Deans' stroke musings: Locomotor Rehabilitation of Individuals With Chronic Stroke: Difference Between Responders and Nonresponders

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, January 23, 2016

Locomotor Rehabilitation of Individuals With Chronic Stroke: Difference Between Responders and Nonresponders

You'll have to ask your doctor to get the walking protocol they were using because our fucking failures of stroke associations have no mechanism to collect and distribute research protocols. You would think that at a minimum they would collect such data. But no, they are too busy putting out stupid press releases.
http://www.archives-pmr.org/article/S0003-9993%2812%2901196-3/abstract

Mark G. Bowden, PhD, PT

Andrea L. Behrman, PhD, PT

Richard R. Neptune, PhD

Chris M. Gregory, PhD, PT

Steven A. Kautz, PhD

DOI: http://dx.doi.org/10.1016/j.apmr.2012.11.032

Article Info

Abstract

Objectives

To identify the clinical measures associated with improved walking speed after locomotor rehabilitation in individuals poststroke and how those who respond with clinically meaningful changes in walking speed differ from those with smaller speed increases.

Design

A single group pre-post intervention study. Participants were stratified on the basis of a walking speed change of greater than (responders) or less than (nonresponders) .16m/s. Paired sample t tests were run to assess changes in each group, and correlations were run between the change in each variable and change in walking speed.

Setting

Outpatient interdisciplinary rehabilitation research center.

Participants

Hemiparetic subjects (N=27) (17 left hemiparesis; 19 men; age: 58.74±12.97y; 22.70±16.38mo poststroke).

Intervention

A 12-week locomotor intervention incorporating training on a treadmill with body weight support and manual trainers accompanied by training overground walking.

Main Outcome Measures

Measures of motor control, balance, functional walking ability, and endurance were collected at pre- and postintervention assessments.

Results

Eighteen responders and 9 nonresponders differed by age (responders=63.6y, nonresponders=49.0y, P=.001) and the lower extremity Fugl-Meyer Assessment score (responders=24.7, nonresponders=19.9, P=.003). Responders demonstrated an average improvement of .27m/s in walking speed as well as significant gains in all variables except daily step activity and paretic step ratio. Conversely, nonresponders demonstrated statistically significant improvements only in walking speed and endurance. However, the walking speed increase of .10m/s was not clinically meaningful. Change in walking speed was negatively correlated with changes in motor control in the nonresponder group, implying that walking speed gains may have been accomplished via compensatory mechanisms.

Conclusions

This study is a step toward discerning the underlying factors contributing to improved walking performance. Did you look at the damage location at all? Or are you that stupid? And these people have PhDs?

Deans' stroke musings