Deans' stroke musings: Immediate effects of rest periods on balance control in patients after stroke. A randomized controlled pilot trial

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, June 6, 2018

Immediate effects of rest periods on balance control in patients after stroke. A randomized controlled pilot trial

I thought repetitions were the most important part of recovery.
Animal studies have shown that 400-600 repetitions of a challenging task are needed per day to make changes in the brain. With all this resting and most therapy sessions lasting an hour you'll never get in enough repetitions.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968623/

Bernhard Elsner,^1,² Simon Schweder,² and Jan Mehrholz^1,³

Author information ► Article notes ► Copyright and License information ► Disclaimer

Abstract

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Objectives

This randomized controlled trial evaluates the effects of two different rest periods between as set of balance exercises after stroke during inpatient rehabilitation.

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Results

Twenty patients after stroke [11 males; mean (SD) age 65.4 (11.5) years; duration of illness 5.3 (3.4) weeks; 16 (80%) left-sided strokes] were randomly allocated into two groups of either a full rest (FR) of 4 min (n = 10) or a short rest (SR) of 1 min between exercise sets (n = 10). Patients improved from baseline until immediately after exercises in one-leg standing time on the affected leg [SR: mean difference 5.1 s (SD 10.3) and FR: 2.0 s (2.4)] and tandem standing time (TST). [SR: 14.9 s (SD 24.6) and FR: 5.7 s (12.0)], but OLST and TST did not differ significantly between groups (p = 0.35 and p = 0.52, respectively).

Trial registration The study was registered retrospectively in the German Register of Clinical Trials with the ID: DRKS00013979

The online version of this article (10.1186/s13104-018-3450-2) contains supplementary material, which is available to authorized users.

Keywords: Stroke, Balance, Rest, Rehabilitation, Physiotherapy

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Introduction

The effects of rest periods between physical exercises have considerable importance when viewed from the perspective of practice effectiveness as practice efficiency [1]. For instance in continuous tasks fatigue increases and acquisition and retention decreases when the rest period between trials decreases []. Therefore the rest periods between trials or exercises may play an important role in rehabilitation to improve performance. Some authors proposed that longer rest periods generally lead to more skill performance during practice [3].

Controversially in the cognitive skill literature, however, between-session delays have been seen either as having a negligible effect on performance or as causing forgetting []. In contrast, in the procedural skill literature, overnight between-session delays can result in performance gains [].

For the motor rehabilitation of patients after stroke there is not much literature about optimal rest periods between exercise sets. In contrast to this, the use of rests should be a very important aspect of daily clinical physiotherapy. Some investigators in gait rehabilitation for example use rather long rest periods between the trials (2–3 min) [] but other used diametrically short rests of 10 s []. Until now no rigorous study has evaluated the immediate effects of different rest periods between common balance exercises after stroke.

The aim of the present study was therefore to investigate the immediate effects of different rest periods on the balance performance of patients after stroke.