Deans' stroke musings: Breaking proportional recovery 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.

Saturday, January 25, 2020

Breaking proportional recovery after stroke

Survivors don't want proportional recovery, they want 100% recovery. When the hell are you blithering idiots going to provide the research that does EXACTLY THAT? Maybe after you are the 1 in 4 per WHO that has a stroke? This tyranny of low expectations needs to stop. Scream at your doctor for putting any limit on your recovery.

Breaking proportional recovery after stroke

Neurorehabilitation and Neural Repair (NNR) , Volume 33(11) , Pgs. 888-901.

NARIC Accession Number: J82574. What's this?
ISSN: 1545-9683.
Author(s): Senesh, Merav R.; Reinkensmeyer, David J..
Publication Year: 2019.
Number of Pages: 14.

Abstract:

Article addresses the mathematical and behavioral interpretation of the proportional recovery rule. People with hemiparesis after stroke appear to recover 70 to 80 percent of the difference between their baseline and the maximum upper-extremity Fugl-Meyer (UEFM) score, a phenomenon called proportional recovery (PR). Two recent commentaries explained that PR should be expected (THIS is the tyranny of low expectations in full display.)because of mathematical coupling between the baseline and change score. This article explores why, if mathematical coupling encourages PR, some stroke patients (the “non-fitters”) do not exhibit PR. At the neuroanatomical level of analysis, this question was answered by Byblow et al—non-fitters lack corticospinal tract (CST) integrity at baseline. Here, the mathematical and behavioral causes are examined. The authors first derive a new interpretation of the slope of PR: It is the average probability of scoring across remaining scale items at follow-up. PR therefore breaks when enough test items are discretely more difficult for a patient at follow-up, flattening the slope of recovery. For the UEFM, the authors show that non-fitters are most unlikely to recover the ability to score on the test items related to wrist/hand dexterity, shoulder flexion without bending the elbow, and finger-to-nose movement, supporting the finding that non-fitters lack CST integrity. However, they also show that a subset of non-fitters respond better to robotic movement training in the chronic phase of stroke. These people are just able to move the arm out of the flexion synergy and pick up small blocks, both markers of CST integrity. Non-fitters therefore raise interesting questions about CST function and the basis for response to intensive movement training.
Descriptor Terms: HEMIPLEGIA, MOTOR SKILLS, OUTCOMES, REHABILITATION RESEARCH, RESEARCH METHODOLOGY, STATISTICS, STROKE.

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

Citation: Senesh, Merav R., Reinkensmeyer, David J.. (2019). Breaking proportional recovery after stroke. Neurorehabilitation and Neural Repair (NNR) , 33(11), Pgs. 888-901. Retrieved 1/25/2020, from REHABDATA database.