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 438 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

Sunday, November 23, 2014

Music’s Amazing Effect on Long-Term Memory and Mental Abilities In General

How much research does your doctor need to create a music protocol post-stroke? Or will this never occur until until your doctor dies and is replaced by someone with a curious/innovative mind?

1.  Exploring a Neuroplasticity Model of Music Therapy

2.  Revealed: The Type of Music That Makes You Feel Most Powerful

3. 11 Problems Music Can Solve

4. How playing an instrument benefits your brain - Anita Collins

5. Why does music therapy work? The Science Behind the Music.

6. Musical Training Can Increase Blood Flow in Brain

7.  Listening to classical music ameliorates unilateral neglect after stroke

8. Music brings memories back to the brain injured 

9.  Plasticity in the sensorimotor cortex induced by Music-supported therapy in stroke patients: a TMS study

10.  Moderating variables of music training-induced neuroplasticity: a review and discussion

11. Hand-Clapping Songs Improve Motor and Cognitive Skills, Research Shows

12. Music listening enhances cognitive recovery and mood after middle cerebral artery stroke

13. Intensive musical therapy may help improve speech in stroke patients

http://www.spring.org.uk/2014/11/musics-amazing-effect-on-long-term-memory-and-mental-abilities-in-general.php?utm_source=PsyBlog
Dr Heekyeong Park, who led the study, said:
“Musically trained people are known to process linguistic materials a split second faster than those without training, and previous research also has shown musicians have advantages in working memory.
What we wanted to know is whether there are differences between pictorial and verbal tasks and whether any advantages extend to long-term memory.
If proven, those advantages could represent an intervention option to explore for people with cognitive challenges.”

More at link.

Saturday, November 22, 2014

Design Factors of Virtual Environments for Upper Limb Motor Rehabilitation of Stroke Patients

Your hospital can just buy the damn article and implement it. They don't even have to think which is a good thing since your hospital hasn't spent any time in the last 30 years figuring out how to get stroke survivors rehabbed better. I expect hundreds of hospitals responding back with the details of their stroke protocols.
http://dl.acm.org/citation.cfm?id=2676700
Stroke survivors are often left with motor disabilities. Virtual environments for motor therapy are an emerging strategy to motivate, entertain or engage the rehabilitation patient to the therapy after stroke. The design of these specialized virtual environments requires to meet the needs of patients and therapists, which is not a simple task. To support the design of these applications a number of recommendations for the developers have been proposed in literature. Here, a taxonomy is proposed to classify the identified principles, criteria, implications, usability factors or guidelines on which the recommendations are based. The taxonomy identifies key factors in the design of virtual environments for upper limb motor therapy. The taxonomy is organized into three categories corresponding to different stages of the therapy: configuration of the exercise, assistance during the execution of the exercise and management of therapy results. We believe that agglutinating and organizing design factors into a taxonomy may reduce development times, facilitate communication between developers and clinical counterparts and increase chances of therapeutic validity.
Full Text: PDFPDF Buy this ArticleBuy this Article
Authors: Cristina Ramírez-Fernández Facultad de Ciencias, Universidad Autónoma de Baja California, Ensenada, México
Alberto L. Morán Facultad de Ciencias, Universidad Autónoma de Baja California, Ensenada, México
Eloísa García-Canseco Facultad de Ciencias, Universidad Autónoma de Baja California, Ensenada, México
Felipe Orihuela-Espina Instituto Nacional de Astrofísica, Óptica y Electrónica, Puebla, México
Design Factors of Virtual Environments for Upper Limb Motor Rehabilitation of Stroke Patients Published by ACM 2014 Article
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Developing technology in treating stroke victims studied at St. Joseph's Wayne

