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Objectives
Traditionally, patients have had passive roles in medical education; however, there have been increasing efforts to partner with communities to create authentic representation of laypeople in medical education. Communities’ perspectives of these initiatives have rarely been reported in the literature. This study explores the perspectives of members of community-based organisations (CBOs) who were partnered with a community engagement programme for intercalating medical students at Imperial College London.

Design
A qualitative study using semistructured interviews was conducted, employing reflexive thematic analysis.

Setting
London, UK.

Participants
A total of five participants (one member from five CBOs who agreed to participate) were interviewed for this study. The selection criterion was direct involvement in the community engagement programme.

Results
Three key themes were identified aligning with the core principles of co-production: building partnership, reciprocity in partnership and maintenance of relationship. Partnership development was influenced by the CBOs’ perception of students which caused power differentials in the development of learning plans. Reciprocity refers to a multidirectional benefit pathway resulting from the community involvement programme, which had short-term and anticipated long-term effects. Relationships built were maintained via a service evaluation report, and participants discussed how attitudes of academic institutions towards collaboration influence communities’ ability to participate in medical education.

Conclusions
The perspectives of CBOs reported in this study demonstrate that factors important to partnership development in community-engaged medical education are consistent with the key principles of co-production. Supported by literature, the findings emphasise that community involvement can be linked to social accountability and sustainable health practice. Provided that the possible risks/challenges are appropriately identified and mitigated to facilitate co-productive partnerships between stakeholders, the involvement of CBOs in medical education has the potential to provide benefits for communities, students and educational institutions.

Stroke, Volume 56, Issue Suppl_1, Page ATP313-ATP313, February 1, 2025. Background:Lipoprotein(a) (lp(a)) concentrations is an independent risk factor of atherosclerotic cardiovascular disease (ASCVD). The association between lp(a) and prognosis of ischemic stroke patients is uncertain.Hypothesis:The study is aimed to investigate the shape and the association of the risk of short-term and long-term stroke recurrence across the distribution of lp(a) concentrations, and explore whether combining ASCVD risk has an influence on the association.Method:Patients with acute ischemic stroke within 7 days in the Third China National Stroke Registry (CNSR-III) having lp(a) measurements were included in the study. The outcomes were stroke recurrence within one year and two years. ASCVD risk included diabetes mellitus, stroke history and early onset. Based on ASCVD risk and lp(a) concentrations, there were four groups: lp(a)70 mg/dL without ASCVD risk. To display the shape of the relationship between lp(a) and stroke recurrence within two years, lp(a) concentrations were modeled using natural cubic splines with median concentration serving as the reference adjusted by confounders. And the association was assessed using Cox proportional hazards models and Kaplan-Meier curves.Result:Among 9952 included patients with the mean age of 63 years and 69% of male, the median lp(a) concentrations was 18.06 (inter-quartile range, 8.85-35.66) mg/dL. The relationship between lipoprotein(a) and stroke recurrence appeared linear across the distribution. Compared to patients with lp(a)=50 mg/dL was associated with a higher risk of stroke recurrence (adjusted HR for one-year outcome:1.19, 95%CI: 1.01-1.41, p =0.04; adjusted HR for two-year outcome:1.21, 95%CI: 1.04-1.40, p =0.01). Compared to patients with lp(a)70 mg/dL without ASCVD risk (HR:0.90, 95%CI: 0.65-1.26, p =0.55).Conclusion:Lipoprotein(a) concentrations was associated with short-term and long-term prognosis of ischemic stroke, with a linear risk gradient across the distribution. Baseline ASCVD risk may influence the association between lp(a) and stroke recurrence.

