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

Wednesday, January 17, 2018

Compliance to rehab makes recovery from stroke more effective

Yes, blame the patient for their lack of recovery. Wrong, wrong, wrong, the blame belongs squarely on your doctor.
https://economictimes.indiatimes.com/magazines/panache/compliance-to-rehab-makes-recovery-from-stroke-more-effective/articleshow/62521616.cms
There has been a lot of focus on preventing strokes and measures taken to manage the risk factors.

However, there is limited evidence available regarding the patients’ journey during the time period after discharge from hospitals post stroke.

Due to lack of awareness regarding availability of rehabilitation services and less focus on the comprehensive approach to therapy, the burden of care falls on family members.

A recent study by Nightingales Home Health which incorporated clinicians’ perspective, looks at how to bridge the gap in community reintegration of stroke patients, finding insights regarding current practices in stroke rehabilitation in the community and understanding patients’ behaviour.
Here are some key takeaways:

Stroke Stats
1.5 million+
Number of cases of stroke reported in India each year
17.5%
increase in incidence of stroke in the past 15 years

Urban India - one-and-a-half times more at risk of stroke than rural India

2:1 ratio of male-female incidence of stroke; men are more at risk than women

About The Study
Quantitative survey conducted among 31 neurologists

Research conducted across 3 cities: Bengaluru, Mumbai and Hyderabad

Double-blinded research: Participating doctors were not aware of the organisation behind the study and vice-versa, thereby achieving unbiased result.

Findings
80% - neurologists perceive home rehab to be a feasible option for stroke patients.

90% - neurologists perceive multidisciplinary services as an ideal solution to manage disabilities caused by stroke at home.

What makes home rehab feasible?
Compliance to prescribed therapy - 78 %

Cost effectiveness - 61 %

Improved access to quality comprehensive care - 61 %

Stroke rehabilitation may take years to see positive outcomes.
Reasons for patient dropout from rehabilitation:

Lack of motivation due to severity of disability - 56 %

Lengthy rehabilitation phase - 29 %

Physiotherapy (77%) is the top service offering that neurologists recalled to be included in a home rehab programme, also widely accepted by patients. Other services like speech and language therapy or occupational therapy are not very well accepted by patients due to lack of awareness or lack of availability.

77% neurologists feel family members learning exercises and treating patients at home without therapists’ supervision adds to their care-giving burden.

Home rehabilitation as a concept is considered a feasible option by a majority of neurologists owing to the associated benefits/drivers sucsuch as compliance, access, cost effectiveness and multidisciplinary services. Early comprehensive rehabilitation post stroke and compliance to prescribed rehabilitation programme increases patients’ chances of a better recovery and resumption of their daily activities with minimal support.



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