Deans' stroke musings: The Best Time to Start Stroke Rehabilitation: A Review of the Evidence in Resource- Adequate and Resource Constrained Settings

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 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:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. 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 lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, November 15, 2016

The Best Time to Start Stroke Rehabilitation: A Review of the Evidence in Resource- Adequate and Resource Constrained Settings

Still told me nothing other than maybe something or other.
https://www.researchgate.net/publication/301289445_The_Best_Time_to_Start_Stroke_Rehabilitation_A_Review_of_the_Evidence_in_Resource-_Adequate_and_Resource_Constrained_Settings

Article (PDF Available) · April 2016 with 130 Reads

DOI: 10.21617/jprm.2016.0101.2

1st Margaret Mweshi

4.2 · University of Zambia
2nd Hastings K. Shula
3rd Loveness Nkhata

2.45 · University of Zambia
4th Brian Chiluba

Abstract

Structured Abstract

Background: Stroke is a global health problem and one of the major causes of death, disability and impairment among adults worldwide. Post-stroke outcomes vary widely, between and within world regions depending on a range of factors including demographic profile, stroke type, severity and immediate and long-term post stroke care. It has been reported that early initiation of rehabilitation following stroke promotes better long-term outcomes than delayed rehabilitation, although this has been disputed by some researchers in the AVERT (A very early rehabilitation trial) study. Purpose of Review: To evaluate the best time to start stroke rehabilitation with good outcomes Results of the Review: There is limited evidence to show that later rehabilitation is better than early rehabilitation. It also remains unclear whether early mobilization is more effective than mobilization at a later stage, due to insufficient statistical power of the studies that have examined this practice because clinicians around the world are practicing this model to this day. Furthermore, some trial limitations of the AVERT study in line with the uncertainty of the external validity of the results, make generalizability something to be concerned about.

Conclusion: The best time to start stroke rehabilitation is as soon as the patient is clinically stable i.e; as early as possible. The results of the poor outcomes of the AVERT study in providing evidence of the impact of early stroke rehabilitation, should not be interpreted as proof of the ineffectiveness of early physical rehabilitation. Every stroke is different from one person to another(Stop using this fucking shortcut explanation) because the impact of the damage to the brain is associated with the different functions of several parts of the brain making generalizability quite difficult(So what?). Therefore, in the absence of provision of high quality evidence, clinicians like physiotherapists should base their decisions on clinical experience, individual circumstances and patient preferences as appropriate.(NO, no, no; It should be based upon objective damage diagnosis scans) It is extremely important to develop evidence-based practice protocols that can guide clinical practice on the best time to start stroke rehabilitation and also enhancing plasticity and reducing the negative impact of stroke through pharmacotherapy, especially for survivors in resource constrained places like sub-Saharan Africa.