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

Lesion location associated with balance recovery and gait velocity change after rehabilitation in stroke patients

Well DUH, smaller lesions and locations outside of the walking control areas lead to better recovery. The brainpower to come up with that could never have occurred in stroke-addled survivors like me.
http://link.springer.com/article/10.1007/s00234-017-1840-0
  • Hyun Im Moon
  • Hyo Jeong Lee
  • Seo Yeon Yoon
  • Hyun Im Moon
    • 1
  • Hyo Jeong Lee
    • 1
  • Seo Yeon Yoon
    • 1
  1. 1.Department of Rehabilitation MedicineBundang Jesaeng General HospitalSeoungnam-siRepublic of Korea
Functional Neuroradiology
DOI: 10.1007/s00234-017-1840-0
Cite this article as:
Moon, H.I., Lee, H.J. & Yoon, S.Y. Neuroradiology (2017). doi:10.1007/s00234-017-1840-0

Abstract

Purpose

Impaired gait function after stroke contributes strongly to overall patient disability. However, the response to rehabilitation varies between individuals. The aims of this study were to identify predictors of gait velocity change and to elucidate lesion location associated with change of balance and gait function.

Methods

We reviewed 102 stroke patients. The patients were divided into two groups according to gait ability post-rehabilitation, and we analyzed differences in their characteristics, such as demographic information, lesion factors, and initial balance function. Multivariate regression analyses were performed to examine the predictors of rehabilitation response. Lesion location and volume were measured on brain magnetic resonance images. We generated statistical maps of the lesions related to functional gains in gait and balance using voxel-based lesion symptom mapping (VLSM).

Results

The group of patients who regained independent ambulation function showed a smaller lesion size, a shorter duration from stroke onset, and higher initial balance function. In the regression model, gait velocity changes were predicted with the initial Berg balance scale (BBS) and duration post-onset. Absolute BBS changes were also correlated with the duration post-onset and initial BBS, and relative BBS changes were predicted by the baseline BBS. Using VLSM, lesion locations associated with gait velocity changes and balance adjusting for other factors were the insula, internal capsule, and adjacent white matter.

Conclusion

Initial balance function as well as the interval between stroke onset and the initiation of therapy might influence balance recovery and gait velocity changes. Damage to the insula and internal capsule also affected gait velocity change after rehabilitation.

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