Stroke, Volume 56, Issue Suppl_1, Page ATMP30-ATMP30, February 1, 2025. Background:The prehospital scales have been developed to identify stroke patients with large vessel occlusion (LVO) to facilitate rapid transport to appropriate stroke centres. In practice, these stroke scales have moderate accuracy. There is a pressing need for adjunct easy-to-use and interpret diagnostic devices to improve prehospital stroke diagnosis and LVO detection. We aim to determine whether a machine learning algorithm using adjunct electroencephalography (EEG) Spectra can improve the accuracy of LVO detectionMethods:Adult patients with suspected acute stroke were prospectively enrolled as soon as possible on arrival at the emergency department. A wearable MuseTMheadband (InteraXon Inc, Canada) with an embedded 4-channel EEG was used for a resting 3-minute recording. EEG Spectra including relative alpha, beta, theta and delta spectral powers, delta-alpha ratio (DAR) and pairwise-derived brain symmetry indices (pdBSI) were calculated. These indices were compared between patients with LVO and non-LVO groups. The accuracy of LVO detection was tested with the aid of supervised machine learning(ML) algorithms including EEG Spectra, Los Angeles Motor Stroke Scale (LAMS), sex and side of stroke.Results:A total of 142 patients were included in the analysis with a mean age of 69.6±13.7 years, 60(42.2%) females, (Stroke Subtype:113[79.6%] were ischemic stroke, 22[15.5%] stroke mimics, 7[4.9%] intracerebral hemorrhage) and median NIHSS 5(2-11). Thirty-seven(26.1%) patients had LVO and EEG was acquired at a median of 6h 45m (3h 29m – 14h 15m) after symptom onset. Relative alpha spectral power was lower in both affected (p

Stroke, Volume 56, Issue Suppl_1, Page ATMP40-ATMP40, February 1, 2025. Introduction:Stroke patients experience higher levels of social isolation (SI) compared to their age matched healthy cohorts which is associated with poor quality of life and increased morbidity and mortality. However, frequency and associates of SI among patients with intracerebral hemorrhage (ICH) have not been described.Methods:Data for adult ( >18 years) primary non-traumatic ICH patients with prospectively collected Patient-Reported Outcomes Measurement Information System (PROMIS) measures and modified Rankin scores (mRS) on 1-year follow up were extracted from a stroke outcomes registry for a 7-hospital stroke certified healthcare system. Socioeconomic deprivation was measured using the state-level Area Deprivation Index (ADI; high deprivation defined as ADI > 7). Comorbidity burden was graded by Charlson Comorbidity Index (CCI). The PROMIS short form v2.0 social isolation 4a score was used to assess SI, with SI considered positive at T-scores above 54.9 and further categorized into mild (55-60) and moderate-severe (≥60). Patients with mRS ≥ 3 were considered functionally dependent. Descriptive statistics are provided as proportions (%) and medians with interquartile ranges (IQR). Demographic and comorbidity differences were assessed using chi-squared and Mann-Whitney U tests.Results:The cohort included 110 ICH patients (age median [IQR]: 60 [47-71], 43.6% female), of whom 20% were Hispanic and had a racial distribution of 59.0% White, 27.2% Black, 8.2% Asian, 5.5% other (Table 1). Overall, 24 (21.8%) patients experienced some degree of social isolation (54.2% mild, and 45.8% moderate-severe). Among patients with 1-year SI, 33.3% were initially discharged home, 33.3% to rehab, 16.7% to long-term acute care (LTAC), 12.5% to skilled-nursing facility, and 4.2% other. SI patients had higher comorbidity burden (vs non-isolation group; 95.8% vs. 68.6%, p=0.025), higher rates of functional dependence (70.8% vs. 30.8%, p=0.001), and higher rates of diabetes (33.3% vs 12.8%, p=0.040). Finally, patients with moderate-severe SI showed a significantly greater proportion of high socioeconomic deprivation (vs mild; 54.5% vs 7.7%, p=0.039) (Table 2).Conclusion:More than 1 in 5 ICH patients may experience long-term SI particularly those with higher comorbidity burden. Furthermore, long-term dependency is associated with higher likelihood of SI among ICH patients. .SI risk stratification for ICH patients is a critical gap in improving post-ICH outcomes.

