Top PDF Visual contrast sensitivity in patients with impairment of functional independence after stroke

Visual contrast sensitivity in patients with impairment of functional independence after stroke

Visual contrast sensitivity in patients with impairment of functional independence after stroke

The stimuli were set to appear in the center of a 19-inch video monitor (LG) CRT (Cathode Ray Tube) with high resolution (1024 x 768) and a 70-Hz frame rate. Input was controlled by a microcomputer through a video board with VGA and DVI connectors. The voltage lumi- nance of the monitor was expanded from 8 to 14 bits using BITS++ (Cambridge Research Systems, Rochester, Kent, England, 2002), allowing the use of visual stimuli with lower contrast gradations. LightScan software, equipped with OptiCAL Photometry (Cambridge Re- search Systems, Rochester, Kent, England, 2002), was used to measure screen luminance and gamma correct the monitor using 48 index values ranging from 0 to 255 (gamma = 1.8) as a sample. The lowest and highest lumi- nance values of the screen were 0.20 cd/m 2 and 80.0 cd/ m 2 (mean luminance = 40.1 cd/m 2 ). The room was 2.5 x 2.0 m in size and was illuminated by a fluorescent 20 W bulb (Philips). The walls of the room were gray, which allowed for better control of the room lightning condi- tions during the experiment. A C++ computer program, developed by the responsible lab, was used to run the experiment (generating the stimuli, controlling stimuli presentation and registering contrast thresholds).
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Functional Independence, Mental Health and Quality of Life among Middle Cerebral Artery Stroke patients

Functional Independence, Mental Health and Quality of Life among Middle Cerebral Artery Stroke patients

Another important factor that influences the stroke recovery is stroke pathogenesis. Cause of stroke can be broadly classified into intra cerebral hemorrhage or cerebral infarction. Stroke can affect the people physically, mentally and emotionally. So knowledge of long-term outcome after stroke rehabilitation is important for optimization of patient management but studies on long term outcomes are only few. Middle cerebral artery (MCA) stroke describes the sudden onset of focal neurologic deficit resulting from brain infarction or ischemia in the territory supplied by cerebrovascular middle cerebral artery is by far the largest cerebral artery and is the vessel most commonly affected by cerebrovascular accident. Functional disability and motor impairment are important concerns of post stroke, therefore improving functional and motor outcome is one of the main goals of stroke rehabilitation. Most of recovery is seen in the first few weeks after stroke, with a recovery slope reaching plateau between 3months and 6 months. It remains unclear whether early improvement can be sustained long term after stroke. There is only few information available relating to the patients status after the time of discharge from hospital 13
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Impact of cognitive impairment on falls efficacy and functional performance in stroke patients

Impact of cognitive impairment on falls efficacy and functional performance in stroke patients

After completion of this the Modified Falls Efficacy Scale (MFES) was administered to measure fall-related efficacy. It is the visual questionnaire scale, which has 14 different day-to- day tasks a person does. Scoring from 0 to 10 is there. 0 is equal to no confidence at all to 10 is equal to extreme confidence. The total score of less than 8 indicates the fear of falling, and above 8 indicates lack of fear. The third most component of the functional performance was assessed by the Functional Independence Measure (FIM) instrument. This scale rates the patient on their performance of the activity taking into account their need for assistance from another person or a device. 18 items (13 are motor skills and 5 are of cognition) comprise the FIM and has maximum score of 7 which indicates complete independence and lowest score of 1 that represent total assistance. Score of 6-7 suggests ‘no helper’ status and 1- 5 is ‘helper’ category. All the collected data was entered into MS Excel sheet, processed and analyzed.
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The relationship between sensory impairment and functional independence among elderly

The relationship between sensory impairment and functional independence among elderly

Our study also showed that individuals with severe sen- sory disabilities were more likely to have an IADL restric- tion and less likely to have decision-making control and be happy with their lives than individuals with mild sensory disabilities. Decrements in seeing and hearing impairment associated with IADL restrictions were sup- ported by Dargent-Molina and colleagues [15]. They found that community-dwelling women aged 75 years and older with serious hearing difficulties were four times more likely to be physically dependent than respondents with less serious hearing difficulties. Moreover, elderly women with visual impairments, such as low visual acuity and low contrast sensitivity, were almost twice as likely to be physically disabled compared with women with good vision [15].
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Ranibizumab in the treatment of patients with visual impairment due to diabetic macular edema

