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, May 2, 2018

Transcranial Direct Current Stimulation Enhances Motor Skill Learning but Not Generalization in Chronic Stroke

Useless, even though it didn't work the protocols are not available for the next researcher to avoid. 

Is anyone ever going to put together a protocol on using tDCS and which type?   Otherwise all this fucking research and reviews are totally worthless.  This is why we need strong stroke leadership, to actually help stroke survivors.



Transcranial Direct Current Stimulation Enhances Motor Skill Learning but Not Generalization in Chronic Stroke

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Manuela Hamoudi1
Manuela Hamoudi
1University Hospital Freiburg, Freiburg, Germany
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, Heidi M. Schambra, MD23
Heidi M. Schambra
2New York University, NY, USA3National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
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, Brita Fritsch, MD1 ,
Annika Schoechlin-Marx, MD1
Annika Schoechlin-Marx
1University Hospital Freiburg, Freiburg, Germany
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, Cornelius Weiller, MD1
Cornelius Weiller
1University Hospital Freiburg, Freiburg, Germany
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, Leonardo G. Cohen, MD3
Leonardo G. Cohen
3National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
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, Janine Reis, MD13
Janine Reis
1University Hospital Freiburg, Freiburg, Germany3National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
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...
First Published April 22, 2018 Research Article
https://doi.org/10.1177/1545968318769164

Article Information

Article first published online: April 22, 2018
https://doi.org/10.1177/1545968318769164
Manuela Hamoudi1, Heidi M. Schambra, MD2, 3, Brita Fritsch, MD1, Annika Schoechlin-Marx, MD1, Cornelius Weiller, MD1, Leonardo G. Cohen, MD3, Janine Reis, MD1, 3
1University Hospital Freiburg, Freiburg, Germany
2New York University, NY, USA
3National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA

Corresponding Author: Janine Reis, MD, Department of Neurology, Albert-Ludwigs-University Freiburg, Breisacher Str 64, 79106 Freiburg, Germany. Email:

Abstract

Background. Motor training alone or combined with transcranial direct current stimulation (tDCS) positioned over the motor cortex (M1) improves motor function in chronic stroke. Currently, understanding of how tDCS influences the process of motor skill learning after stroke is lacking. Objective. To assess the effects of tDCS on the stages of motor skill learning and on generalization to untrained motor function.  
Methods. In this randomized, sham-controlled, blinded study of 56 mildly impaired chronic stroke patients, tDCS (anode over the ipsilesional M1 and cathode on the contralesional forehead) was applied during 5 days of training on an unfamiliar, challenging fine motor skill task (sequential visual isometric pinch force task). We assessed online and offline learning during the training period and retention over the following 4 months. We additionally assessed the generalization to untrained tasks. Results. With training alone (sham tDCS group), patients acquired a novel motor skill. This skill improved online, remained stable during the offline periods and was largely retained at follow-up. When tDCS was added to training (real tDCS group), motor skill significantly increased relative to sham, mostly in the online stage. Long-term retention was not affected by tDCS. Training effects generalized to untrained tasks, but those performance gains were not enhanced further by tDCS. Conclusions. Training of an unfamiliar skill task represents a strategy to improve fine motor function in chronic stroke. tDCS augments motor skill learning, but its additive effect is restricted to the trained skill.
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