Deans' stroke musings: Use it or Lose it

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.

Friday, February 1, 2013

Use it or Lose it - stroke rehab

This seems to be one of the golden pillars of stroke rehab. I think everyone is mostly wrong on this.

You are told as soon as the first therapist talks to you that you need to use any movement/sensation you have or you will lose it. They believe it because they see survivors who initially had some movement and a month or two later that movement is gone. They question the survivor about how often they tried the movement and the response usually is, 'Except for therapy sessions I never tried that movement'. This is correlation not causation. Poor analytical thinking on their part. They are probably thinking about atrophied muscles and their lack of use.

I'll argue that the reason it was lost is that that area was partially damaged; in the penumbra or blood drainage area and the neuronal cascade of death was initiated and neurons died over the next week or so. The initial tries worked because the neurons were still alive and barely functioning.

This just points out the absolute imperative to find out how to stop that death cascade. 177 possibilities here.This can also be the reason that very early therapy does not have a good success rate. Movement regresses for a while until the cascade resolves itself and the surviving neurons start taking on their tasks. This would look like failure on early rehab.

This should be fairly easy to figure out, you can use nanowires to listen in on single neurons or lay a grid across the cortex to listen in.

Some of the causes of those neuron deaths;

1. Excitotoxicity

2 comments:

Rebecca DuttonFebruary 2, 2013 at 9:14 AM
Musicians practice for hours every day when they are not performing. Athletes work out in the off season. Ballet dancers take class every day even when they are performing that night.
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