Ranibizumab in the treatment of patients with visual impairment due to diabetic macular edema

hundred and twenty-six patients were randomized to receive 0.5 mg of ranibizumab, focal/grid laser photocoagulation, or a combination of 0.5 mg of ranibizumab and focal/grid laser. In the ranibizumab group, 42 patients received 0.5 mg at baseline and months 1, 3, and 5. In the laser group, 42 patients received focal/grid laser photocoagulation at baseline and month 3 if needed (center subfield thickness was .250 µ m). In the combined therapy group, 42 patients received a combination of 0.5 mg of ranibizumab and focal/ grid laser at baseline and month 3. The primary outcome was the change in BCVA at month 6 in comparison with baseline values. After six months, the ranibizumab group showed a significant improvement in mean BCVA com- pared with patients receiving focal/grid laser. BCVA in the group receiving combined therapy was not statistically different from the first two groups. A resolution of 50%, 33%, and 45% of excess foveal thickening was documented in the ranibizumab, laser, and combined therapy groups, respectively. After six months, for the two years of follow-up, if retreatment criteria were met, all subjects could be treated with ranibizumab. In the ranibizumab group, BCVA improved from 7.4 letters at six-month follow-up to 7.7 letters at the end of the 24-month follow-up. The laser group improved BCVA from 0.5 letters to 5.1 letters at the end of follow-up, and the combined therapy group patients showed an improvement in BCVA of 6.8 letters at month 24, compared with 3.8 letters in the same patients at month 6. These data demonstrate that intravitreal ranibizumab is effective in the treatment of recurrent and persistent diabetic macular edema and that the improvement of visual acuity could be maintained during a follow-up of two years. This study also showed that ranibizumab is associated with sig- nificant improvement in patients who previously received only laser photocoagulation.
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Update on the Preventive Antibiotics in Stroke Study (PASS): a randomised controlled phase 3 clinical trial

Update on the Preventive Antibiotics in Stroke Study (PASS): a randomised controlled phase 3 clinical trial

Infection rate during hospital admission will be assessed in two ways. First, clinical diagnosis according to the treating physician will be recorded. Second, diagnosis of infection will be judged by two experienced infectious diseases specialists, blinded for treatment allocation, using the modified criteria of the United States Centres for Disease Control and Prevention [15]. This will be done in all patients who developed fever or a new onset delirium during admission, in patients in whom there was suspicion of infection but no diagnostics were performed, and in patients in a palliative care setting. One important issue that needs to be addressed is the risk of performance and detection bias. Since the treating physician is aware of the treatment allocation, this could influence decisions on non-scheduled treatment. For the PASS, the most important issue to address is the detection and treatment of infection. A physician could be more or less likely to order investigations or start treatment for a possible infection depending on the treatment allocation. By giving recommendations for diagnostic procedures in the previ- ously mentioned subgroups of patients, and by collecting results of these procedures in standardized case record forms, we try to limit this form of bias.
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Visual resolution and contrast sensitivity in two benthic sharks

Visual resolution and contrast sensitivity in two benthic sharks

During optokinetic experiments, sharks were gently restrained in a small square tank (30×25 cm) by placing small wooden pegs along the side of the body. The head and tail were secured with flexible plastic straps. A 1 cm clear Perspex plate in front of the shark maintained the animal ’ s head 5 cm from the front edge of the tank. The tank was positioned in the centre of four radiance-calibrated LCD computer monitors (Dell E2310Hc, Dell Inc.) with the midpoint between the animals ’ eyes positioned 25 cm away from all monitors (Fig. 1A,B). The monitors had a light intensity of 3.2×10 −5 W sr −1 cm −2 , measured using a calibrated light meter (International Light Technologies, ILT1700). The monitors covered approximately 65 deg of the sharks ’ vertical visual field and 360 deg of their horizontal field. The visual fields of the species used in this study have not been measured, but the monitors would have covered approximately 68% of the total visual field of a lemon shark (Negaprion brevirostris), which have comparable eye position to the species used in this study (McComb et al., 2009).
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Effect of retinal laser photocoagulation on contrast sensitivity and visual acuity in patients of diabetic retinopathy

Effect of retinal laser photocoagulation on contrast sensitivity and visual acuity in patients of diabetic retinopathy

