Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 433 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Friday, July 25, 2014

Risk Factors For Sleep Disturbance After Traumatic Brain Injury

I bet your doctor hasn't done any analysis on why you are having sleep problems post-stroke. It was common in the hospital I was at for every stroke patient to get Ambien.
http://brainposts.blogspot.com/2014/07/risk-factors-for-sleep-disturbance.html

Steve Adsley survives stroke by drinking toilet water for 7 days

Another reason to always have your cell phone on you. But then there is the problem of letting emergency responders into your place since you probably can't get to the door to open it. In my bathroom there is no cell service so that wouldn't help me.
http://www.cbc.ca/news/canada/british-columbia/steve-adsley-survives-stroke-by-drinking-toilet-water-for-7-days-1.2717679

Smartest Neurologist Quiz: Dementia

Not a single question on prevention. So I don't know whom you need to see that will help you prevent your upcoming dementia.
Who gives a shit about your 33% dementia chance post-stroke from an Australian study?  
Or the 1 in 3 seniors who die who have dementia.
I will however prevent my dementia by these totally unapproved ways.
Dementia prevention 19 ways


Dear Smartest Neurologist Player,
We invite you to take the
"Dementia" Quiz
>>Click Here to Play!

More than 3 million strokes treated through Get With The Guidelines program

I know they are trying to pat themselves on the back but the guidelines are worthless if you aren't measuring results. A good manager would never let you set goals on processes/guidelines. Your manager would always ask what the results were. The current situation here makes it impossible to make it better because they aren't measuring the right things.
http://blog.heart.org/more-than-5-million-treated-through-get-with-the-guidelines/

Actual guidelines here:
http://www.heart.org/HEARTORG/HealthcareResearch/GetWithTheGuidelinesHFStrokeResus/GetWithTheGuidelinesStrokeHomePage/Get-With-The-Guidelines-Stroke-Overview_UCM_308021_Article.jsp 

Thursday, July 24, 2014

Driving dogs

Just in case you don't feel comfortable driving and you can't wait for the Google car.
https://www.youtube.com/user/TheDrivingDogs

3D Rendered walk cycle (looped)

Rather distracting for guys. And it doesn't show the feet/ankle movement. But the arm swing is interesting, I don't think it normally curls quite so much in front. A great stroke association would have thousands of these movement gifs for all our action observation needs.
https://www.youtube.com/watch?v=ZiZlW2mjKLc
It's only a 9 second loop.

Rigid connections: Molecular basis of age-related memory loss explained

So is this the reason for your memory problems rather than your stroke?  Or is your doctor enamored with Occams razor?
http://www.alphagalileo.org/ViewItem.aspx?ItemId=143921&CultureCode=en
From telephone numbers to foreign vocabulary, our brains hold a seemingly endless supply of information. However, as we are getting older, our ability to learn and remember new things declines. A team of scientists around Associate Prof Dr Antonio Del Sol Mesa from the Luxembourg Centre for Systems Biomedicine of the University of Luxembourg and Dr Ronald van Kesteren of the VU University Amsterdam have identified the molecular mechanisms of this cognitive decline using latest high-throughput proteomics and statistical methods.
The results were published this week in the prestigious scientific journal “Molecular and Cellular Proteomics” (doi:.10.1074/mcp.M113.032086).
Brain cells undergo chemical and structural changes, when information is written into our memory or recalled afterwards. Particularly, the number and the strength of connections between nerve cells, the so-called synapses, changes. To investigate why learning becomes more difficult even during healthy ageing, the scientists looked at the molecular composition of brain connections in healthy mice of 20 to 100 weeks of age. This corresponds to a period from puberty until retirement in humans. "Amazingly, there was only one group of four proteins of the so-called extracellular matrix which increased strongly with age. The rest stayed more or less the same," says Prof Dr Antonio del Sol Mesa from the Luxembourg Centre for Systems Biomedicine.
The extracellular matrix is a mesh right at the connections between brain cells. A healthy amount of these proteins ensures a balance between stability and flexibility of synapses and is vital for learning and memory. "An increase of these proteins with age makes the connections between brain cells more rigid which lowers their ability to adapt to new situations. Learning gets difficult, memory slows down," Dr Ronald van Kesteren of the VU University Amsterdam elaborates.
In addition, the researchers not only looked at the individual molecules but also analysed the whole picture using a systems biology approach. Here they described the interplay between molecules as networks that together tightly control the amount of individual molecules and their interactions. “A healthy network keeps all molecules in the right level for proper functioning. In older mice we found, however, that the overall molecular composition is more variable compared to younger animals. This shows that the network is losing its control and can be more easily disturbed when we age,” Prof Dr Antonio del Sol Mesa explains. According to the researchers this makes the brain more susceptible to diseases.
Hence, this insight into the normal aging process could also help in the future to better understand complex neurodegenerative diseases such as Alzheimer's and Parkinson's disease. Chemical compounds that modulate the extracellular matrix might be promising new treatments for learning disorders and memory loss.

