Dietary blueberry improves cognition among older adults in a randomized, double-blind, placebo-controlled trial

Obviously nothing can be done with this information until 50 years from now when your doctor is gone and a dietary stroke protocol is finally implemented.
So we have cranberry research from 2002, blueberries from 2013 and beets from 2010. Which food is in your dietary protocol? Or is your doctor, hospital and stroke association so fucking incompetent that they have done nothing about this for 16 years? And you are paying them money?
https://www.mdlinx.com/internal-medicine/medical-news-article/2018/03/30/aging-blueberry-cognition-gait/7508897/?

European Journal of Nutrition — | March 30, 2018

sponsor

Miller MG, et al. - Whether or not dietary blueberry improves mobility and cognition among older adults was determined. Mobility and cognition were compared at baseline and after 45 and 90 days of dietary intervention among men and women between the ages of 60 and 75 years. The participants were asked to consume freeze-dried blueberries (24 g/day [equivalent to 1 cup of fresh blueberries]) or a blueberry placebo for 90 days. Significantly fewer repetition errors in the California Verbal Learning test and reduced switch cost on a task-switching test were noted among participants in the blueberry group relative to controls. No improvement in gait or balance was observed. Overall, it was shown that some aspects of cognition can be improved by the addition of easily achievable quantities of blueberries to the diets of older adults.

• See Also: Influence of strength training intensity on subsequent recovery in elderly

Read the full article on European Journal of Nutrition

Social isolation and loneliness as risk factors for myocardial infarction, stroke and mortality: UK Biobank cohort study of 479 054 men and women

All the more reason you need to demand your doctor have protocols that get you 100% recovered. NO EXCUSES ALLOWED!
http://heart.bmj.com/content/early/2018/03/16/heartjnl-2017-312663 
 

PDF

Coronary artery disease

Original research article

Social isolation and loneliness as risk factors for myocardial infarction, stroke and mortality: UK Biobank cohort study of 479 054 men and women

1. Christian Hakulinen1,2,
2. Laura Pulkki-Råback1,
3. Marianna Virtanen3,4,
4. Markus Jokela1,
5. Mika Kivimäki5,6,
6. Marko Elovainio1,2

Author affiliations

Abstract

Objective To examine whether social isolation and loneliness (1) predict acute myocardial infarction (AMI) and stroke among those with no history of AMI or stroke, (2) are related to mortality risk among those with a history of AMI or stroke, and (3) the extent to which these associations are explained by known risk factors or pre-existing chronic conditions.

Methods Participants were 479 054 individuals from the UK Biobank. The exposures were self-reported social isolation and loneliness. AMI, stroke and mortality were the outcomes.

Results Over 7.1 years, 5731 had first AMI, and 3471 had first stroke. In model adjusted for demographics, social isolation was associated with higher risk of AMI (HR 1.43, 95% CI 1.3 to –1.55) and stroke (HR 1.39, 95% CI 1.25 to 1.54). When adjusted for all the other risk factors, the HR for AMI was attenuated by 84% to 1.07 (95% CI 0.99 to 1.16) and the HR for stroke was attenuated by 83% to 1.06 (95% CI 0.96 to 1.19). Loneliness was associated with higher risk of AMI before (HR 1.49, 95% CI 1.36 to 1.64) but attenuated considerably with adjustments (HR 1.06, 95% CI 0.96 to 1.17). This was also the case for stroke (HR 1.36, 95% CI 1.20 to 1.55 before and HR 1.04, 95% CI 0.91 to 1.19 after adjustments). Social isolation, but not loneliness, was associated with increased mortality in participants with a history of AMI (HR 1.25, 95% CI 1.03 to 1.51) or stroke (HR 1.32, 95% CI 1.08 to 1.61) in the fully adjusted model.

