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.

Tuesday, June 14, 2016

Altering the Rehabilitation Environment to Improve Stroke Survivor Activity (AREISSA): A Phase II Trial

All this seems like followup to enriched environment as talked about by Dr. Dale Corbett in 2011

Has your doctor done one fucking thing about enriched environment since 2011? Call the hospital president and ask what the goals and objectives are for stroke doctors. If there is nothing on staying current with research or updating stroke protocols you need to have a lot of people fired.

In a March 2015 report patients undertook a mean of 61 minutes (SD = 39) of activity per day.

Ask your doctor how much structured stroke rehab activity occurs on a daily basis. If  not close to 12-14 hours ask why the hell not.

There should be hours upon hours of action observation videos to watch.

Meditation to do.

Tai chi or yoga to do.

Music listening.

Passive movement.

Lucid dreaming to continue stroke rehab during sleep.

Has your doctor thought about any of this stuff?  Or was it just signing ET(Evaluate and Treat) prescriptions to the therapists thus washing their hands of any failures in recovery?

Altering the Rehabilitation Environment to Improve Stroke Survivor Activity (AREISSA): A Phase II Trial


Project team: A/Prof Neil Spratt, Prof Julie Bernhardt, Dr Heidi Janssen, Prof Louise Ada, Prof Michael Nilsson, A/Prof Michael Pollack and Prof Leonid Churilov
Design: Before-after non-randomised controlled trial
Current status: Recruitment ongoing
Site/s:. Bankstown Lidcombe, NSW; St Vincent’s Hospital Sacred Heart Rehabilitation Unit, NSW; Austin Health Royal Talbot, Mellor Unit, VIC, and Monash Health Kingston Centre, VIC
Background:
Despite higher levels of activity being associated with better stroke recovery, stroke patients on most rehabilitation units spend the majority of their day inactive and alone. In animal models, Environmental Enrichment (EE) involves organisation of the environment and provision of equipment to facilitate physical, cognitive and social activity. EE promotes rewiring of the brain after stroke and has been found to significantly enhance functional recovery. Preliminary work on the use of a human model of EE using individual (eg. iPods, & word puzzles) and communal (eg. access to interactive gaming, computer, books/newspapers & jigsaws) enrichment in a rehabilitation unit indicates it encourages stroke patients to be more active. Greater activity during rehabilitation has numerous benefits, the most important of which is achieving better functional recovery and subsequently, greater independence. Altering the Rehabilitation Environment to Improve Stroke Survivor Activity (AREISSA) is a Phase II Trial involving four rehabilitation units, 2 in NSW and 2 in VIC, which seeks to determine the safety, efficacy, feasibility and patient and staff acceptability of this model of EE during stroke rehabilitation. This and the other enrichment projects conducted alongside AREISSA, will be used to inform future larger trials required to determine the effect of EE on stroke survivor recovery and quality of life.
Aims:
To determine the clinical and operational feasibility and safety of Environmental Enrichment (EE)
Methods:
Behavioural mapping, in-depth interview, audit and survey
References:
  1. Janssen H, Bernhardt J, Collier JM, Sena ES, McElduff P, Attia J, Pollack M, Howells DW, Nilsson M, Calford MB, Spratt NJ (2010). An enriched environment improves sensorimotor function post-ischemic stroke. Neurorehabil Neural Repair. 24: 802-813.
  2. Janssen H, Ada L, Bernhardt J, McElduff P, Pollack M, Nilsson M, Spratt NJ (2014). An enriched environment increases activity in stroke patients undergoing rehabilitation in a mixed rehabilitation unit: a pilot non-randomized controlled trial. Disabil Rehabil. 36: 255-262.
  3. White J, Bartley E, Janssen H, Jordan LA and Spratt NJ (2015). Exploring stroke survivor experience of participation in an enriched environment: a qualitative study. Disabil Rehabil. 37(7): 593-600.
  4. White JH, Alborough K, Janssen H, Spratt N, Jordan L, Pollack M (2013). Exploring staff experience of an "enriched environment" within stroke rehabilitation: a qualitative sub-study. Disabil Rehabil. 36 (21): 1783-1789.
  5. Janssen H, Ada L, Bernhardt J, McElduff P, Pollack M, Nilsson M, Spratt NJ (2014). Physical, cognitive and social activity levels of stroke patients undergoing rehabilitation within a mixed rehabilitation unit. Clin Rehabil. 28: 91-101.
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