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:

Friday, September 9, 2016

USC professor helps develop the first stroke rehab guidelines

This is fucking worthless. Guidelines tell you nothing at all, you need stroke protocols with efficacy ratings. With that you actually know the results expected. A great stroke association president would know this and focus our stroke medical teams on the correct strategy. But we have none, so we are continually screwed.

Every year, 800,000 Americans suffer a stroke, with more than 80 percent surviving, many of them living for decades with some degree of disability.
For the first time, the American Heart Association/American Stroke Association (AHA/ASA) has issued evidence-based strategies to help improve outcomes for adult stroke survivors. The “how-to” manual recommends a comprehensive post-acute care strategy, thanks in large part to Carolee Winstein MS ’84.
“Previous guidelines have focused on the medical issues involved in the initial management of stroke, but many people survive a stroke with some level of disability,” said Winstein, professor at the USC Division of Biokinesiology and Physical Therapy and lead author of the guidelines. “There is increasing evidence that rehabilitation can have a big impact on the survivors’ quality of life, so the time is right to review the evidence in this complex field and highlight effective and important aspects of rehabilitation.”
Among the guidelines:
  • Rehab should include intense mobility-task training for stroke patients with walking limitations.
  • Stroke survivors should be given individually tailored exercise programs to improve their cardiovascular fitness after rehabilitation.
  • Patients should be provided intellectually stimulating environments, with access to computers, books, music, etc.
  • Patients with impaired speech should be offered speech therapy.
  • Eye exercises should be given to patients with impaired eye coordination and focus.
  • Stroke survivors with balance issues should be provided a balance training program.
You could meet every single one of these guidelines and the survivor may not recover anything at all because the damage was greater than the guidelines expected, or you didn't adjust for the resilience and persistence needed. With protocols you would write them up based upon the damage diagnosis.
Winstein has worked at the USC Division of Biokinesiology and Physical Therapy since 1990. She has a dual appointment with the neurology department at the Keck School of Medicine of USC. Her research has focused on neurological rehabilitation. Winstein has written more than 100 research articles and book chapters. She is the director of the Motor Behavior and Neurorehabilitation Lab.
She served as the chair of an expert writing team that put together these guidelines, which was published May 4 in the journal Stroke.

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