Novel Upper-Limb Rehabilitation System Based on Attention Technology for Post-Stroke Patients: A Preliminary Study

Then a protocol on this should be written and distributed worldwide, but won't be. 

Novel Upper-Limb Rehabilitation System Based on Attention Technology for Post-Stroke Patients: A Preliminary Study

 Bor-Shing Lin, Member, IEEE, Jean-Lon Chen, and Hsiu-Chi Hsu
Abstract—In this study, we proposed an upper-limb post-stroke rehabilitation system integrating a motion tracking device (MTD), a portable electroencephalogram (EEG) device for an attentional feedback, and interactive virtual reality (VR) game with the goal to assist patients in upper-limb rehabilitation. Fifteen post-stroke patients were recruited and randomly assigned to a control group (A) or one of two experimental groups (B and C). Group B played the game using a MTD and group C played it using a MTD and brain–computer-interface-based attention-monitoring EEG device.  In group C, patients’ attention was measured in real time using the EEG while the patients performed tasks; visual and auditory stimuli were emitted when their attention lowered. The primary outcome was a change in score on the upper extremity section of the Fugl-Meyer assessment, which was used to evaluate the severity of motor impairment and indicate any improvement of motor function. Improvement in motor function, associated with game performance, was found in group C. Based on their performance quality during 12 training sessions, the higher performance of group C patients in the VR game was significantly correlated with attention level and motor performance. Higher attention level is associated with higher game performance after 12 training sessions, and our MTD-EEG-VR training system may facilitate the improvement of motor function and assist patients in upper-limb rehabilitation. Our MTD-EEG-VR game with the attentional EEG-feedback device is a potential intervention for improving motor function in patients with stroke.
 

Retire With a Smile: 10 Surprising Secrets to a Happy Retirement

I think I have these all covered, none are surprising.
https://www.cheatsheet.com/money-career/surprising-secrets-to-happy-retirement.html/?ref=YF&yptr=yahoo

1. Don’t assume it’s all about the money

My Monte Carlo simulations look good.

2. But don’t ignore your finances

. The divorce took a huge hit on this but still left me enough to not worry.

3. Stay healthy

I'm as healthy as all get out, few my age can keep up with me. 
4. Find your purpose
This is easy, solve stroke for all.

5. Don’t try to keep up with the Joneses

Never a problem. 

6. Give back

What # 4 will do.

7. Stay social

Found out I was a situational extrovert. My original plan to retire to a cabin in the woods in northern Minnesota will not be occurring. 

8. Communicate with your spouse

This is why I'm happily divorced, I communicated. Very good friends of mine wrote separate lists of what they wanted to do in retirement, neither list matched anything. They decided divorce was best. It definitely was best for them. 

9. Think twice before relocating

I will have no problem relocating if I need to, I found out from my move to Michigan that I am quite good at meeting people and making friends. 

10. Be satisfied with what you have

Never, that would imply stagnation.

Brain plasticity and sleep: Implication for movement disorders

You'll have to ask your doctor the difference between Hebbian and non-Hebbian synaptic plasticity and which one is in your stroke protocols for 100% recovery. 

Brain plasticity and sleep: Implication for movement disorders

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https://doi.org/10.1016/j.neubiorev.2017.12.009

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Highlights

Chapter 1 and 2: Focus on the complex interplay between brain plasticity and sleep.

Chapters 3: Focus on the complex interplay between brain plasticity and movement disorders such as Parkinson’s disease and dystonia.

Chapter 4: The relation between sleep disturbances and movement disorders: causative or epiphenomenon?

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Abstract

Brain plasticity is a lifelong process and involves both Hebbian and non-Hebbian synaptic plasticity. The latter, such as intrinsic plasticity and homeostatic synaptic plasticity or synaptic scaling, is thought to counteract Hebbian plasticity, in order to maintain a balanced network. Recent studies support the role of sleep in the regulation of homeostatic synaptic plasticity involved in memory and learning processes. Most evidence focus on the dependence of memory and plasticity in sleep mechanisms. Abnormal brain plasticity during sleep might be implicated in the development of movement disorders, particularly Parkinson’s disease (PD) and dystonia. From that, the great interest to understand the underlying process of sleep in relation to movement disorders. The first objective of the review is to summarize the latest knowledge about brain plasticity. The second objective is to analyze the association between sleep, memory and brain plasticity. Finally, the review aims to assess the consequence of abnormal plasticity during PD and dystonia with a viewpoint on the underling pathogenesis of these disorders.

