Deans' stroke musings: Structural changes in the muscle-tendon complex of triceps surae after a daily self-stretch program in chronic hemiparesis: A one-year randomized controlled trial

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 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:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. 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 lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, October 2, 2017

Structural changes in the muscle-tendon complex of triceps surae after a daily self-stretch program in chronic hemiparesis: A one-year randomized controlled trial

Useless, NO clue what objective starting point for the research subjects was, or by what objective criteria you will know who can benefit from this. Or what stretching entails. They never mentioned if the spasticity was removed.
http://www.sciencedirect.com/science/article/pii/S1877065717301549

https://doi.org/10.1016/j.rehab.2017.07.033 Get rights and content

Objective

The effects of long-term (> 6 months) stretching in spastic paresis are unknown. The objective of this study was to compare the architectural and clinical changes in plantar flexors in patients with chronic hemiparesis following a one-year daily self-stretch program vs. standard rehabilitation.
(Nothing on actually helping survivors)

Material/patients and methods

Twenty-three patients with chronic hemiparesis (8 W; mean age, 56 [12]; time since lesion 9 [8]) participated in a one-year randomized controlled trial involving either conventional therapy (CONV) or a daily self-stretch program within a Guided Self-rehabilitation Contract (GSC). Assessments involved: (i) soleus and medial gastrocnemius (MG) fascicle length, pennation angle, thickness, tendon length, measured by ultrasonography; (ii) XV1, angle of arrest at slow stretch in soleus (XV1SOL), gastro-soleus complex (XV1GAS), gluteus maximus (XV1GM) and rectus femoris (XV1RF); (iii) 10-meter maximal ambulation speed. Correlations (Pearson's) between architectural parameters and XV1 were also explored.

Results

After one year, soleus fascicle length increased by +16.6 mm (CI95 [+10.3; +22.9]; +42%), in the GSC group vs. −0.1 mm (CI95 [−7.3; +7.1]; −3.7%), in the CONV group (P = 0.005, Rank-Ancova), MG fascicle length increased by +5.2 mm (CI95 [+2.75; +7.65]; +13%), in the GSC group vs. +1.2 mm (CI95 [−2.0; +4.4]; +7%), in the CONV group (P = 0.01), soleus thickness increased by +4.3 mm (CI95 [+2.7; +5.9]; +33%), vs. −0.3 mm (CI95 [−2.4; +1.8]; −0.8%), in the CONV group (P = 0.005). Changes in XV1 involved XV1SOL, +2.4° (CI95 [+0.9; +4.0]; +2.4%), in the GSC group vs. +0.1° (CI95 [−2.7; +2.8]; +0.1%), in the CONV group (P = 6.9 E-05); XV1GAS, +7.4° (CI95[+5.0; +9.8]; +8%) vs. +1.5° (CI95 [−3.3; +6.3]; +1.5%; P = 0.003); XV1GM, +5.3° (CI95[+2.7; + 7.9]; 4.2%) vs. +1.5° (CI95[+0.1; +5.4]; +1.2%; P = 0.025); XV1RF, +10.5° (CI95 [+5.8; + 16.4]; +3.4%) vs. +1.5° (CI95 [−3.75; +6.65]; +1.9%; P = 0.08). Walking speed increased by +0.08 m/s (CI95 [+0.04; +0.12]; +14%, P = 0.006, t-test) in the GSC group vs. +0.04 m/s (CI95[0.0; +0.08]; +5%, NS) in the CONV group. At baseline, XV1SOL correlated negatively with soleus tendon length (R = −0.74, P = 0.0003) and positively with muscle thickness (R = 0.68, P = 0.015).

Discussion – conclusion

In patients with chronic hemiparesis, a daily self-stretch program of soleus and medial gastrocnemius through Guided Self-rehabilitation Contract over one year increased muscle fascicle length and thickness more than conventional rehabilitation.