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:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Tuesday, August 9, 2016

Somatosensory Impairments in the Upper Limb Poststroke Distribution and Association With Motor Function and Visuospatial Neglect

Why the hell are we still writing research papers on this? Did the mentors for this not ever read

Margaret Yekutiel in the book, Sensory Re-Education of the Hand After Stroke in 2001?  Better sensation leads to better motor recovery.  What the hell will it take to write a simple fucking protocol on sensation and motor recovery? Is everyone in stroke that godammed lazy AND incompetent?

http://nnr.sagepub.com/content/30/8/731?etoc
  1. Sarah Meyer, PhD1
  2. Nele De Bruyn, BSc1
  3. Christophe Lafosse, PhD2
  4. Margaretha Van Dijk, MSc3
  5. Marc Michielsen, MSc4
  6. Liselot Thijs, MSc4
  7. Veronik Truyens, MSc5
  8. Kristine Oostra, MD6
  9. Lena Krumlinde-Sundholm, PhD7
  10. Andre Peeters, MD8
  11. Vincent Thijs, PhD1,3,9
  12. Hilde Feys, PhD1
  13. Geert Verheyden, PhD1
  1. 1KU Leuven-University of Leuven, Leuven, Belgium
  2. 2Rehabilitation Hospital RevArte, Edegem, Belgium
  3. 3University Hospitals Leuven, Leuven, Belgium
  4. 4Jessa Hospital - Rehabilitation Centre Sint Ursula, Herk-de-stad, Belgium
  5. 5Rehabilitation and MS Centre Overpelt, Overpelt, Belgium
  6. 6Ghent University Hospital, Ghent, Belgium
  7. 7Karolinska Institutet - Astrid Lindgren Children’s Hospital, Stockholm, Sweden
  8. 8Cliniques Universitaires Saint-Luc, Brussels, Belgium
  9. 9Vesalius Research Center - VIB, Leuven, Belgium
  1. Sarah Meyer, PhD, Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, Bus 1501, 3001 Leuven, Belgium. Email: sarah.meyer@faber.kuleuven.be

Abstract

Background. A thorough understanding of the presence of different upper-limb somatosensory deficits poststroke and the relation with motor performance remains unclear. Additionally, knowledge about the relation between somatosensory deficits and visuospatial neglect is limited.  
Objective. To investigate the distribution of upper-limb somatosensory impairments and the association with unimanual and bimanual motor outcomes and visuospatial neglect.  
Methods. A cross-sectional observational study was conducted, including 122 patients within 6 months after stroke (median = 82 days; interquartile range = 57-133 days). Somatosensory measurement included the Erasmus MC modification of the (revised) Nottingham Sensory Assessment (Em-NSA), Perceptual Threshold of Touch (PTT), thumb finding test, 2-point discrimination, and stereognosis subscale of the NSA. Upper-limb motor assessment comprised the Fugl-Meyer assessment, motricity index, Action Research Arm Test, and Adult-Assisting Hand Assessment Stroke. Screening for visuospatial neglect was performed using the Star Cancellation Test. 
Results. Upper-limb somatosensory impairments were common, with prevalence rates ranging from 21% to 54%. Low to moderate Spearman ρ correlations were found between somatosensory and motor deficits (r = 0.22-0.61), with the strongest associations for PTT (r = 0.56-0.61) and stereognosis (r = 0.51-0.60). Visuospatial neglect was present in 27 patients (22%). Between-group analysis revealed somatosensory deficits that occurred significantly more often and more severely in patients with visuospatial neglect (P < .05). Results showed consistently stronger correlations between motor and somatosensory deficits in patients with visuospatial neglect (r = 0.44-0.78) compared with patients without neglect (r = 0.08-0.59). 
Conclusions. Somatosensory impairments are common in subacute patients poststroke and are related to motor outcome. Visuospatial neglect was associated with more severe upper-limb somatosensory impairments.

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