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, June 3, 2016

Long-term Effectiveness of Intensive Therapy in Chronic Stroke

For your doctor to update your stroke protocols for your out-patient therapy.
http://nnr.sagepub.com/content/30/6/583?etoc
  1. Xiaotian Wu, MS1,2
  2. Peter Guarino, MPH, PhD1,2
  3. Albert C. Lo, MD PhD3,4
  4. Peter Peduzzi, PhD1,2
  5. Michael Wininger, PhD1,2,5
  1. 1Yale University, New Haven, CT, USA
  2. 2VA Connecticut Healthcare System, West Haven, CT, USA
  3. 3VA RRD Center of Excellence for Neurorestoration and Neurotechnology, Providence, RI, USA
  4. 4Brown University, Providence, RI, USA
  5. 5University of Hartford, West Hartford, CT, USA
  1. Michael Wininger, PhD, Department of Veterans Affairs, VA Connecticut Healthcare System, Cooperative Studies Program, 950 Campbell Avenue, Building 35 (151-A), West Haven, CT 06516, USA. Email: michael.wininger@va.gov

Abstract

Background. While recent clinical trials involving robot-assisted therapy have failed to show clinically significant improvement versus conventional therapy, it is possible that a broader strategy of intensive therapy—to include robot-assisted rehabilitation—may yield clinically meaningful outcomes.  
Objective. To test the immediate and sustained effects of intensive therapy (robot-assisted therapy plus intensive conventional therapy) on outcomes in a chronic stroke population.  
Methods. A multivariate mixed-effects model adjusted for important covariates was established to measure the effect of intensive therapy versus usual care. A total of 127 chronic stroke patients from 4 Veterans Affairs medical centers were randomized to either robot-assisted therapy (n = 49), intensive comparison therapy (n = 50), or usual care (n = 28), in the VA-ROBOTICS randomized clinical trial. Patients were at least 6 months poststroke, of moderate-to-severe upper limb impairment. The primary outcome measure was the Fugl-Meyer Assessment at 12 and 36 weeks. Results. There was significant benefit of intensive therapy over usual care on the Fugl-Meyer Assessment at 12 weeks with a mean difference of 4.0 points (95% CI = 1.3-6.7); P = .005; however, by 36 weeks, the benefit was attenuated (mean difference 3.4; 95% CI = −0.02 to 6.9; P = .05). Subgroup analyses showed significant interactions between treatment and age, treatment and time since stroke.  
Conclusions. Motor benefits from intensive therapy compared with usual care were observed at 12 and 36 weeks posttherapy; however, this difference was attenuated at 36 weeks. Subgroups analysis showed that younger age, and a shorter time since stroke were associated with greater immediate and long-term improvement of motor function.

1 comment:

  1. Fine, but I haver already lost enough because of the stroke, without being cursed with even MORE boring repetitive exercise, that only MAY. help, more like will exhaust and frustrate me

    ReplyDelete