Demand your doctor get the protocol.
http://www.northjersey.com/news/health-news/wayne-hospital-in-a-study-of-virtual-reality-stroke-rehab-1.1139527
Gerald Fluet is in the business of mind games. Manipulation. Illusion. Not as a con or scam, but as a way to help the injured heal and get even stronger.
Using a robotic arm and virtual-reality technology, Fluet, an assistant professor in the physical therapy program at Rutgers University, is working with patients at St. Joseph's Wayne Hospital to regain arm, wrist and hand function impaired by a recent stroke.
The patient straps on the robotic arm and is given various "tasks" to perform, images to manipulate or games to play at various levels of difficulty. Moving their real arms to point and aim the robotic device, patients use their onscreen avatar arms to "pick up," say, a virtual ball, move it to the other side of the virtual room and then "drop" it into a virtual bucket.
"Virtual movements basically produce the same reaching patterns as real-world reaching movements do," Fluet said.
But why not just toss a real ball across the room, and save all this time and expense on researching the technology? "It's more time-efficient," Fluet said. "It's more space-efficient. I can play catch with you without ever dropping the ball and it rolling across the room and under the table. Plus, I can adjust the level of difficulty. ... I have this incredible, fine-tuning control, that is very convenient."
The concept of using "virtual rehabilitation" and robotic arms to relearn cognitive and physical tasks has been around for about eight years now, and has been implemented as part of overall physical therapy programs at such major institutions as Kessler Institute, according to Fluet. But it is not more widely available for several reasons, he said. "The big knock on it is it's expensive, and it doesn't do anything that you couldn't do in a normal therapy setting without the robots or computers. Our response to that is, the technology is becoming much less expensive. By the time we know how to use it, it will be cost-effective."
Fluet is conducting the current study at St. Joseph's – one of four sites worldwide participating — in conjunction with the biomedical engineering program at New Jersey Institute of Technology. The robots, at about $65,000 each, were purchased by NJIT and the simulations were developed by NJIT students and staff. The NJIT team is headed by Sergei Adamovich, associate professor of biomedical engineering, whose prior research on the use of technology for rehabilitation of arm and hand function after stroke has received a $1.2 million grant from the National Institutes of Health.
Adamovich said that because there is no data out there now on how virtual rehabilitation works on patients within days or weeks after their strokes, the information collected in the current study will be invaluable. He also noted that the technology allows the patient to train more, and for longer periods of time, without assistance. In an age where insurance will pay for physical therapists only for a matter of weeks, he said, this aspect of the virtual therapy is important. Now it's just a matter of making the technology more affordable. "We're moving in the right direction," he said.
But the technology — and its place in modern-day physical therapy regimens — is still developing.
What makes the current research project at St. Joseph's Wayne unique, Fluet said, is that it's the first to actually use patients fresh from their strokes. Each patient must be about seven days into their recovery when beginning virtual rehabilitation with the robotic arm. This period is important — and often elusive in terms of finding people to study, he said.
He explained that as part of "neuroplasticity," the brain rewires itself in response to experiences like strokes. "Let's say you need to learn to brush your hair with your left hand. If you practice it enough, your brain cells make new connections with each other and the body part you are using in order to perform those skills efficiently."
Thus, getting patients to use their arms soon after their strokes, when the brain is at its busiest trying to figure out how to adapt, is crucial. "The recruiting is the most arduous and challenging part," Fluet said. "St. Joe's was rare as a hospital in the U.S. to come forward and be comfortable with us working with a patient a week after having a stroke," he said.
He started working one-on-one with patients in July. So far he has worked with about 25 people, and the goal is between 40 and 50. No one – patients, researchers or the hospital — is being charged anything for their involvement. The data collected will, it's hoped, help secure grants to fund more research, all with the goal of making the technology more accessible and effective.
Dr. Supriya Massood, medical director of the In-patient Acute Rehabilitation Unit at St. Joseph's Wayne Hospital, said she welcomed the opportunity to provide patients for the study. "Stroke is the number one leading cause of institutionalization in our country and the number three cause of death," she said. "Because the impact on health care dollars is so great, this just seemed like a no-brainer."
She said rehabilitating patients virtually works the mind and body in a whole other way than traditional physical therapy. "The brain is targeting the goal, and increasing impulses in a more coordinated and desired outcome," she said of the tasks patients perform. "The second part is, they [researchers] take this data and then use 'brain mapping,' a hot field in stroke recovery, to determine whether damaged nerve cells should be targeted for repair, or do we just abandon them altogether and use a different part of the brain to perform the same functions. That can all be measured, and it can significantly change the scope with how we intervene with rehabilitation."
Marcia Harris of Clifton, who was part of the study at St. Joe's, said it seemed not only helpful but fun. "Six weeks ago I had a stroke and my left side was weakened," she explained. She was admitted into acute rehabilitation at St. Joe's. Harris had no hesitation about trying the unconventional-sounding therapy. "I said, 'As long as there's no pain, OK.' "
She said much of what she did was performed while she wore a cap that measured her brain waves. "It requires great focus. And it is tiring. You're concentrating very hard and it requires a lot of hand-eye coordination," she said.
She still has some work ahead of her, she said. But her improvement, using the technology, is significant. "I'm doing great now," she said.

A Mirror Therapy–Based Action Observation Protocol to Improve Motor Learning After Stroke

This is not what I'd call mirror therapy, it is action observation.
http://nnr.sagepub.com/content/early/2014/11/14/1545968314558598.abstract?
  1. Wouter J. Harmsen, MSc1,2
  2. Johannes B. J. Bussmann, PhD1
  3. Ruud W. Selles, PhD1,3
  4. Henri L. P. Hurkmans, PhD1
  5. Gerard M. Ribbers, MD, PhD1,2
  1. 1Erasmus MC, Department of Rehabilitation Medicine, Rotterdam, the Netherlands
  2. 2Rijndam Rehabilitation Centre, Rotterdam, the Netherlands
  3. 3Erasmus MC, Department of Plastic and Reconstructive Surgery, Rotterdam, the Netherlands
  1. Wouter J. Harmsen, MSc, Department of Rehabilitation Medicine, Erasmus MC–University Medical Center, Room: Ee 1622, Dr Molewaterplein 50, 3015 GE Rotterdam, Netherlands. Email: w.harmsen@erasmusmc.nl

Abstract

Background. Mirror therapy is a priming technique to improve motor function of the affected arm after stroke. Objective. To investigate whether a mirror therapy–based action observation (AO) protocol contributes to motor learning of the affected arm after stroke. Methods. A total of 37 participants in the chronic stage after stroke were randomly allocated to the AO or control observation (CO) group. Participants were instructed to perform an upper-arm reaching task as fast and as fluently as possible. All participants trained the upper-arm reaching task with their affected arm alternated with either AO or CO. Participants in the AO group observed mirrored video tapes of reaching movements performed by their unaffected arm, whereas participants in the CO group observed static photographs of landscapes. The experimental condition effect was investigated by evaluating the primary outcome measure: movement time (in seconds) of the reaching movement, measured by accelerometry. Results. Movement time decreased significantly in both groups: 18.3% in the AO and 9.1% in the CO group. Decrease in movement time was significantly more in the AO compared with the CO group (mean difference = 0.14 s; 95% confidence interval = 0.02, 0.26; P = .026). Conclusion. The present study showed that a mirror therapy–based AO protocol contributes to motor learning after stroke.

Novel robotic walker invented by NUS researchers helps patients regain natural gait and increases productivity of physiotherapists

Which robotic walker does your doctor consider the best?
Which one of these exoskeletons have they already looked at?

