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

Tuesday, December 13, 2016

Effects of professional rehabilitation training on the recovery of neurological function in young stroke patients

As compared to non-professional training? Like what all stroke survivors have to do because there are no protocols to get you to 100% recovery from any so-called professional?
http://www.nrronline.org/article.asp?issn=1673-5374;year=2016;volume=11;issue=11;spage=1766;epage=1772;aulast=Li



1 School of Rehabilitation Medicine, Capital Medical University, Beijing; Department of Neurological Rehabilitation, Beijing Bo’ai Hospital, China Rehabilitation Research Center, Beijing, China
2 Department of Neurology, Xi'an Gaoxin Hospital, Xi'an, Shaanxi Province, China
3 School of Rehabilitation Medicine, Capital Medical University, Beijing; Room of Medical Records, Beijing Bo’ai Hospital, China Rehabilitation Research Center, Beijing, China
4 School of Rehabilitation Medicine, Capital Medical University, Beijing, China

Date of Acceptance06-Feb-2016
Date of Web Publication9-Dec-2016
Correspondence Address:
Xiao-xia Du
School of Rehabilitation Medicine, Capital Medical University, Beijing; Department of Neurological Rehabilitation, Beijing Bo’ai Hospital, China Rehabilitation Research Center, Beijing
China
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Source of Support: This research was supported by the Special Fund of Basic Scientific Research Service Fee of Central Public Welfare Scientific Research Institute of China, No. 2014CZ-13., Conflict of Interest: None

DOI: 10.4103/1673-5374.194746
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  Abstract
Young stroke patients have a strong desire to return to the society, but few studies have been conducted on their rehabilitation training items, intensity, and prognosis. We analyzed clinical data of young and middle-aged/older stroke patients hospitalized in the Department of Neurological Rehabilitation, China Rehabilitation Research Center, Capital Medical University, China from February 2014 to May 2015. Results demonstrated that hemorrhagic stroke (59.6%) was the primary stroke type found in the young group, while ischemic stroke (60.0%) was the main type detected in the middle-aged/older group. Compared with older stroke patients, education level and incidence of hyperhomocysteinemia were higher in younger stroke patients, whereas, incidences of hypertension, diabetes, and heart disease were lower. The average length of hospital stay was longer in the young group than in the middle-aged/older group. The main risk factors observed in the young stroke patients were hypertension, drinking, smoking, hyperlipidemia, hyperhomocysteinemia, diabetes, previous history of stroke, and heart disease. The most accepted rehabilitation program consisted of physiotherapy, occupational therapy, speech therapy, acupuncture and moxibustion. Average rehabilitation training time was 2.5 hours/day. Barthel Index and modified Rankin Scale scores were increased at discharge. Six months after discharge, the degree of occupational and economic satisfaction declined, and there were no changes in family life satisfaction. The degrees of other life satisfaction (such as friendship) improved. The degree of disability and functional status improved significantly in young stroke patients after professional rehabilitation, but the number of patients who returned to society within 6 months after stroke was still small.
Keywords: nerve regeneration; young stroke patients; risk factors; recovery of neurological function; prognosis; Life Satisfaction Questionnaire; Barthel Index; modified Rank Scale; neural regeneration

How to cite this article:
Li Cj, Du Xx, Yang K, Song Lp, Li Pk, Wang Q, Sun R, Lin Xl, Lu Hy, Zhang T. Effects of professional rehabilitation training on the recovery of neurological function in young stroke patients. Neural Regen Res 2016;11:1766-72

How to cite this URL:
Li Cj, Du Xx, Yang K, Song Lp, Li Pk, Wang Q, Sun R, Lin Xl, Lu Hy, Zhang T. Effects of professional rehabilitation training on the recovery of neurological function in young stroke patients. Neural Regen Res [serial online] 2016 [cited 2016 Dec 13];11:1766-72. Available from: http://www.nrronline.org/text.asp?2016/11/11/1766/194746


  IntroductionTop


Stroke with high incidence and high disability seriously threatens human life and health. Stroke onset in young patients between 18 and 44 years, is inclusive. Morbidity has been reported between 7 and 15 cases per 100,000 individuals (Griffiths and Sturm, 2011). Morbidity accounts for 5–15% of all strokes (Bi and Beijing Neurologist Club, 2003). In recent years, the incidence of stroke is rising. The etiology and risk factors for young stroke patients differ from those for middle-aged and older stroke patients, and are complicated in young patients with ischemic stroke (Béjot et al., 2013; Sultan and Elkind, 2013). Numerous studies have shown that the onset of stroke in young people is associated with hypertension, family history of stroke, smoking and hyperhomocysteinemia in developing countries (Hill et al., 1991; Lee et al., 2002; Feigin et al., 2003; Benninger et al., 2009; De Silva et al., 2009; Onwuchekwa et al., 2009; Griffiths and Sturm, 2011; Park et al., 2014). Moreover, the proportion of stroke without any clear cause increases year by year, and different risk factors are reported in different studies (Hill et al., 1991; Lee et al., 2002; Feigin et al., 2003; Benninger et al., 2009; De Silva et al., 2009; Onwuchekwa et al., 2009; Griffiths and Sturm, 2011; Park et al., 2014).

Professional rehabilitation relieves dysfunction in stroke patients, and promotes and maintains the recovery of cognition, language, movement, psychology, and social function. The demand to return to society and work is high in young stroke patients, but there are few studies that focus on rehabilitation training items, intensity, or prognosis for young stroke patients. Indeed, a multicenter study demonstrated a current lack of unified evaluation criteria for the effect of rehabilitation therapy in stroke patients (Engbers et al., 2005; Kuptniratsaikul et al., 2009). No studies regarding the rehabilitation, strength, or prognosis for young stroke patients have been performed in China.

We sought to analyze the clinical data of stroke patients hospitalized over the course of one year in the Department of Neurological Rehabilitation, China Rehabilitation Research Center, Capital Medical University, China. We compared general data and risk factors between young stroke patients and middle-aged/older stroke patients. We first analyzed rehabilitation and strength in young stroke patients by comparing the degree of disability and functional status between the time of admission and the time of discharge. We also collected information regarding the degree of disability, functional changes, life satisfaction, and return to society 6 months after discharge in young stroke patients. This was done to help patients have better access to rehabilitation services and to improve their quality of life.

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