Stroke, Volume 56, Issue Suppl_1, Page ATMP32-ATMP32, February 1, 2025. Introduction:Facilitating evidence-based uptake of new medication regimens for disease prevention is a well-recognized public health challenge. Using data from GWTG-Stroke, researchers previously reported that, after minor ischemic stroke (NIHSS 0-3), the use of aspirin-clopidogrel for stroke prevention is highly variable despite guideline recommendations. We sought to explore potential changes in dual antiplatelet therapy (DAPT) use in patients with moderate ischemic stroke (NIHSS 4-5) after the publication of the THALES (The Acute Stroke or Transient Ischemic Attack Treated With Ticagrelor and ASA for Prevention of Stroke and Death) trial in 2020.Methods:We used the GWTG-Stroke registry to describe patterns of DAPT use in the U.S. from 2019 to 2023. All patients with a final diagnosis of ischemic stroke, NIHSS 4-5, hospital arrival within 24 hours, who lacked an indication for anticoagulation (e.g., atrial fibrillation) and were not treated with thrombolysis/thrombectomy were included in our study. Patients with NIHSS 4-5 (moderate stroke) were not included in prior randomized controlled trials of aspirin-clopidogrel for short-term stroke prevention but were included in THALES. We reported basic demographic features of our cohort and used the Cochran-Armitage trend test to report changes in aspirin-ticagrelor use by year.Results:We identified a total of 40,624 acute ischemic stroke patients with NIHSS 4-5 during the study period. The mean age was 68 years and 47% of patients were women. We found that a total of 20,293 (50%) patients were discharged on aspirin-clopidogrel whereas 1,335 (3.5%) were discharged on aspirin-ticagrelor. The use of both DAPT regimens significantly increased over time (Figure 1, p

Stroke, Volume 56, Issue Suppl_1, Page A85-A85, February 1, 2025. Background:Systolic blood pressure (SBP) fluctuation is linked to increased death or disability in intracerebral hemorrhage (ICH) patients. We analyzed data from the Antihypertensive Treatment of Acute Cerebral Hemorrhage (ATACH)-2 trial to explore whether the association between SBP fluctuation and 90-day outcomes varies with time from randomization.Methods:We calculated hourly SBP fluctuation based on the difference between maximum and minimum SBP during the first 24 hours post-randomization. Logistic regression models assessed the impact of SBP fluctuation on: 1) death or disability (modified Rankin scale [mRS] 4-6 at 90 days); 2) hematoma expansion ( >33% increase in volume on 24-hour CT scan); 3) neurological deterioration within 24 hours (defined as ≥2-point decrease on Glasgow Coma Scale or ≥4-point increase on NIH Stroke Scale); and 4) acute kidney injury (AKI) within 72 hours. Adjustments were made for baseline Glasgow Coma Scale score, intraventricular hemorrhage, hematoma volume, and maximum SBP.Results:The hourly SBP fluctuations according to 90-day outcomes (dichotomized into good outcome, mRS 0-3, and poor outcome, mRS 4-6) in 961 patients with ICH are presented in Figure. The SBP fluctuation at 5 hours (p=0.014) and 6 hours (p=0.014) post randomization were significantly associated with death or disability at 90 days, with positive, but not statistically significant associations observed at all other points up to 13 hours after randomization. Risk of neurological deterioration within 24 hours was highly associated with SBP fluctuation, with the largest association observed between 1 (p