Barriers preventing post-stroke care

Every survivor that writes about recovery states it is extremely hard, repetitive and time-consuming. Don't doctors and therapists understand that that needs to be forcefully communicated to all survivors? Along with the fact that magic doesn't occur. If you don't do the work, you won't recover.
http://medicalxpress.com/news/2014-07-barriers-post-stroke.html
For stroke victims, rehabilitation is crucial to their recovery. But a Flinders University study conducted in Singapore found that rehabilitation rates following discharge from hospital are poor because of gaps in the continuum of stroke care.
The study – published last month in the International Journal of Therapy and Rehabilitation – identified five major barriers to post-stroke rehabilitation in Singapore including; difficulties accessing rehabilitative services; gaps in discharge coordination; the influence of family members; discrepancies in expectation; and the perception that rehabilitation is simple. As part of the research, interviews were conducted with 68 who were discharged from a Singapore rehabilitation unit between December 2012 and April 2013. Of those, 31 participants reported not following recommendations to continue their rehabilitation. There was no difference in gender, age or type of stroke between those who did and not complete the rehabilitation.
Flinders Clinical Rehabilitation lecturer Dr Christopher Barr, a co-investigator of the study, said access barriers, including mobility difficulties and transport costs, along with affordability of services, were the chief obstacles precluding rehabilitation.
"The lack of transport means and the associated costs were the main barriers that hindered adherence to continuing post-stroke rehabilitation," Dr Barr said.
"Affordability of services also had a direct influence, with one participant's family member stating: 'money is a concern and also who [is going] to bring my dad to therapy'," he said.
"Gaps in the transition from hospital to outpatient services were also cited as a reason for not continuing rehabilitation – in some cases participants fell through the unnoticed gap and were left waiting for follow-up appointments."
Dr Barr said family members were either facilitators or inhibitors of rehabilitation: "One participant said they have to prompt their mother to go because they think it's good for her but another participant said they missed two appointments because their son forgot.
"It wasn't uncommon for patients and carers to feel stranded and helpless."
Dr Barr said most participants regarded rehabilitation as simple, common-sense knowledge that could easily be self-replicated or substituted without the help of a therapist, leading them to seek alternatives to their therapy recommendation.
He said the findings highlighted the need to review current goal-setting processes for rehabilitation and the need to establish a common understanding of rehabilitation practice between patients, carers and clinicians.
"Clinicians need to be more aware of their role in providing well-coordinated information about therapy, and goals need to be more patient-centred to reduce the discrepancies in expectations of rehabilitation.
"Carers also need to be more empowered and involved in discharge planning to minimise the dissatisfaction in care arrangements and information delivery."

New Rehabilitation Institute of Chicago Brain Stimulation Study Reveals Breakthrough in Stroke Recovery

Ok, the RIC I guess can do good things also. Bad stuff here.
I like the fact that this was for chronic, a 5 year survivor.  This sounds like applying the earlier studies on contralateral recovery like these;
Cortical Reorganization After Stroke How Much and How Functional?