Conclusions Isolated and lonely persons are at increased risk of AMI and stroke, and, among those with a history of AMI or stroke, increased risk of death. Most of this risk was explained by conventional risk factors.

http://dx.doi.org/10.1136/heartjnl-2017-312663

Introduction

Individuals who are socially isolated (ie, are lacking social contacts and participation in social activities) or feel lonely (ie, feel that they have too few social contacts or are not satisfied with the quality of their social contacts) have been found to be at increased risk of incident coronary heart disease (CHD),1 stroke2 and early mortality.3–7 A recent meta-analysis—including 11 longitudinal studies on cardiovascular disease and 8 on stroke—suggested that social isolation and loneliness are associated with 30% excess risk of incident CHD and stroke.8 However, most of the studies were small in scale, with only one study reporting more than 1000 events,1 and meta-analytic evidence suggests selective publishing of positive findings.8 Furthermore, only a limited set of potential explanatory factors have been examined in previous studies and mortality after incident CHD or stroke remains unexplored. Thus, it remains unclear whether these associations are independent of biological, behavioural, psychological, health and socioeconomic factors9–11 that are known to increase risk of cardiovascular diseases.12 13 In addition, although other risk factors, such as physical inactivity14 and depression,15 have been associated with poorer outcomes among individuals with pre-existing cardiovascular disease, it remains unclear whether socially isolated or lonely individuals have an elevated risk of early mortality after cardiovascular disease event.

In this analysis using the UK Biobank study, a very large prospective population-based cohort study, we examined the associations of social isolation and loneliness with first acute myocardial infarction (AMI) and first stroke. In addition, we examined whether social isolation and loneliness before AMI or stroke event are associated with mortality risk after the event. A broad range of biological, behavioural, psychological, socioeconomic and mental health-related factors were included as potential mediators or confounders of these associations.

Upper-limb recovery after stroke: A randomized controlled trial comparing EMG-triggered, cyclic, and sensory electrical stimulation

What the fuck is the protocol for this? Don;'t be a fucking lazy asshole and tell me it doesn't work, I can just wait for spontaneous recovery to occur. You don't need therapists at all in this case.
https://search.naric.com/research/rehab/redesign_record.cfm?search=2&type=all&criteria=J77948&phrase=no&rec=135941&article_source=Rehab&international=0&international_language=&international_location=
Neurorehabilitation and Neural Repair , Volume 30(10) , Pgs. 978-987.

NARIC Accession Number: J77948.  What's this?
ISSN: 1545-9683.
Author(s): Wilson, Richard D.; Page, Stephen J.; Delahanty, Michael; Knutson, Jayme S.; Gunzler, Douglas D.; Sheffler, Lynne R.; Chae, John.
Publication Year: 2016.
Number of Pages: 10.
Abstract: Study compared the effect of cyclic neuromuscular electrical stimulation (NMES), electromyographically (EMG)-triggered NMES, and sensory stimulation on motor impairment and activity limitations in patients with upper-limb hemiplegia. This was a multicenter, balanced randomization, single-blind, multi-arm parallel-group study of non-hospitalized hemiplegic stroke survivors conducted at 3 medical centers. A total of 122 individuals within 6 months of stroke were randomized to receive either cyclic NMES, EMG-triggered NMES, or sensory stimulation twice every weekday in 40-minute sessions, over an 8 week-period. Outcomes assessments were completed at each site by a blinded occupational therapist at baseline, midtreatment, end of treatment, and 1, 3, and 6 months after completion of treatment. The primary outcome measure was the upper-extremity section of the Fugl-Meyer Assessment (FMA). A secondary outcome was the ability of a hemiparetic upper limb to execute specific activities, assessed with the modified Arm Motor Ability Test (mAMAT). There were significant increases in the FMA, FMA Wrist and Hand, and mAMAT for all 3 groups. There was no significant difference in the improvement among the treatment groups in the FMA, FMA Wrist and Hand, or the mAMAT. All groups exhibited significant improvement of impairment and functional limitation with electrical stimulation therapy applied within 6 months of stroke. Improvements were likely a result of spontaneous recovery. There was no difference based on the type of electrical stimulation that was administered.
Descriptor Terms: ELECTRICAL STIMULATION, HEMIPLEGIA, LIMBS, MOTOR SKILLS, OUTCOMES, STROKE.


