As of 2021 it remained to be confirmed whether a booster dose was required, but the Advisory Committee on Immunization Practices (ACIP) in the United States recommends Shingrix for adults over the age of 50, including those who have already received Zostavax. Shingrix
The ACIP voted that Shingrix is preferred over Zostavax for the prevention of zoster and related complications because data showed vaccine efficacy of more than 90% against shingles across all age groups. Unlike Zostavax, which is given as a single shot, Shingrix is given as two intramuscular doses, two to six months apart. Most of the studies conducted showed efficacy to at least 4 years post-vaccination, but it is possible the vaccine may provide protection for much longer.A large randomized clinical trial showed Shingrix reduced the incidence of shingles 96.6% in the 50–59 age group, and 91.3% in those over age 70. The absolute decrease in risk of herpes zoster following immunization over three and a half years is 3.3% (3.54% down to 0.28%) while the decrease in the risk of postherpetic neuralgia is 0.3% (0.34% down to 0.06%). Zostavax
A Cochrane review concluded that Zostavax is "effective in preventing herpes zoster disease for up to three years". The duration of protection beyond four years after vaccination with the zoster vaccine is unknown. The need for re-vaccination remains to be confirmed.Zostavax was shown to reduce the incidence of shingles by 51% in a study of 38,000 adults aged 60 and older who received the vaccine.
The disability component assesses any changes in physical function including gross motor function and walking ability. The disability inventory can have a maximum score of 100 with 70 from the gross motor index and 30 from the walking index. Each task in this inventory has a maximum score of seven except for the 2 minute walk test which is out of two. The impairment component of the test evaluates the upper and lower extremities, postural control and pain. The impairment inventory focuses on the seven stages of recovery from stroke from flaccid paralysis to normal motor functioning. A training workshop is recommended if the measure is being utilized for the purpose of data collection. The Stroke Rehabilitation Assessment of Movement (STREAM)The STREAM consists of 30 test items involving upper-limb movements, lower-limb movements, and basic mobility items. It is a clinical measure of voluntary movements and general mobility (rolling, bridging, sit-to-stand, standing, stepping, walking and stairs) following a stroke. The voluntary movement part of the assessment is measured using a 3-point ordinal scale (unable to perform, partial performance, and complete performance) and the mobility part of the assessment uses a 4-point ordinal scale (unable, partial, complete with aid, complete no aid). The maximum score one can receive on the STREAM is a 70 (20 for each limb score and 30 for mobility score). The higher the score, the better movement and mobility is available for the individual being scored. Treatment
Treatment for hemiparesis is the same treatment given to those recovering from strokes or brain injuries.