In the study we found that around 38% of the eyes treated with laser photocoagulation had an improvement in BCVA compared to the baseline, while 40% maintained a stable vision. Remaining 23% had a drop in the post laser BCVA in the final follow up. CS improved from the baseline in 49.1% (26 eyes) of the eyes out of which 61.5% (16 eyes) had undergone focal laser for DME. A decrease in CS compared to baseline was observed in 20% of the eyes undergoing PRP which is more as compared to that with focal laser (9%). Lövestam-Adrian et al. 15 in their study in 20 eyes treated with PRP for proliferative diabetic retinopathy too noted a loss in CS following PRP compared to the untreated eyes. Despite of the fact that focal laser has its maximum effect on the cones at macula, CS improves the most after focal laser due to the resolution of macular edema following treatment.
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<p>The potential risk factors of cortical visual impairment following cerebral angiography: a retrospective study</p>

<p>The potential risk factors of cortical visual impairment following cerebral angiography: a retrospective study</p>

In this patient cohort, 4,528 patients who met the inclusion criteria were enrolled, and 11 cases (0.24%) exhibited cortical visual impairment after cerebral angiography, including 6 males and 5 females (Table 1). The average age of the patient cohort was 51.08±11.84 years, ranging from 24 to 75 years. Patients who exhibited post-operative cortical visual impairment were slightly older, with an average age of 58.34±12.36 years. However, there was no statistical signi fi cance between these two groups. The average body weight was 66.28±11.71 kg in the entire patient cohort, and 58.45±10.36 kg in the patients with cortical visual impairment. Blurred vision was present in 7 cases of post-operative cortical visual impairment (63.63%), and the clinical symptom lasted for 8 hrs to 6 days. Four patients presented with binocular blindness (36.37%), lasting for 1 – 2 weeks (Table 2). In the current study, eight cases of cortical visual impairment occurred within 1 – 6 hrs and three cases within 6 – 24 hrs after the
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A study of effect on visual acuity and contrast sensitivity following Nd-YAG laser capsulotomy in patients with posterior capsular opacification

A study of effect on visual acuity and contrast sensitivity following Nd-YAG laser capsulotomy in patients with posterior capsular opacification

Improvement in visual acuity and contrast sensitivity are the main aims for successful YAG laser posterior capsulotomy. Previous reports have focused primarily on visual acuity improvement after Nd:YAG laser as the main outcome measure. But this is inadequate to assess visual function which necessitates evaluation of contrast sensitivity 57 . In our study,

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Continuous Apomorphine Infusion in Patients with Advanced Parkinson’s Disease with Varying Degrees of Functional Impairment

Continuous Apomorphine Infusion in Patients with Advanced Parkinson’s Disease with Varying Degrees of Functional Impairment

Introduction: Continuous apomorphine infusion (CAI) is effective in improving complications in advanced Parkinson’s disease (APD). The effectiveness and toler- ance of CAI in patients with APD with varying degrees of functional impairment was studied. Methods: In this comparative observational study, consecutive APD who started treatment with CAI were included. They were classified into two groups of functional impairment: A) moderate (Schwab and England (S & E) = 60% - 80% and Hoehn and Yahr (H & Y) = 2 - 3; Group (A), and (B) severe (S & E < 60; H & Y > 3; Group B). Clinical follow-up was performed with concomitant medication and CAI adjustment at 3, 6 and 12 months. Clinical evaluation included a dyskinesia diary and AIMS, S & E, NPI, NMSS and HADS questionnaires. Results: Eighteen patients par- ticipated (A = 9 and B = 9) with EP diagnosed 7 (A) and 13 (B) years before. Their baseline dose of levodopa was 728 mg (A) and 925 mg (B), which did not change during follow-up. Dopamine agonists were progressively reduced in both groups. Progressive titration of CAI resulted in abandonment of apomorphine bolus admin- istration. Both groups experienced improvements in all variables, higher in group A; motor fluctuations = 69% (A), 53% (B); AIMS = 82% (A), 71 (B); S & E = 32% (A), 18% (B); NMS = 62% (A), 19% (B); NPI = 75% (A), 50% (B); HADS (anxiety) = 26% (A), 21% (B); HADS (depression) = 52% (A), 31% (B). Adverse effects were generally mild and resolved without reducing CAI dose. There were no withdrawals. Conclu- sions: Patients with APD and moderate functional impairment treated with CAI may obtain greater functional, cognitive and emotional improvement than patients more severely affected.
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Evaluation of Contrast Sensitivity in Diabetic Patients