1. Cyberdyne exoskeleton

2. Multi-function robotic exoskeleton REX.

3.  Korean Factory Workers Don Exoskeletons for Superhuman Strength

4.  Gait training early after stroke with a new exoskeleton - the hybrid assistive limb: a study of safety and feasibility

Other possibilities:

5.  A TED talk by Eythor Bender of Berkeley Bionics on HULC and eLEGS
O maybe one of these three.

6.  Advanced exoskeleton promises more independence for people with paraplegia

Or

7.  This Indego device 

Or

8.  LOPES Robotic Exoskeleton Helps Stroke Victims Walk Again



Or

9.  ‘Exoskeleton’ Helps Paralyzed Stand, Take Steps

Or

10.  Walk Again Project

11.  Honda Walking Assist Device

12.  Wearable device brings hope for spinal injury, stroke recovery



The latest here:
http://www.alphagalileo.org/ViewItem.aspx?ItemId=147500&CultureCode=en
Survivors of stroke or other neurological conditions such as spinal cord injuries, traumatic brain injuries and Parkinson’s disease often struggle with mobility. To regain their motor functions, these patients are required to undergo physical therapy sessions. A team of researchers from the National University of Singapore’s (NUS) Faculty of Engineering has invented a novel robotic walker that helps patients carry out therapy sessions to regain their leg movements and natural gait. The system also increases productivity of physiotherapists and improves the quality of rehabilitation sessions.
Designed by a team of researchers led by Assistant Professor Yu Haoyong from the NUS Department of Biomedical Engineering, the robotic walker is capable of supporting a patient’s weight while providing the right amount of force at the pelvis of the patient to help the patient walk with a natural gait. In addition, quantitative data can be collected during the therapy sessions so that doctors and physiotherapists can monitor the progress of the patient’s rehabilitation.
Improving therapy outcomes with robotic aid
The robotic walker comprises six modules: an omni-directional mobile platform; an active body weight support unit; a pelvic and trunk motion support unit; a suite of body sensors; a functional electrical stimulation unit; and an intuitive user control interface.
The suite of body sensors measure the gait of the patient so that the walker can provide the right amount of support to help the patient walk with a natural gait. The electrical stimulation unit can deliver targeted electrical current to stimulate the correct muscle at the correct timing to facilitate joint movement. The walker can also provide assistive force, resistive force, and disturbance force depending on the training requirements set by the therapists. In this way, patients can go through different training schemes that are often difficult to achieve manually. The patient interacts with the walker through a force sensor which detects the user intent. The intelligent control system uses this information as well as the gait information provided by the body sensors to control the movement of the walker. Another unique feature of this walker is that it allows the patient to practice gait movements by walking over ground instead of on a treadmill.  Such features enable the gait training to be conducted in a natural and intuitive way for the patients.
Asst Prof Yu explained, “This robotic walker allows patients to practice their gait movements continuously to optimise their therapy. When patients repeat the movements in a natural setting, the routine can be imprinted into their brains which gradually learn to correct from the damage resulting from their medical conditions.”
In addition, the robotic walker is capable of collecting data on the gait kinematics and muscle activation pattern of the patient. Such information is useful for doctors and therapists to monitor the progress of the patients’ recovery.
A robotic helper for physiotherapists
Besides improving the quality of rehabilitation sessions, the robotic walker will also relieve physiotherapists from the physical strain of assisting patients with the exercises.
Currently, gait training requires one or two physiotherapists to support the patient’s body weight and trunk, and an additional physiotherapist may be needed to move the paretic leg. Such therapy sessions are labour intensive, and they are also ergonomically unfavourable for the physiotherapists as they often suffer from back injuries. This limits the quality, duration and frequency of rehabilitation sessions.
With the robotic walker, manual therapy can be taken over by the robotic system, while physiotherapists can focus on providing better assessment and training guidance for patients. The device also reduces the number of physiotherapists needed to conduct each rehabilitation session, thereby increasing productivity and reducing the cost of care.
Clinical studies and commericalisation
Asst Prof Yu is collaborating with homegrown company Hope Technik to fine-tune the robotic walker. He is also planning to conduct clinical studies to validate the training effects on patients and to develop novel therapy regimes together with clinicians at the National University Hospital. There are also plans to commercialise the device with Hope Technik.
“Our vision is for the robotic walker to be installed at outpatient clinics and rehabilitation centres to benefit patients who need therapy sessions. There is also a possibility that patients can perform exercises in the comfort of their own homes,” said Asst Prof Yu.

Interesting design compared to most robotic walkers.

Friday, November 21, 2014

Damage to Brain Networks Affects Stroke Recovery

DUH!!! How f*cking stupid do you have to be to not understand this? And why did it take so long?
http://www.biosciencetechnology.com/news/2014/11/damage-brain-networks-affects-stroke-recovery?

Initial results of an innovative study may significantly change how some patients are evaluated after a stroke, according to researchers at Washington University School of Medicine in St. Louis.
 
For more than a century, physicians have made it a priority to learn where stroke has injured the brain and the extent of the damage. The new results suggest another question may be equally or more important: How has the stroke affected the ability of uninjured brain regions to network with each other?
 
According to senior author Maurizio Corbetta, MD, the answers to this question may help physicians more accurately predict the challenges a patient recovering from stroke may face and guide application of new approaches for accelerating recovery.
“Studying the way different brain regions connect with each other as networks appears to be a powerful way of determining the nature and location of the problems caused by stroke,” said Corbetta, the Norman J. Stupp Professor of Neurology. 
 
The paper appears online in Brain.
 
Many hospitals have MRI scanners that can gather information on brain networks. The expertise needed to use this data to assess network health is less widely available, but Corbetta expects that to change as the benefits of this approach become more apparent.
 
“Understanding whether pathways that appear to be structurally intact are actually under- or overconnected from a networking point of view may provide targets for novel treatments,” he added. “One example is transcranial magnetic stimulation, which uses exposure to strong magnetic fields to adjust the activity levels of groups of brain cells.” 
 
The findings come from an ongoing study of stroke patients. Most stroke research focuses on patients with damage to particular brain areas, but this study is different. Researchers are enrolling anyone who recently had a stroke for the first time.
 
“Our strategy is to enroll anyone with a first-time stroke, no matter where in the brain their strokes caused damage and no matter what problems the strokes have caused for the patients,” said first author Antonello Baldassarre, PhD, now at the University of Chieti-Pescara in Italy. “We think that makes this study a more relevant representation of the problems strokes cause for patients.”
 
In every subject, the researchers assess the size and location of stroke damage. They use MRI scans to measure functional connectivity, or the ability of brain regions to communicate with each other in a coordinated fashion. They also check attention, vision, movement, language and memory, which often are impaired by stroke. These evaluations occur two weeks, three months and one year after stroke.
 
The research analyzes data gathered from 84 patients in the first five years of the study.
 
