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, February 21, 2018

Patient registry of spasticity care world: Data analysis based on physician experience

My doctor knew nothing about botox or spasticity, my botox sessions were set up by my OT. Physician experience should make no difference in treatment results, they should all be following exact protocols. Excuses like, 'All strokes are different, all stroke recoveries are different' should be challenged and demand to know why they subscribe to such bullshit.
https://search.naric.com/research/rehab/redesign_record.cfm?search=2&type=all&criteria=J77565&phrase=no&rec=135501&article_source=Rehab&international=0&international_language=&international_location=
Journal of Physical Medicine and Rehabilitation , Volume 96(12) , Pgs. 881-888.

NARIC Accession Number: J77565.  What's this?
ISSN: 0894-9115.
Author(s): Esquenazi, Alberto; Lee, Stella; Mayer, Nathaniel; Garreta, Roser; Patel, Atul; Elovic, Elie; Koelbel, Stephen; Francisco, Gerard; Reuter, Iris.
Publication Year: 2017.
Number of Pages: 8.
Abstract: Study examined “real-world” treatment patterns of physicians with different levels of experience with using botulinum toxin type A in patients with stroke and traumatic brain injury (TBI). A prospective, multicenter, international observational registry design was used. The primary purpose for this registry was to describe treatment patterns and clinical presentation from a global perspective on the basis of clinical experience. Ashworth Scale (AS) scores, presence of pain, and patient-reported satisfaction after treatment were stratified on the basis of reported physicians' clinical experiences to determine treatment effect. Six hundred twenty-seven participants with stroke and 132 participants with TBI were assessed and treated by 17 more-experienced physicians and 12 less-experienced physicians. Due to the limited usage of abobotulinumtoxinA Dysport and incobotulinumtoxinA Xeomin, data were reported on onabotulinumtoxinA BOTOX only. Based on physician experience, onabotulinumtoxinA doses were statistically different with larger mean doses injected by more-experienced physicians in the upper limb and the lower limb. Treated deformities significantly differed for both upper limb and lower limb. More-experienced physicians showed a larger mean change in AS scores from baseline for the equinovarus/equinus foot and stiff knee. Less-experienced physicians showed a larger mean change in AS scores from baseline for the adducted thigh. Less-experienced physicians had statistically significant larger change in hand pain scores for clenched fist deformity treatment at follow-up compared with more-experienced physicians. Physician experience demonstrated a significant difference on patients reported satisfaction toward their secondary goal with higher scores for more-experienced physicians.
Descriptor Terms: BRAIN INJURIES, CLINICAL MANAGEMENT, DRUGS, INTERNATIONAL REHABILITATION, MEDICAL TREATMENT, MUSCULAR IMPAIRMENTS, PHARMACOLOGY, PHYSICIANS, SPASTICITY, STROKE.


Can this document be ordered through NARIC's document delivery service*?: Y.

Citation: Esquenazi, Alberto, Lee, Stella, Mayer, Nathaniel, Garreta, Roser, Patel, Atul, Elovic, Elie, Koelbel, Stephen, Francisco, Gerard, Reuter, Iris. (2017). Patient registry of spasticity care world: Data analysis based on physician experience.  American Journal of Physical Medicine and Rehabilitation , 96(12), Pgs. 881-888. Retrieved 2/21/2018, from REHABDATA database.

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