Deans' stroke musings: Standardizing the approach to evidence-based upper limb rehabilitation after stroke

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.

Wednesday, February 19, 2014

Standardizing the approach to evidence-based upper limb rehabilitation after stroke

How did these researchers get past the meme, 'All strokes are different, all stroke recoveries are different'? to create some standards? They need to be shot as heretics. Its only 9 pages long, maybe your doctor can get it instituted in the next 10 years.
http://search.naric.com/research/rehab/redesign_record.cfm?search=2&type=all&criteria=J67361&phrase=no&rec=123163
NARIC Accession Number: J67361. What's this?
ISSN: 1074-9357.
Author(s): McDonnell, Michelle N.; Hillier, Susan L.; Esterman, Adrian J..
Publication Year: 2013.
Number of Pages: 9.
Abstract: Study describes the development of a clinical algorithm to enable standardized intervention prescription and progression for hemiparetic upper-limb rehabilitation following stroke. The standardized clinical algorithm involved assessment of 18 critical impairments of upper-limb function and application of task-specific exercises appropriate to the individual’s level of impairment. These tasks were consistent with recent evidence-based guidelines. Feasibility was tested with 20 participants recently discharged from inpatient rehabilitation following stroke who received outpatient therapy according to the clinical algorithm. Participants’ abilities were regularly re-evaluated and task difficulty progressed. Outcomes were assessed at the level of impairment (Action Research Arm Test, Fugl-Meyer Assessment) and activity (Motor Activity Log). All participants attended the 9 sessions of training over the 3-week intervention period. No adverse events were reported. There were significant improvements in all outcome measures. This evidence-based, upper-limb clinical algorithm provides a framework for standardizing task-specific training following stroke based on the assessment of functioning of the individual following stroke in day-to-day life. This approach is appropriate for patients with different functional levels and may be used to standardize individual or group self-directed practice sessions or to standardize the intervention and progressions in experimental studies.