Scientists have long thought stroke does most of its damage in the cortex, the outer layer of brain cells where higher mental functions occur. But the results suggest stroke causes more harm to the connections in the white matter, which is underneath the cortex and connects different parts of the cortex to the cortex and the spinal cord. 
 
“We think this is why a stroke that damages one part of the brain can seriously disrupt the function of another, distant part of the brain,” Corbetta said. 
 
For the analysis, researchers focused on problems with spatial attention deficits, which affect 250,000 to 300,000 stroke patients in the United States each year. These impairments include an inability to notice or respond to stimuli on one side of the body. A male patient asked to shave his face, for example, might shave only one side of it.
 
In the patients, the researchers compared changes in functional connections with the severity of spatial attention deficits 1-2 weeks after their strokes. They also identified two groups of patients with similarly placed brain lesions. One group had developed problems with attention, while another had not. 
 
The scientists could not differentiate between the two groups based on the physical damage to their brains. But when they tested brain networking by monitoring patients as they rested in an MRI scanner, a significant distinction emerged.
 
“In the patients with spatial attention problems, the connections between the left and right hemispheres of the brain were decreased in proportion to the severity of their impairment,” Corbetta said. “But those same connections were fairly normal in the group that did not have impaired attention.”
 
A second abnormal networking pattern also was associated with impaired attention. Regions in the damaged hemisphere of the brain that do not normally work together in networks started communicating with each other after stroke. This abnormal crosstalk was linked to increased problems with attention.
 
“Proper balancing of the interactions between different brain regions appears to be a key component of healthy brain function. You don’t want these interactions to increase or decrease too much, or problems will result,” Corbetta said. “Our field is developing novel strategies that may help restore these imbalances, and looking at the brain’s functional connections will help us determine where those techniques should be applied.”
 

The brain’s sense of walking: a study on the intertwine between locomotor imagery and internal locomotor models in healthy adults

How is your doctor setting up stroke protocols to have you create locomotor imagery to get you back to healthy locomotor walking? Anything at all?
http://journal.frontiersin.org/Journal/10.3389/fnhum.2014.00859/full?
Marco Iosa1*, Loredana Zoccolillo2, Michela Montesi1,3, Daniela Morelli2, Stefano Paolucci1 and Augusto Fusco1
  • 1Clinical Laboratory of Experimental Neurorehabilitation, IRCCS Fondazione Santa Lucia, Rome, Italy
  • 2Department of Children Neurorehabilitation, IRCCS Fondazione Santa Lucia, Rome, Italy
  • 3School of Physiotherapy, University of Rome Tor Vergata, IRCCS Fondazione Santa Lucia, Rome, Italy
Motor imagery and internal motor models have been deeply investigated in literature. It is well known that the development of motor imagery occurs during adolescence and it is limited in people affected by cerebral palsy. However, the roles of motor imagery and internal models in locomotion as well as their intertwine received poor attention. In this study we compared the performances of healthy adults (n = 8, 28.1 ± 5.1 years old), children with typical development (n = 8, 8.1 ± 3.8 years old) and children with cerebral palsy (CCP) (n = 12, 7.5 ± 2.9 years old), measured by an optoelectronic system and a trunk-mounted wireless inertial magnetic unit, during three different tasks. Subjects were asked to achieve a target located at 2 or 3 m in front of them simulating their walking by stepping in place, or actually walking blindfolded or normally walking with open eyes. Adults performed a not significantly different number of steps (p = 0.761) spending not significantly different time between tasks (p = 0.156). Children with typical development showed task-dependent differences both in terms of number of steps (p = 0.046) and movement time (p = 0.002). However, their performance in simulated and blindfolded walking (BW) were strictly correlated (R = 0.871 for steps, R = 0.673 for time). Further, their error in BW was in mean only of −2.2% of distance. Also CCP showed significant differences in number of steps (p = 0.022) and time (p < 0.001), but neither their number of steps nor their movement time recorded during simulated walking (SW) were found correlated with those of blindfolded and normal walking (NW). Adults used a unique strategy among different tasks. Children with typical development seemed to be less reliable on their motor predictions, using a task-dependent strategy probably more reliable on sensorial feedback. CCP showed less efficient performances, especially in SW, suggesting an altered locomotor imagery.

The heart's content: the association between positive psychological well-being and cardiovascular health

What exactly is your doctor doing to make sure of your positive psychological well-being?
It's only 2 years old, so plenty of time for those thousands of stroke doctors worldwide to each write up a stroke potocol to accomplish this. You better hope your doctor is one of the more brilliant ones.
http://www.ncbi.nlm.nih.gov/pubmed/22506752

Author information

  • 1Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA 02215, USA. jboehm@hsph.harvard.edu

Abstract

This review investigates the association between positive psychological well-being (PPWB) and cardiovascular disease (CVD). We also consider the mechanisms by which PPWB may be linked with CVD, focusing on the health behaviors (e.g., smoking, alcohol consumption, physical activity, sleep quality and quantity, and food consumption) and biological functions (e.g., cardiovascular, inflammatory, and metabolic processes) that are most relevant for cardiovascular health. Because PPWB is a broad concept, not all aspects of PPWB may be associated with cardiovascular health. Thus, we distinguish between eudaimonic well-being, hedonic well-being, optimism, and other measures of well-being when reviewing the literature. Findings suggest that PPWB protects consistently against CVD, independently of traditional risk factors and ill-being. Specifically, optimism is most robustly associated with a reduced risk of cardiovascular events. In general, PPWB is also positively associated with restorative health behaviors and biological function and inversely associated with deteriorative health behaviors and biological function. Cardiovascular health is more consistently associated with optimism and hedonic well-being than with eudaimonic well-being, although this could be due in part to more limited evidence being available concerning eudaimonic well-being. Some similarities were also evident across different measures of PPWB, which is likely due to measurement overlap. A theoretical context for this research is provided, and suggestions for future research are given, including the need for additional prospective investigations and research that includes multiple constructs of psychological well-being and ill-being.