Stroke, Volume 56, Issue Suppl_1, Page AWP176-AWP176, February 1, 2025. Introduction:Informed consent for clinical trials in the acute stroke setting is challenging. There is a need for context-appropriate approaches to consent, but few data exist regarding implementation of innovative approaches. In the Multi-Arm Optimization of Stroke Thrombolysis (MOST) trial (NCT03735979), a consent process was designed in collaboration with patient advisors that included a short consent form and a companion information sheet. This approach was implemented at all study sites, and participants’ experiences were assessed using a post-enrollment survey.Methods:All participants enrolled in MOST were eligible for the survey. The person who provided consent for enrollment (patient or surrogate) was asked to fill out the survey. The survey was adapted from a prior survey of patients’ and surrogates’ experiences with consent in acute care research and was cognitively pre-tested. Descriptive statistics were tabulated. Likert scale responses on a scale of 1-5 with 1 being strongly agree and 5 being strongly disagree and on a scale of 1-5 with 1 being extremely helpful and 5 being not helpful at all were collapsed into agree (1-2)/not agree (3-5) and helpful (1-2)/not helpful (3-5), respectively.Results:There were 195 completed surveys out of 514 enrollments in the MOST trial (overall capture rate 37.9%). Seventeen surveys were excluded due to mismatch between who consented to MOST and who completed the survey (total n=178 analyzable surveys). Patients completing the survey (or for whom a surrogate completed the survey) were similar to the overall enrolled population in terms of age, sex, race, and stroke severity (Table 1). The average age of survey respondents was 60.1 years, with 42.1% being male and 61.8% being surrogates (Table 2). Overall patients’ and surrogates’ experiences were positive. Post-enrollment communication and consent materials were viewed favorably (Table 3). Open-ended feedback was positive; participants acknowledged that time stress was intrinsic to the situation, encouraged simplicity, and offered few suggestions for improvement.Conclusions:A patient-centered consent process in an acute stroke trial was positively viewed by both patients and surrogates. Embedding assessments of patients’ and surrogates’ experiences within clinical trials offers an important opportunity for understanding the impact of innovation regarding consent.

Stroke, Volume 56, Issue Suppl_1, Page ATP363-ATP363, February 1, 2025. Introduction:IL-6 is a pro-inflammatory cytokine typically low in healthy young individuals but elevated after stroke, correlating with worse outcomes. IL-6 binds to soluble IL-6 receptors, which then interact with the glycoprotein gp130, initiating pro-inflammatory trans-signaling. In young mice, gp130Fc administration showed dose-dependent benefits. To test this in older individuals, gp130Fc (0.5 mg/kg, intraperitoneally) was given to aged mice 4 hours after middle cerebral artery occlusion. This dose caused 80% mortality in aged males within 72 hours, while all females survived. A lower dose (0.25 mg/kg) improved survival to 70% in aged males. Aged females had higher baseline plasma IL-6, which may explain their higher dose tolerance. Aging is associated with cognitive decline, leading us to hypothesize that inhibiting IL-6 trans-signaling could improve cognitive function in older animals.Methods:Aged (18-19 months) C57BL/6 male and female mice were used to assess cognitive deficits following gp130Fc treatment. The mice received either saline or gp130Fc at doses of 0.25 mg/kg (for males) and 0.5 mg/kg (for females) via intraperitoneal injection a week before behavioral testing and at day 14. Cognitive function was evaluated using several tests: Y-Maze on day 7, Novel Object Recognition Test (NORT) on day 14, and Object Location (OL) on day 21. From days 22-26, mice underwent training on the Barnes Maze, with testing on day 27. Mice were euthanized on day 28.Results:Older animals exhibited similar deficits in short-term memory as assessed on the Y maze, NORT, and OL task regardless of sex, but aged females showed worse long-term memory retention compared to age-matched males, as assessed by the Barnes Maze. Female mice took longer to escape and made more incorrect entries (P

Stroke, Volume 56, Issue Suppl_1, Page ATP109-ATP109, February 1, 2025. Introduction:Upper extremity motor impairment and hemiparesis are prevalent following stroke, and can impact independence, ability to perform activities of daily living and overall quality of life.1 While the majority of motor recovery post stroke occurs within the initial 3 months, gains can continue through chronic stages.2 Evidence has identified vagus nerve stimulation (VNS) paired with intensive rehabilitation as an effective intervention for improving upper extremity (UE) function in persons with chronic stroke.3 Utilization of gaming-based stroke rehabilitation has been shown to increase engagement and improve UE motor function.4–6 This work reports on a cohort of patients with chronic stroke who participated in gamified UE rehabilitation paired with VNS.Methods:Data from 6 patients with UE motor impairment due to chronic stroke ( > 1 year) were included. Following surgical vagus nerve stimulator implantation, patients participated in UE therapy sessions 3 times a week for 6 weeks. Intervention included gamified rehabilitation with VNS triggered upon each movement attempt. Between sessions, patients were provided with a magnet to activate VNS while performing an UE home activity program up to 8 times per day. Each self-initiated stimulator activation delivered 30 minutes of VNS. At the conclusion of 6 weeks, patients were encouraged to continue their VNS home program. Safety was assessed using adverse event reporting. Feasibility was assessed using time on task reported by the gamified rehabilitation software. Exploratory clinical outcomes included the Action Research Arm Test (ARAT) and Fugl Meyer Assessment (FMA) at baseline following implantation, upon completion of 6 weeks of therapy, and at 4 months post intervention.Results:Patients participated in 64.1 ± 14.9 mins of gamified rehabilitation per session with 29.9 ±8.6 of those minutes being active time on task. No adverse events were reported. FMA-UE motor subscale and ARAT scores increased from baseline to the end of 6 weeks by an average of 9.3±3.6 and 7±7.4 respectively. Average increases from baseline to 4 month follow up for FMA-UE motor subscale and ARAT score were 14±6.3 and 10±8.2 respectively.Conclusion:These findings suggest that VNS paired with gamified rehabilitation is a safe and feasible intervention for UE motor impairment post stroke. Future work will investigate short- and long-term feasibility and efficacy of the intervention in patients with chronic stroke.

