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:

Tuesday, June 20, 2017

Concise Arm and Hand Rehabilitation Approach in Stroke (CARAS): A practical and evidence-based framework for clinical rehabilitation management

There might be a protocol in here but let your doctor find and pay for it.

Credentials Display

Johan A. Franck, MSc, OT; Jos H.G. Halfens, PT; Rob J.E.M. Smeets, Prof, PhD, MD; Henk A.M. Seelen PhD


The volume of information on new treatment techniques supporting the restoration of arm-hand function (AHF) and arm-hand skill performance (ASHP) in stroke survivors overwhelms therapists in everyday clinical practice when choosing the appropriate therapy. The Concise Arm and Hand Rehabilitation Approach in Stroke (CARAS) is designed for paramedical staff to structure and implement training of AHF and AHSP in stroke survivors. The CARAS is based on four constructs: (a) stratification according to the severity of arm–hand impairment (using the Utrecht Arm/Hand -Test [UAT]), (b) the individual’s rehabilitation goals and concomitant potential rehabilitation outcomes, (c) principles of self-efficacy, and (d) possibilities to systematically incorporate (new) technology and new evidence-based training elements swiftly. The framework encompasses three programs aimed at treating either the severely (UAT 0-1), moderately (UAT 2-3), or mildly (UAT 4-7) impaired arm-hand. Program themes are: taking care of the limb and prevention of complications (Program 1), task-oriented gross motor grip performance (Program 2), and functional AHSP training (Program 3). Each program is preceded and followed by an assessment. Training modularity facilitates rapid interchange/adaptation of sub-elements. Proof-of-principle in clinical rehabilitation has been established. The CARAS facilitates rapid structured design and provision of state-of-the-art AHF and ASHP treatment in stroke patients.


Johan A. Franck, MSc, OT 1, 2, Jos H.G. Halfens, PT 1,
Rob J.E.M. Smeets, Prof, PhD, MD 2, 3, Henk A.M. Seelen PhD 2, 3
  1. Adelante Rehabilitation Centre, Department of Brain Injury, Hoensbroek, the Netherlands
  2. Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands
  3. Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht, the Netherlands

Recommended Citation

Franck, Johan A.; Halfens, Jos; Smeets, Rob; and Seelen, Henk (2015) "Concise Arm and Hand Rehabilitation Approach in Stroke (CARAS): A practical and evidence-based framework for clinical rehabilitation management," The Open Journal of Occupational Therapy: Vol. 3: Iss. 4, Article 10.
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