Deans' stroke musings: Physiotherapy for patients with mobility problems more than 1 year after stroke: a randomised controlled trial

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.

Sunday, November 3, 2013

Physiotherapy for patients with mobility problems more than 1 year after stroke: a randomised controlled trial

Once again proving that therapy is not the easy solution to recovery problems. Probably not enough repetitions. This should lead to the recognition that stopping the neuronal cascade of death will result in less dead and damaged neurons. Why can't these people look at the big picture and make appropriate corrections rather than staying within their own silo(area of expertise)?
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2802%2907443-3/fulltext

The Lancet, Volume 359, Issue 9302, Pages 199 - 203, 19 January 2002

doi:10.1016/S0140-6736(02)07443-3

Cite or Link Using DOI

John Green MSc a

, Anne Forster PhD b, Sue Bogle PhD c, John Young PhD b

Summary

Background

Community physiotherapy is often prescribed for stroke patients with long-term mobility problems. We aimed to assess the effectiveness of this treatment in patients who had mobility problems 1 year after stroke.

Methods

We screened 359 patients older than 50 years for a single-masked, randomised controlled trial to assess the effects of community physiotherapy. Assessments were made at baseline, 3, 6, and 9 months in 170 eligible patients assigned treatment or no intervention. The primary outcome measure was mobility measured by the Rivermead mobility index. Secondary outcome measures were gait speed, number of falls, daily activity (Barthel index scores), social activity (Frenchay activities index), hospital anxiety and depression scale, and emotional stress of carers (general health questionnaire 28). Analyses were by intention to treat.

Findings

Follow-up was available for 146 patients (86%). Changes in scores on the Rivermead mobility index (score range 0—15) differed significantly between treatment and control groups at 3 months (p=0·018), but only by a median of 1 point (95% CI 0—1), with an interpolated value of 0·55 (0·08—1·04). Gait speed was 2·6 m/min (0·30—4·95) higher in the treatment group at 3 months. Neither treatment effect persisted at 6-months' and 9-months' follow-up. Treatment had no effect on patients' daily activity, social activity, anxiety, depression, and number of falls, or on emotional stress of carers.

Interpretation

Community physiotherapy treatment for patients with mobility problems 1 year after stroke leads to significant, but clinically small, improvements in mobility and gait speed that are not sustained after treatment ends.