Deans' stroke musings: VA, DoD update guideline for rehabilitation after stroke

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, November 20, 2019

VA, DoD update guideline for rehabilitation after stroke

Useless, guidelines NOT PROTOCOLS. No talk of results from using these guidelines so useless.

VA, DoD update guideline for rehabilitation after stroke

(HealthDay)—In a systematic review and clinical practice guideline, published online Nov. 19 in Annals of Internal Medicine, recommendations from the U.S. Department of Veterans Affairs and the U.S. Department of Defense are presented for stroke rehabilitation and nonpharmacologic and pharmacologic treatments for motor deficits and mood disorders in adults who have had stroke.

James Sall, Ph.D., from the Department of Veterans Affairs in Los Angeles, and colleagues provide recommendations for rehabilitation care of patients after stroke. Recommendations were developed in six areas, including timing of rehabilitation treatment, motor therapy, dysphagia management, cognitive rehabilitation approaches, mental health treatment, and community reintegration such as returning to work and driving. Stroke rehabilitation requires an interdisciplinary, holistic approach to poststroke sequelae, according to the authors.
Kristen E. D'Anci, Ph.D., from the ECRI Institute in Plymouth Meeting, Pennsylvania, and colleagues summarized evidence on the benefits and harms of nonpharmacologic and pharmacologic treatments for motor deficits and mood disorders in adults who have had stroke. Data were included from 19 systematic reviews and 37 randomized controlled trials. The researchers found that most interventions did not improve motor function. Based on high-quality evidence, fluoxetine use was not supported for improving motor function. There was moderate-quality evidence for use of cardiorespiratory training for improving maximum walking speed and repetitive task training or transcranial direct current stimulation for improving activities of daily living. Based on low-quality evidence, antidepressants may reduce depression, although the frequency and severity of related adverse events is unclear; cognitive behavioral therapy and exercise may reduce symptoms of anxiety and depression.
"We recommend using these guidelines as an adjunct to the American Heart Association/American Stroke Association for Adult Stroke Rehabilitation and Recovery," Sall and colleagues write.