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, June 20, 2017

Brain stimulation protocol reduces spasticity in spinal cord injury patients

Now to compare this to these other ones and write up a fucking protocol. Is your doctor going to take on that challenge or just twiddle her/his thumbs and DO NOTHING?

A single blind, clinical trial to investigate the effects of a single session extracorporeal shock wave therapy on wrist flexor spasticity after stroke

 

Strengthening a Spastic Muscle. Why the Kerfuffle?

 

Apparatus for reduction of spasticity in male and female patients having spinal cord injury as well as obtaining semen from males by stimulation of ejaculatory nerves 

 

S2-3 Improvements in spasticity and motor function using a foot bath for people with chronic hemiparesis following stroke

 

Oromucosal Spray Improves Tough-to-Treat Spasticity in Patients With MS

 

 

https://m.medicalxpress.com/news/2017-06-brain-protocol-spasticity-spinal-cord.html#jCp
Spasticity, uncontrolled muscle contractions, is a common disorder experienced by patients with spinal cord injuries (SCI)(and 30% of stroke patients). Previous studies have shown that excitatory repetitive transcranial magnetic stimulation (rTMS) can reduce spasticity. In a new study published in Restorative Neurology and Neuroscience, researchers found that a protocol of rTMS, excitatory intermittent theta burst stimulation (iTBS), was successful in reducing spasticity in patients with SCI and therefore may be a promising therapeutic tool.
"The aim of this study was to assess whether a different rTMS protocol may have significant beneficial clinical effects in the treatment of lower limb spasticity in SCI , namely iTBS, a safe, non-invasive and well-tolerated protocol of rTMS. Patients receiving real iTBS, compared to those receiving sham treatment, showed significant improvement," explained lead investigator Raffaele Nardone, MD, PhD, Paracelsus Medical University, Salzburg, Austria, and the Franz Tappeiner Hospital, Merano, Italy.
Ten patients with chronic SCI, classified as grades C or D according to the American Spinal Cord Injury Association Impairment Scale, participated in the study. Five received real treatment and the remaining five received sham treatment. After two months, the sham group was switched to real iTBS and the study continued. All eligible patients took antispastic medications and received physical therapy, both before and after the study.
Patients receiving real iTBS showed significant positive effects in several measurements of nerve function, suggesting increased cortical excitability and decreased spinal excitability. Other improvements measured by the Modified Ashworth Scale and the Spinal Cord Injury Assessment Tool persisted up to one week after the end of the iTBS treatment.
Motor-evoked potentials (MEP) were measured in the soleus, or calf muscle, during magnetic stimulation over the most responsive area of the scalp. M-wave and H reflexes, which are measures of muscle contractions due to stimulation of the tibial nerve, were assessed for each subject and a Hmax/Mmax ratio was determined. These measurements were used to assess any changes in spasticity over the two-week stimulation period and the four weeks afterwards.
"Although this study has a small sample size and validation with data from a larger group of patients is needed to confirm the results, our findings clearly suggest that iTBS can be considered as a promising tool for the of spasticity in patients with traumatic SCI and perhaps for other pathological conditions. In comparison with standard rTMS protocols, iTBS represents a more feasible approach because of lower stimulation intensity and shorter duration of application in each single session," commented Dr. Nardone.
More information: Raffaele Nardone et al, Effects of intermittent theta burst stimulation on spasticity after spinal cord injury, Restorative Neurology and Neuroscience (2017). DOI: 10.3233/RNN-160701
Provided by: IOS Press

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