Evidence
Alert

Fluoxetine does not improve outcomes after stroke

Many people experience disability after a stroke, such as weakness in the arm or leg, or problems with language and communication. The antidepressant drug fluoxetine has been used to reduce disability following a stroke but it is unclear how effective it is. The first of three large-scale trials into the impact of fluoxetine in stroke ...

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New research supports the move to raise the blood pressure target for frail older people

Frail older people may not benefit from the same tight blood pressure control that has been shown to benefit relatively younger, healthier groups in existing trials. The medical records of more than 400,000 patients in primary care were reviewed. The researchers found that lower than normal blood pressures were associated with a higher death rate ...

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Tranexamic acid is safe to use following mild-to-moderate traumatic brain injury and reduces deaths

In people with mild-to-moderate traumatic brain injury, tranexamic acid (a drug which reduces bleeding) given within three hours of injury reduces the risk of death by 22%. This effect is seen in a subgroup of those who are less severely affected. This NIHR-funded multi-centre international trial randomised 12,737 adults with intracranial bleeding to receive either ...

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Computerised speech and language therapy can help people with aphasia find words following a stroke

People with aphasia caused by a stroke show improvements in retrieving words when they use self-managed computerised speech and language therapy in addition to usual care from a speech and language therapist. No improvements are seen in patients’ conversational abilities or their quality of life. Aphasia is a complex language and communication disorder. It can affect people’s ...

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On balance, antiplatelet drugs may be restarted for stroke survivors who have bled into the brain

Early research suggests that antiplatelet drugs, such as aspirin, can provide more benefit than harm if restarted at about 2 to 3 months after a brain bleed. The results seem to apply best to those patients with a good prognosis who survive with less disability. Antiplatelet drugs are of proven benefit to those with a ...

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Robot-assisted training offers little useful improvement in severe arm weakness and function after stroke

People who have severe arm weakness following stroke have no better function after robot-assisted training or enhanced upper limb therapy than those who have usual NHS care. This large multicentre trial, funded by the NIHR, randomised 770 adult stroke patients to robot-assisted training using the MIT-Manus robotic gym, to an enhanced therapy programme or to ...

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Centralising stroke services can save lives

Changing access to more specialised stroke centre care in one city (London) was estimated to save an additional 96 lives per year (1%) compared to the reductions occurring in the rest of England. These improvements were sustained over time. Other cities did well on quality of care indicators, including time to admission in a stroke ...

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Transcutaneous electrical stimulation (TENS) may help lower limb spasticity after stroke

Transcutaneous electrical stimulation (TENS) delivered alongside standard physical therapies could reduce spasticity in the lower limbs following a stroke. Spasticity is a muscle control disorder characterised by tight muscles. It is common after stroke and accounts for significant disability. TENS is often used to treat pain and can affect nervous stimulation of the muscles. The ...

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A commonly-used antidepressant doesn’t improve recovery after stroke

The antidepressant fluoxetine works no better than placebo to reduce disability after a stroke, lowering hopes that had been raised by other smaller studies. After a six month trial including more than 3,000 adult stroke patients recruited at 103 UK hospitals, researchers concluded that fluoxetine should not be used to promote recovery from stroke-related disability, ...

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Robot-assisted arm training after stroke helps people regain some strength and independence

People who have electromechanical or robot-assisted arm rehabilitation after stroke have better arm function and strength as well as finding it easier to complete activities of daily living. Although moderate, the improvements suggest it may be worth considering these interventions as an adjunct to usual therapy. Many people have impaired arm function after a stroke ...

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