Thursday, November 20, 2014

4 Surprising Advantages of Being Depressed

And after you ruminate on your stroke problem for awhile, you will realize you are F*cking screwed. Is your doctor not treating your depression  because of these advantages?
http://www.spring.org.uk/2014/11/4-surprising-advantages-of-being-depressed.php
In fact, people who are depressed display some surprising advantages in their thinking skills.
Depressed people:
  1. process information more deeply.
  2. are more accurate at complex tasks.
  3. make better judgements on detail-oriented information.
  4. make more accurate cost-benefit analyses.
More at link

Joe Landolina: This gel can make you stop bleeding instantly

I could see this as a way to stop hemorrhages, except we would need to solve the problem of not completely blocking the artery that burst and thus changing the stroke to ischemic.  Oh well, what would life be without challenges? A TED talk.
http://www.ted.com/talks/joe_landolina_this_gel_can_make_you_stop_bleeding_instantly?

Forget stitches — there's a better way to close wounds. In this talk, TED Fellow Joe Landolina talks about his invention — a medical gel that can instantly stop traumatic bleeding without the need to apply pressure. (Contains medical images.)

Vitamin B May Not Reduce Risk of Memory Loss

More questions for your doctor. Ask for a specific protocol that will prevent dementia post-stroke.
http://dgnews.docguide.com/vitamin-b-may-not-reduce-risk-memory-loss?overlay=2&
Taking vitamin B12 and folic acid supplements may not reduce the risk of memory and thinking problems after all, according to a study published in the online edition of the journal Neurology.
The study is one of the largest to date to test long-term use of supplements and thinking and memory skills. The study involved people with high blood levels of homocysteine.

“Since homocysteine levels can be lowered with folic acid and vitamin B12 supplements, the hope has been that taking these vitamins could also reduce the risk of memory loss and Alzheimer’s disease,” said Rosalie Dhonukshe-Rutten, PhD, Wageningen University, Wageningen, the Netherlands.

More at link.

Over-Anticoagulation Linked to Dementia in Patients With Atrial Fibrillation

Something to talk to your doctors about.
http://dgnews.docguide.com/over-anticoagulation-linked-dementia-patients-atrial-fibrillation?overlay=2&
Patients who receive anticoagulation with warfarin and anti-platelet agents such as aspirin appear to be at in increased risk of developing dementia if they are over-anticoagulated more than 25% of the time, researchers reported here at the 2014 Annual Meeting of the American Heart Association (AHA).
“There are multiple hypotheses for how over-anticoagulation can cause dementia, possibly because over anti-coagulation might cause some micro-bleeds into the brain,” said Jared Bunch, MD, Intermountain Health System, Salt Lake City, Utah.
Patients who were chronically over-anticoagulated -- more than 25% of the time having an International Normalized Ratio (INR) >3 -- had a 5.8% risk of developing dementia during a median of 4 years.

More at link.

Oxygen therapy no better than placebo for treating concussion, study finds

How many times will HBOT need to be proven to not be useful before it stops being mentioned as a solution to brain injuries?

Hyperbaric Oxygen Therapy Can Improve Post Concussion Syndrome Years after Mild Traumatic Brain Injury - Randomized Prospective Trial

I'm not sure I trust this. At least one of the authors, Dr. Shai Efrati, is directly associated with
Head of the Hyperbaric Unit at Assaf Harofeh Medical Center. Using SPECT scan to prove anything may be worthless.

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TAU Research Team Discovers New Treatment for Stroke 

You will notice it doesn't say anything about recovery, only 'increased neuronal activity'.  That is a huge red flag stating that this hasn't proven anything.  


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Can Hyperbaric Oxygen Repair the Damaged Brain?

While many agree that Efrati’s data are promising, a prior study run by the U.S. Air Force found no significant differences between hyperbaric oxygen treatment and a sham treatment on patients with mild traumatic brain injury (TBI). Both groups showed significant improvement over the course of the trial.  

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hbot as stroke therapy - quackery?

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Long Course Hyperbaric Oxygen Stimulates Neurogenesis and Attenuates Inflammation after Ischemic Stroke

see if the conclusions match the results. I doubt it.  

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Hyperbaric Oxygen Induces Late Neuroplasticity in Post Stroke Patients - Randomized, Prospective Trial

Shai Efrati has conflicts, he is the director of the Hyperbaric Oxygen Institute at the Assaf Harofeh Medical Center.
Without reading the complete article I wouldn't trust this because 6 of them work for the
Hyperbaric Oxygen Institute. They believe because they have to believe.

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This is a fascinating idea, treat your recently oxygen starved brain with more reduced oxygen supply.


Mayo clinics take:

Agency Research for Healthcare and Quality:

 The latest here:

Oxygen therapy no better than placebo for treating concussion, study finds

Wednesday, November 19, 2014

How To Increase IQ by 10% Using The Weirdest Method Ever

Don't do this. Your doctor would never prescribe anything that would make you smarter than them. Think of all the dangers involved. You doctors high blood pressure, exploding heads, etc.
http://www.spring.org.uk/2014/11/how-to-increase-iq-by-10-using-the-weirdest-method-ever.php
A new study which trained people to associate colours with letters has also found that their IQ was boosted by an average of 12 points.

More at link.

Success or failure, feds want trial results posted online

This is so necessary, With 1000+ trials of neuroprotective drugs that worked in rodents but failed in humans, it would probably make solving that problem much faster and cheaper than waiting for 1000 clinical trials to fail.
http://www.fiercebiotech.com/story/success-or-failure-feds-want-trial-results-posted-online/2014-11-19
Federal regulators are proposing a rule that would require makers of drugs and medical devices to publicize the results of thousands of clinical trials, regardless of whether they succeed, part of a global move toward transparency in R&D.
The proposal, developed by the Department of Health and Human Services and the National Institutes of Health (NIH), would require the makers of unapproved drugs and devices to post summaries of study results on ClinicalTrials.gov, the government's public portal, within a year of trial conclusion. As it stands, sponsors are required to disclose results only on studies of approved products, which account for about 15,000 of the roughly 178,000 trials posted on the site, according to NIH.
The new rules, if adopted, would generally exclude Phase I and feasibility trials, NIH said, and they wouldn't alter the trial-design requirements needed to win FDA approval. Instead, they would greatly expand the public pool of clinical results, preventing unnecessary duplication, weeding out unsafe or ineffective products, and informing future research, according to NIH.