Stroke, Volume 56, Issue Suppl_1, Page ATP114-ATP114, February 1, 2025. Background and Aims:Globally, 87% of stroke patients are left with disability in low and middle-income countries. Continual rehabilitation is significant to maximize functional recovery. However, heterogeneity exists due to lack of guidelines, low prioritization of rehabilitation services, inadequate numbers of skilled rehabilitation specialists, limited health literacy, financial constraints and transportation limitations which leads to suboptimal rehabilitation. In this study we have presented tele-rehabilitation model of care for post stroke patients.Methods:IMPETUS stroke is an ongoing multicentric, prospective, multiphase, mixed-method, quasi- experimental implementation study intended to examine changes in a select set of stroke care-related indicators over time within 23 medical colleges in India. As a part of study, low cost model of tele-rehablitation services initiated using WhatsApp video communication. Periodic meetings with the collaborators and Rehabilitation teams had been done to outline the different strategies. Audio-visual training materials such as rehabilitation video and teaching manual are used as a study tool. Short specific videos had been crafted and finalized with the rehabilitation experts and collaborators specifically directed towards the post stroke recovery rehabilitation. Feasibility assessment will be done based upon the caregiver responses on the Client Satisfaction Questionnaire . Barthel Index, Stroke Rehabilitation Assessment of Movemement (STREAM) assessment and Modified Rankin Scale (mRS) will be used to assess the motor and functional outcomes.Results:A total of 731 patients provided the telerehabilitation services through live WhatsApp video conferencing after discharge. Initial assessments were done using Barthel Index, Stroke Rehabilitation Assessment of Movement assessment and Modified Rankin Scale at the time of discharge. Tailor-made exercise programs were prepared for each patient based upon the impairments. Primary caregivers were trained through on-patient demonstration and rehabilitation videos. One on one interactive and guided sessions were conducted on the 7th, 15th, 30th day of discharge in one month and then every once in a month for the next 2 months. The patient outcome data will be presented.Conclusions:The aforementioned tele-rehabilitation model of care will help to optimize motor and functional outcomes of the patient. Understanding the limitations and success of these interventions will be helpful.

