Brain Stent Fails to Prevent Strokes, NIH Stroke Prevention Trial has Immediate Implications for Clinical Practice

Patients at a high risk for a second stroke who received intensive medical treatment had fewer strokes and deaths than patients who received a brain stent in addition to the medical treatment, a large nationwide clinical trial has shown. The investigators published the results in the online first edition of the New England Journal of Medicine [1]. The National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health, funded the trial. The medical regimen included daily blood-thinning medications and aggressive control of blood pressure and cholesterol.

New enrollment in the study was stopped in April because early data showed significantly more strokes and deaths occurred among the stented patients at the 30-day mark compared to the group who received the medical management alone.

Stent

Exercise Intensity, Not Quantity Reduces Risk of Death from Heart Disease

New research suggests that the intensity of exercise might be more important than the quantity in helping to prevent death from heart disease and other causes.

In a study presented last week at the European Society of Cardiology Congress 2011, scientists described new research that examined the relationship between exercise duration, exercise intensity, and total risk of death [1]. Lead researcher Peter Schnohr of Copenhagen, Denmark explained that both male and female cyclists had a decreased total risk of death if they cycled vigorously (by their own perception), but that cycling duration didn’t show a similar protective effect.

Cycling vigorously

Rehabilitation Study Looks at Getting Stroke Patients Back on Their Feet

In the largest stroke rehabilitation study ever conducted in the United States, stroke patients who had physical therapy at home improved their ability to walk just as well as those who were treated in a training program that requires the use of a body-weight supported treadmill device followed by walking practice.

The study, funded by the National Institutes of Health, also found that patients continued to improve up to one year after stroke, defying conventional wisdom that recovery occurs early and tops out at six months. In fact, even patients who started rehabilitation as late as six months after stroke were able to improve their walking.

The results of the study were announced last month at the American Stroke Association’s International Stroke Conference 2011 in Los Angeles. NIH’s National Institute of Neurological Disorders and Stroke (NINDS) provided primary funding for the study.

Exercise on a treadmill

Health Highlights – January 29th, 2010

Health Highlights is a biweekly summary of particularly interesting articles from credible sources of health and medical information that we follow & read.

Health Highlights

Tackling Heart Disease Together or Alone: The Behavioural Science of Self-Management

Heart disease is the leading killer in the U.S. and throughout most of Europe. People’s behaviour can protect and reduce risk of heart disease, and interventions to help people “self-manage” exist. But what is the best way to “self-manage”? A recent study shows that group programmes and self-directed programmes have remarkably different effects [1].

heart-disease

Self-management interventions exist for many health problems. They are notoriously difficult to define. One thorough definition is that it relates to activities undertaken by the person who has a “chronic” or “long-term” condition such as asthma, multiple sclerosis or arthritis. These activities include problem solving, decision making, resource utilization, the formation of a patient-provider partnership, action planning and self tailoring [2]. Interventions or programmes are designed around these activities to help support people to manage their own illness. The idea is that following attendance at a programme of some sort, the activities and skills learned will be continued to be used, thus improving health, maintaining fitness and/or quality of life and reducing the risk of future acute episodes of ill health. These interventions are popular for many reasons, including the relatively low cost to health service providers as interventions can be delivered by health-care professionals or by people with the relevant condition who have been trained, or a mixture of both. Self-management interventions also allow people with long-term conditions to be meet in a group with people with similar conditions. The experience of being in a group, knowing one is not alone and sharing stories is thought to play some part in the effectiveness of self-management interventions. But to what extent is this true?