New model of how brain functions are organized may revolutionize stroke rehab

Magic for Stroke Patients: The One-Sided Workout

 So ask your therapists why this isn't available in their clinic and exactly what the protocol is.
http://www.wspa.com/story/25587087/new-rehabilitation-institute-of-chicago-brain-stimulation-study-reveals-breakthrough-in-stroke-recovery#.U8OcnUKrd_0.email
Doctors at the Rehabilitation Institute of Chicago (RIC) revealed the results of a study wherein 80 percent of stroke survivor participants regained arm and hand use – 30 percent more than possible with standard therapies. The breakthrough study combines for the first time a new, non-invasive brain stimulation technique with traditional occupational therapy (OT) to improve upper limb (arm and hand) movement recovery – and give patients back the independence they lost as a result of their strokes.
Richard L. Harvey, MD, medical director at the RIC Center for Stroke Rehabilitation and lead scientist of this study, researched and developed a new approach to modulate brain healing and improve lasting arm and hand use in stroke survivors. This type of brain stimulation is the only technology that has been shown to deliver greater functional improvements when accompanied with an OT session. Typically, only about 50 percent of post-stroke patients regain full upper limb use through OT alone.1 The results from RIC's study indicate this combined treatment could increase that success rate to 80 percent.
RIC worked with Nexstim Corporation to apply this novel type of non-invasive brain stimulation – navigated brain stimulation (NBS) – to standard stroke rehabilitation. After a stroke blocks blood to the brain, some regions of the affected brain hemisphere become less active, while some areas on the healthy side of the brain become more active. By externally and painlessly stimulating the overly active parts of the healthy brain with NBS magnetic waves, these targeted parts calm down. The RIC study indicates that when the overly active healthy brain areas quiet down, the stroke-damaged areas respond more fully and sustainably to occupational therapy. This allows the patient to have a better recovery and increased arm use.
"This study represents what could be a significant breakthrough in the treatment of strokes," said Harvey. "Our results indicate that targeting stimulation to the correct area can set up the brain to learn and retain more during traditional stroke rehabilitation. We know that stroke is a leading cause of serious disability and costs the U.S. more than $36 billion each year from lost work days and long-term health care. To these patients, regaining arm use and mobility means increasing their ability and, thus, their quality of life."
Darryl Holmes, one of the 30 stroke survivors with severe arm impairments in this pilot study, had a stroke in 2009 at age 57. After his stroke, his movement was limited. He had trouble using his left side, including his arm and hand, which prevented him from performing many of his regular activities, like driving and writing.
In 2013, Holmes participated in RIC's six-month stroke study and received treatment with NBS in combination with occupational therapy. This study used NBS to stimulate the brain with magnetic waves using a navigation system akin to a GPS map. Adding navigation to regular brain stimulation allows doctors to locate the exact area of the brain that should be inhibited, or calmed down, by this type of stimulation.
"Since the RIC study treatment, I've gone back to work," said Holmes. "I've gone into private practice. I drive a new car. Participating in this research has made me a healthier person, both physically and mentally. I have my life back, and it's good."
The Center for Stroke Rehabilitation at RIC integrates research directly into patient care and is the only federally-designated Rehabilitation Research and Training Center for Stroke, as recognized by the National Institute on Disability and Rehabilitation Research. RIC is the first hospital to run a trial with NBS as an aid to OT in stroke survivors. Now that the pilot study is complete, RIC has expanded the study and currently manages 12 other research centers in a nationwide study – the first large-scale trial of its kind to take a major step toward clinical availability of this treatment.
About The Rehabilitation Institute of Chicago
The Rehabilitation Institute of Chicago (RIC) is the nation's leading provider of comprehensive physical medicine and rehabilitation care to patients from around the world. Founded in 1954, RIC has been designated the "No. 1 Rehabilitation Hospital in America" by U.S. News & World Report every year since 1991. RIC sets the standard of care in the post-acute market through its innovative applied research and discovery programs, particularly in the areas of neuroscience, bionic medicine, musculoskeletal medicine and technology transfer. For more information, go to www.ric.org.

Ballet dancers' brains adapt to stop them feeling dizzy

If you had a cerebellar stroke your doctor should be using this to fix your balance and dizziness issues.
http://www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssummary/news_26-9-2013-17-43-4
The research suggests that years of training can enable dancers to suppress signals from the balance organs in the inner ear.
The findings, published in the journal Cerebral Cortex, could help to improve treatment for patients with chronic dizziness. Around one in four people experience this condition at some time in their lives.
Normally, the feeling of dizziness stems from the vestibular organs in the inner ear. These fluid-filled chambers sense rotation of the head through tiny hairs that sense the fluid moving. After turning around rapidly, the fluid continues to move, which can make you feel like you’re still spinning.
Ballet dancers can perform multiple pirouettes with little or no feeling of dizziness. The findings show that this feat isn’t just down to spotting, a technique dancers use that involves rapidly moving the head to fix their gaze on the same spot as much as possible.
Researchers at Imperial College London recruited 29 female ballet dancers and, as a comparison group, 20 female rowers whose age and fitness levels matched the dancers’.

