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:

Sunday, February 26, 2017

Abstract TMP38: Virtual Reality in Stroke Rehabilitation: Identifying Responders in Evrest Multicentre Trial

The WMFT has been posited as instructive for assessing the motor status of higher functioning chronic patients with stroke and traumatic brain injury, in terms of severity and upper extremity motor deficiency.
You can check it out here to see if you think this has useful objectivity at all.  I likely would fail almost every test. I thinks the results mean this failed.

Wolf Motor Function Test (WMFT)

Abstract TMP38: Virtual Reality in Stroke Rehabilitation: Identifying Responders in Evrest Multicentre Trial

Gustavo Saposnik, Steve Cramer, Leonardo G Cohen, Ashley Cohen, Andreas laupacis, Mark Bayley


Introduction: Despite the modest benefits of non-immersive virtual reality (VR) in small, single center studies, our largest trial (EVREST Muticentre) showed no significant difference in motor recovery when VR was compared to an active control. More crucial is to determine the presence of a treatment effect by evaluating respondents.
Methods: Adults <3 months of stroke with a Chedoke-McMaster >3 were randomized to receive VR using the Nintendo Wii™ gaming system (VRWii) vs. recreational activities (playing cards, ‘Jenga’, domino) (RA). All participants received usual care consisting of conventional rehabilitation at each center. Participants received an intensive program of 10 sessions of either VR or RA, 60 minutes each, over a 2-week period. The primary outcome was a difference in motor performance between groups using the Wolf Motor Function test (WMFT) at the end of the intervention. We defined respondents based on the accepted minimally clinically important difference (MCID) of ≥20% improvement from the baseline WMFT.1 Secondary outcomes included a MCID of 30% in the Stroke impact Scale (hand) and in the perception of improvement.2
Results: Between May 2012 and Oct, 2015, 141 patients received either VRWii (n=71) or RA (n=70). Mean age was 62±12 years. Overall, 63 (53%) participants achieved the MCID (47% % in the VRWii vs 58% RA; p=0.32) at the end of the intervention and 81% 4-weeks post intervention (74 % in the VRWii vs 87% RA; p= 0.21). The total duration of each intervention between respondents and non-respondents was similar (589±57 vs. 579±31 min; p=0.47). Multivariable analysis revealed no difference in the response to VRWii compared to RA (OR 0.63; 95%CI 0.30-1.33). Other outcomes are summarized in the Table.

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Conclusions: The responder analysis in EVREST Multicenter showed no significant difference between groups (VRWii vs RA) for the primary and secondary outcomes. Our results are in agreement with prior analyses that compared mean change across groups.
  • Author Disclosures: G. Saposnik: Research Grant; Significant; Dr. Saposnik is supported by the Distinguished Clinician Scientist Award given by Heart & Stroke Foundation of Canada following an open peer reviewed application.. S. Cramer: None. L.G. Cohen: None. A. Cohen: None. A. laupacis: None. M. Bayley: None.

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