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, May 23, 2017

Feasibility of Integrating Post Stroke Rehabilitation and Recovery Assessments in Stroke Clinic (P5.295)

The assessments should have come up with mapping deficits to protocols that correct those deficits. But NO, this was fucking useless research for getting patients closer to 100% recovery.
http://www.neurology.org/content/88/16_Supplement/P5.295.short
  1. Amre Nouh1
  1. Neurology vol. 88 no. 16 Supplement P5.295

Abstract

Objective: To assess the feasibility of integrating post-stroke rehabilitation and recovery guideline assessment during the outpatient post-stroke follow-up visit.
Background: While a large focus of post-stroke follow-up is secondary prevention, many patients experience fatigue, depression, cognitive and rehabilitation challenges requiring attention. In May 2016, the AHA/ASA issued guidelines(not protocols) on adult stroke rehabilitation and recovery integrating objective assessments and treatment recommendations. Ensuring these aspects of care(not results) are adequately addressed by the provider during follow-up can be challenging, particularly in mild stroke patients.
Design/Methods: After IRB approval, a prospective collection of rehabilitation and recovery parameters for all patients seen in the stroke clinic after hospital discharge was performed using a structured questionnaire format completed by trained research personnel. Metrics including clinical parameters, stroke severity, modified Rankin Scale, Patient Health Questionnaire 9, Fatigue Assessment Scale, Montreal Cognitive Assessment, and rehabilitation status including ability to drive, return to work, and sexual dysfunction were collected.
Results: Thus far, 37 patients were surveyed with each assessment averaging 15 minutes. Patients were 60% male with mean age of 65+/− 14.4 years. Despite low mean NIHSS (1 +/−2) and MoCA score of 25 (+/−3), approximately 16% had clinical depression, 10% had mildly depressive symptoms, and 38% complained of post stroke fatigue. Furthermore, 41% could not return to driving. Roughly 64% of patients were assessed within 3 months of stroke and 36% >3 months. All but 4 patients required assistance in completing the survey.
Conclusions: Significant post stroke fatigue, depression and rehabilitative challenges are prevalent, even in patients with mild stroke. Utilizing a structured assessment tool with dedicated personnel is a feasible and sensitive method in evaluating post stroke patients and guiding management, particularly those with mild disability.
Disclosure: Dr. Taboada has nothing to disclose. Dr. Taboada has nothing to disclose. Dr. Nouh has nothing to disclose.

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