Single motor unit firing rate after stroke is higher on the less-affected side during stable low-level voluntary contractions

What is your doctor doing with this knowledge to update your stroke protocols and get you closer to 100% recovery?
http://journal.frontiersin.org/Journal/10.3389/fnhum.2014.00518/full?
Penelope A. McNulty1,2*, Gaven Lin1 and Catherine G. Doust1,2
  • 1Neuroscience Research Australia, Sydney, NSW, Australia
  • 2School of Medical Sciences, UNSW Australia, Sydney, NSW, Australia
Muscle weakness is the most common outcome after stroke and a leading cause of adult-acquired motor disability. Single motor unit properties provide insight into the mechanisms of post-stroke motor impairment. Motor units on the more-affected side are reported to have lower peak firing rates, reduced discharge variability and a more compressed dynamic range than healthy subjects. The activity of 169 motor units was discriminated from surface electromyography in 28 stroke patients during sustained voluntary contractions 10% of maximal and compared to 110 units recorded in 16 healthy subjects. Motor units were recorded in three series: ankle dorsiflexion, wrist flexion and elbow flexion. Mean firing rates after stroke were significantly lower on the more-affected than the less-affected side (p < 0.001) with no differences between dominant and non-dominant sides for healthy subjects. When data were combined, firing rates on the less-affected side were significantly higher than those either on the more-affected side or healthy subjects (p < 0.001). Motor unit mean firing rate was higher in the upper-limb than the lower-limb (p < 0.05). The coefficient of variation of motor unit discharge rate was lower for motor units after stroke compared to controls for wrist flexion (p < 0.05) but not ankle dorsiflexion. However the dynamic range of motor units was compressed only for motor units on the more-affected side during wrist flexion. Our results show that the pathological change in motor unit firing rate occurs on the less-affected side after stroke and not the more-affected side as previously reported, and suggest that motor unit behavior recorded in a single muscle after stroke cannot be generalized to muscles acting on other joints even within the same limb. These data emphasize that the less-affected side does not provide a valid control for physiological studies on the more-affected side after stroke and that both sides should be compared to data from age- and sex-matched healthy subjects.

Introduction

Stroke is the leading cause of adult-acquired motor disability in developed countries (WHO, 2003). The most common outcome after stroke, and the most common cause of motor disability, is hemiparesis or weakness on the side of the body contralateral to the stroke lesion (e.g., Chang et al., 2013). Although the acute lesion is restricted to the brain, secondary adaptive and maladaptive changes may contribute to hemiparesis. There are four principal sites where such degeneration has the capacity to contribute to muscle weakness: (i) cerebral diaschisis (Feeney and Baron, 1986); (ii) reduced corticospinal tract integrity (Fries et al., 1993; Pineiro et al., 2000; Sterr et al., 2010; Stinear et al., 2012); (iii) changes to peripheral motor axon properties (Jankelowitz et al., 2007; Huynh et al., 2013); and (iv) anatomical and physiological changes within the muscle and its constituent single motor units. This study will consider single motor unit discharge behavior.
There are both anatomical and physiological changes within the muscles of the more-affected side after stroke. The anatomical changes may include disuse atrophy (Jørgensen and Jacobsen, 2001; Ryan et al., 2002; Hara et al., 2004; Arasaki et al., 2006; Li et al., 2011); altered muscle phenotype (Jakobsson et al., 1991; De Deyne et al., 2004; Lukács et al., 2008; McKenzie et al., 2009); and reinnervation (Dattola et al., 1993; Hara et al., 2004; Lukács, 2005). Physiological changes include altered motoneuron pool activation so that there is a reduction in the mean motor unit discharge rate and the variability of this discharge (Rosenfalck and Andreassen, 1980; Dietz et al., 1986; Gemperline et al., 1995; Chou et al., 2013); disrupted recruitment threshold (including lower recruitment thresholds, reversed recruitment thresholds so that fast motor units are recruited before slower motor units, and a reduced range over which recruitment occurs), reduced modulation of firing rates, and compression of the dynamic range of motor unit discharge rates (Rosenfalck and Andreassen, 1980; Gemperline et al., 1995; Hu et al., 2012; Chou et al., 2013). Such changes contribute not only to hemiparesis, but also to reduced control of muscles on the more-affected side after stroke.
Single motor units are the smallest functional division of muscles. They represent the most distal component of the motor pathway and their discharge behavior reflects the intrinsic properties of both the motoneuron and the muscle fibers in addition to the net synaptic drive through this pathway. Recent data from our group recorded during post-stroke therapy demonstrated that the activity of isolated single motor units in severely paretic muscles precedes the development of compound muscle activity (i.e., multiple motor units recruited through voluntary commands), and that this progression is a hallmark of improved movement ability, even many years post-stroke (see McNulty et al., 2013; Thompson-Butel et al., 2013). To understand the process of recovery from isolated single motor unit activity to compound activity during dynamic movements it is simpler to begin with more controlled static tasks so that changes in the properties of single motor units, and the mechanisms controlling this behavior, can be investigated more systematically. The aim of this study was to examine the pattern of motor unit behavior during sustained static contractions.
The changes in motor unit discharge properties noted above have been measured over brief periods, usually from 5–20 s with a range of different tasks and levels of voluntary contraction. Each of these differences may be sufficient to alter the net synaptic drive to the motoneuron pool. For this reason, we extracted the action potentials of single motor units that were either spontaneously active or task-driven during a sustained isometric voluntary contraction at a functionally relevant duration and force intensity during ankle dorsiflexion, wrist flexion and elbow flexion. Motor units were recorded from both the more- and less-affected side after stroke and on both the dominant and non-dominant side in healthy subjects. Motor unit activity during contractions acting on three joints was studied because there are anatomical and functional differences in the control of muscles in the upper and lower limbs, and between proximal and distal muscles of the upper-limb. These differences include different innervation ratios (Buchthal and Schmalbruch, 1980), more numerous monosynaptic corticospinal (Palmer and Ashby, 1992) or bilateral (Colebatch et al., 1990) projections, and differences in mean firing rates (Petajan and Philip, 1969; de Luca, 1985). These differences are superimposed on functional recovery after stroke that is typically greater for the lower-limb than for the upper-limb although the reason for this is not clear. To ensure the results of this study do not simply reflect the differences listed here, data were collected during contractions at three joints. We compared differences in firing rates and the variability of the firing rate between sides and between the upper and lower limb. Data were recorded during elbow flexion from stroke subjects only to examine the effect of hand dominance on the control of motor unit behavior after stroke. Our results suggest that although motor units on the more-affected side have a reduced firing rate compared to the less-affected side as reported previously, the important difference is that the firing rate of motor units on the less-affected side after stroke is higher than both the more-affected side and motor units of healthy subjects.

