The conclusions from this could just as easily be explained by those people able to get moving earlier had less severe strokes.
http://www.npr.org/sections/health-shots/2015/07/06/419519145/people-with-brain-injuries-heal-faster-if-they-get-up-and-get-moving
When Kate Klein began working as a nurse in the Cleveland Clinic's
Neurointensive Care Unit, one of the first things she noticed was that
her patients spent a lot of time in bed. She knew patients with other
injuries benefitted from getting up and moving early on, and she
wondered why not patients with brain injuries.
"I asked myself
that question. I asked my colleagues that question," Klein says. "Why
aren't these patients getting out of bed? Is there something unique
about patients with neurologic injury?"
Doctors have long encouraged their surgical patients to get out of
bed as soon as it's safe to do so. Movement increases circulation,
reduces swelling, inflammation and the risk of blood clots, and it
speeds healing.
But that wasn't the thinking with brain injuries, explains Edward Manno, director of the Neurointensive Care Unit at the Cleveland Clinic
and one of the neurologists who works with Klein. "The predominant
thinking was that rest was better suited for the brain," Manno says.
Often
the damaged brain is susceptible to lack of blood flow. Increased
activity may make things worse if initiated too quickly, Manno says. "So
many of us thought for quite some time that we needed to put the brain
to rest after the initial insult of stroke or other neurologic injury."
But some doctors, including Manno, suspected patients with brain
injuries could benefit from getting out of bed sooner. They just didn't
have any proof.
Although plenty of research had been done on
early mobilization of patients with other injuries, Klein discovered
that no one had actually studied whether it was safe or beneficial for
patients with brain injuries caused by seizures, stroke or head trauma to start rehabilitation right away. So she designed a study of her own.
Over
the course of a year, Klein tracked more than 600 patients with brain
injury, getting more than half of them up and out of bed as early as the
first day they were admitted to the ICU. What she found was that
getting up and moving had clear benefits. Patients who started their
rehabilitation earlier spent less time in the ICU and less time in the
hospital. "They have less pressure ulcers, less infections and spend
less time on the ventilator if they need ventilator therapy," says
Klein. And most say they feel a lot better.
One of the barriers
to getting patients with brain injury up is how difficult it is. It
took two nurses more than half an hour to get patient Patricia Weeden
out of bed and into a chair to visit with her daughter. Weeden, 66, from
Cleveland, has suffered severe seizures that damaged her brain. She's
hooked to a ventilator, so she can't speak. And she's unable to sit,
stand or walk on her own.
"It is difficult to get these patients up," explains Klein.
As
a result of her study, the Cleveland Clinic has installed ceiling
mounted lifts at each patient's bedside in the Neurointensive Care Unit.
Nurses receive other equipment and training to make moving patients
safer and easier.
And although it seems like a lot of effort
for a few steps from bedside to chair, Klein says it represents huge
progress for a patient like Weeden. The benefits may go beyond
preventing bed sores or infections. Manno says it may also speed the
recovery of the brain.
The brain rewires itself, explains Jeffrey Kleim,
an associate professor of biomedical engineering at Arizona State
University who studies what happens to the brain after injury.
"And it does this by forming new synapses, forming new
connections," says Kleim. "The neural circuits begin to change and
adapt, and that's how these new functions begin to emerge in the
remaining brain areas."
That neuroplasticity
has been shown to be heightened immediately after injury in studies
with animals. If the same is true in humans, the sooner patients get up
and engage their brains the better their chances of recovery.
Kleim says much of the animal research has been focused on finding ways to jumpstart the rewiring process with drugs or electrical stimulation. But in people, he says, there is a much simpler way to drive the recovery process.
By
getting patients up and out of bed early, even taking them outside,
Klein and Manno say they are attempting to provide the sort of familiar
experiences that are already known to stimulate the brain's natural rewiring process.
Those experiences can be powerful, explains Klein, recalling a patient
who suddenly began to speak after being outside for the first time.
"She
was listening to the traffic, feeling the wind on her face, and then
her sons came and they said 'Hi Mom,' and she looked up and said, 'Well,
how are you doing?' Those were her first words," Klein says.
But
as dramatic as those moments are, Manno says they only illustrate how
much we still don't know about the recovery of the brain. For example,
it's still unclear if all kinds of brain injuries can or should be
treated the same.
"We are just scratching the surface here," says Manno. "There's a tremendous amount of work to be done in this area."
Use the labels in the right column to find what you want. Or you can go thru them one by one, there are only 29,112 posts. Searching is done in the search box in upper left corner. I blog on anything to do with stroke.DO NOT DO ANYTHING SUGGESTED HERE AS I AM NOT MEDICALLY TRAINED, YOUR DOCTOR IS, LISTEN TO THEM. BUT I BET THEY DON'T KNOW HOW TO GET YOU 100% RECOVERED. I DON'T EITHER, BUT HAVE PLENTY OF QUESTIONS FOR YOUR DOCTOR TO ANSWER.
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.
Subscribe to:
Post Comments (Atom)
No comments:
Post a Comment