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

Sunday, September 25, 2016

Pediatric stroke rehabilitation: A review of techniques facilitating motor recovery

 

Pediatric stroke rehabilitation: A review of techniques facilitating motor recovery

Abstract

Objective

Paediatric stroke is a relatively rare medical condition, but it often leads to long lasting motor and cognitive impairments. Rehabilitation of motor impairments has been widely studied, with most studies performed in children with cerebral palsy (CP). However, CP covers a variety of medical conditions, including brain lesions due to paediatric stroke occurring early in life, but not stroke occurring later on during childhood. The specificity of rehabilitation after paediatric stroke remains understudied. This paper aims to present current motor rehabilitation practices (from birth to age 18) and examine which of these techniques are applicable and efficient for paediatric stroke.

Materials/Patients and methods

We first conducted searches using Ovid Database, for motor rehabilitation techniques used in childhood hemiplegia and/or CP. As a second step, a systematic search was conducted up to March 2016, combining the therapies retrieved in the first search AND key words referring to paediatric stroke. Separate searches were conducted for each rehabilitation technique previously identified, namely: constraint induced movement therapy (CIMT), hand arm bimanual training (HABIT), occupational therapy combined with botulinum toxin injections, non-invasive brain stimulation, virtual reality, robotics, action-observation therapy, functional electric stimulation and prismatic or mirror adaptations.

Results

In paediatric stroke, studies on rehabilitation of lower limb present low or insufficient evidence, whereas most studies refer to rehabilitation of upper-limb disabilities. CIMT presents moderate to strong evidence, sometimes coupled with imaging studies examining the associated brain changes. Individual case studies propose CIMT for toddlers or infants, both for motor rehabilitation or unilateral spatial neglect. Contrary to CP literature, there is no available evidence on bimanual training or botulinum toxin injections, whereas there is a growing body of research on non-invasive brain stimulation, (tDCS or TMS) providing preliminary evidence on the efficacy, as well as safety and feasibility of such methods for older children. Novel approaches such as functional electric stimulation, robotic therapy, virtual reality and action–observation therapy present low or insufficient evidence, but may be promising for more severe upper limb deficits or early intervention.

Discussion/Conclusion

Rehabilitation of motor deficits following paediatric stroke remains understudied, but a number of promising therapies are emerging.

 

 

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