collateralization, as determined by leptomeningeal anastomoses (LMAs), on the treatment outcomes of IA therapy. The system of LMA constitutes the secondary network of cerebral collateral circulation apart from the Circle of Willis. Both anatomic and angiographic studies confirmed significant interindividual variability in LMA. This review aims to outline the current understanding of arterial collateralization and its impact on outcomes after IA therapy for acute ischemic stroke, underpinning the possible role of arterial collateralization assessment as a selection tool for patients most likely to benefit from IA therapy.
    Matched MeSH terms: Stroke/physiopathology
  17. Bharathi V, Lee FS
    Med J Malaysia, 2006 Oct;61(4):490-2.
    PMID: 17243530
    Emotional incontinence is a disorder of emotional control following brain damage. It refers to the heightened tendency to cry or less commonly laugh, out of proportion to the underlying mood. Recognition of this phenomenon is often lacking as it is confused with other related sequelae of brain damage such as depression. This is a case report of an elderly female exhibiting poststroke emotional incontinence.
    Matched MeSH terms: Stroke/physiopathology
  18. Rameezan BAR, Zaliha O
    Med J Malaysia, 2005 Dec;60(5):548-59.
    PMID: 16515104
    Stroke is a leading cause of death and disability in most developed countries and developing nations. Majority of the stroke survivors are left with significant physical and cognitive impairments. In addition to the improved acute stroke care, they often benefit from rehabilitation in improving their function. This was the first study done to document function for post stroke patients in Malaysia. It was prospective study conducted to document functional status of acute stroke patients upon admission, discharge and at 3 months post stroke. Assessment of functional status for these patients are based on their activities of daily living and ambulation i.e. self-care, sphincter control, mobility, locomotion, communication and social cognition. It is also aimed to describe their demographic and clinical characteristics. Correlation of functional status at 3 months post stroke with the initial severity of stroke was also explored. A total of fifty-one patients with acute stroke in University Malaya Medical Centre (UMMC) were recruited. The patient's age ranged from 38 to 83 years with a mean of 60.2 years. Thirty-six patients (71%) were first stroke sufferers and fifteen patients (29%) had recurrent stroke. At discharge from acute stay, 13% of patients were able to ambulate with aids and 87% needed assistance for ambulation in varying degrees. Eighty-two percent of patients showed improvement in overall function (both motor and cognition) at 3 months post stroke. Sixty percent of patients were independent in ambulation and 40% required assistance. Significant correlation was seen between the initial severity of stroke and functional status at 3 months post stroke. Functional status of patients with stroke has improved at 3 months post stroke. A comprehensive rehabilitation medicine programme should be incorporated into management of stroke patients to expedite functional recovery and improve patient's independence.
    Matched MeSH terms: Stroke/physiopathology*
  19. Rasool AH, Rahman AR, Choudhury SR, Singh RB
    J Hum Hypertens, 2004 Mar;18(3):187-92.
    PMID: 14973513 DOI: 10.1038/sj.jhh.1001647
    Stroke is one of the leading causes of death worldwide, and spontaneous bleeding into the brain parenchyma, intracerebral haemorrhage (ICH), is a stroke subtype associated with high morbidity and mortality. Overall, it comprises about 15% of all stroke in Caucasians, this figure being much higher in Asians and black people. Blood pressure (BP) appears to play an important role in this disease. We have reviewed available literature on the relationship of BP to the occurrence of primary and secondary ICH, the association of BP levels measured early after stroke with prognosis and complications, and evidence about the effects of early BP lowering treatments on post-stroke outcomes. BP appears to be an important risk factor for primary and secondary ICH. In addition, high BP early after ICH may be detrimental to outcome, possibly contributing to complications such as rebleeding and haematoma enlargement. Few data are available about the effects of early lowering of BP on outcome after ICH with no reliable trial yet conducted. Proper randomised trials are required to establish the effect of early lowering of BP on outcome after ICH.
    Matched MeSH terms: Stroke/physiopathology
  20. Wang QM, Cui H, Han SJ, Black-Schaffer R, Volz MS, Lee YT, et al.
    Neurosci Lett, 2014 May 21;569:6-11.
    PMID: 24631567 DOI: 10.1016/j.neulet.2014.03.011
    Noninvasive transcranial direct current stimulation (tDCS) and methylphenidate (MP) are associated with motor recovery after stroke. Based on the potentially complementary mechanisms of these interventions, we examined whether there is an interactive effect between MP and tDCS. In this preliminary study, we randomized subacute stroke subjects to receive tDCS alone, MP alone or combination of tDCS and MP. A blinded rater measured safety, hand function, and cortical excitability before and after treatment. None of the treatments caused any major or severe adverse effects or induced significant differences in cortical excitability. Analysis of variance of gain score, as measured by Purdue pegboard test, showed a significant between-group difference (F(2,6)=12.167, p=0.008). Post hoc analysis showed that the combination treatment effected greater Purdue pegboard gain scores than tDCS alone (p=0.017) or MP alone (p=0.01). Our preliminary data with nine subjects shows an interesting dissociation between motor function improvement and lack of motor corticospinal plasticity changes as indexed by transcranial magnetic stimulation in subacute stroke subjects.
    Matched MeSH terms: Stroke/physiopathology
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