More at link, including tables and graphs.

Hospital gets A+ for stroke recovery - Lakeridge Health, Oshawa, ONT

Sorry but there is nothing here that is objectively relevant to survivors. 30 day death rates maybe? 100% recovery statistics? You do not measure procedures, you measure results, take a business 101 course.
Big f*cking whoopee.
http://www.oshawaexpress.ca/viewposting.php?view=6735

Monitoring Pulse After Stroke May Prevent a Second Stroke

I wish they would at least mention that the whole point of this exercise was to detect atrial fibrillation and get that treated. Worthless article.
http://dgnews.docguide.com/monitoring-pulse-after-stroke-may-prevent-second-stroke?

Acupuncture from Mayo Clinic Housecall

Absolutely nothing in here proves any of these statements.
THIS WEEK'S TOP STORIES  
 
Acupuncture
This traditional Chinese medicine technique may relieve pain. It boosts the activity of the body's natural painkillers and increases blood flow.
 

Five Top Clinical Trials in Traumatic Brain Injury

Your doctor should know the top five currently running clinical trials for stroke, and have them at the tip of their tongue. And know the last 5 clinical trials that changed procedures and protocols in stroke.  They don't know? Why the hell are you seeing them and paying them?
http://brainposts.blogspot.com/

Wednesday, July 23, 2014

Blood donation and stroke rehab

Today was my first time. I wasn't worried about the blood draw, I was worried about getting the bandaid off the right arm. She looked at the left arm but since it requires being able to squeeze a soft rubber ball to make your veins bulge, that was a failure. So right arm it was and even though I requested no bandaid I got one because another person came to finish me up. After the bandaid goes on it is wrapped with this stretchy, sticky elastic to make sure it stays on. I managed to get that red wrapping started off by rubbing it on my car door corner. That now left about an inch dangling, enough to get my teeth on it to pull off 4 inches. And since it was wrapped around my arm I had to shut the car door on that 4 inch length to get it unwrapped all the way.  I did ask back at the blood draw station to remove the small bandaid after lunch. I can't get my teeth deep enough into the crook of my elbow. Feeling ok.

