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

Friday, August 4, 2017

AExaCTT – Aerobic Exercise and Consecutive Task-specific Training for the upper limb after stroke: Protocol for a randomised controlled pilot study

If you can do these hours of training you are already high functioning so this research will tell you nothing. With my spasticity I could really do no upper arm exercises until that spasticity is cured. No talk of fixing that. 
http://www.sciencedirect.com/science/article/pii/S2451865416301296?

Under a Creative Commons license

Abstract

Motor function may be enhanced if aerobic exercise is paired with motor training. One potential mechanism is that aerobic exercise increases levels of brain-derived neurotrophic factor (BDNF), which is important in neuroplasticity and involved in motor learning and motor memory consolidation. This study will examine the feasibility of a parallel-group assessor-blinded randomised controlled trial investigating whether task-specific training preceded by aerobic exercise improves upper limb function more than task-specific training alone, and determine the effect size of changes in primary outcome measures. People with upper limb motor dysfunction after stroke will be allocated to either task-specific training or aerobic exercise and consecutive task-specific training. Both groups will perform 60 hours of task-specific training over 10 weeks, comprised of 3 × 1 hour sessions per week with a therapist and 3 × 1 hours of home-based self-practice per week. The combined intervention group will also perform 30 minutes of aerobic exercise (70–85%HRmax) immediately prior to the 1 hour of task-specific training with the therapist. Recruitment, adherence, retention, participant acceptability, and adverse events will be recorded. Clinical outcome measures will be performed pre-randomisation at baseline, at completion of the training program, and at 1 and 6 months follow-up. Primary clinical outcome measures will be the Action Research Arm Test (ARAT) and the Wolf Motor Function Test (WMFT). If aerobic exercise prior to task-specific training is acceptable, and a future phase 3 randomised controlled trial seems feasible, it should be pursued to determine the efficacy of this combined intervention for people after stroke.

Keywords

Stroke
Motor function
Aerobic exercise
Task-specific training

Abbreviations

ARAT
Action Research Arm Test
BDNF
brain-derived neurotrophic factor
CERT
Consensus on Exercise Reporting Template
CM
centimetre
CONSORT
Consolidated Standards of Reporting Trials
ECG
electrocardiography
ELISA
enzyme-linked immunosorbent assay
FAS
Fatigue Assessment Scale
GP
general practitioner
HRmax
age-predicted maximal heart rate maximum
HRpeak
peak heart rate
IPAQ
International Physical Activity Questionnaire
MAL
Motor Activity Log
mL.kg−1.min−1
millilitres per kilogram per minute
MRI
magnetic resonance imaging
MS
Microsoft
m/s
millimetres per second
NAA
N-acetyl Aspartate
PV
Peak Velocity
PD
Peak Deceleration
REDCap
Research Electronic Data Capture
reps
repetitions
RPE
rating of perceived exertion
RPM
revolutions per minute
SIS
Stroke Impact Scale
s
seconds
VO2
oxygen uptake
VO2peak
peak oxygen uptake
WMFT
Wolf Motor Function Test
6MWT
Six Minute Walk Test

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