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

Thursday, December 1, 2016

RCP stroke guidance recommends 45 minutes of therapy daily

What a fucking piece of shit guideline. You should be doing hours upon hours of therapy daily including action observation, mirror therapy, meditation, PROM, music listening and virtual realty game playing.  You will never recover much if you listen to this stupid bullshit.  Until the stroke medical world starts writing protocols instead of guidelines they really are useless.
http://www.csp.org.uk/news/2016/11/30/rcp-stroke-guidance-recommends-45-minutes-therapy-daily
People with stroke should receive at least 45 minutes of each appropriate therapy a day, guidance from the Royal College of Physicians (RCP) recommends.
Rehabilitation is central to the document, which says the frequency of therapy must enable stroke patients to meet their rehabilitation goals.(That goal is 100% recovery, nothing less) And, very importantly, therapy should continue as long as patients are willing and capable of participating and showing measurable benefit from treatment.
The RCP’s Key Recommendations for Stroke 2016 offers a concise guide to better stroke care. Its 30 recommendations are based on the RCP’s detailed 151-page National Clinical Guideline for Stroke, with more than 400 recommendations covering almost every aspect of stroke management.(Pretty much useless since these are guidelines not protocols)
A stroke unit must be capable of providing rehabilitation to all its patients, it tells commissioners. In addition, it calls on them to provide a specialist early supported discharge service, so stroke patients can continue their rehabilitation at home.
Commissioners are recommended to look for specialist rehabilitation services which meet the specific health, social and vocational needs of people with stroke of all ages. And they should commission services capable of delivering specialist rehabilitation in out-patient and community settings, in liaison with inpatient services.
Daily mobilisation
Early mobilisation is key, the document says. Patients who are medically stable but have difficulty moving soon after a stroke should be offered frequent, short, daily mobilisations by appropriately trained staff. Typically this should begin between 24 and 48 hours after a stroke.
Inpatient stroke units should be staffed by a multidisciplinary team that meets at least once each week to exchange information about patients.
Nicola Hancock, lecturer in physiotherapy at the University of East Anglia, contributed to the guidance. She said physiotherapists would find the concise guidance highly accessible and hoped it would be used, along with the full guidelines, to inform, support and improve acute and rehabilitation services.
'The new National Clinical Guideline for Stroke is the most comprehensive, evidence-based tool available to guide practice all the way through the stroke pathway, from the earliest stages to long-term management of this important condition,’ she said.
‘The guidelines were developed using a highly-rigorous process of searching, appraising and compiling the evidence. The concise guide brings together a number of guidelines from the main document that are particularly relevant to physiotherapy practice.’


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