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Akinetopsia
Published in Alexander R. Toftness, Incredible Consequences of Brain Injury, 2023
There are other areas of the brain that play roles in the detection of movement which can help compensate for damage to V5. Because other areas contribute to the perception of motion, akinetopsia is unusual among brain damage in that it is generally not permanent. The amount of time that it takes to recover motion perception after damage to V5 depends on the amount of brain damage. For example, in a stroke, recovery depends on the size of the brain lesion that develops. In cases where damage was done to a large region, the motion blindness can become mostly permanent with only partial recovery (Shipp et al., 1994). In some cases, even after the experience of akinetopsia goes away, there are still detectable abnormalities in the way the person tracks moving objects with their eyes (Cooper et al., 2012). So, the next time that you catch a moving object in your hand, or watch as a movie tricks your brain into seeing movement, spare a moment to think about how hard your brain is working to smooth out those movements.
Language
Published in Andrei I. Holodny, Functional Neuroimaging, 2019
In a similar study, Fernandez and coworkers have described a case of a patient with conduction aphasia during the first year of stroke recovery (56). This group also studied a group of 10 healthy right-handed volunteers with repeated scanning to evaluate both intersubject robustness and intrasubject reproducibility (56). While the controls did not demonstrate any significant changes (good reproducibility of activation was noted at both the intersubject and intrasubject levels), the patient did display dynamic changes in activation that were most prominently seen during performance of a phonological language task: one month following the stroke, homotopic right-hemispheric activation was noted, but 12 months poststroke, substantial left-hemispheric perilesional activation was seen (56). These findings are consistent with those of Saur’s group described above.
Ethical decisions and end-of-life care in older patients with cardiovascular disease
Published in Wilbert S. Aronow, Jerome L. Fleg, Michael W. Rich, Tresch and Aronow’s Cardiovascular Disease in the Elderly, 2019
Esther S. Pak, James N. Kirkpatrick, Craig Tanner, Sarah J. Goodlin
Patients and families have great palliative care needs throughout the stages of stroke. In the acute stages, patients and families can benefit from decision-making support and symptom management in times of crisis and uncertain prognosis. During post-stroke recovery, palliative care needs include support during adjustment to new functional and cognitive impairments, symptoms such as pain, and psychosocial distress (77). Patients and families often face decisions regarding CPR, mechanical ventilation, artificial nutrition, and dialysis. Palliative care involvement could help facilitate advance care planning and provide decision-making support, especially in consideration of withdrawal of life-sustaining support (78). As with other terminal illness, the use of hospice services can be of great benefit to patients dying of stroke and to their families. A 2010 study of US Medicare beneficiaries found that among patients dying within 30 days of an acute stroke, 23% utilized hospice services, which is on par with both malignant and other nonmalignant diseases (79).
Dance-based exergaming on postural stability and kinematics in people with chronic stroke – A preliminary study
Published in Physiotherapy Theory and Practice, 2022
Savitha Subramaniam, Shuaijie Wang, Tanvi Bhatt
In conclusion, the current study is the first of its kind to evaluate postural stability and lower extremity joint kinematics to understand the use of DBExG among PwCS. The findings support the postulation that DBExG improves postural stability, joint kinematics, gait function, and improving falls-self efficacy among PwCS. Clinical practice guidelines for rehabilitation and stroke recovery among PwCS recommend structured interventions for incorporating physical activity to improve motor functions. Given the results of this study, future studies should consider examining randomized controlled trials to compare DBExG to in-person dance instructor lead protocols, which have been previously piloted in other neurological conditions, such as Parkinson’s disease. Along with evaluating the feasibility of translating DBExG into group therapy programs in PwCS.
How active are stroke patients in physiotherapy sessions and is this associated with stroke severity?
Published in Disability and Rehabilitation, 2022
Jimmy James, Mark P. McGlinchey
The influence of stroke severity on stroke recovery and the rehabilitation process is increasingly being recognised. Stroke recovery is a complex process which involves both spontaneous neuronal recovery and motor learning. It has been demonstrated that increasing stroke severity is associated with less complete physical recovery post-stroke [11–13]. Stroke severity is also a factor associated with physiotherapy provision after stroke [5,14]. Patients with higher stroke severity receive less intensity of physiotherapy and participate in less physical activity during inpatient rehabilitation [4,5,14]. Given that high-intensity repetitive practice helps promote recovery [15], lower levels of active exercise undertaken in these patients may be a contributing factor to poorer functional recovery. As international clinical guidelines for stroke rehabilitation do not specify how to tailor physiotherapy according to stroke severity [8,16–18], it is important to understand the reality of physiotherapy provision according to stroke severity. In particular, it is important to understand how time undertaking active exercise within physiotherapy sessions differs across all levels of stroke severity.
Participation in social and leisure activities while re-constructing the self: understanding strategies used by stroke survivors from a long-term perspective
Published in Disability and Rehabilitation, 2022
Anna Norlander, Susanne Iwarsson, Ann-Cathrin Jönsson, Arne Lindgren, Eva Månsson Lexell
Our participants chose to engage in activities that strengthened their self and avoided those that did not, suggesting that engagement in social and leisure activities can be part of a person’s struggle to maintain a positive or familiar identity after stroke. These findings relate to those of Charmaz [39] who described how chronic illness disrupts the taken-for-granted notions about self, as well as the daily habits that support this self. As described by Charmaz, different activities and contexts are assigned certain qualities and symbolic values. Therefore, engaging in activities such as hiking, attending lectures, taking care of the grandchildren or managing the home could contribute to maintaining the image of oneself as a physically active, intellectual, caring or independent person. Moreover, by avoiding activities that could no longer be performed satisfactorily, our participants protected their pre-stroke identity. By accepting change and adopting new (or adapted) activities, they started to reconstruct their post-stroke self. Thus, an important task for rehabilitation professionals is to support people towards building a new and accepted identity after stroke. Considering that stroke recovery as well as accepting and adapting to a new situation is a long-term process [40], individual needs will likely vary during different stages. Therefore, implementation of routine follow-ups over an extended period of time, with a possibility to address identified needs, is required.