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

Citation: Wilson, Richard D., Page, Stephen J., Delahanty, Michael, Knutson, Jayme S., Gunzler, Douglas D., Sheffler, Lynne R., Chae, John. (2016). Upper-limb recovery after stroke: A randomized controlled trial comparing EMG-triggered, cyclic, and sensory electrical stimulation.  Neurorehabilitation and Neural Repair , 30(10), Pgs. 978-987. Retrieved 3/28/2018, from REHABDATA database.


* The majority of journal articles, books, and reports in our collection are only available by regular mail, rather than downloadable electronic format. Learn more about our digital collection and our document delivery service.

More information about this publication:
Neurorehabilitation and Neural Repair.

Known risk factors largely explain links between loneliness and first time heart disease / stroke

Loneliness has never been my problem. 
https://medicalxpress.com/news/2018-03-factors-largely-links-loneliness-heart.html

Conventional risk factors largely explain the links observed between loneliness/social isolation and first time heart disease/stroke, finds the largest study of its kind published online in the journal Heart.

But having few social contacts still remains an independent risk factor for death among those with pre-existing cardiovascular disease, the findings show.

Recent research has increasingly highlighted links between loneliness and social isolation and cardiovascular disease and death. But most of these studies have not considered a wide range of other potentially influential factors, say the authors.

In a bid to clarify what role these other factors might have, they drew on data from nearly 480,000 people aged between 40 and 69, who were all part of the UK Biobank study between 2007 and 2010.

Participants provided detailed information on their ethnic background, educational attainment, household income, lifestyle (smoking, drinking, exercise) and depressive symptoms.

They were also asked a series of questions to gauge their levels of social isolation and loneliness. Height, weight, and grip strength were measured, and blood samples taken.

Their health was then tracked for an average of 7 years.

Nearly one in 10 (9%) respondents were deemed to be socially isolated, 6 percent lonely, and 1 percent both.

Those who were socially isolated and/or lonely were more likely to have other underlying long term conditions and to be smokers, while those who were lonely reported more depressive symptoms.

During the 7 year monitoring period, 12,478 people died. And 5731 people had a first time heart attack while 3471 had a first time stroke.

Social isolation was associated with a 43 percent higher risk of first time heart attack, when age, sex, and ethnicity were factored in.

But when behavioural, psychological, health, and socioeconomic factors were added into the mix, these factors accounted for most (84%) of the increased risk, and the initial association was no longer significant.

Similarly, social isolation was initially associated with a 39 percent heightened risk of a first time stroke, but the other conventional risk factors accounted for 83 percent of this risk.

Similar results were observed for loneliness and risk of first time heart attack or stroke.

But this was not the case for those with pre-existing cardiovascular disease among whom social isolation was initially associated with a 50 percent heightened risk of death. Although this halved when all the other known factors were considered, it was still 25 percent higher.

Similarly, social isolation was associated with a 32 percent heightened risk of death even after all the other conventional factors had been accounted for.

This is an observational study so no firm conclusions can be drawn about cause and effect, but the findings echo those of other research in the field, say the study authors.

And the size and representative nature of the study prompt the authors to conclude that their findings "indicate that social isolation, similarly to other risk factors such as depression, can be regarded as a risk factor for poor prognosis of individuals with cardiovascular disease."

This is important, they emphasise, as around a quarter of all strokes are recurrent, and targeting treatment of conventional risk factors among the lonely and isolated might help stave off further heart attacks and strokes, they suggest.

Explore further: Starting periods before age of 12 linked to heightened risk of heart disease and stroke

More information: Social isolation and loneliness as risk factors for myocardial infarction, stroke, and mortality: UK Biobank cohort study of 479 054 men and women, Heart (2018). DOI: 10.1136/heartjnl-2017-312663

Journal reference: Heart

Provided by: British Medical Journal

Combining mental training and physical training with goal oriented protocols in stroke rehabilitation: a feasibility case study

Once again your doctor has absolutely nothing to do to get you recovered. You are completely on your own to figure out your 100% recovery. 
https://www.frontiersin.org/articles/10.3389/fnhum.2018.00125/abstract

