22. European Stroke Conference 803 Rehabilitation and reorganisation after stroke Prevalence and associated clinical factors of GERD (gastro-esophageal reflux disease) in isch-emic 770 © 2013 S. Karger AG, Basel Scientific Programme stroke patients M. Igase1, K. kohara2, K. Igase3, S. Yamashita4, M. Fujisawa5, R. Katagi6, T. Miki7 Department of Geriatric Medicine, Ehime University Graduate School of Medicine, Toon, JA-PAN1, Department of Geriatric Medicine, Ehime University Graduate School of Medicine, Toon, JAPAN2, Department of Neurosurgery, Washokai Sadamoto Hospital, Matsuyama, JAPAN3, Ryoten-kai Katagi Neurosurgery, Imabari, JAPAN4, Ryotenkai Katagi Neurosurgery, Imabari, JAPAN5, Ry-otenkai Katagi Neurosurgery, Imabari, JAPAN6, Department of Geriatric Medicine, Ehime Universi-ty Graduate School of Medicine, Toon, JAPAN7 Background Aspirin is protective against ischemic stroke, but its use is a significant risk factor for gastro-esopha-geal reflux disease (GERD). We investigated the prevalence and associated clinical factors of GERD in ischemic stroke patients treated with aspirin. Methods We recruited 116 ischemic stroke outpatients who were receiving aspirin. Sixteen patients who had received proton pump inhibitors or H2 receptor antagonists within the previous month were exclud-ed. The presence of GERD was defined using the GerdQ questionnaire, with a score of 8 or higher considered positive for GERD. Logistic regression analysis was conducted using variables which exhibited a significant correlation coefficient on two-group comparison as factors, with the presence or absence of GERD as the dependent variable. Results Mean age of the 100 patients analyzed was 69.3 +/- 8.9 years. The incidence of GERD was 28%. Mean body weight (BW) of patients with GERD was significantly higher than of those without GERD (P < 0.05). The proportion of patients receiving angiotensin II receptor blockers (ARBs) was significantly lower in the GERD group (P=0.04). In contrast, no significant difference was seen in the proportion of patients receiving calcium channel blockers (CCBs). Logistic regression analysis showed that ARB use and increased BW were independent predictors of GERD. Conclusions ARBs appear to be better suited than CCBs for use in hypertensive patients with ischemic stroke with regard to the prevention of GERD. A comprehensive understanding of the relationship between ARBs and GERD prevalence awaits additional studies in a larger number of patients. 805 Rehabilitation and reorganisation after stroke Effects of game-based exercise on the balance of the disabled patients H. Maeoka1, A. Matsuo2, M. Hiyamizu3, S. Morioka4 Kio University, Nara, JAPAN1, Kio University, Nara, JAPAN2, Kio University, Nara, JAPAN3, Kio University, Nara, JAPAN4 Background Recently, the development of virtual reality-based (VR) exercise allows participants to be engaged within an illusion of three dimensional space and move safely. Moreover, we are able to be provid-ed a goal-oriented exercise and a visual or auditory feedback in real time. VR exercise also allows the participant to experience the emotional sense of “winning” in a particular game. The aim of this study was to investigate the efficacy of game-based (GB) exercise in improving for dynamic balance of the disabled patients. Methods Twenty-one patients (mean age: 68.7 +/- 15.6 years, mean period from onset: 29.1 +/- 16.2 days) were randomly extracted from the recovery ward. Informed consent was obtained in writing from all subjects before the study. The GB system used in this study was the balance exercise of Wii Fit (Nintendo, Japan). Initially, the participants underwent general physical therapy (120 minutes a day) and received an additional 15 minutes of the GB exercise for 14 days. After that, the participants continuously underwent only general physical therapy for 14 days. All participants were evaluated at baseline, at 14 days and at 28 days with the Functional Reach test (FR), Timed Up & Go test (TUG) and 30-second chair stand test (CS-30). Additionally, the center of pressure measured using a stabi-lometer was assessed by rectangular area. Results When evaluating it after the period of the GB exercise, TUG (p<0.01) and CS-30 (p<0.001) were significantly improved in the comparison with the initial assessment. There were no significant dif-ferences between after the period of the GB exercise and after the total process ends. Conclusion Our results suggest that GB exercise has a positive additional effect on inpatients rehabilitation. There is a possibility that VR exercise facilitates motor learning by providing appropriate feedback and repetitive approach to improve dynamic balance.
Karger_ESC London_2013
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