Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 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:

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's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:

Wednesday, August 24, 2016

Aquatic treadmill walking may increase exercise capacity after stroke

And how many stroke departments do you think have this? I'd say none except for this one. The hospital I was at gave up their pool years before.Useless because 10 or so people might be able to take advantage when there are 10 million survivors a year.
For patients in rehabilitation after a stroke, walking on an underwater treadmill produces better measures of exercise performance compared to conventional treadmill walking, reports a study in the American Journal of Physical Medicine & Rehabilitation.
"Aquatic treadmill exercise may be a useful option for early intensive aerobic exercise after subacute stroke, as it may both improve their aerobic capacity and maximize functional recovery," according to the preliminary research by Bo Ryun Kim, MD, PhD, and colleagues of Jeju National University Hospital, Korea.
Walking in Water May Have Advantages for Post-Stroke Rehab
The study included 21 patients recovering after a stroke—average time since their stroke was about two months. All patients had some walking ability, but with impaired leg movement on the side affected by the stroke.
The patients underwent two exercise tests: one on a conventional land treadmill and one on an aquatic treadmill, submerged in water up to their chests. In both tests, walking speed and slope were gradually increased until the patients felt they couldn't go any further. Measures of exercise capacity were compared between the two tests.Two key measures were higher on the aquatic treadmill test: maximal oxygen consumption (VO2max), reflecting heart and lung function during exercise; and metabolic equivalents (METs), reflecting energy use. Heart rate was not significantly different, but was significantly related to oxygen consumption on both tests.
Even though their was higher on the water treadmill, patients felt they weren't working as hard as on the land treadmill, based on a measure called rating of perceived exertion. "This improved performance may reflect the fact that the aquatic treadmill exercise involved the fluid resistance of the water environment," Dr. Kim and colleagues write.
Regaining walking ability is a major challenge after a stroke. Because it's so difficult to walk, patients may be physically inactive, further their reducing exercise capacity. This suggests that early intensive aerobic exercise training might be beneficial in the early weeks after stroke. Treadmill walking is commonly recommended, but may be difficult or impossible because of decreased muscle power.
"The fact that the aquatic treadmill efficiently provides aerobic exercise without requiring full weight bearing means that it may be highly suitable for rehabilitation after stroke," according to the authors. The buoyancy provided by water reduces musculoskeletal impact while allowing combined aerobic and resistance exercise. Exercising in water also has the psychological benefit of freedom from the fear of falling.
The preliminary study is the first to explore the benefits of aquatic treadmill exercise for stroke patients. Further research will be needed to determine whether this approach leads to lasting improvements in exercise capacity and walking ability, several months after the stroke.
If so, then approaches including underwater treadmill exercise may help to overcome the low aerobic capacity seen in stroke survivors—which can contribute to decreased social activity and poor quality of life. Dr. Kim and colleagues conclude, "Aquatic may not only improve baseline functional status and functional recovery during the subacute period, it may also enhance social participation and quality of life during the chronic period."
More information: Yong Ki Lee et al. Peak Cardiorespiratory Responses of Patients with Subacute Stroke During Land and Aquatic Treadmill Exercise, American Journal of Physical Medicine & Rehabilitation (2016). DOI: 10.1097/PHM.0000000000000603

Journal reference: Archives of Physical Medicine and Rehabilitation search and more info website

1 comment:

  1. Back when I was doing aquatic rehab.. (that was what really turned me around for moving and confidence) one of the things that they had was two underwater stationary bike. The rehab program was mainly people recovering from arthritis surgery, stroke and other movement disorders. The Canadian Arthritis society funded a study and gave the bikes. Pretty much the same research style and results as in the article. I think the bike was really good in that people were seated so not tipping over and felt more secure but muscles still had to work hard and had to be going up and down with no outward swing to the leg, and the foot needs to flex as you pedal. My perfect aquatic therapy pool would have both the bike and the treadmill, and lots of pool noodles