Xin Zhang¹, Ahmed M. Elnady¹, Bubble K. Randhawa¹, Lara Boyd² and Carlo Menon^1*

• ¹School of Engineering Science, Simon Fraser University, Canada
• ²University of British Columbia, Canada

Stroke is one of the leading causes of permanent disability in adults. The literature suggests that rehabilitation is key to early motor recovery. However, conventional therapy is labor and cost intensive. Robotic and functional electrical stimulation (FES) devices can provide a high dose of repetitions and as such may provide an alternative, or an adjunct, to conventional rehabilitation therapy. Brain-computer interfaces (BCI) could augment neuroplasticity by introducing mental training. However, mental training alone is not enough; but combining mental with physical training could boost outcomes. In the current case study, a portable rehabilitative platform and goal-oriented supporting training protocols were introduced and tested with a chronic stroke participant. A novel training method was introduced with the proposed rehabilitative platform. A 37-year old individual with chronic stroke participated in six-weeks of training (18 sessions in total, 3 sessions a week, and one hour per session). In this case study, we show that an individual with chronic stroke can tolerate a six-week training bout with our system and protocol. The participant was actively engaged throughout the training. Changes in the Wolf Motor Function Test (WMFT) suggest that the training positively affected arm motor function (12% improvement in WMFT score).

Keywords: mental training, physical training, BCI, exoskeleton, FES, stroke rehablitation

Received: 07 Dec 2017; Accepted: 16 Mar 2018.

Edited by:

Stephane Perrey, Université de Montpellier, France

Reviewed by:

Silmar Teixeira, Federal University of Piauí, Brazil
Kyuhwa Lee, Campus Biotech, Eidgenössische Technische Hochschule, Switzerland  

Copyright: © 2018 Zhang, Elnady, Randhawa, Boyd and Menon. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Carlo Menon, Simon Fraser University, School of Engineering Science, Burnaby, V5A 1S6, British Columbia, Canada, cmenon@sfu.ca

VRInsole: An Unobtrusive and Immersive Mobility Training System for Stroke Rehabilitation

What other virtual reality interventions does your doctor have you doing? 95 posts on virtual reality.
VRInsole: An Unobtrusive and Immersive Mobility Training System for Stroke Rehabilitation

H. Oagaz, A. Sable, M. Choi, and F. Lin are with the Department of Computer Science and Engineering, University of Colorado Denver, Denver, CO 80204 USA. (e-mail:{hawkar.oagaz, anurag.sable, min.choi, feng.2.lin}@ucdenver.edu).  

Abstract— Stroke is a leading cause of long-term impairment, causing a fatality if not act upon in time. Home-based post-stroke rehabilitation plays an important role in helping patients to regain normal mobility and functionality at their residence. However, existing home-based rehabilitation approaches fail to effectively motivate patients on frequent engagement with exercise to achieve the intended outcome. In this paper, we develop VRInsole, a synthetical solution combining a Smart Insole footwear sensor and virtual reality (VR), targeting lower extremity mobility training in an immersive environment for stroke rehabilitation. Specifically, the motion information collected from the Smart Insole serve as the input for the VR to perform corresponding exercise animations. To prove the feasibility of VRInsole, an experiment is conducted on the recognition of lower extremity motion direction, which achieves an average accuracy of 93.9%. I. INTRODUCTION Stroke is one of the leading causes of long-term ailments, affecting 795,000 people every year in the U.S., out of which 185,000 are recurrent attacks [1]. Deficits following stroke lead to increased rates of fatality or a repeated episode of stoke. Therefore, these individuals require training of movement to optimize their mobile performance with the long-term goal of decreasing fatality rate post stroke and improving balance efficiency.  While many clinical treatments are available for poststroke rehabilitation, it may not be within every patient’s reach. Thus, encouraging patients to practice activities outside of therapy times has been advocated for in rehabilitation. Also, frequently practicing contributes significantly to regain as much motion function as possible. The current rehabilitation practice relies on the static written home program, which is a monotonous repetition and has no encouragement for patients to motivate and refine their motion. The lack of motivation, and assistance in such environments, makes the existing home-based therapy ineffective [2].  In this paper, we proposed VRInsole, a home-based, virtual reality (VR) assisted environment that will promote selfmanagement across the lifespan in stroke rehabilitation, with a focus on the lower extremity mobility training. It is a synthetical solution comprising of an unobtrusive Smart Insole footwear device and a head-mounted VR device. Smart Insole can be used in home environments, record foot motion data over extended time, and provide these data for creating VR animation. Many research works have shown the potential


