Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 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:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. 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 lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Wednesday, June 8, 2011

Body-Weight–Supported Treadmill Rehabilitation after Stroke

Maybe they couldn't prove it was better but I feel that the Locomat was the best help for getting me to a somewhat decent form of walking.  And once again the research has no repeatable defined starting point. Moderate or severe means nothing if you have no idea whether you are trying to recover from penumbra damage vs. dead brain damage, or if the damage is from motor cortex , pre-motor or executive control damage. Based on these flaws nothing can be inferred from this trial.
http://www.mdlinx.com/neurology/xml-article.cfm/3620131

Duncan PW et al. – Locomotor training, including the use of body–weight support in stepping on a treadmill, was not shown to be superior to progressive exercise at home managed by a physical therapist.
Methods
  • The authors stratified 408 participants who had had a stroke 2 months earlier according to the extent of walking impairment — moderate (able to walk 0.4 to <0.8 m per second) or severe (able to walk <0.4 m per second) — and randomly assigned them to one of three training groups.
  • One group received training on a treadmill with the use of body-weight support 2 months after the stroke had occurred (early locomotor training), the second group received this training 6 months after the stroke had occurred (late locomotor training), and the third group participated in an exercise program at home managed by a physical therapist 2 months after the stroke (home-exercise program).
  • Each intervention included 36 sessions of 90 minutes each for 12 to 16 weeks.
  • The primary outcome was the proportion of participants in each group who had an improvement in functional walking ability 1 year after the stroke.
Results
  • At 1 year, 52.0% of all participants had increased functional walking ability.
  • No significant differences in improvement were found between early locomotor training and home exercise (adjusted odds ratio for the primary outcome, 0.83; 95% confidence interval [CI], 0.50 to 1.39) or between late locomotor training and home exercise (adjusted odds ratio, 1.19; 95% CI, 0.72 to 1.99).
  • All groups had similar improvements in walking speed, motor recovery, balance, functional status, and quality of life.
  • Neither the delay in initiating the late locomotor training nor the severity of the initial impairment affected the outcome at 1 year.
  • Ten related serious adverse events were reported (occurring in 2.2% of participants undergoing early locomotor training, 3.5% of those undergoing late locomotor training, and 1.6% of those engaging in home exercise).
  • As compared with the home-exercise group, each of the groups receiving locomotor training had a higher frequency of dizziness or faintness during treatment (P=0.008).
  • Among patients with severe walking impairment, multiple falls were more common in the group receiving early locomotor training than in the other two groups (P=0.02).

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