Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 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:

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's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Thursday, February 20, 2014

Abstract T MP46: Stroke-Related Neuroplasticity During Steering of Human Gait

It seems to me that if your are going to get better at 'steering' you have to get a lot closer to falling by massive number of perturbations in your gait. Like this;
Motorized Shoes Help Elderly Prepare for Walking Accidents
Or this;
The effect of vibrotactile feedback on postural sway during locomotor activities
Or this;
Clinic helps stroke patients recover balance, avoid future falls
Or these;
1. Unstable Shoes Increase Energy Expenditure of Obese Patients
2. Compelled BodyWeight Shift Technique to Facilitate Rehabilitation of Individuals with Acute Stroke
3. Documenting abnormal anticipatory control prior to gait initiation in sub-acute stroke
4.  spnKiX motorized shoes edge closer to production
5. Motivation through Inclusion of Failure in Stroke Rehabilitation 
Or this;
Training to walk amid uncertainty with Re-Step: measurements and changes with perturbation training for hemiparesis and cerebral palsy
And the newest one here;
http://stroke.ahajournals.org/content/45/Suppl_1/ATMP46.short 
  1. Jean-Paul Soucy2
+ Author Affiliations
  1. 1Kinesiology and Physical Education, McGill Univ, Montreal, Canada
  2. 2Neurology &Neurosurgery, McGill Univ, Montreal, Canada

Abstract

Background: The risk of falling is higher in stroke survivors than among the general population. These falls are more frequent during walking and transfers or during turning. The neuronal substrates involved in steering of locomotion are poorly understood due to methodological limitations in quantifying brain activations during whole-body movements. Thus, no data is currently available to study the mechanisms of post-stroke brain plasticity for steering of gait. This study tested the hypothesis that stroke-induced neuroplastic changes for steering of gait can be quantified using 18F- fluorodesoxy-glucose (18F-FDG) Positron Emission Tomography (PET) in-vivo in humans
Methods: PET imaging with 18F-FDG tracer was used to quantify cerebral glucose metabolism (CMRGlc) during two locomotor tasks (straight walking and turning) measured on separate days. Immediately prior to each walking task, a 5 mCi bolus of 18F-FDG was injected. Subjects walked for 40 minutes (duration of 18F-FDG uptake). Subjects were scanned on an ECAT HR+ scan (20min emission followed by 10min transmission) within 10 minutes of completing the walking task, well within reaching the 2h half-life of 18F. Images obtained during straight walking were subtracted from the ones acquired during steering
Results: Subjects post-stroke showed an asymmetrical pattern of CMRGlc in sensorimotor areas and superior parietal lobule where the affected hemisphere shows no increase in CMRGlc. Differences between groups were also observed in the cerebellum where CMRGlc was increased in the vermis for controls, an area predominant for the control of trunk and gait. Stroke subjects, in contrast, showed increased CMRGlc in the hemishperes, associated with goal-directed leg movements.
Conclusions: Neuroplasticity in complex locomotor tasks such as steering can be quantified using 18F-FDG PET in subjects post-stroke. This study showed that changes affect several brain regions remote to the infarct. Understanding stroke-related changes in brain activity during steering of locomotion is crucial for improving rehabilitative strategies to minimize falls and injuries in stroke survivors.




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