effectiveness of VR in rehabilitation therapy[3]. Moreover, VR has demonstrated improvement in walking ability and motor function in general[4, 5]. Therefore, the intention of using VR was to motivate stroke patients to practice more often by providing an immersive near-real environment and feedback on exercise quality. This proposed system is intended to overcome the shortfalls of the current standard of care of written home exercise programs [6] to guide rehabilitation efforts after discharge from clinical therapy services. II. RELATED WORK A. VR-based Rehabilitation Several systems for upper extremity rehabilitation using VR are available in our society. Some utilize off-the-shelf hardware such as Nintendo Wii U VR [7]. In academia, Jack et al. [8] used a Cyber-Glove to interact with a VR environment for hand function rehabilitation. Frisoli et al. [9] presented an upper-limb force-feedback exoskeleton for robotic-assisted rehabilitation in VR. The exoskeleton measures the user’s activity and converts it into VR movement. However, no such system is available for lower extremity mobility rehabilitation. B. Exergames Various exergames such as SoccAR [10] use an augmented reality (AR)-based approach for creating fast-paced, motivated games to promote health-related benefits in home and social environments. These systems mainly create a virtual environment to motivate users and provide a suitable scenario wherein the user can perform physical activities. However, these exergames focus more on daily life and sports activities rather than dedicated rehabilitation tasks for stroke patients. III. SYSTEM DESIGN A. System Overview The overall VRInsole workflow diagram is illustrated in Fig. 1. A patient who is demanded to perform exercises for stroke rehabilitation is supplied with a Smart Insole wearable sensor worn with the shoe. After the user performing exercise routines as prescribed by the VR system, the acceleration, and angular velocity data were generated by the inertial motion unit (IMU) sensor embedded in Smart Insole and were sent to a connected VR system. After that, the VR system can utilize the obtained data to recognize the user’s activity and render the activity in a virtual environment. 
W. Xu is with the Department of Computer Science and Engineering, State University of New York at Buffalo, Buffalo, NY 14260 USA (e-mail: wenyaoxu@buffalo.edu).  Corresponding author: Feng Lin, phone: 303-315-0161; e-mail: feng.2.lin@ucdenver.edu.

Accelerating Stroke Recovery: Body Structures and Functions, Activities, Participation, and Quality of Life Outcomes From a Large Rehabilitation Trial

You will notice that your doctor has absolutely nothing to do here to help your recovery. Their time frame for action was in the first week by stopping the 5 causes of the neuronal cascade of death. But they did nothing then.
http://journals.sagepub.com/doi/abs/10.1177/1545968318760726

Show all authors

Rebecca Lewthwaite, PhD¹²*

Rebecca Lewthwaite

1University of Southern California, Los Angeles, CA, USA2Rancho Los Amigos National Rehabilitation Center, Downey, CA, USA
See all articles by this author

Search Google Scholar for this author

, Carolee J. Winstein, PhD¹*

Carolee J. Winstein

1University of Southern California, Los Angeles, CA, USA
See all articles by this author

Search Google Scholar for this author

, Christianne J. Lane, PhD¹

Christianne J. Lane

1University of Southern California, Los Angeles, CA, USA
See all articles by this author

Search Google Scholar for this author

,

Sarah Blanton, DPT³

Sarah Blanton

3Emory University, Atlanta, GA, USA
See all articles by this author

Search Google Scholar for this author

, Burl R. Wagenheim, PhD²

Burl R. Wagenheim

2Rancho Los Amigos National Rehabilitation Center, Downey, CA, USA
See all articles by this author

