Deans' stroke musings: Strategy Training Shows Promise for Addressing Disability in the First 6 Months 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.

Friday, December 12, 2014

Strategy Training Shows Promise for Addressing Disability in the First 6 Months After Stroke

This is all well and good but I bet we wouldn't need as much after the fact rehabilitation if our stroke medical teams would stop all the death and destruction during the neuronal cascade of death in the first week. Would music listening produce the same results? Send your doctor after the strategy training protocols.
http://nnr.sagepub.com/content/early/2014/11/21/1545968314562113?papetoc

¹University of Pittsburgh, Pittsburgh, PA, USA
²Rotman Research Institute at Baycrest, Toronto, Ontario, Canada
³University of Toronto, Toronto, Ontario, Canada
⁴Western Psychiatric Institute & Clinic, Pittsburgh, PA, USA

Elizabeth Skidmore, Department of Occupational Therapy, University of Pittsburgh, 5012 Forbes Tower, Pittsburgh, PA 15260, USA. Email: skidmore@pitt.edu

Abstract

Background. Cognitive impairments occur frequently after stroke and contribute to significant disability. Strategy training shows promise but has not been examined in the acute phase of recovery. Objective. We conducted a single-blind randomized pilot study estimating the effect of strategy training, relative to reflective listening (attention control), for reducing disability and executive cognitive impairments. Methods. Thirty participants with acute stroke who were enrolled in inpatient rehabilitation and had cognitive impairments were randomized to receive strategy training (n = 15, 10 sessions as adjunct to usual inpatient rehabilitation) or reflective listening (n = 15, same dose). The Functional Independence Measure assessed disability at baseline, rehabilitation discharge, 3, and 6 months. The Color Word Interference Test of the Delis–Kaplan Executive Function System assessed selected executive cognitive impairments (inhibition, flexibility) at baseline, 3, and 6 months. Results. Changes in Functional Independence Measure scores for the 2 groups over 6 months showed significant effects of group (F_1,27 = 9.25, P = .005), time (F_3,74 = 96.00, P < .001), and group * time interactions (F_3,74 = 4.37, P < .007) after controlling for baseline differences in stroke severity (F_1,27 = 6.74, P = .015). Color Word Interference Inhibition scores showed significant effects of group (F_1,26 = 6.50, P = .017) and time (F_2,34 = 4.74, P = .015), but the group * time interaction was not significant (F_2,34 = 2.55, P = .093). Color Word Interference Cognitive Flexibility scores showed significant effects of group (F_1,26 = 23.41, P < .001), time (F_2,34 = 12.77, P < .001), and group * time interactions (F_2,34 = 7.83, P < .002). Interaction effects suggested greater improvements were associated with strategy training. Conclusions. Strategy training shows promise for addressing disability in the first 6 months after stroke. Lessons from this pilot study may inform future clinical trials.