How Our Arms Help Us Run

Have your doctor interpret this in how your spastic arm is inhibiting your running. What is your doctors solution to this problem? And don't let your doctor brush off the question, they are supposed to actually know something about getting you recovered. I expect my doctor to know the exact steps and protocols needed to get back to running. But for those of you that have doctors that are worthless read this book;  Teaching Me to Run by Tommye-K. Mayer
The New York Times article here:
How Our Arms Help Us Run
The research article here: 
The metabolic cost of human running: is swinging the arms worth it?

Tuesday, July 22, 2014

Cognitive Reserve Boosts Traumatic Brain Injury Recovery

The same should be studied for stroke. I attribute my reasonable recovery to my cognitive reserve
http://brainposts.blogspot.com/

Groundbreaking marijuana study canceled

Have at it, and let the University of Arizona know they need to support full legalization of marijuana.
Why it should be legalized so survivors can benefit;
13 reasons to use it post-stroke.


The University of Arizona fired Dr. Suzanne Sisley rather than let her study how medical marijuana can help veterans like me. Help me get her job back.

 
dean -
Doctor Suzanne Sisley is an amazing woman -- she's the only doctor in the country who has federal permission to conduct research on how medical marijuana can help veterans. Her study was supposed to be housed at the University of Arizona, but rather than let her conduct it, the university fired her with no explanation whatsoever. As an Iraq veteran and an Arizona alum, I'm fighting to help Doc Sisley get her job back so she can continue her groundbreaking research to help veterans.
I know firsthand how important Doc Sisley's work is, because I had severe PTSD when I came home from my tour of duty in Iraq. I experienced insomnia, anxiety, depression, panic attacks, and fits of rage. My doctors tried for years to cure my PTSD, gave me every pill they could think of. Nothing worked, until 2010, when I started using medical marijuana. 
I wish you could see how much medical marijuana changed my life, made it possible for me to do simple things like get some sleep at night. It gave me so much pride and hope that Doc Sisley was going to do research at my alma mater to bring this miracle to other veterans like me.
This isn't just a matter of one woman losing her job unfairly. Doc Sisley's study could be a matter of life or death for many veterans. Our veterans are committing suicide at an astonishing rate: 22 every single day. Medical marijuana is one of the most promising avenues of treatment for these at-risk veterans, and Doc Sisley's study could make the difference in getting that treatment to those who need it the most.
Our veterans risk their lives overseas. The least we can do for them is provide them with the best care possible when they come home.
The good news is that petitions really work in cases of unfair teacher firings. Already this year, two teachers have gotten their jobs back after petitions supporting them took off on Change.org. I know that if enough people sign my petition, we can help Doc Sisley, too.
Thank you,
Ricardo Pereyda
United States Army VeteranTucson, Arizona

Eating probiotics regularly may improve your blood pressure

I'm sure your doctor will know exactly how to accomplish this. Hah?
http://newsroom.heart.org/news/eating-probiotics-regularly-may-improve-your-blood-pressure?preview=7599
Study Highlights
  • Probiotics – a bacteria in yogurt and supplements – appear to modestly lower blood pressure, according to a review of nine studies.
  • The blood pressure-lowering effect from probiotics was greatest among people with elevated blood pressure.
  • Additional studies are needed before doctors can confidently recommend probiotics for high blood pressure control and prevention.
Embargoed until 3 p.m. CT/4 p.m. ET MONDAY, JULY 21, 2014
DALLAS, July 21, 2014 — Eating probiotics regularly may modestly improve your blood pressure, according to new research in the American Heart Association journal Hypertension.
Probiotics are live microorganisms (naturally occurring bacteria in the gut) thought to have beneficial effects; common sources are yogurt or dietary supplements.
“The small collection of studies we looked at suggest regular consumption of probiotics can be part of a healthy lifestyle to help reduce high blood pressure, as well as maintain healthy blood pressure levels,” said Jing Sun, Ph.D., lead author and senior lecturer at the Griffith Health Institute and School of Medicine, Griffith University, Gold Coast, Queensland, Australia. “This includes probiotics in yogurt, fermented and sour milk and cheese, and probiotic supplements.”
Analyzing results of nine high-quality studies examining blood pressure and probiotic consumption in 543 adults with normal and elevated blood pressure, researchers found:
  • Probiotic consumption lowered systolic blood pressure (the top number) by an average 3.56 millimeters of mercury (mm Hg) and diastolic blood pressure (the lower number) by an average 2.38 mm Hg, compared to adults who didn’t consume probiotics.
  • The positive effects from probiotics on diastolic blood pressure were greatest in people whose blood pressure was equal to or greater than 130/85, which is considered elevated.
  • Consuming probiotics for less than eight weeks didn’t lower systolic or diastolic blood pressure.
  • Probiotic consumption with a daily bacteria volume of 109-10 12 colony-forming units (CFU) may improve blood pressure. Consumption with less than 109 CFU didn’t lower blood pressure. CFU is the amount of bacteria or the dose of probiotics in a product.
  • Probiotics with multiple bacteria lowered blood pressure more than those with a single bacteria.
“We believe probiotics might help lower blood pressure by having other positive effects on health, including improving total cholesterol and low-density lipoprotein, or LDL, cholesterol; reducing blood glucose and insulin resistance; and by helping to regulate the hormone system that regulates blood pressure and fluid balance,” Sun said.
“The studies looking at probiotics and blood pressure tend to be small,” Sun said. “Moreover, two studies had a short duration of three to four weeks of probiotic consumption, which might have affected the overall results of the analysis.
Additional studies are needed before doctors can confidently recommend probiotics for high blood pressure control and prevention, she said.
Co-authors are Saman Khalesi, M.Sc., Ph.D.; Nicholas Buys, Ph.D.; and Rohan Jayasinghe, Ph.D. Author disclosures are on the manuscript.
Additional Resources:
###
Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding.

