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.

Saturday, September 27, 2014

An International Randomized Clinical Trial of Activity Feedback During Inpatient Stroke Rehabilitation Enabled by Wireless Sensing

What a novel idea. Objective measurements of muscle activity. What took so f*cking long to think of this?
Would this

3-D Body Suit Put to Use in Healthcare Research

have been even better?

Or this?

Rapid Rehab Smart Insole Will Train Athletes and Assist Rehab Patients

And Bruce Dobkin is known for this book:

The Clinical Science of Neurologic Rehabilitation.

From this lack of using the most up-to-date technology for research our stroke researchers are failing us.
http://nnr.sagepub.com/content/early/2014/09/24/1545968314550369?papetoc

Andrew K. Dorsch, MD1
Seth Thomas1
Xiaoyu Xu, PhD1
William Kaiser, PhD1
Bruce H. Dobkin, MD1
on behalf of the SIRRACT investigators

¹University of California, Los Angeles, CA, USA

Bruce H. Dobkin, Department of Neurology, Geffen School of Medicine, University of California Los Angeles, RNRC, Room 1-129, 710 Westwood Plaza, Los Angeles, CA 90095, USA. Email: bdobkin@mednet.ucla.edu

Abstract

Background. Walking-related disability is the most frequent reason for inpatient stroke rehabilitation. Task-related practice is a critical component for improving patient outcomes.

Objective. To test the feasibility of providing quantitative feedback about daily walking performance and motivating greater skills practice via remote sensing.

Methods. In this phase III randomized, single blind clinical trial, patients participated in conventional therapies while wearing wireless sensors (triaxial accelerometers) at both ankles. Activity-recognition algorithms calculated the speed, distance, and duration of walking bouts. Three times a week, therapists provided either feedback about performance on a 10-meter walk (speed only) or walking speed feedback plus a review of walking activity recorded by the sensors (augmented). Primary outcomes at discharge included total daily walking time, derived from the sensors, and a timed 15-meter walk.

Results. Sixteen rehabilitation centers in 11 countries enrolled 135 participants over 15 months. Sensors recorded more than 1800 days of therapy, 37 000 individual walking bouts, and 2.5 million steps. No significant differences were found between the 2 feedback groups in daily walking time (15.1 ± 13.1 vs 16.6 ± 14.3 minutes, P = .54) or 15-meter walking speed (0.93 ± 0.47 vs 0.91 ± 0.53 m/s, P = .96). Remarkably, 30% of participants decreased their total daily walking time over their rehabilitation stay.

Conclusions. In this first trial of remote monitoring of inpatient stroke rehabilitation, augmented feedback beyond speed alone did not increase the time spent practicing or improve walking outcomes. Remarkably modest time was spent walking. Wireless sensing, however, allowed clinicians to audit skills practice and provided ground truth regarding changes in clinically important, mobility-related activities.