Telemedicine decreases time to alteplase administration for stroke

Don't try to push this off as a success. It is still a complete failure, administration should be in the ambulance. If that isn't your goal get the fuck out of medicine. 

Hats off to Helmet of Hope - stroke diagnosis in 30 seconds

 

Microwave Imaging for Brain Stroke Detection and Monitoring using High Performance Computing in 94 seconds

 

New Device Quickly Assesses Brain Bleeding in Head Injuries - 5-10 minutes

The failure passed off as success here:

Telemedicine decreases time to alteplase administration for stroke

Nguyen-Huynh MN, et al. Stroke. 2017;doi:10.1161/STROKEAHA.117.018413.

December 28, 2017

A novel telemedicine program increased alteplase administration rates and shortened door-to-needle times without an increase in adverse outcomes, according to a study published in Stroke.

“When a stroke happens, minutes matter,” Mai Nguyen-Huynh, MD, MAS, vascular neurologist and research scientist in the division of research at Kaiser Permanente in Oakland, California, said in a press release. “Faster treatment with intravenous [alteplase], which dissolves the stroke-causing clot and restores blood flow to the brain, is strongly associated with better functional outcomes for stroke patients.”

See Also

• In-transit telemedicine reduces time to treatment for…
• Low-dose alteplase fails to prove noninferiority to…
• Alteplase within 5 hours of stroke onset linked to…

Researchers analyzed data from 310 patients (mean age, 71 years; 50% women) who received alteplase (Activase, Genentech) before the telemedicine program was implemented and 557 patients (mean age, 74 years; 53% women) who received it after the program was initiated in 21 Kaiser Permanente Northern California hospitals.

The telemedicine program included ambulance prenotification, neurological evaluation, medical history review from electronic medical records, notification of potential transfer for endovascular stroke treatment, alteplase administration in the CT suite and rapid transport to the suite. A teleneurologist was on-call to examine and monitor the patient.

The primary outcome was the door-to-needle time for the administration of alteplase. Secondary outcomes were symptomatic intracranial hemorrhage, rate of alteplase administrations per month and disposition at discharge.

Alteplase administrations increased from 34 per month before implementation to 62 per month once the program was in place (P < .001). Door-to-needle times decreased from 52 minutes to 34 minutes (P < .001).

Alteplase administration times of less than 60 minutes occurred in 87.1% of patients during the program vs. 61% before it was implemented (P < .001). Patients who were treated within 30 minutes increased from 4.2% before the program was initiated to 40.8% after the program started (P < .001).

The rate of symptomatic intracranial hemorrhage was similar before (2.2%) and after (3.8%) the program was in place (P = .29).

“Future studies are needed to better evaluate the long-term sustainability of the intervention and its effect on clinical outcomes, including mortality and long-term disability,” Nguyen-Huynh and colleagues wrote. – by Darlene Dobkowski

Disclosures: The study was funded by the Permanente Medical Group. Nguyen-Huynh reports she received funding from the Permanente Medical Group.

This Cause Of Dementia Linked To 66% Higher Risk

Well I hit the overweight category for a couple years post-stroke until I could regularly get in 10,000 steps a day. Ask your doctor for a weight loss diet protocol. Ask your doctor if this is more likely a cause of dementia than your stroke.
1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.
2. Then this study came out and seems to have a range from 17-66%. December 2013.
3. A 20% chance in this research.   July 2013.
http://www.spring.org.uk/2017/12/dementia-cause.php?omhide=true

People with a higher body-mass index are more likely to develop dementia, new research finds. Being classed as overweight rather than in the normal range increases the dementia risk by 16-33%. For a person who is 170cm (5’7″), for example, carrying an extra 14.5kg (32lbs) over the ideal weight, will increase their dementia risk between 16 and 33%. Being classed as obese (an additional 14.5kg) adds the same amount of dementia risk again, making a total of up to 66%. The study analysed data from 1.3 million adults in the US and Europe.

Professor Mika Kivimäki, the study’s first author, said:

“The BMI-dementia association observed in longitudinal population studies, such as ours, is actually attributable to two processes. One is an adverse effect of excess body fat on dementia risk. The other is weight loss due to pre-clinical dementia.

For this reason, people who develop dementia may have a higher-than-average body mass index some 20 years before dementia onset, but close to overt dementia have a lower BMI than those who remain healthy. The new study confirms both the adverse effect of obesity as well as weight loss caused by metabolic changes during the pre-dementia stage.”