Stroke, Volume 56, Issue Suppl_1, Page ATMP68-ATMP68, February 1, 2025. Background:The use of statins following intracranial hemorrhage (ICH) is disputed. Prior studies have found inconsistent effects of statins on the risk of subsequent ICH and other outcome measures. Moreover, many previous studies do not distinguish between post-ICH statin treatment in patients resuming previous statin therapy versus initiation in statin-naïve patients. This meta-analysis consolidates the evidence surrounding the use of therapies following ICH, with a focus on mortality in these two subgroups.Methods:A comprehensive search of MEDLINE, EMBASE, and The Cochrane Library was conducted up to 2024 to identify studies on statin initiation or resumption versus no statin use in intracerebral/intraparenchymal hemorrhage patients, yielding 8 studies meeting inclusion/exclusion criteria. The protocol was registered with PROSPERO, and data were analyzed using a Pairwise Meta Analysis in R, applying common and random effects models with heterogeneity assessed via I2statistics. Mortality outcomes were categorized into “short-term” (≤90 days) and “long-term” ( >90 days to 1 year) mortality.Results:Mortality events occurred in 2946 out of 9501 patients (31.0%) in the control group, 123 out of 2248 patients (5.5%) in the statin initiation group, and 787 out of 3944 patients (20.0%) in the statin resumption group. For the ≤90 days timeframe, the random effects model showed a significant reduction in mortality with statin initiation, with a relative risk (RR) of 0.15 (95% CI [0.081; 0.26], p < 0.0001), and with statin resumption, the RR was 0.32 (95% CI [0.18; 0.55], p < 0.0001). Heterogeneity was high, with an I2of 84.3%. For the >90 days up to 1 year timeframe, statin initiation was associated with a reduction in mortality, with an RR of 0.39 (95% CI [0.29; 0.53], p < 0.0001). Statin resumption also showed a reduction in mortality, with an RR of 0.65 (95% CI [0.46; 0.92], p = 0.0145). Heterogeneity was moderate, with an I2of 41.7%.Conclusion:Statin therapy following ICH, whether through initiation or resumption, is associated with a significant reduction in mortality both within 90 days and beyond 90 days up to one year. Interestingly, statin initiation showed a stronger effect compared to resumption. These findings support the continuation or initiation of statins in the acute phases of ICH management regardless of previous statin use.

Stroke, Volume 56, Issue Suppl_1, Page ATP137-ATP137, February 1, 2025. Subarachnoid hemorrhage can cause debilitating headaches, affecting 90% of these patients in the intensive care unit, and 40% at 32 month follow up. Current literature suggests that opioids are ineffective for treating subarachnoid hemmorhage pain, despite their widespread use and perceived efficacy. There is evidence that dot-phrase implementation and electronic medical record alerts can positively influence physician behavior, including with reducing opioid prescriptions in the primary care setting. We added a standardized dot-phrase to discharge summaries for our subarachnoid hemmorhage patients, prompting providers to answer whether the patient was being prescribed opioids, the rationale for this, and plan for weaning. Rates of opioid prescription inpatient were 93%, but inclusion of the dot phrase reduced opioid prescription at discharge to 14% compared to 43% in patients who did not have dot phrase included. Our results suggest that dot-phrase implementation can successfully reduce opioid prescription at discharge for this patient population.

Stroke, Volume 56, Issue Suppl_1, Page ADP1-ADP1, February 1, 2025. Background:Cerebral amyloid angiopathy (CAA) is a hemorrhagic cerebrovascular disease that is thought to be due to excess protein deposition in vessel walls that lead to fragility and increase the risk of rupture. Whether intravenous thrombolysis (IVT) is safe and effective for acute ischemic stroke (AIS) patients with CAA is largely unknown.Methods:This was an explorative analysis of a nationwide database of hospitalizations in the United States. AIS patients with CAA were identified by ICD-10 codes and included in the study, and cases were divided into IVT and no-IVT groups. Propensity score matching was performed to balance treatment groups, and additional multivariable logistic regressions were used for doubly robust analyses. Primary outcome was routine discharge to home with self-care. Secondary outcomes include discharge to home, in-hospital mortality, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH).Results:5,100 patients were identified; 498 (9.8%) received IVT. After propensity score matching and doubly robust analyses with additional multivariable logistic regression, IVT was associated with better discharge outcomes (Figure 1), with significantly higher odds of routine discharge (adjusted OR 1.77 [95%CI 1.12-2.80], p=0.015) despite higher odds of ICH (aOR 4.00 [95%CI 2.79 to 5.75], p

