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

Saturday, June 17, 2017

A systematic review and meta-analysis on the role of exercise or rest in patients with concussion and mild traumatic brain injury

These reviews would not be necessary if you lazy bastards wrote up publicly available protocols for the world to see and update. Then the work you would be doing is refining the protocols to make them better rather than seeing what research is already out there. 
http://bjsm.bmj.com/content/51/11/A83.2?rss=1

  1. Avtar Lal1,
  2. Stephanie Kolakowsky-Hayner1,
  3. Jamshid Ghajar2,
  4. Oscar Vazquez1,
  5. Maya Balamane1

Author affiliations

Abstract

Objective To conduct a systematic review and meta-analysis evaluating the role of exercise or rest in patients with concussion or mild traumatic brain injury.
Design Systematic review and meta-analysis.
Data sources Medline, PsychInfo, Scopus, Cochrane Controlled Trials Registers and Sport Discus, till March 2016 and hand search of some articles.
Study selection Randomised controlled trials (RCTS) and observational studies (OBS) comparing the effect of exercise or rest in patients with concussion, on different outcomes.
Participants Children and adults with concussion or mild traumatic brain injury.
Intervention Exercise or Rest.
Outcomes Post concussive symptoms (PCCS), balance error scoring system (BESS), immediate post concussion assessment and cognitive testing (ImPACT).
Main results Our search generated 921 studies. Of these, 5 RCTs and 12 OBS met our inclusion criteria. Methodological quality of most of the studies was poor. Meta-analysis of 6 studies involving more than 556 patients showed statistical significant decrease in PCCS with exercise compared to control, Mean Difference (MD) [95% Confidence Interval (CI)], −14.6 [−17.8, −11.3], p<0.001. There was some clinical, but no statistical heterogeneity among the studies (I2=32%). Exercise did not affect BESS, neuropsychological scale and ImPACT score.
There was not effect of rest on total symptoms in patients with concussion and number of patients with symptoms.
Conclusion Our systematic review and meta-analysis showed clear benefits of exercise in PCCS. However, the evidence was based on poor quality studies that vary in duration, frequency and intensity of exercise. A good quality RCT needs to be conducted to evaluate a clear effect of exercise and rest in patients with concussion.
Competing interests None.

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