Evaluation of Contrast Sensitivity in Diabetic Patients

Diabetes mellitus is a series of chronic metabolic disorders due to the pancreas does not produce enough insulin resulting from defects in insulin secretion, insulin action, or both leading to the increase of glucose concentration in blood. Diabetic retinopathy is a retinal disorder found in diabetic patients. It is a cause of blindness found throughout the world. As diabetes increases and glycemic control worsens, these diabetic patients have a decrease in contrast sensitivity. Clinically, it can be used as a tool in assessing retinal function in diabetic patients. Contrast sensitivity test has a strong indication and is a prediction of a real picture of vision that affects the quality of life of someone.
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Visual recovery after perinatal stroke evidenced by functional and diffusion MRI: case report

Visual recovery after perinatal stroke evidenced by functional and diffusion MRI: case report

Functional recovery observed in the left occipital lobe was supported by structural modifications evidenced in both DTI-12 and DTI-20 experiments. DTI-20 delineated fibers in continuity with the optic radiations and immediately adjacent to the cystic lesion. Thus, our DTI experiments illustrate the development of optic radiations in the left hemisphere, initially not visible at 3 month [7], deline- ated at 12 month, and clearly reinforced at 20 months of age. The optic radiations recovery in the left hemisphere might occur in congruence with maturation mechanisms observed during the early period of life [34]. Indeed, pre- vious studies have shown that the optic radiation tracts are clearly visible in the newborn (even in premature new- borns, e.g. [35]) and their maturation with myelination is largely achieved during the first year of life (e.g. [36]). Here, the differences in visibility with DTI across ages between the optic radiations in left and right hemispheres indicated that recovery mechanisms might be responsible for the development of tracts in the injured hemisphere after perinatal stroke. These arguments support recovered connectivity in the ipsilateral optic radiations that corre- lated with some of the observed functional responses. Moreover, the parallel occurrence of optic radiations traced with DTI and the activated visual regions detected with fMRI agreed well with previous findings in healthy adults [37,38]. The correspondence between optic radia- tions development and visual cortex activation is in line with the observed interdependency between these struc- tures [39]. Thus, the observed functional resilience in this infant agrees well with observations suggesting that plas- ticity occurs maximally during the first 2 years of age [40]. Different mechanisms underlying plasticity processes have been discussed elsewhere (for review see [41,42]), and include pathway expansion around the area of injury,
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Inpatient rehabilitation outcome: a matter of diagnosis?

Inpatient rehabilitation outcome: a matter of diagnosis?

We enrolled 199 patients (56 males (28.1%), 143 females (71.9%); average age, 78.2 ± 11.3 years) consecutively admitted in 2010 to a specialist rehabilitation facility (“Santa Maria alle Fonti” Medical Center, Salice Terme, Pavia, Italy), where an interdisciplinary team had established an individualized postacute rehabilitation program. These patients had been discharged from surgical and medical acute care units after treatment was considered to be adequate given that it stabilized vital functions and allowed the patients to attend rehabilitation programs. Patients admitted directly from their homes were excluded because it was not possible to verify their initial health conditions (ie, we could not exclude a priori an acute and eventually life-threatening disorder). Moreover, patients with a Folstein’s Mini Mental State Examination score ,20 were excluded as they would not have been able to collaborate with a rehabilitation program. 15
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Robot-aided therapy for upper limbs in patients with stroke-related lesions. Brief report of a clinical experience

Robot-aided therapy for upper limbs in patients with stroke-related lesions. Brief report of a clinical experience

though the sample under examination included subjects in a stable disease stage. Our results are in accordance with those of Bosecker 2010, who studied 111 indivi- duals with chronic impairment caused by stroke and trained with a robot [25]. Such a robot-guided treatment must be task-oriented, functional and motivating for the patient [4,5,23], and therefore capable of determining a process of learning, acquisition and generalization [6,7]. The use-dependent robot-aided instruments (intensive and repetitive treatment) may favor functional reorgani- zation phenomena, typical of neuronal plasticity [3,26]. Our experience is also in line with studies [6,27] that confirm how this type of treatment does not negatively affect spasticity: in our sample, the elbow AS score was reduced, while no change, nor an increase in spasticity, was detected for the other joints [28]. The positive effect observed on the quality and speed of the walking perfor- mance, assessed through TUG both at T1 and T2, is also interesting. This data conforms with Esquinazi paper [29]. The results obtained from our study suggest that a motor and functional recovery takes place and can be interpreted as a possible result of the process of adaptation. In addition, it was also possible to observe a motor learning and generalization process, confirmed by the baseline improvements observed at T1 and main- tained until 1 month after (T2), an indication of the fact that patients were not in a spontaneous recovery stage.
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Analysis of visual function and quality of life in patients with uveitis