Long-term three-stage rehabilitation intervention alleviates spasticity of the elbows, fingers, and plantar flexors and improves activities of daily living in ischemic stroke patients: a randomized, controlled trial

Your doctor will need to see the details of this in order to set up a stroke protocol to reduce your arm/finger spasticity. Good luck with that.
http://journals.lww.com/neuroreport/Abstract/publishahead/Long_term_three_stage_rehabilitation_intervention.99036.aspx

Bai, Yu-long; Hu, Yong-shan; Wu, Yi; Zhu, Yu-lian; Zhang, Bei; Jiang, Cong-yu; Sun, Li-min; Fan, Wen-ke

Supplemental Author Material
Published Ahead-of-Print

Abstract

To investigate the effects of rehabilitation interventions on spasticity and activities of daily living (ADL) in ischemic stroke patients. A total of 165 ischemic stroke patients were recruited and assigned randomly to a control group (CG, n=82) or a therapeutic group (TG, n=83). Rehabilitation interventions were performed in the TG. The Modified Ashworth Scale was used to evaluate the severity of spasticity in the fingers, elbows, and plantar flexors, and the Modified Barthel Index (MBI) was used to measure ADL performance. Evaluations were performed at baseline (M0) and at the end of the first, third, and sixth months (M1, M3, M6) after enrollment. At M0, 20.8% (16/77) in the CG and 29.9% (23/77) in the TG developed spasticity, whereas at M6, the incidence of spasticity increased to 36.4% (28/77) in the TG and 42.9% (33/77) of patients in the CG. Fewer patients developed spasticity in the fingers, elbows, and ankles in the TG than CG, respectively. Both groups showed significant improvements in MBI scores (M6 vs. M0, P<0.01). MBI scores correlated negatively with the severity of spasticity in both groups at M6. Long-term standardized rehabilitation interventions alleviate spasticity and promote ADL with the presence of minor spasticity (Supplementary video, Supplemental digital content 1, http://links.lww.com/WNR/A291).

Falls and Use of Assistive Devices in Stroke Patients with Hemiparesis: Association with Balance Ability and Fall Efficacy

You will need to ask your therapist what fall efficacy is and whether it is something to try to accomplish.
http://onlinelibrary.wiley.com/doi/10.1002/rnj.173/abstract;jsessionid=FC6AD4F231695A31A89C7677B14E315B.f04t01?

  1. Oksoo Kim PhD, RN1 and
  2. Jung-Hee Kim PhD, RN Assistant Professor2,*
Article first published online: 17 JUL 2014
DOI: 10.1002/rnj.173

Keywords:

  • Fall;
  • balance;
  • self-help device;
  • stroke

Abstract

Purpose

This study investigates balance ability and the fall efficacy with regard to the experiences of stroke patients with hemiparesis.

