Deans' stroke musings: Exercise-mediated locomotor recovery and lower-limb neuroplasticity 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.

Sunday, January 19, 2020

Exercise-mediated locomotor recovery and lower-limb neuroplasticity after stroke

Maybe you can get a protocol out of this. I don't do treadmills anymore, they don't readily transfer to the vagaries of walking over rocks, tree roots and through water. Real life walking will train your balance much faster and you can get forest bathing out of it.

Exercise-mediated locomotor recovery and lower-limb neuroplasticity after stroke

Larry W. Forrester, PhD;
1–2
*
Lewis A. Wheaton, PhD;
3
Andreas R. Luft, MD
4
1
Department of Veterans Affairs (VA) Maryland Health Care System, Research Service, Baltimore, MD;
2
Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD;
3
VA Maryland Health Care System, Baltimore, MD;
4
Hertie Brain Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany

Abstract—

Assumptions that motor recovery plateaus within months after stroke are being challenged by advances in novel motor-learning-based rehabilitation therapies. The use of lower-limb treadmill (TM) exercise has been effective in improving hemiparetic gait function. (Improving is NOT GOOD ENOUGH! We want full recovery. Damn it all, do the right thing. 100% recovery for all.)In this review, we provide a rationale for treadmill exercise as stimulus for locomotor relearning after stroke. Recent studies using neuroimaging and neurophysiological measures demonstrate central nervous system (CNS) influences on lower-limb motor control and gait. As with studies of upper limbs, evidence shows that rapid transient CNS plasticity can be elicited in the lower limb. Such effects observed after short-term paretic leg exercises suggest potential mechanisms for motor learning with TM exercise. Initial intervention studies provide evidence that long-term TM exercise can mediate CNS plasticity, which is associated with improved gait function. Critical needs are to determine the optimal timing and intensities of TM therapy to maximize plasticity and learning effects.