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.

Monday, March 26, 2012

A Hand-Arm Rehabilitation Interface (HARI): Preliminary trial with stroke subjects

I wish we had someone who was interested and invested in consolidating all the various hand therapies and putting together a protocol with efficacy ratings.
http://scholar.google.com/scholar_url?hl=en&q=http://share.rurehablab.org/HARI/HARI_JRRD.doc&sa=X&scisig=AAGBfm0iTAPA_PsSXapQgvgklqf6EYCLHA&oi=scholaralrt

Many veterans are approaching the age when stroke and other risk factors for stroke, such as high blood pressure and carotid artery disease, are major health concerns. Surgical treatment of one ailment can accidentally initiate a stroke by cerebral thrombosis, such as by cardiac catheterization. In addition to those veterans who have survived a stroke or who have significant risk factors, there are particular groups of active military personnel who are at potential risk of stroke by virtue of their occupation. Divers and aviators are subjected to extreme changes in pressure, which places them at risk for arterial gas embolism, type II decompression sickness, and internal carotid artery dissection, which can lead to stroke. Traumatic brain injury also strikes many veterans and military personnel, which can exhibit stroke-like symptoms and disabilities.

Many stroke survivors recover ambulation through intensive rehabilitation, but arm function is often neglected, precluding a complete return of functionality. Since neither stroke nor TBI are inherently progressive diseases, the continued disability and often-inexorable decline in health and mental function are strictly due to secondary processes related to disuse. Thus the enormous health care expense borne by the military and loss in productivity could be cost-effectively ameliorated with improved rehabilitation strategies. The devices and protocols to be developed during this research are simple, and may be sufficiently inexpensive as a home use rehabilitation aid. Possible spin-offs include assistive devices, such as a controller for a computer mouse and a keyboard interface. With simple modifications, HARI technology could also be applied to the lower limbs.

1. Abstract

Recovery of upper-limb function after central paralysis is an uphill battle that can sometimes be won through intensive repetitions of task-oriented exercises. To help clients with these exercises, we developed the Hand Arm Rehabilitation Interface (HARI), a tool that guides the arm passively through task-specific reaching motions while providing biofeedback of muscular effort. Preliminary results with stroke subjects demonstrate its acceptability and utility for guiding motor rehabilitation of the paretic arm.

Keywords: hand, arm, upper-limb, paralysis, stroke, rehabilitation, biofeedback.

2. Introduction

2.1. Rationale

Paralysis of upper limb (PUL) affects many people each year through ischemic brain injury (stroke), traumatic brain injury and neurological conditions. Stroke in particular attacks over 700,000 Americans each year and there are over 4.8 million stroke survivors in the U.S.[1]. Typically, the stroke affects one arm significantly hindering fundamental activities of daily living (ADL) such as eating, self-care, writing, etc. Beyond functional loss, persons can experience chronic pain and distortion in the affected limb, as well as inexorable musculoskeletal deterioration through learned disuse[2].

Recovery outlook for PUL is relatively poor; for example, a study of stroke patients entering rehabilitation with non-functional arms revealed that 61% showed no improvement after 2 years[3], in contrast to steady improvement in walking. This dichotomy may be partly due to the fact that a lower limb devoid of sensorimotor control can ambulate, but a similarly affected arm cannot manipulate, and hence tends to stagnate. To give the arm an equal chance to function and exercise, rehabilitation strategies must encourage manipulation. When done repetitively over months, such exercises can maintain and possibly improve the integrity of the musculoskeletal system as well as the brain sensorimotor regions[3-23].