Deans' stroke musings: Is stroke rehabilitation a metabolic problem?

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 28, 2014

Is stroke rehabilitation a metabolic problem?

Well I don't know so ask your doctor that question. And an email is provided for your doctors ease in contacting the researcher.

Is stroke rehabilitation a metabolic problem?

2014, Vol. 28, No. 2 , Pages 161-173 (doi:10.3109/02699052.2013.860470)

Roberto Aquilani¹, Mirella Boselli², Baiardi Paola³, Evasio Pasini⁴, Paolo Iadarola⁵, Manuela Verri⁶, Simona Viglio⁷, Annamaria Condino⁸, & Federica Boschi⁸

¹Servizio di Fisiopatologia Metabolico-Nutrizionale e Nutrizione Clinica,

²Unità di Riabilitazione Neuromotoria, Unità Gravi Cerebrolesioni Acquisite, Fondazione S. Maugeri, IRCCS, Istituto Scientifico di Montescano,

Montescano, Pavia

, Italy,

³Consorzio Valutazioni Biologiche e Farmacologiche, Fondazione S. Maugeri e Università degli Studi di Pavia,

Pavia

, Italy,

⁴Fondazione S. Maugeri, IRCCS, Istituto Scientifico di Lumezzane,

Lumezzane, Brescia

, Italy,

⁵Dipartimento di Biologia e Biotecnologie, Università degli Studi di Pavia,

Pavia

, Italy,

⁶Dipartimento di Medicina Legale, Scienze Forensi e Farmaco-Tossicologiche ‘A. Fornari’, Sezione di Scienze Farmacologiche e Tossicologiche, Università degli Studi di Pavia,

Pavia

, Italy,

⁷Dipartimento di Medicina Molecolare, and

⁸Dipartimento di Scienze del Farmaco, Università degli Studi di Pavia,

Viale Taramelli, Pavia

, Italy

Correspondence:

Dr Federica Boschi

, Dipartimento di Scienze del Farmaco, Università degli Studi di Pavia,

Viale Taramelli, 12, 27100 Pavia

, Italy. Tel: 39-0382-987398. Fax: 39-0382-987405. Email: federica.boschi@unipv.it

Abstract

Background: This study looks at the impact of inflammation during the rehabilitation stage of strokes and its effect on neuro-functional recovery.
Methods: This study investigated 94 patients suffering from strokes and admitted to rehabilitation. Anthropometric characteristics, serum proteins and inflammatory markers, plasma amino acids and neurofunction were all assessed.
Results: 55.3% patients had an inflammatory status (Interleukin-6 = 19.24 ± 23.01 pg ml⁻¹ vs. 4.1 ± 1.6 pg ml⁻¹ for non-inflamed subjects (p < 0.001). Inflammation was positively linked to positive proteins (alpha-1 globulin, p < 0.02) and negatively linked to negative proteins (albumin, p < 0.02; prealbumin, p < 0.01; transferrin, p < 0.05) of the acute-phase response. Inflammation was associated with low plasma concentrations of total amino acids. For the multiple logistic regression analysis, albumin (p < 0.001) and body weight maintenance (p < 0.001) were independent predictors of patient functional independence. Inflammation in dysphagic stroke (31.9%) patients was associated with more accentuated disability compared to non-inflamed dysphagics. The serum positive reactant alpha 1 globulin was the most powerful predictor of dysphagia severity (p < 0.001). At discharge, dysphagia improvement was associated with improved acute-phase negative proteins.

Conclusions: An inflammatory status may persist for most patients with strokes during the rehabiliation stage of the disease, its prevalence being higher in dysphagic compared to non-dysphagic subjects. The improvement in circulating albumin(how is that done?) and body weight maintenance are predictors of neuro-function, even in dysphagic subjects.