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.

Saturday, September 8, 2012

Longitudinal Analysis of Balance Confidence in Individuals With Stroke Using a Multilevel Model for Change

I do remember my OT telling me I needed confidence in my bad legs ability  to hold myself up. And I bet I would have had a lot more confidence if fall-based therapy had been available.
http://nnr.sagepub.com/content/26/8/999.abstract?etoc

Abstract

Background. Confidence about balance may be an important factor affecting self-efficacy for daily activities after stroke. Objective. The authors investigated whether confidence changes and the parameters that may predict changes in self-perceived balance within the first year of community reintegration. Methods. In this prospective study, 98 hemiparetic participants who could walk at least 10 m independently were assessed 1, 3, 6, and 12 months postdischarge from rehabilitation by the Berg Balance Scale, Timed Up and Go, 6-minute walking distance, and depression and anxiety scales. The 98 age-/sex-matched controls were assessed at enrollment and the same intervals. Multilevel modeling was used to determine if assessed covariates predicted changes in balance confidence by the Activities-Specific Balance Confidence Scale. Results. Stroke subjects had lower initial balance confidence than controls and showed a statistically significant increase in confidence over 1 year at each assessment. Poor balance and high state anxiety were associated with lower balance confidence. Significant interactions were observed between greater depression, along with more impaired walking capacity and balance tests, in predicting lower change trajectories in confidence. Falls predicted a reduced rate of improvement. Conclusions. Balance confidence after stroke remained lower than controls over the first year. Physical therapies and supportive interventions designed to treat confidence should be initiated at discharge from inpatient rehabilitation.

3 comments:

  1. ya know... if you are frequently loosing your balance and getting hurt and then you still show "balance confidence" I am guessing you might qualify for other therapy to help you learn to accept the reality of your situation.

    That said (whined about) once I got in the pool and figured out that I would not get hurt falling in water my confidence in the aquatic physiotherapy improved so I was more willing to work on more challenging movements.

    More safe exercise-- more improvement.. more fall confidence! Ta da.

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    Replies
    1. That gets into the point, do you learn faster by analyzing why you fell or just practicing the stuff you already know how to do?. I bet Michael Jordan worked on impossible shots a lot more than layups.
      I did wish the pool hadn't closed a couple of years earlier, but then I would have worried about drowning, with the inability to get my feet under me to stand up again.

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    2. Aww Dean.. the pool's therapists stay close by and they can put floaty things on you to keep you right side up!

      Those Impossible shots are my goals.


      Linda

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