Methods

The experience of falling, the use of assistive devices, and each disease-related characteristic were assessed using face-to-face interviews and a self-reported questionnaire. The Berg Balance Scale and Fall Efficacy Scale were used to measure balance ability and confidence.

Results

The fall efficacy was significantly lower in participants who had experienced falls than those who had not. The participants who used assistive devices exhibited low balance ability and fall efficacy compared to those who did not use assistive devices.

Conclusions

Stroke patients with fall experience and walking aids might be considered at increased risk of falling.

Clinical Relevance

Preventive measures for individuals using walking aids may be beneficial in reducing the fall rate of community-dwelling stroke patients.

Fish Oil Supplements Reduce Incidence of Cognitive Decline, Brain Atrophy

This is one of the legs on my three-legged milking stool for preventing dementia. I bet it's more than your doctor is telling you about. So ask him/her.
Fish Oil Supplements Reduce Incidence of Cognitive Decline, Brain Atrophy
Leg two:
Coffee May Lower Your Risk of Dementia
Leg three:
Evidence-Based Medicinal Properties of Coconut Oil - brain boosting


Monday, July 21, 2014

CardioBuzz: Vegan Diet, Healthy Heart?

Talk to your doctor to see what s/he is saying. I bet they have no idea on the studies I refer to.
Something else to think about:

Quantitative analysis of dietary protein intake and stroke risk

Study: Protein from meat, fish may help men age well

 

What would a post-stroke diet look like per Dean?

 

 

Government needs to focus on stroke rehab - New Zealand

And you, Stroke Foundation CEO Mark Vivian, need to learn where the focus should be on stroke research. It's not rehab, that has only a 10% chance of getting to full recovery. It's stopping the neuronal cascade of death. You New Zealanders will need to educate him on what is the best way to reduce stroke disability. His pronouncements do not leave me with a warm feeling that he understands at all. He then joins the presidents of the ASA, NSA and WSO in being obtuse about where stroke research should be going. If only we had a survivor-driven organization, that would keep their eye on the correct goal.

And yes, I am damn arrogant in thinking that I know more that these 'supposed' stroke professionals.

http://www.nzdoctor.co.nz/un-doctored/2014/july-2014/21/government-needs-to-focus-on-stroke-rehab.aspx

How To Make Hot Pepper Cream

This is totally not to be followed unless your doctor approves. I however will do something like this after my next stroke because the extra sensation is good for prepping your motor recovery.  Like what Margaret Yekutiel wrote in the book, Sensory Re-Education of the Hand After Stroke in 2001.
And this:

Tingling sensation caused by Asian spice could help patients with chronic pain 

 

Never do anything I suggest, you would hate to prove your doctor doesn't know anything about stroke recovery newer than their medical school.

http://www.herbs-info.com/blog/how-to-make-hot-pepper-cream-for-arthritis-and-joint-pain/?c=d 

Can ecstasy treat the agony of PTSD?

If we can't even get marijuana off the Schedule I drug list because our legislators are stupid we'll never get this approved.
And since stroke can cause PTSD your doctor will never stick their head out for a non standard of care to help any stroke patient.
Cannabis Effects on PTSD: Can Smoking Medical Marijuana Reduce Symptoms
Can ecstasy treat the agony of PTSD?
For almost 30 years, Rick Doblin has pushed the idea of using the drug MDMA, better known as ecstasy, in psychotherapy. The Multidisciplinary Association for Psychedelic Studies, which he founded, has funded two phase II trials of MDMA to treat post-traumatic stress disorder (PTSD), one with encouraging results, and is supporting several others. Doblin and some other scientists believe the drug may help PTSD patients relive their traumas with a therapist in a safe atmosphere without overwhelming emotions. Swiss neurobiologist Franz Vollenweider says Doblin has a political agenda and lacks the expertise or the money to organize a phase III study.

National Stroke Foundation (NSF) Australia is updating its research strategy - survey

Have them solve the neuronal cascade of death. Copy this wholesale into their what should we be doing box.
At least one of these 5 problems.
1.  glutamate poisoning
2.  excitotoxicity
3.  Capillaries that don't open due to pericytes
4.  Inflammatory action leaking through the blood brain barrier.
http://link.springer.com/article/10.1007/s12975-013-0301-2
5. Lysosomal Membrane Permeabilization as a Key Player in Brain Ischemic Cell Death: a “Lysosomocentric” Hypothesis for Ischemic Brain Damage

Survey here:
https://www.surveymonkey.com/s/NSFConsumerSurvey2014