Deans' stroke musings: Motor learning during poststroke gait rehabilitation: a case study

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.

Thursday, November 21, 2019

Motor learning during poststroke gait rehabilitation: a case study

No protocol but more paretic propulsion stuff. It must be important. What the fuck protocol does your doctor have you doing to improve your paretic propulsion? NONE I BET.

Motor learning during poststroke gait rehabilitation: a case study

Trisha M. Kesar, PT, PhD, Michelle J. Sauer, BE, Stuart A. Binder-Macleod, PT, PhD, and Darcy S. Reisman, PT, PhD

Introduction:
To develop more effective gait rehabilitation strategies, it is important to understand the time course of motor learning that underlies improvements achieved with gait training. The purpose of this case study was to evaluate motor learning through the measurement of within-session and across-session changes in gait biomechanics during the ﬁrst and sixth weeks of a 6-week clinical gait training program.
Case Description:
A47-year-old man with post stroke left hemiparesis participated in the study(15.5 months post stroke, lower extremity Fugl-Meyer score of 12).
Intervention:
The subject participated in 6 weeks of training with 3 sessions per week, comprising fast treadmill walking and functional electrical stimulation to plantar and dorsiﬂexors. In one training session during the ﬁrst and sixth weeks, paretic propulsion and swing phase knee ﬂexion were measured during a pretest (before the training session), post test (after the training session), and retention test (48 hours after training).
Outcomes:
After 6 week of training, the subject’s gait speed increased from 0.38 to 0.57 m/s; there was a 55.4% improvement in paretic propulsion and 25% increase in swing phase knee ﬂexion. Examination of change scores revealed greater within session gains and greater retention during the ﬁrst versus sixth weeks of gait training for both paretic propulsion and knee ﬂexion.
Discussion:
We demonstrate the feasibility and advantage of using within and across session changes for evaluating motor learning during clinical gait rehabilitation. An understanding of the time course of motor learning that underlies gait training can guide the development