"Medical advances would not be possible without participants in clinical trials," Director Francis Collins said in a statement. "We owe it to every participant and the public at large to support the maximal use of this knowledge for the greatest benefit to human health. This important commitment from researchers to research participants must always be upheld."
The proposed changes would also streamline the rules for just who is required to submit trial information; expand the amount of information that must be disclosed shortly after study startup; and force sponsors to update their ClinicalTrials.gov entries more regularly.
HHS and NIH are soliciting feedback on the proposal from industry and academia through Regulations.gov, opening up a 90-day window for discussion before making a final decision on the new rules.
Meanwhile, some of the world's largest drug developers have capitulated to the prodding of global regulators, making varying amounts of data available through ClinicalStudyDataRequest.com. Some, like Sanofi ($SNY) and Bayer, are disclosing only the results on newly approved products, while others, including GlaxoSmithKline ($GSK) and Johnson & Johnson ($JNJ), have agreed to hand over huge swaths of anonymized data in the interest of global R&D.
- read the release
- get more from NIH

7 Habits of Chronically Unhappy People

Is your psychologist from the hospital discussing stroke protocols with you to discover happiness?
I use Tiny Buddha. But never follow anything I do.
http://www.huffingtonpost.com/tamara-star/7-habit-of-chronically-unhappy-people_b_6174000.html?
Here are the 7 qualities of chronically unhappy people.
1. Your default belief is that life is hard.
2. You believe most people can't be trusted.
3. You concentrate on what's wrong in this world versus what's right.

4. You compare yourself to others and harbor jealousy.

5. You strive to control your life.

6. You consider your future with worry and fear.

7. You fill your conversations with gossip and complaints.

Details at link.

Tuesday, November 18, 2014

Posttraumatic Growth

Maybe I'm totally wrong and your doctor is not setting up stroke protocols or figuring out how to get you 100% recovered  because the whole plan is for 'You turn it around so that it becomes a creative, positive force.’ Is your doctor that Machiavellian? that s/he is playing with your life?
When my parents used the term, ' God doesn't give you anything you can't handle', that threw me completely into atheism. 
http://www.psychologytoday.com/blog/what-doesnt-kill-us/201402/posttraumatic-growth
‘Suffering is universal: you attempt to subvert it so that it does not have a destructive, negative effect. You turn it around so that it becomes a creative, positive force.’ Those are the words of Terry Waite who survived four years in solitary confinement, chained, beaten and subject to mock execution. 
Interest in how trauma can be a catalyst for positive changes began to take hold during the mid 1990’s when the term posttraumatic growth was introduced by two pioneering scholars Richard Tedeschi and Lawrence Calhoun.
The term posttraumatic growth proved to be popular and has since developed into one of the flagship topics for positive psychology.

In my book What Doesn't Kill Us I describe how after experiencing a traumatic event, people often report three ways in which their psychological functioning increases:
1.      Relationships are enhanced in some way. For example, people describe that they come to value their friends and family more, feel an increased sense of compassion for others and a longing for more intimate relationships.
2.      People change their views of themselves in some way. For example, developing in wisdom, personal strength and gratitude, perhaps coupled with a greater acceptance of their vulnerabilities and limitations.
3.      People describe changes in their life philosophy. For example, finding a fresh appreciation for each new day and re-evaluating their understanding of what really matters in life, becoming less materialistic and more able to live in the present.
Importantly, and this just can’t be emphasised enough, this does not mean that trauma is not also destructive and distressing. No one welcomes adversity.  But the research evidence shows us that over time people can find benefits in their struggle with adversity.  Indeed, across a large number of studies of people who have experienced a wide range of negative events, estimates are that between 30 and 70% typically report some form of positive change
We can all use this knowlwdge to help us cope when adversity does strike, be it bereavement, accident or illness.  We can seek to live more wisely in the aftermath of adversity and as the opening quote says, subvert suffering. 

Alzheimer's Association Joins Global Consortium to Strengthen the Drug Pipeline for Brain Diseases

Completely f*cking appalling, NO  stroke association involved. I don't care if stroke is not a neurodegeneration disease, there could be lots of solutions repurposed for stroke. We have no one in stroke with even two neurons to rub together. Stupidity personified.
http://act.alz.org/site/R?i=bq8i3FRET9bj-vfI-2k2iQ
Today, the Alzheimer's Association announced its leadership role in the Neurodegeneration Medicines Acceleration Program (Neuro-MAP), which plans to uncover promising drugs for degenerative brain diseases in pharmaceutical company libraries and put them into early-stage clinical trials. Many potential drugs are languishing in laboratories because the companies who own them have moved in other directions. By identifying these projects and moving them forward, Neuro-MAP aims to bring these drugs closer to the people who desperately need them.
Partners in Neuro-MAP are: Alzheimer's Association, Alzheimer's Research UK, Alzheimer's Society (UK), ALS Association, Michael J. Fox Foundation for Parkinson's Research, Motor Neurone Disease Association, MRC Technology, Northern Health Science Alliance, and Parkinson's UK. The consortium represents more than 50 million people living with neurodegenerative conditions worldwide.
Neuro-MAP will ask pharmaceutical and biotechnology companies to propose projects to the consortium. The Neuro-MAP partner organizations will decide which projects to take on by evaluating patient needs, scientific excellence and commercial potential. Projects taken on by Neuro-MAP remain the property of the industry partner, but the consortium will share in a proportion of the revenue generated if the product goes on the market. These funds will be reinvested in additional research.
Consortium program manager, MRC Technology, will augment the initial investment from Neuro-MAP partners by seeking co-investment from the pharmaceutical and biotechnology industries, social investors, and venture philanthropists. As a result, the current target for total annual investment is in the region of $48 million.
Learn More

The website for the program is www.medicinesaccelerationprogram.org

Arm spasticity while driving

This year I've started trying to place my left arm between the car seat and the door, wedging it in place. This is all trying to stop the irrational bicep spasticity. During the summer it worked fairly well. I would only have to push it back in place when moving around in my seat a lot. Now that winter is approaching I'm lucky if I can get the arm past 90 degrees, and I have to quite often push it back down. There is nothing to hold on down there and even if there was I would never be able to get the fingers extended enough to grab it.
Damnable spasticity. I still blame Dr. William M. Landau and his blasted opinion;

Spasticity After Stroke: Why Bother?

