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, November 1, 2014

Explicit and implicit motor learning during early gait rehabilitation post stroke

It is only a 404 page thesis that I'm not going to read. It is your doctors responsibility to keep abreast of current news on stroke, so ask him/her to see if anything in there will change your stroke protocols. My reading of the abstract would have me believe that practically everything my therapists were teaching me were done the wrong way.

Explicit and implicit motor learning during early gait rehabilitation post stroke

Learning can be explicit or implicit.
Explicit learning takes place intentionally, in the presence
of factual task-relevant knowledge; whereas implicit learning takes place unintentionally, without concurrent acquisition of knowledge about task performance.
The relative benefits of implicit learning have been well investigated within healthy populations.  Research consistently demonstrates that skills learnt implicitly are more likely to be retained, and are more robust under secondary task load. However, study protocols tend to involve laboratory
based activities, which do not take into account the complexities of motor learning in natural settings. Direct transferability of the findings to stroke rehabilitation is therefore questionable.
Two factors in explicit and implicit learning are the concepts of attentional capacity and attentional focus.
Attentional capacity refers to the ability to attend to and process incoming
information,  whereas attentional focus refers to the location of attention in relation to specific aspects of the task being performed.
Theories propose that focussing on specific movements(internal focus)
may actually constrain or interfere with automatic control processes that
would normally regulate movement, whereas if attention is focussed towards the movement effect (external focus) the motor system is able to more naturally self-organize, resulting in more effective performance, and learning. An internal focus of attention is therefore allied to
explicit learning; whilst an external focus of attention is allied to implicit l
earning. This research aimed to improve understanding of explicit and implicit learning within early gait rehabilitation post stroke; primarily through the development and testing of explicit and implicit models of learning interventions. It has comprised three phases; a review of the literature;
an observational study to gain insight into current practice; and a
feasibility study to test the ability of therapists to deliver interventions with a bias towards either an explicit or implicit approach. Therapists were found to favour the use of explicit techniques; internally focussed instructions
and feedback statements were used in high quantities. Practice therefore appeared to be at odds with current evidence; albeit primarily from healthy populations.Guidance for the delivery of explicit
and implicit learning models in clinical practice was developed, and then
tested in a feasibility study. Therapists demonstrated the ability to change their practice to bias either explicit or implicit learning; both approaches were found to be acceptable to patients and therapists. Recommendations are made on the content and evaluation of explicit and implicit learning
 

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