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.

Monday, April 4, 2016

Slow gait speed may predict mortality, hospitalization in older patients with HF

What association between gait speed after stroke and mortality exists? I was damn slow, barely could make it from kitchen to living room.
www.healio.com/cardiology/hf-transplantation/news/online/{fc344c26-eea7-47ff-bbfe-946ea99e38be}/slow-gait-speed-may-predict-mortality-hospitalization-in-older-patients-with-hf?ecp-=26917F13-635A-E411-BD8D-A4BADB296AA8
The association between reduced gait speed and mortality or hospitalization in older patients with HF may offer a simple way to predict prognosis, researchers reported in JACC: Heart Failure.

In the IMAGE-HF study, researchers evaluated gait speed as a part of frailty assessment in 331 older patients with HF from seven HF clinics in Italy. All patients were aged 70 years or older (mean age, 78 years; 43% women; mean left ventricular ejection fraction 35 11%; mean NYHA class 2.7 0.6) and were enrolled in 2007.
All patients were given a 4-m corridor walk test and placed into tertiles based on gait speed: up to 0.65 m/s, 0.66 m/s to 0.99 m/s and at least 1 m/s. They were then followed up for 1 year. Primary endpoints were all-cause mortality, HF hospitalization and all-cause hospitalization.
Mean gait speed was 0.74 0.23 m/s, and 115 patients were in the lowest tertile, the researchers reported.
During follow-up, 80 patients (24.2%) died, 125 (37.8%) were hospitalized for HF and 198 (59.8%) were hospitalized for other reasons.
The researchers found that 1-year mortality was higher in the lowest and intermediate tertiles: 38.3% ( 0.65 m/s), 21.9% (0.66-0.99 m/s) and 9.1% ( 1 m/s; P < .001).
After adjustment for age, EF, systolic BP and beta-blocker therapy, faster gait speed was associated with lower risk for all-cause death (HR = 0.62; 95% CI, 0.43-0.88), they wrote.
According to the data, gait speed also was a predictor of risk for HF hospitalization (lowest tertile, 48.7%; highest tertile, 25%; P = .002) and all-cause hospitalizations (lowest tertile, 71.3%; highest tertile, 26.6%; P = .002),
When added to the Cardiac and Comorbid Conditions HF score, gait speed improved risk stratification for all-cause mortality (net reclassification improvement = 0.49; P < .001) and HF hospitalizations (net reclassification improvement = 0.37; P < .001).
Those with reduced gait speed were also more likely to have atrial fibrillation, a Mini Mental State Examination score of less than 24 and preserved LVEF.
The researchers wrote that for high-risk patients, a slow gait speed was linked to a nearly fivefold increase in mortality compared with patients who could achieve a faster gait, and for the lowest-risk patients, there was a more than sixfold risk for mortality associated with slow gait speed.
“Assessment of frailty using gait speed is simple and should be part of the clinical evaluation process,” the researchers wrote. “Early detection of frailty may potentially lead to interventions aimed at preventing or reversing the development of frailty, such as regular exercise and balanced nutrition.”
They wrote that future studies are still needed to determine whether such interventions actually lead to improved clinical outcomes. – by Tracey Romero

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