For stopping or slowing down spasticity research.  Is there any way schadenfreude could occur?

The Effects of Exercise Training on Anxiety

How is your doctor handling your anxiety? Pooh poohing it?

I was anxious since my doctor told me nothing, no diagnosis of what damage I had, no explanation of what stroke protocol I would be using, nothing on what recovery would look like.  Anybody who gets such little to no information after a stroke has a perfect right to be anxious, angry and depressed. And I lay it all on the feet of the stroke medical world. Don't start blaming stroke patients for feeling anxious/depressed, we have every right.

All the stuff your doctor should know about;

1.  Difference Between Stress and Anxiety

2.  Treating anxiety can improve patients' sleep

3.  Fight like a ferret: a novel approach of using art therapy to reduce anxiety in stroke patients undergoing hospital rehabilitation

4.  Study reveals how ecstasy acts on the brain and hints at therapeutic uses

5.  How to make stress your friend

6.  Mindfulness meditation may ease anxiety, mental stress

7.  Nociceptin: Nature’s Balm for the Stressed Brain

8.  Anxiety Linked to Increased Stroke Risk

9.  Heart Patients Need Anxiety Checkup Too

10.  Mayo Clinic Debuts Anxiety Coach App for iPhone, iPad and iPod Touch

11.  Frequency of anxiety after stroke: a systematic review and meta-a12nalysis of observational studies

 12.  Anxiety Medications May Be Tied to Alzheimer's

The latest here:

The Effects of Exercise Training on Anxiety

  1. Matthew P. Herring, PhD
  2. Jacob B. Lindheimer, MA
  3. Patrick J. O’Connor, PhD
  1. Department of Epidemiology, University of Alabama at Birmingham, Alabama (MPH)
  2. Department of Kinesiology, The University of Georgia, Athens, Georgia (JBL, PJO)
  1. Matthew P. Herring, PhD, Department of Epidemiology, University of Alabama at Birmingham, 417 Ryals Public Health Building, Birmingham, AL 35294; e-mail: mattpherring@gmail.com.

Abstract

This review summarizes the extant evidence of the effects of exercise training on anxiety among healthy adults, adults with a chronic illness, and individuals diagnosed with an anxiety disorder. A brief discussion of selected proposed mechanisms that may underlie relations of exercise and anxiety is also provided. The weight of the available empirical evidence indicates that exercise training reduces symptoms of anxiety among healthy adults, chronically ill patients, and patients with panic disorder. Preliminary data suggest that exercise training can serve as an alternative therapy for patients with social anxiety disorder, generalized anxiety disorder, and obsessive–compulsive disorder. Anxiety reductions appear to be comparable to empirically supported treatments for panic and generalized anxiety disorders. Large trials aimed at more precisely determining the magnitude and generalizability of exercise training effects appear to be warranted for panic and generalized anxiety disorders. Future well-designed randomized controlled trials should (a) examine the therapeutic effects of exercise training among understudied anxiety disorders, including specific phobias, social anxiety disorder and posttraumatic stress disorder; (b) focus on understudied exercise modalities, including resistance exercise training and programs that combine exercise with cognitive-behavioral therapies; and (c) elucidate putative mechanisms of the anxiolytic effects of exercise training.

 

 

 

 

 

 

 

 

 

 

 

 

 

2 Exciting Alzheimer’s Advances: A Novel Early Detection Test Using Peanut Butter, and a Study Evaluating Coconut Oil

Three sections in this article that you will want to read about coconut oil. But never do anything without your doctors ok. This is from Dr. Mercola so you will need to decide how trustworthy he is.
http://www.theepochtimes.com/n3/1086012-2-exciting-alzheimers-advances-a-novel-early-detection-test-using-peanut-butter-and-a-study-evaluating-coconut-oil/

AHA: Aspirin Flops in Primary Prevention for Seniors

Good luck trying to get a definitive statement from your doctor about what to do with aspirin.
http://www.medpagetoday.com/MeetingCoverage/AHA/48645?

Action Points

  • Note that this large Japanese trial of older adults with cardiovascular risk factors found that the use of aspirin did not reduce the risk of a composite of death, nonfatal stroke, or MI.
  • Note that while aspirin did appear to reduce the risk of nonfatal MI, this was balanced by an increased risk of extracranial hemorrhage.

The Properties of Lauric Acid and Their Significance in Coconut Oil

I'm sure your doctor is not subscribing to Journal of the American Oil Chemists' Society
http://link.springer.com/article/10.1007/s11746-014-2562-7
$39.95 / €34.95 / £29.95 *
* Final gross prices may vary according to local VAT.
Get Access

Abstract

The primary fatty acid of coconut oil is lauric acid, which is present at approximately 45–53 %. The metabolic and physiological properties of lauric acid account for many of the properties of coconut oil. Coconut oil is rapidly metabolized because it is easily absorbed and lauric acid is easily transported. Detailed studies have shown that the majority of ingested lauric acid is transported directly to the liver where it is directly converted to energy and other metabolites rather than being stored as fat. Such metabolites include ketone bodies, which can be used by extrahepatic tissues, such as the brain and heart, as an immediate form of energy. Studies on the effect of lauric acid on serum cholesterol are contradictory. Among saturated fatty acids, lauric acid has been shown to contribute the least to fat accumulation. Lauric acid and monolaurin have demonstrably significant antimicrobial activity against gram positive bacteria and a number of fungi and viruses. Today there are many commercial products that use lauric acid and monolaurin as antimicrobial agents. Because of the significant differences in the properties of lauric acid relative to longer chain fatty acids, they are typically differentiated as medium-chain fatty acids covering C6–C12, and long-chain fatty acids covering C14 and longer.