Stroke, Volume 56, Issue Suppl_1, Page A22-A22, February 1, 2025. Introduction:Though clinical practice guidelines support high repetitions of walking after stroke, practice is slow to change with low levels of walking activity in stroke rehabilitation units. We undertook an implementation trial to change practice; we enabled entire stroke units to use the Walk ‘n Watch protocol and determined the effect of implementation on the 6 Minute Walk Test (6MWT) at hospital discharge.Methods:This 12-site clinical trial across 7 Canadian provinces used a stepped-wedge cluster design to randomize when each site switched from Usual Care to the Walk ‘n Watch protocol. At the start of the Walk ‘n Watch phase, we trained all front-line physical therapists on the unit with training workshops, manuals, hands-on practice, and videos. Each site was provided onboarding materials to address staff changes so therapists who did not attend the initial training could adopt the protocol. Each site also identified a ‘protocol champion’ to facilitate initial weekly huddles with therapists to discuss barriers to implementation. Therapists were trained to complete safety screening and to determine eligibility. The Walk ‘n Watch protocol focused on completing a minimum of 30-minutes of daily weight-bearing, walking-related activities that progressively increased in intensity informed by activity trackers measuring heart rate and step number. Blinded assessors completed the outcomes at baseline and 4-weeks later (near discharge). Primary analysis used a linear mixed-effects model adjusted for stratum, date of enrollment, age, sex and baseline 6MWT.Results:The total number of participants was 306 (162 Usual Care, 144 Walk ‘n Watch, 188 males/118 females) with a mean(SD) age of 68(13), 29(17) days since stroke, and a baseline 6MWT of 152(106) m. The improvement on the 6MWT was 43.6m (95%CI 12.7, 76.1) greater in the Walk ‘n Watch group compared to the Usual Care group. Further, the Walk ‘n Watch group improved quality of life (EQ5D), balance and mobility (Short Physical Performance Battery) and gait speed.Conclusions:The implementation trial design enabled the protocol to be tested under real-world conditions, involving all therapists on each unit to deliver the protocol. The trial had a deliberate aim to facilitate changes in practice that resulted in clinically meaningful improvements in walking and quality of life.

Stroke, Volume 56, Issue Suppl_1, Page A24-A24, February 1, 2025. Objectives:To investigate the correlation between iron deposition changes in the lesioned thalamic nuclei and the presence and severity of central post-stroke pain (CPSP) after thalamic infarction using quantitative susceptibility mapping (QSM) technique.Methods:We consecutively enrolled patients with unilateral chronic thalamic infarction with radiological examination conformed . Detailed and multidimensional pain characteristics measured as follows: Douleur Neuropathique 4 (DN4) questionnaire for validation of neuropathic pain diagnosis, Short-Form McGill Pain Questionnaire (SF-MPQ) for comprehensive representation of pain experience, Present Pain Intensity index (PPI) for current pain severity upon examination, and Visual Analogue Scale (VAS) for overall pain feeling since symptom onset. Age- and sex-matched stoke-free healthy controls were recruited simultaneously. High resolution structural image 3D-T1 BRAVO and QSM sequences were obtained with 3.0T MRI. The voxel-lesion-symptom-mapping (VLSM) was used to determine lesioned thalamic nuclei at the high risk for CPSP. Then ipsilateral QSM values of the whole thalamus and subregions were compared with contralateral side and healthy controls. Partial correlation analysis were performed to explore the relationship between QSM value and pain severity.Results:Finally, 28 CPSP patients, 33 non-CPSP patients and 55 healthy controls were included in the study. Our results indicated no significant difference in overall QSM values of the whole thalamus among the groups. The VLSM results showed lesion involving ventral posterolateral nuclei (VPL) was highly orrelaed with occurance of CPSP (pFWE=0.0092.). The QSM values of each subnuclei in the thalamus ipsilateral to infarction were lower compared with the contralateral side and healthy controls (p

Stroke, Volume 56, Issue Suppl_1, Page A16-A16, February 1, 2025. Background:Colchicine has shown to reduce major adverse cardiovascular events and stroke among patients with coronary artery disease. However, its efficacy with short and long use and risk of stroke has not been well studied with conflicting results till date.Objective:We sought to evaluate the short and long term efficacy of Colchicine for prevention of stroke and major adverse cardiovascular events (MACE).Methods:We performed a systematic literature search on PubMed, EMBASE, and Clinicaltrial.gov for relevant randomized controlled trials (RCTs) from inception until July 20th, 2024. Odds ratios (OR) were pooled using a random-effect model, and a p-value of