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

Friday, September 30, 2016

Upper-Limb Recovery After Stroke A Randomized Controlled Trial Comparing EMG-Triggered, Cyclic, and Sensory Electrical Stimulation

What protocol came out of this?
http://nnr.sagepub.com/content/30/10/978?etoc
  1. Richard D. Wilson, MD1,2,3
  2. Stephen J. Page, PhD4
  3. Michael Delahanty, D.O.5,6
  4. Jayme S. Knutson, PhD1,2,3
  5. Douglas D. Gunzler, PhD2
  6. Lynne R. Sheffler, MD1,2,3
  7. John Chae, MD1,2,3
  1. 1MetroHealth Rehabilitation Institute, MetroHealth Medical Center, Cleveland, OH, USA
  2. 2Case Western Reserve University, Cleveland, OH, USA
  3. 3Cleveland FES Center, Cleveland, OH, USA
  4. 4The Ohio State University, Columbus, OH, USA
  5. 5Akron General Medical Center, Akron, OH, USA
  6. 6Northeast Ohio Medical University, Rootstown, OH, USA
  1. Richard D. Wilson, MD, MetroHealth Rehabilitation Institute, 4229 Pearl Road, Cleveland, OH, USA. Email: rwilson@metrohealth.org

Abstract

Background and purpose. This study compared the effect of cyclic neuromuscular electrical stimulation (NMES), electromyographically (EMG)-triggered NMES, and sensory stimulation on motor impairment and activity limitations in patients with upper-limb hemiplegia.  
Methods. This was a multicenter, single-blind, multiarm parallel-group study of nonhospitalized hemiplegic stroke survivors within 6 months of stroke. A total of 122 individuals were randomized to receive either cyclic NMES, EMG-triggered NMES, or sensory stimulation twice every weekday in 40-minute sessions, over an 8 week-period. Patients were followed for 6 months after treatment concluded.  
Results. There were significant increases in the Fugl-Meyer Assessment [F(1, 111) = 92.6, P < .001], FMA Wrist and Hand [F(1, 111) = 66.7, P < .001], and modified Arm Motor Ability Test [mAMAT; time effect: F(1, 111) = 91.0, P < .001] for all 3 groups. There was no significant difference in the improvement among groups in the FMA [F(2, 384) = 0.2, P = .83], FMA Wrist and Hand [F(2, 384) = 0.4, P = .70], or the mAMAT [F(2, 379) = 1.2, P = .31].  
Conclusions. All groups exhibited significant improvement of impairment and functional limitation with electrical stimulation therapy applied within 6 months of stroke. Improvements were likely a result of spontaneous recovery. There was no difference based on the type of electrical stimulation that was administered.

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