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.

Tuesday, January 3, 2012

Advance in Early Diagnosis of Spatial Neglect After Stroke

So I wonder how much difference between spatial neglect and proprioception loss?
http://www.sciencedaily.com/releases/2012/01/120103135556.htm
Researchers at Kessler Foundation and Seton Hall University report findings in the early diagnosis of acute spatial neglect, a hidden disability that is a common complication of stroke. In the weeks after stroke, 30-50% of stroke survivors cannot reliably report or respond to external events that take place in the space opposite the side of their brain injury. Called spatial neglect, this disorder is a problem with attention and action rather than vision. Often overlooked, it is associated with accidents, falls, safety problems and functional disability that impedes recovery.


According to Anna Barrett, MD, director of Stroke Rehabilitation Research at Kessler Foundation, this study is unique in its focus on patients in the acute phase. "Early detection of spatial neglect after stroke could enable cognitive interventions to improve function, and might prevent chronic disability," explained Dr. Barrett. "Spatial neglect is often thought of as a visual problem, but it critically impairs action and movement."

While the impact of weakness and paralysis are well recognized, the effects of hidden disabilities like spatial neglect are underestimated. "Spatial neglect doubles or triples the disability a stroke survivor with paralysis experiences," said Dr. Barrett, " and could make the difference between chronic dependence and successful return to work and life. That is why it is important to diagnosis early and include cognitive interventions in the rehabilitation plan."

The study is unique in looking at correlations between laboratory tools and the bedside tools clinicians use to diagnose spatial-motor dysfunction. Investigators studied 51 consecutive inpatients with right brain stroke and left neglect, within a mean 22.3 days post-stroke. Each was evaluated with laboratory measures of perceptual-attentional and motor-intentional deficits and 2 bedside measures-- the Behavioral Inattention Test (BIT)-conventional and the Catherine Bergego scale (CBS).

Researchers determined that these psychometric assessments may be used to identify specific motor-exploratory deficits in spatial neglect. Specifically, obtaining CBS-ME scores routinely might improve the detection of spatial action deficits so that clinicians can implement appropriate care and safety interventions. Without specific cognitive rehabilitation, spatial-action deficits may persist and cause chronic disability. "Much effort goes into hi-tech approaches," commented Dr. Barrett. "This study, however, shows that clinical tools can be optimized for the bedside, to identify patients who need targeted management and therapy."

The article, "Psychometric evaluation of neglect assessment reveals motor-exploratory predictor of functional disability in acute-stage spatial neglect," appears in the January 2012 issue of Archives of Physical Medicine & Rehabilitation, vol. 93(1)(doi:10.1016/j.apmr.2011.06.036). Authors are Kelly M. Goedert, PhD, of Seton Hall University, South Orange, NJ, Peii Chen, PhD, Amanda Botticello, PhD, Jenny R. Masmela, BA, and Anna M. Barrett, MD, of Kessler Foundation, West Orange, NJ, and Uri Adler, MD, of Kessler Institute For Rehabilitation, West Orange, NJ. Dr. Barrett is also chief of Neurorehabilitation Program Innovation at Kessler Institute. Drs. Barrett, Adler, Botticello, and Chen are also affiliated with UMDNJ-New Jersey Medical School, Newark, NJ.

Research was supported by Kessler Foundation and the National Institute of Neurological Disorders and Stroke (grant nos. K02 ns 047099-05, R01 ns 055808-02).

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