Glycemic State in Diabetic Patients during the Post-Stroke Recovery Phase.

Background: Hyperglycemia is common in the early acute stroke phase especially in patients with diabetes. To the best of our knowledge, no study has evaluated the course of hyperglycemia in patients with diabetes during the post-stroke recovery phase. Methods: It was an observational study conducted in Tabassom Rehabilitation Center for Stroke Patients, Tehran, Iran, 2018-2021. Forty-seven consecutive patients with diabetes and stroke were enrolled and included if at least 3 months had passed from their stroke . Any change in glycemic control before and after stroke was controlled by monitoring drugs used for diabetes treatment and laboratory results. To assess categorical variables, the Pearson chi-squared test was used. Quantitative variables before and after the stroke were analyzed by the paired sample t-test. Results: The mean age was 63.6 ± 6.9 years, and 22 patients were women. The median time from occurrence of stroke to the first visit was 5 months and 6 days. Glycemic control improved among patients with diabetes during the post-stroke recovery phase. There was a significant decrease of 0.7 ± 1.3 % in HbA1c (P = 0.001). The number and the dose of drugs needed for diabetes treatment decreased. No significant correlation could be found between changes in HbA1c and weight. Conclusion: Despite the initial increase in glycemia in patients with diabetes in the acute phase of stroke, glycemic control improves after stroke, and often, it is necessary to decrease diabetes drugs to prevent hypoglycemia. This topic is important and should be addressed by guidelines and institutions involved in the care of patients with diabetes and stroke.

Feasibility of Robot-Assistance Hand Physiotherapy in Post-Stroke Patients.

Background: Patients with experienced stroke have suffered from long-term disability, especially in their distal upper extremities. Physiotherapy programs are considered a proper treatment to overcome the complications caused by stroke. The use of robots in physiotherapy is also considered a newfound procedure as an alternative to conventional methods. Objective: This study aimed to describe a feasibility test on a physiotherapy robot and evaluate the efficacy of the proposed device. Material and Methods: In this experimental study, a 4-degrees-of-freedom robot was designed and fabricated for hand physiotherapy, which was tested on 17 and 4 post-strokes in the passive and active modes for the best efficiency. Additionally, the patient's hand spasticity was measured according to the Modified Ashworth Scale pre- and post-usage of the device. Results: A total of 12 of 17 individuals could do the exercises and follow the instructions without any problem, and 8 of 12 individuals had a decrease in their spasticity. All 4 patients in active-assisted mode could fulfill the activity. Conclusion: Physiotherapy based on a robot-assisted is considered a promising method with effective treatments for post-stroke patients, which can be a good alternative to routine methods of physiotherapy. However, more tests are needed to determine the rate of functions' restoration.

Effect of RehaCom cognitive rehabilitation software on working memory and processing speed in chronic ischemic stroke patients.

Stroke survivors need assistance to overcome cognitive impairments. Working memory (WM) and processing speed (PS) as two critical cognitive functions are disrupted by stroke. The goal of this study was to investigate the effect of RehaCom rehabilitation software on WM and PS in participants with chronic ischemic stroke with hemiplegia (right/left side). Participants were selected among stroke patients who were referred to our special rehabilitation clinic. Fifty participants were assigned to control (n = 25) and experimental (n = 25) groups. The results of the experimental group were compared with the control group before and after the treatment with RehaCom (ten 45-min sessions across five weeks, two sessions per week). The results showed a significant improvement in WM and PS in the experimental group in comparison with the control group after a 5-week training with RehaCom. In conclusion, our findings indicate that treatment with RehaCom software improves WM and PS in chronic ischemic stroke participants with hemiplegia. The exact mechanism of RehaCom is largely unknown and further studies are needed, but its effects on the function of brain regions involved in modulating cognitive functions such as the prefrontal cortex, cingulate cortex, and parietal cortex may be mechanisms of interest.

Efficacy of RehaCom cognitive rehabilitation software in activities of daily living, attention and response control in chronic stroke patients.

BACKGROUND: Our world is unfortunately facing a huge number of stroke. Attention, response control and activities of daily living (ADL) are important cognitive functions affected by stroke. In line with this explanation, we aimed to investigate the effect of RehaCom rehabilitation software on ADL, attention and response control in chronic stroke patients with damage to middle and anterior cerebral arteries. METHOD: For selecting participants, among chronic stroke patients who referred to our special rehabilitation clinic for patients with stroke, fifty patients selected. Participants were assigned to control (n = 25) and experimental (n = 25) groups. The experimental group was compared with the control group before and after using RehaCom (ten 45-min sessions in five weeks). RESULTS: There is a significant enhancement in ADL, attention and response control scores in the experimental group compared with the control group. In fact, treatment with RehaCom significantly improved the score of all studied variables in chronic stroke patients. CONCLUSIONS: In conclusion, RehaCom cognitive rehabilitation software has improvement effect on ADL, attention and response control in patients with chronic stroke. Our study reveals a new information about the efficacy of computerized training in the rehabilitation of stroke patients.