Neuroplasticity in normal and brain injured patients: Potential relevance of ear wiggling locus of control and cortical projections

This seems to be quite a reach and I can't quite see your therapist writing this in your record and getting your insurance to pay for those sessions.
http://www.medical-hypotheses.com/article/S0306-9877%2814%2900399-5/abstract
Research Fellow of the National Trauma Research Institute, Monash Alfred Psychiatry Research Centre, The Alfred & Monash University Central Clinical School, Melbourne, Victoria, Australia
1J.J.M. is a Research Fellow of the National Trauma Research Institute and an Industry Career Development Fellow of the Australian NH&MRC.
Publication stage: In Press Corrected Proof

Abstract

Recovery after brain insult is variable. Research has shown that activation of higher-order cognitive processes create larger gains in recovery than repetitive tasks, most likely due to neuroplasticity. That is, neuroplasticity is promoted by task complexity. Ear wiggling is a rare skill among humans yet may activate and promote advanced recovery after a brain injury. Increased cognitive complexity of learning a new task could allow insights into plasticity in learning new motor tasks and the role of cognitive complexity in learning that task. This paper focuses on a hypothesis relating to white matter pathways dormant in most people (such as those related to ear wiggling). If these pathways can be triggered by electrical/magnetic stimulation and/or higher-order thought into becoming consciously controllable, then it is possible that activation of a dormant, complex skill may assist in re-growth or repair of brain-damaged pathways. The broader potential impact of the proposed hypothesis is that ear wiggling could be used for improving the recovery of TBI or stroke subjects via neuroplasticity processes.

Treatment strategies for Genu recurvatum in adult patients with hemiparesis: a case series

No idea on Genu recurvatum, that is what your doctor and therapists are supposed to know more about than you.
http://www.pmrjournal.org/article/S1934-1482%2814%2901474-9/abstract
, ,
Nisha Patel, MD1
,
Nancy Yeh, MD2
,
Ona Bloom, Ph.D3
,
Address where study conducted: Department of Physical Medicine and Rehabilitation The Hofstra North Shore Long Island Jewish health system 1554 Northern Blvd, 4th Floor Manhasset, New York 11030 TEL: 516-627-8470 FAX: 516-365-8941
1Current institutional affiliation: Adventist rehab hospital 9909 Medical center drive Rockville MD 20850
2Department of Physical Medicine and Rehabilitation The Hofstra North Shore Long Island Jewish health system 1554 Northern Blvd, 4th Floor Manhasset, New York 11030 TEL: 516-627-8470 FAX: 516-365-8941
3Assistant Investigator, The Feinstein Institute for Medical Research Assistant Professor, Dept. of Physical Medicine and Rehabilitation; Molecular Medicine The Hofstra North Shore-LIJ School of Medicine 350 Community Drive, Fl 2352 Manhasset, NY 11030 Tel: #516-562-3839
Publication stage: In Press Accepted Manuscript

Abstract

Objective

To report our clinical experience and propose a biomechanical factor-based treatment strategy for improvement of genu recurvatum (GR), in order to reduce the need for knee-ankle-foot orthosis (KAFO) or surgical treatment.

Design

Case series.

Setting

Outpatient clinic of a Department of Physical Medicine and Rehabilitation in an academic medical center.

Subjects and interventions

Adult subjects (n=22) with hemiparesis and GR who received Botulinium injections alone or in combination with multiple types of orthotic interventions that included solid AFO ± heel lift, hinged AFO with an adjustable posterior stop (APS) ± heel lift, AFO with dual-channel ankle joint ± heel lift or a knee AFO (KAFO) with offset knee joint. Biomechanical factors reviewed included muscle strength, modified Ashworth score (MAS) for spasticity, presence of clonus, posterior capsule laxity, sensory deficits and proprioception.

Outcome Measurements

Outcome factors were improvement or elimination of GR based on subjective assessment before and after the interventions by the same experienced clinician.

Results

More than one biomechanical factor contributed to GR in all patients. Botulinium toxin A injection was used in patients who had significant plantar flexor spasticity and/or clonus. Four types of orthotic interventions were used based on the biomechanical factor : solid AFO in patients with severe ankle dorsiflexion and plantar flexion weakness or clonus; hinged ankle joint with APS with less severe ankle dorsiflexion weakness in the absence of clonus; AFO with a dual-channel ankle joint for quadriceps weakness or severe proprioceptive deficits; KAFO with offset knee joints in Achilles tendon contracture or severe proprioceptive deficits. Adjunctive options included addition of heel lifts and to toe plate modifications. Combinatorial interventions of Botulinium injection, modified AFOs, and heel lifts improved or eliminated GR and avoided need for cumbersome orthotics or surgical interventions.

Conclusions

GR in hemiparesis is multifactorial and can be successfully controlled by a using a conservative biomechanical factor-based approach and using combined medical and orthotic interventions. A algorithmic approach and a prospective study design is proposed to determine a combination of effective interventions to correct GR.

Virgin coconut oil and its potential cardioprotective effects

Remember nothing here is to be done without your doctors ok. You can have your doctor purchase the article. I am using it for dementia prevention.
http://europepmc.org/abstract/med/25387216
, , , ,
Assistant Professor, Department of Physiotherapy, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India. abrahambabu@gmail.com.
Highlight Terms
Emphasis on diet to improve the cardiovascular (CV) risk profile has been the focus of many studies. Recently, virgin coconut oil (VCO) has been growing in popularity due to its potential CV benefits. The chemical properties and the manufacturing process of VCO make this oil healthier than its copra-derived counterpart. This review highlights the mechanism through which saturated fatty acids contribute to CV disease (CVD), how oils and fats contribute to the risk of CVD, and the existing views on VCO and how its cardioprotective effects may make this a possible dietary intervention in isolation or in combination with exercise to help reduce the burden of CVDs.