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, October 30, 2016

Breaking up sitting time after stroke (BUST-Stroke)

It will never happen. Our doctors don't read and implement information from stroke research. And we have NO stroke leadership pushing such information out to stroke hospitals. Incompetency run amok in the stroke world. But what the hell, it is just stroke survivors that are impacted. And since 90% of strokes are preventable, the problem is completely on the patient to solve. You caused it, you solve it.
http://wso.sagepub.com/content/early/2016/10/27/1747493016676616.abstract
  1. Heidi Janssen1,2,3,4
  2. David W Dunstan5
  3. Julie Bernhardt6,7
  4. Frederick R Walker2,4,8
  5. Amanda Patterson3
  6. Robin Callister2,4,8,9
  7. Ashlee Dunn9
  8. Neil J Spratt2,4,8,10
  9. Coralie English2,3,4
  1. 1Hunter Stroke Service, Hunter New England Local Health District, Newcastle NSW, Australia
  2. 2Centre for Research Excellence in Stroke Rehabilitation and Recovery, Hunter Medical Research Institute, Newcastle NSW, Australia
  3. 3School of Health Sciences, Faculty of Health, University of Newcastle, Newcastle NSW, Australia
  4. 4Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle NSW, Australia
  5. 5Baker IDI Heart and Diabetes Institute, Melbourne VIC, Australia
  6. 6Centre for Research Excellence in Stroke Rehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Heidelberg VIC, Australia
  7. 7University of Melbourne, Parkville VIC, Australia
  8. 8School of Biomedical Science and Pharmacy, Faculty of Health, University of Newcastle, Newcastle NSW, Australia
  9. 9Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle NSW, Australia
  10. 10Department of Neurology, John Hunter Hospital, Hunter New England Local Health District, Newcastle NSW, Australia
  1. Heidi Janssen, Hunter Medical Research Institute, Stroke Recovery Group, Level 3 East, Kookaburra Crt, New Lambton Heights, NSW 2305, Australia. Email: heidi.janssen@hnehealth.nsw.gov.au

Abstract

Rationale Prolonged sitting is associated with an increased risk of cardiovascular and all-cause mortality and morbidity. The metabolic and cardiovascular effects of breaking up sitting time in people with stroke are unknown.
Aims and hypotheses To determine the (i) metabolic and cardiovascular effects and (ii) safety and feasibility of an experimental protocol to break up uninterrupted sitting in people with stroke. We hypothesize that activity breaks will attenuate the effects of uninterrupted sitting on glucose and insulin metabolism, blood pressure, lipid profiles, and plasma fibrinogen and that it will be both safe and feasible.
Sample size estimate Based on previous estimates of population variability (SD 1% glucose and 30% insulin), 19 paired observations (i.e. participants) will achieve a power of 0.9 to detect a difference of 0.8% in glucose and 24% in insulin area under the curve (two-tailed testing, α = 0.05).
Methods and design People with stroke will complete three experimental conditions one week apart in randomized order: (a) uninterrupted sitting, (b) prolonged sitting with intermittent walking, and (c) prolonged sitting with intermittent standing exercises. Serial blood samples will be collected and blood pressure measured at 30 min intervals for 8 h.
Study outcomes Primary outcome will be postprandial glucose and insulin responses. Secondary outcomes will include fibrinogen concentrations, blood pressure, and adverse events and protocol feasibility.
Discussion This is the first important step in determining the cardiovascular effects of breaking up sitting time after stroke. Findings will guide future studies testing behavioral strategies to reduce sitting time for the purpose of lowering recurrent stroke risk.

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