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.

Wednesday, November 15, 2017

Early Rehabilitation After Stroke: a Narrative Review

My god, no understanding of the neuronal cascade of death in the first days at all. The therapy initiated in the first 24 hours doesn't cause harm. You fuckers need to understand cause and effect.  This lack of knowledge is appalling
https://link.springer.com/article/10.1007/s11883-017-0686-6

  • Elisheva R. Coleman
  • Rohitha Moudgal
  • Kathryn Lang
  • Hyacinth I. Hyacinth
  • Oluwole O. Awosika
  • Brett M. Kissela
  • Wuwei Feng
  • Elisheva R. Coleman
    • 1
  • Rohitha Moudgal
    • 2
  • Kathryn Lang
    • 3
  • Hyacinth I. Hyacinth
    • 4
  • Oluwole O. Awosika
    • 1
  • Brett M. Kissela
    • 1
  • Wuwei Feng
    • 5
  1. 1.Department of Neurology and Rehabilitation MedicineUniversity of Cincinnati Gardner Neuroscience InstituteCincinnatiUSA
  2. 2.University of Cincinnati College of MedicineCincinnatiUSA
  3. 3.Department of Rehabilitation ServicesUniversity of CincinnatiCincinnatiUSA
  4. 4.Aflac Cancer and Blood Disorder Center of Children’s Healthcare of Atlanta and Emory University Department of PediatricsAtlantaUSA
  5. 5.Department of NeurologyMedical University of South CarolinaCharlestonUSA
Cardiovascular Disease and Stroke (S. Prabhakaran, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Cardiovascular Disease and Stroke

Abstract

Purpose of Review

Despite current rehabilitative strategies, stroke remains a leading cause of disability in the USA. There is a window of enhanced neuroplasticity early after stroke, during which the brain’s dynamic response to injury is heightened and rehabilitation might be particularly effective. This review summarizes the evidence of the existence of this plastic window, and the evidence regarding safety and efficacy of early rehabilitative strategies for several stroke domain-specific deficits.

Recent Findings

Overall, trials of rehabilitation in the first 2 weeks after stroke are scarce. In the realm of very early mobilization, one large and one small trial found potential harm from mobilizing patients within the first 24 h after stroke, and only one small trial found benefit in doing so. For the upper extremity, constraint-induced movement therapy appears to have benefit when started within 2 weeks of stroke. Evidence for non-invasive brain stimulation in the acute period remains scant and inconclusive. For aphasia, the evidence is mixed, but intensive early therapy might be of benefit for patients with severe aphasia. Mirror therapy begun early after stroke shows promise for the alleviation of neglect. Novel approaches to treating dysphagia early after stroke appear promising, but the high rate of spontaneous improvement makes their benefit difficult to gauge.

Summary

The optimal time to begin rehabilitation after a stroke remains unsettled, though the evidence is mounting that for at least some deficits, initiation of rehabilitative strategies within the first 2 weeks of stroke is beneficial. Commencing intensive therapy in the first 24 h may be harmful.

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