Search Google Scholar for this author

, Monica A. Nelsen, DPT¹

Monica A. Nelsen

1University of Southern California, Los Angeles, CA, USA
See all articles by this author

Search Google Scholar for this author

, Alexander W. Dromerick, MD⁴⁵⁶*

Alexander W. Dromerick

4Georgetown University, Washington, DC, USA5MedStar National Rehabilitation Hospital, Washington, DC, USA6VA Medical Center, Washington, DC, USA
See all articles by this author

Search Google Scholar for this author

, Steven L. Wolf, PhD³⁷*

Steven L. Wolf

3Emory University, Atlanta, GA, USA7VA Center on Visual and Neurocognitive Rehabilitation, Decatur, GA, USA
See all articles by this author

Search Google Scholar for this author

...

First Published March 19, 2018 Research Article

https://doi.org/10.1177/1545968318760726

Download PDF	Article information

Article Information

Volume: 32 issue: 2, page(s): 150-165

Article first published online: March 19, 2018; Issue published: February 1, 2018

https://doi.org/10.1177/1545968318760726

Rebecca Lewthwaite, PhD^{1, 2}*, Carolee J. Winstein, PhD¹*, Christianne J. Lane, PhD¹, Sarah Blanton, DPT³, Burl R. Wagenheim, PhD², Monica A. Nelsen, DPT¹, Alexander W. Dromerick, MD^{4, 5, 6}*, Steven L. Wolf, PhD^{3, 7}*

¹University of Southern California, Los Angeles, CA, USA

²Rancho Los Amigos National Rehabilitation Center, Downey, CA, USA

³Emory University, Atlanta, GA, USA

⁴Georgetown University, Washington, DC, USA

⁵MedStar National Rehabilitation Hospital, Washington, DC, USA

⁶VA Medical Center, Washington, DC, USA

⁷VA Center on Visual and Neurocognitive Rehabilitation, Decatur, GA, USA

Corresponding Author:

*These authors are a member of The American Society of Neurorehabilitation.

Rebecca Lewthwaite, PhD, Physical Therapy Department, HB 223, Rancho Los Amigos National Rehabilitation Center, 7601 East Imperial Highway, Downey, CA 90242, USA. Email: rlewthwaite@dhs.lacounty.gov

• Abstract
• Full Text
• References
• Supplementary Materials
• PDF

Abstract

Background. Task-oriented therapies have been developed to address significant upper extremity disability that persists after stroke. Yet, the extent of and approach to rehabilitation and recovery remains unsatisfactory to many.  
Objective. To compare a skill-directed investigational intervention with usual care treatment for body functions and structures, activities, participation, and quality of life outcomes. Methods. On average, 46 days poststroke, 361 patients were randomized to 1 of 3 outpatient therapy groups: a patient-centered Accelerated Skill Acquisition Program (ASAP), dose-equivalent usual occupational therapy (DEUCC), or usual therapy (UCC). Outcomes were taken at baseline, posttreatment, 6 months, and 1 year after randomization. Longitudinal mixed effect models compared group differences in poststroke improvement during treatment and follow-up phases.
Results. Across all groups, most improvement occurred during the treatment phase, followed by change more slowly during follow-up. Compared with DEUCC and UCC, ASAP group gains were greater during treatment for Stroke Impact Scale Hand, Strength, Mobility, Physical Function, and Participation scores, self-efficacy, perceived health, reintegration, patient-centeredness, and quality of life outcomes. ASAP participants reported higher Motor Activity Log–28 Quality of Movement than UCC posttreatment and perceived greater study-related improvements in quality of life. By end of study, all groups reached similar levels with only limited group differences.
Conclusions. Customized task-oriented training can be implemented to accelerate gains across a full spectrum of patient-reported outcomes. While group differences for most outcomes disappeared at 1 year, ASAP participants achieved these outcomes on average 8 months earlier (ClinicalTrials.gov: Interdisciplinary Comprehensive Arm Rehabilitation Evaluation [ICARE] Stroke Initiative, at www.ClinicalTrials.gov/ClinicalTrials.gov. Identifier: NCT00871715).