Deans' stroke musings: Motivational Interviewing and Self-Management Support in Early Stroke Rehabilitation: A Feasibility Randomized Controlled 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.

Saturday, March 4, 2023

Motivational Interviewing and Self-Management Support in Early Stroke Rehabilitation: A Feasibility Randomized Controlled Study

You do realize that you are addressing the wrong problem? The stroke medical world needs to be motivated to solve stroke. WORK ON THAT! Stroke survivors would have no problem doing millions of repetitions if they knew that the result of following that protocol would be recovery. You know nothing about stroke survivors, do you?

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https://doi.org/10.1016/j.apmr.2022.12.111 Get rights and content

Research Objectives

To evaluate the feasibility of a trial testing the efficacy of motivational interviewing and a telehealth self-management program in early stroke rehabilitation.

Design

An exploratory randomized controlled trial.

Setting

Hospitalized care (inpatient rehabilitation) and community setting.

Participants

Using convenience sampling, first-time stroke patients with a mild stroke(So cherry picking because they might recover with the limited knowledge we have on recovery. Work on the hard cases like leaders do.) were recruited at a Level 1 Stroke Center inpatient rehabilitation unit and randomized into an intervention or treatment-as-usual group. Out of 24 eligible patients, 15 enrolled, and 10 completed the study (90% male; age=56 (14.5); intervention group n=6).

Interventions

The intervention group participated in five, 30-minute motivational interviewing sessions delivered in person and over phone by a rehabilitation psychologist and a weekly, 6-session, group-based self-management program, called Improving Participation After Stroke Self-management program-TeleRehab (IPASS-TR), delivered by an occupational therapist and stroke survivor via Zoom. Motivational interviewing focused on discussing post-stroke concerns identified by participants. IPASS-TR focused on building self-management skills to improve post-stroke life participation with an emphasis on understanding and navigating the impact of the environment.

Main Outcome Measures

Feasibility (recruitment rate, attrition, resources used, acceptability, fidelity) data through observation, focus groups, and interviews. PROMIS Global Health, Stroke Impact Scale Perceived Recovery Scale, Patient Activation Measure, NeuroQoL Satisfaction with Social Roles, and Participation Strategies Self-Efficacy Scale.

Results

Demographic and baseline outcome measures were similar between the groups. All outcome measures were feasible to use. Intervention attendance rate was 100%, and fidelity remained strong. Telehealth delivery required supports such as reminders and flexibility in scheduling. Participants were satisfied with the timing, structure, and content and reported emotional benefits and gain of new insights and knowledge. Perceived recovery showed moderate effect favoring the intervention group (r=0.54).

Conclusions

The feasibility of the trial and delivery supports the design of a larger scale trial. While preliminary, participant satisfaction and positive effects support the importance of integrating self-management focused interventions early on in stroke rehabilitation to support patients’ transition into their life with a long-term disability.(So you are not even talking recovery, just your FUCKING TYRANNY OF LOW EXPECTATIONS! You want survivors to agree to those low expectations because you are not willing to do the work to solve stroke. It's easier to just do the failure of the status quo and get paid rather than solve stroke? Hope you're OK with not recovering when you are the 1 in 4 per WHO that has a stroke