Previous studies have given conflicting messages about the effect of obesity on dementia.

Some have suggested more weight may have a protective effect, others, like this one, the reverse.

Comprehensive measurement of stroke gait characteristics with a single accelerometer in the laboratory and community: a feasibility, validity and reliability study

Well shit, without an objective analysis of gait defects we will NEVER be able to correlate interventions to results. You have been in an unregulated clinical trial as a guinea pig by your therapists and doctors since the beginning.  With no protocols everyone trying to treat you is shooting in the dark. Hope you don't mind the inaccuracy and the lack of recovery.  I got the 'Walk this way' from my PT, totally useless.

• Sarah A. MooreEmail authorView ORCID ID profile,
• Aodhan Hickey,
• Sue Lord,
• Silvia Del Din,
• Alan Godfrey and
• Lynn Rochester

Journal of NeuroEngineering and Rehabilitation201714:130

https://doi.org/10.1186/s12984-017-0341-z

©  The Author(s). 2017

Received: 8 August 2017

Accepted: 13 December 2017

Published: 29 December 2017

Abstract

Background

Application of objective measurement of stroke gait with accelerometer-based wearable technology and associated algorithms is increasing, despite reports questioning the accuracy of this technique in quantifying specific stroke-related gait impairments. The aim of this study is to determine the feasibility, validity and reliability of a low-cost open-source system incorporating algorithms and a single tri-axial accelerometer-based wearable to quantify gait characteristics in the laboratory and community post-stroke.

Methods

Twenty-five participants with stroke wore the wearable (AX3, Axivity) on the lower back during a laboratory 2 minute continuous walk (preferred pace) on two occasions a week apart and continuously in the community for two consecutive 7 day periods. Video, instrumented walkway (GaitRite) and an OPAL accelerometer-based wearable were used as laboratory references.

Results

Feasibility of the proposed system was good. The system was valid for measuring step count (ICC 0.899). Inherent differences in gait quantification between algorithm and GaitRite resulted in difficulties comparing agreement between the different systems. Agreement was moderate-excellent (ICC 0.503–0.936) for mean and variability gait characteristics vs. OPAL. Agreement was moderate-poor between the system and OPAL for asymmetry characteristics. Moderate-excellent reliability (ICC 0.534–0.857) was demonstrated for 11/14 laboratory measured gait characteristics. Community test-retest reliability was good-excellent (ICC 0.867–0.983) for all except one (ICC 0.699) of the 19 gait characteristics.

Conclusion

The proposed system is a low-cost, reliable tool for quantifying gait post-stroke with multiple potential applications. Further refinement to optimise gait quantification algorithms for certain gait characteristics including gait asymmetry is required.

Immunity and stroke, the hurdles of stroke research translation

I despise these researchers that  work on limiting the pool of survivors that can benefit rather than solving for all survivors. I don't care how fucking hard it is to get everyone recovered. If you were any good at all you would tackle the hard problems rather than taking the lazy way out. You'll have to ask your doctor what immunomodulation can do for recovery. 
https://www.ncbi.nlm.nih.gov/pubmed/27784822#

Send to

Int J Stroke.

2017 Feb;12(2):123-131. doi: 10.1177/1747493016676622. Epub 2016 Oct 26.

Pagram H¹, Bivard A¹, Lincz LF², Levi C¹.

Abstract

Immunomodulatory therapies after stroke have the potential to provide clinical benefit to a subset of patients, but risk subverting the protective, healing aspects of the innate immune response. Neutrophils clear necrotic cerebral tissue and are important in immunomodulation, but can also contribute to tissue injury. Human trials for immunomodulatory stroke treatments in the sub-acute time frame have attempted to prevent peripheral neutrophil infiltration, but none have been successful and one trial demonstrated harm. These unselected trials had broad inclusion criteria and appear to not have had a specific treatment target. Unfortunately, due to the heterogeneous nature of brain ischemia in humans resulting in variation in clinical severity, the negative effect of thrombolytic drugs on the blood-brain barrier, and the heterogeneity of immune response, it may only be a subset of stroke patients who can realistically benefit from immunomodulation therapies. Translational research strategies require both an understanding of lab practices which create highly controlled environments in contrast to clinical practice where the diagnosis of stroke does not require the identification of a vessel occlusion. These differences between lab and clinical practices can be resolved through the integration of appropriate patient selection criteria and use of advanced imaging and ridged patient selection practices in clinical trials which will be an important part to the success of any future trials of translational research such as immunomodulation.