22. European Stroke Conference 787 Rehabilitation and reorganisation after stroke Kinesiotape application in treatment of caput humeri subluxation generated by decrease of muscle strength in patients with acute stroke. D.V. Polyakov1, A.V. Polyakova2, E.A. Mazurkevich3, B.V. Bibulatov4 North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg, RUSSIAN FEDERATION1, Saint Petersburg State Pavlov Medical University, Saint-Petersburg, RUSSIAN FEDERATION2, North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg, RUSSIAN FEDERATION3, North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg, RUSSIAN FEDERATION4 Purpose: to investigate the effectiveness of kinesiotape application with mechanical correction for decrease of caput humeri subluxation in patients with acute stroke. Methods: 24 patients with acute stroke (age 45-78 years) who had decreasing of para-articular muscle strength more than 3 points were enrolled. 10 patients from the first group got kinesiotape (KT) application with mechanical correction technique. In the second group (14 patients) it was applied cravat bandage for fixation of shoulder joint. All patients underwent measurement of shoulder length four times. Pain intensity in shoulder joint area on the affected side was evaluated by visual analogue scale before and after 30 minute fixation. There was calculated the relative elongation of shoulder. Results: the relative elongation of paretic upper extremity shoulder was found in both groups (at an average on 3.89% in the first group and on 4.12% in the second). Decreasing of the relative elongation of fixated shoul-der also was found in both groups (at an average 1.75% in the first group and 1.5% in the second) (p≤0.05). Relative elongation of shoulder after 30 minutes was significantly greater in the second group (at an average 3.74% in the second group comparing to 2.39% in the first) (p≤0.05). After 30 minute of fixation significant decreasing of the relative elongation of shoulder continued in the first group, in the second group there was no significant decreasing of this parameter (p≤0.05). During fixation pain syndrome decreased at an average on 1.5 points in the first group and on 0.4 points in the second group. Conclusions: 1. Kinesiotape application of shoulder joint allows providing more long and effective fixation of shoulder comparing to cravat bandage. 2. Application of this methodology in patients with acute stroke who have subluxation of shoulder lead to decrease the in-tensity of pain syndrome on the affected side. 762 © 2013 S. Karger AG, Basel Scientific Programme 788 Rehabilitation and reorganisation after stroke The Management of Dysphagia in Acute Stroke: A Questionnaire pilot study D.G. Smithard1, C.A. Fairfield2, M Gosney3, C Roffe4 King’s College London, London, UNITED KINGDOM1, University of Reading, Reading, UNIT-ED KINGDOM2, University of Reading, Reading, UNITED KINGDOM3, University of Keele, Stoke, UNITED KINGDOM4 Background: Swallowing problems are a common complication of stroke, and may result in the oc-currence of aspiration pneumonia., increased length of hospital stay and death. 67% of those with pneumonia present with symptoms within 48 hours of admission. Dysphagia protocols reduce the incidence of pneumonia, but the management of swallowing disorders is not uniform with in the UK. This variability has not been described, nor the implications considered. This pilot study be-gins to identify the variations of current practice in the management of dysphagia in acute stroke. Methods: A questionnaire was constructed to investigate the type and timing of assessments(s) in early treatment of dysphagia. The questionnaire addressed the assessments used, by whom and the subsequent management of dysphagia. Questionnaires were distributed to attendees of two dysphagia study events. Results: 53/100 questionnaires were returned, 43 having a complete dataset. All services provided a screening service within 24 hours of admission, subsequent assessments involved the use of Pulse Oximetry (73%) and Cervical Auscultation (66%), 50% used both. 98% services had access to vid-eofluoroscopy (VFS) and 95% to FEES. VFS usage varied between <11% to 50% of cases. Only services that used VFS on a frequent basis, used FEES frequently. The most frequent management was modification of diet (57%) and liquid (50%), 32% used the Frazier free water protocol. Head positioning and swallowing exercises were frequently used. There was a tendency for more senior practitioners that used VFS with FEES, Pulse Oximetry or Cervical Auscultation to implement swal-lowing exercises. Conclusion: Service provision across the UK is varied and instrumentation (VFS and FEES) are not widely used. Those that used VFS or FEES tended to alter their management to include swallowing exercises. Cervical Auscultation and Pulse Oximetry continue to be used despite the lack of evi-dence of benefit.
Karger_ESC London_2013
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