Lack of epidemiological data on secondary stroke prevention

The Lancet Neurology (Impact Factor: 21.82). 10/2005; 4(9):518-9. DOI: 10.1016/S1474-4422(05)70148-4
Source: PubMed
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    ABSTRACT: Background In current literature, strokes of all description have been linked with cervical manipulation. At present, there are no accurate data regarding relative risk or background incidence rates. The background rate of all types of stroke for the UK chiropractic patient population is calculated in this study. Methods The age profiles of 728 consecutive (both new and existing) patients attending four chiropractic clinics were banded into groups to enable comparison with previous major studies of stroke incidence. The number of patients receiving chiropractic neck manipulation was calculated by multiplying the number of registered chiropractors by the known average number of cervical manipulations. These data were then used to extrapolate the expected background rate (i.e. non-causative) of stroke in the chiropractic population. Findings Estimated number of neck manipulations annually by UK chiropractors was 4,439,800, representing 554,975 patients. Estimated number of background strokes in this population over the course of 1 year was 1645. The inferred number of background strokes within 1 and 3 days of manipulation was 36 and 108, respectively. Discussion It is not surprising that some patients presenting to neurologists with stroke have had a recent history of chiropractic cervical manipulation, owing to the high background incidence of stroke and the number manipulations performed annually. The authors propose future prospective studies to ascertain the so far un-elicited risk ratio as well as a co-ordinated neurology based education programme for the recognition of early signs of stroke in chiropractic clinics.
    Clinical Chiropractic 03/2008; 11(1):15-22. DOI:10.1016/j.clch.2008.01.002
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    ABSTRACT: Introduction: Information is currently lacking on the provision of occupational therapy for care home residents with stroke. The aim of this study was to identify current routine occupational therapy practice for this stroke population.Method: A questionnaire targeting qualified occupational therapists with work experience in a care home setting was designed, piloted, and transferred to an online survey. An invitation to participate was distributed via three of the College of Occupational Therapists Specialist Sections, social networking sites, and flyers at conferences.Findings: Responses were analysed from 114 respondents representing the United Kingdom, the majority (72%) of whom were employed by the National Health Service. Ninety-two respondents (81%) had delivered occupational therapy to a care home resident with stroke in the last year but only 16% were 'stroke specialists'. The most common aims of intervention were to: maintain participation in activities of daily living, improve posture and positioning, and provide training. Non-standardized assessment was the most common form of assessment used. The functional approach was most frequently adopted. The most frequently provided intervention was 'seating and positioning'.Conclusion: Occupational therapy is available to some stroke survivors in care homes; however, interventions are not commonly evidence based and are not routinely delivered by stroke specialists.
    International Journal of Stroke 01/2012; 7(2):66-67. DOI:10.4276/030802214X13990455043601 · 4.03 Impact Factor