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:

Saturday, September 23, 2017

Don’t overthink your exercise: just 2.5 hours per week of any kind could help you live longer

Sometimes I get that in a day depending upon how slow I'm walking and how hot it is.
With the explosion of boutique gyms and spin classes and ultramarathons, it can feel like exercise should be both expensive and extreme. But researchers are finding that it really doesn’t seem to matter what kind of physical activity you do to reap great health rewards.
In one of largest global studies ever published on the heart health benefits of physical activity, researchers found that 150 minutes spent exercising per week could cut a person’s risk of cardiovascular disease and death. And, most importantly, the Lancet paper demonstrated that all kinds of physical activity were equally good for the heart.
“I would dispel the notion of having to put out money to be active,” said Dr. Scott Lear, the study lead author and a professor at Simon Fraser University’s Faculty of Health Sciences in Canada, in an email. “Our findings indicate that nonrecreational activity — work, housework, active transportation — is just as beneficial in reducing the risk for premature death and heart disease.”
So, yes, even vacuuming your house or walking on your lunch hour for a solid 30 minutes can help avert an early death and chronic disease.
The researchers tracked the exercise levels — as well as the rate of cardiovascular disease (including heart attacks, stroke, and heart failure) and all-cause mortality — of more than 130,000 adults living in 17 high-, low-, and middle-income countries, from Canada to China.
Following the study participants for an average of seven years, they found the people who reported at least 150 minutes of physical activity per week were much healthier than their sedentary counterparts: They were less likely to have heart attacks, strokes and cardiovascular disease, and less likely to die from any cause. Getting only two and a half hours of weekly exercise was associated with a 28 percent reduction in premature death, and a 20 percent reduction in heart disease.
All forms of exercise appeared to reduce a person’s risk of death and disease, whether people were sweating away in a gym class, cleaning their house, or simply walking to work.
“This is a large study, covering a lot of different countries of different income levels and means of physical activity,” said Brian Elbel, director of NYU’s Langone Comprehensive Program on Obesity, “and it confirms that physical activity is great and focusing on the means of physical activity isn’t important.”

We spend more time glued to our seats, while rates of chronic disease are going up

But while the evidence keeps piling up to show us that physical activity is really important for not dying early, we’re also more sedentary than ever before. Most of us barely manage to meet the minimum exercise requirements — or to carry on the most basic health habits. Only about 38 percent of Americans surveyed in this 2016 Mayo Clinic Proceedings study had a healthy diet, just 10 percent had a normal body fat level — and fewer than half (47 percent) were sufficiently active.
We’re driving more, spending more time in front of screens, and walking less. According to one study of health impact of sedentary behavior, in 1970, only 20 percent of Americans had jobs that required little physical activity (and lots of sitting around). By 2000, that number climbed to 40 percent. All told, Americans now spend up to nine hours each day being sedentary.
Meanwhile, lifestyle-related chronic diseases have shot up dramatically. Having a high body weight contributed to 4 million deaths globally — or 7 percent of the deaths from any cause — in 2015, according to a recent New England Journal of Medicine paper. Most of those deaths were caused by cardiovascular disease, with diabetes following closely behind, along with kidney disease and cancers.

The easiest ways to exercise more without extra time

Americans often complain that they don’t have enough time to work out. A 2015 survey asked a group of 1,000 of them how they'd spend an extra four hours each week if they suddenly had the time. The number one answer? Exercise. The desire for more time to work out trumped the wish for more time spent with family, sleeping, or even doing hobbies.
But this Lancet paper is a reminder that we often overthink exercise — and we may not actually need to set aside extra time to work out. Exercise doesn't require a gym membership or fancy shoes. Exercise is something you can do throughout the day, every day. It also doesn’t need to be grueling, and it doesn’t have to cost anything, to see health benefits.
So how can you incorporate more physical activity in your waking hours? Simply walking more — while commuting, running errands, or on the phone — counts for a lot, health-wise. Dr. Mike Evans, an associate professor of family medicine and public health at the University of Toronto, has a great video on how to fill your day with more activity. He suggests:
  • Scheduling walking meetings
  • Getting off a stop early on your daily commute to work
  • Walking on your lunch hour instead of going to another place to sit
  • Walking to the grocery store instead of driving
  • If you do drive, park far away
  • Taking the stairs to your office instead of the elevator
The researchers in the Lancet study also found there was a linear relationship between the amount of exercise and disease risk, meaning the more hours a person spent doing physical activity (again, of any kind), the lower their risk of disease and death. (The benefits seemed to taper off at 1.8 hours of brisk walking per day.) And the people who reported getting the most physical activity were the ones who had exercise built into their daily lives, Lear noted, through simple things like active transport to work, their jobs, or doing housework.
“I would also stress that physical activity is a good stress release,” Lear said. “I commute by bicycle to work and that ride home is so good for burning off the stress of the work day and I get home much fresher than if I sat in a car fighting traffic.”

Our physical environment encourages sedentary lifestyles — and that needs to change

As we learn more about the importance of exercise for health, we also have to make our communities more amenable to active lifestyles.
Imagine if more cities made their streets pedestrian-friendly and invested in spaces that everyone could access, such as community yoga studios, public parks, or even programs like Sunday San Francisco Streets or the Ciclovía in Bogota, Colombia, which involve closing down streets for walking and biking on the weekend.
Researchers have also found putting traffic-free cycling and walking routes in place increases physical activity levels for the people who live near them.
These public places offer the most cost-effective forms of exercise, and they’re available to everybody. In this 2011 economic analysis, the researchers found Sunday San Francisco Streets cost only $1.35 per week. Meanwhile, they estimated, using pedestrian trails in Nebraska cost 81 cents, and the weekly cost of private fitness centers in cities like San Francisco runs about $20. Compare that with using a boutique spinning or Pilates studio two or three times per week, for which you can shell out more than $90.
“In high income countries in particular, and in occupations that result in a lot of sitting, we have engineered physical activity out of our daily work or domestic lives,” Lear said. We’ve also made working out too complicated. Science suggests that should change.

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