Deans' stroke musings: A systematic review opens the black box of "usual care" in stroke rehabilitation control groups and finds a black hole

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.

Friday, June 17, 2022

A systematic review opens the black box of "usual care" in stroke rehabilitation control groups and finds a black hole

'usual care' in stroke doesn't exist since everyone quotes you the craptastic saying; 'All strokes are different, all stroke recoveries are different'.

But usual results do exist:

You only have a 10% chance of full recovery.
tPA has only a 12% full recovery rate

The latest here:

A systematic review opens the black box of "usual care" in stroke rehabilitation control groups and finds a black hole

Chiara Arienti¹, Riccardo Buraschi², Joel Pollet¹, Stefano G Lazzarini¹, Claudio Cordani³, Stefano Negrini^{3

4}, Massimiliano Gobbo⁵

Affiliations

PMID: 35634889
DOI: 10.23736/S1973-9087.22.07413-5

Free article

Abstract

Introduction: In experimental trials, new methods are tested against the 'best' or 'usual' care. To appraise control group (CG) interventions provided as "usual care", we focused on stroke as a leading cause of disability demanding rehabilitation as a complex intervention.

Evidence acquisition: For this methodological appraisal, we conducted a systematic review of RCTs without timespan limitation. The PICO included stroke survivors, rehabilitation, control group intervention, lower limb function. To assess the risk of bias, we used the Cochrane risk of bias tool (RoB). We identified the terminology describing the CG Program (CGP), performed a knowledge synthesis and conducted a frequency analysis of provided interventions.

Evidence synthesis: We included 155 publications. 13.6% of the articles did not describe the CG, and 11.6% indicated only the professionals involved. In the remaining 116 studies, three studies provided an intervention according to specific guidelines, 106 different 'usual care' CGPs were detected, with nine proposed twice and two between four and five times. The most adopted terminology to state 'usual care' was "conventional physiotherapy".

Conclusions: This study shows that usual care in CG does not actually exist, as both specific terminology and consistency within CGP contents are missing. Reporting guidelines should give better assistance on this issue. These results should be verified in other fields.