Analysis of visual function and quality of life in patients with uveitis

The Light sense refers to the appreciations (awareness) of light and its intensity. The brightness required to induce a light sensation is called light minimum.It is measured after 20-30 minutes after dark adaptation. Dark adaptations is the ability of the eye to adapt itself to decreasing illumination. The rods are much more sensitive to low illumination.The rods are the most sensing receptor for low illumination than cones. This form the basis of the Duplicity. Vision theory states that “rods are used more in dim light (scotopic vision) and cones in bright light (Photopic vision)”..
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Effects of Exercise on Visual Evoked Potentials

Effects of Exercise on Visual Evoked Potentials

for many specific stimuli such as the position of the ball or other players ; the objects in visual space move very quickly and the players decision making proceeds in short time [6] Many visual skills like visual resolution ability, dynamic visual activity, contrast sensitivity, oculomotor function, visual reaction time and visual coincidence anticipation are significant for volleyball players performance[7] There are some proofs that the participation in dynamic reactive training can improve visual reaction processing[8] and visual abilities [9]
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Evaluation of complete functional status of patients with stroke by Functional Independence Measure scale on admission, discharge, and six months poststroke

Evaluation of complete functional status of patients with stroke by Functional Independence Measure scale on admission, discharge, and six months poststroke

above statement applied to motor domain too. It was different in cognition domain. The results showed significantly higher improvement in subjects’ cognition domain of FIM score during the hospital admission. We observed fairly small changes in patients’ cognitive status at staying home periods. On the other hand, about 86% of subjects got the maximum score of cognition domain on six-month follow-up visits. Putting these findings together, it can imply the relative weakness of FIM score in detecting subtle changes of cognitive status. This conclusion is consistent with the results of Hall et al. study. 16 Another
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Acute Damage to the Posterior Limb of the Internal Capsule on Diffusion Tensor Tractography as an Early Imaging Predictor of Motor Outcome after Stroke

Acute Damage to the Posterior Limb of the Internal Capsule on Diffusion Tensor Tractography as an Early Imaging Predictor of Motor Outcome after Stroke

farct volume and motor outcome at day 90. Motor deficit was present only when critical motor regions were involved, sug- gesting that large lesions do not necessarily predict poor out- come and that location of the lesion might be more predictive than its size. Whereas subcortical strokes are normally smaller than cortical strokes, they are also more likely to involve both primary MC and PMC fibers, and patients with subcortical infarcts have worse motor outcome than those with cortical stroke. 14 These findings may indicate that the extent of dam- age specifically within the CST is a major determinant of mo- tor deficit.
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Low contrast visual acuity testing is associated with cognitive performance in multiple sclerosis: a cross-sectional pilot study

Low contrast visual acuity testing is associated with cognitive performance in multiple sclerosis: a cross-sectional pilot study

Clinical examination and neuropsychological testing All participants underwent clinical neurological examin- ation, including the EDSS, under the supervision of a board-certified neurologist [7]. Fatigue was assessed using the Fatigue Severity Scale (FSS) [23]. Patient with a mean FSS score > = 4 were classified as fatigued. Depression was assessed using Beck’s Depression inven- tory (BDI) [24]. Patients’ depression was classified using the following cutoff-values: Minimal: 0 – 9; Mild: 10 – 18; Moderate: 19 – 29; Severe: > = 30. The BDI was not avail- able for two patients. Patients performed all subtests of the German BRB-N version A under supervision of trained examiners and with best available optic correction [21,25]. Tests were performed as previously described in detail [26]. Briefly, the BRB-N consists of the following subtests: 1) Selective Reminding Testing (SRT)[27], which measures verbal learning and memory in terms of imme- diate recall (SRT-LTS and SRT-CLTR) and delayed recall (SRT-D); 2) 10/36-Spatial Recall Testing [28], which mea- sures the visio-spatial memory in terms of immediate re- call (SPART) and delayed recall (SPART-D); 3) Symbol Digit Modalities Testing (SDMT) [29], which tests infor- mation processing speed and concentration; 4) Paced Auditory Serial Addition Testing [30], including the three- second version (PASAT3) and the two-second version (PASAT2), which measures information-processing speed and working memory; 5) Word List Generation (WLG) [31], which tests semantic verbal fluency, verbal produc- tion and executive function. BRB-N z-scores were calcu- lated as previously described against normative data for German MS patients using the original script kindly pro- vided by Dr. Scherer [25]. Patients were classified as cog- nitively impaired when z-score < 1.68 [25].
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