Deans' stroke musings: Quantifying Nonuse in Chronic Stroke Patients: A Study Into Paretic, Nonparetic, and Bimanual Upper-Limb Use in Daily Life

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.

Thursday, March 2, 2023

Quantifying Nonuse in Chronic Stroke Patients: A Study Into Paretic, Nonparetic, and Bimanual Upper-Limb Use in Daily Life

I happen to think your definition of learned non-use is completely wrong. It is vastly more likely that the neuronal cascade of death in the first week is the problem. You may be able to initially move a muscle but after the neuronal cascade of death has occurred, you no longer have live brain cells that can do that task. You are assigning learned non-use to an impossibility and blaming the patient rather than BLAMING THE DOCTOR for not stopping the neuronal cascade of death.

My take is that your doctor has the learned nonuse problem, they have learned to do nothing for stroke survivors and have been getting away with it for decades.

Quantifying Nonuse in Chronic Stroke Patients: A Study Into Paretic, Nonparetic, and Bimanual Upper-Limb Use in Daily Life

2012, Archives of Physical Medicine and Rehabilitation

ORIGINAL ARTICLE
Quantifying Nonuse in Chronic Stroke Patients: A StudyInto Paretic, Nonparetic, and Bimanual Upper-LimbUse in Daily Life
Marian E. Michielsen, MSc
†
, Ruud W. Selles, PhD, Henk J. Stam, MD, PhD Gerard M. Ribbers, MD, PhD, Johannes B. Bussmann, PhD
ABSTRACT. Michielsen ME, Selles RW, Stam HJ, RibbersGM, Bussmann JB. Quantifying nonuse in chronic stroke pa-tients: a study into paretic, nonparetic, and bimanual upper-limb use in daily life. Arch Phys Med Rehabil 2012;xx:xxx.
Objective:
To quantify uni- and bimanual upper-limb use inpatients with chronic stroke in daily life compared with healthy controls.
Design:
Cross-sectional observational study.
Setting:
Outpatient rehabilitation center.
Participants:
Patients with chronic stroke (n=38) and healthy controls (n=18).
Intervention:
Not applicable.
Main Outcome Measures:
Upper-limb use in daily life was measured with an accelerometry-based upper-limb activity monitor, an accelerometer based measurement device. Uni-manual use of the paretic and the nonparetic side and bimanual upper-limb use were measured for a period of 24 hours. Outcomes were expressed in terms of both duration and intensity.
Results:
Patients used their unaffected limb much more than their affected limb (5.3h vs 2.4h), while controls used both limbs a more equal amount of time (5.4h vs 5.1h). Patients used their paretic side less than controls used their nondominant side and their nonparetic side more than controls their dominant side. The intensity with which patients used their paretic side was lower than that with which controls used their nondominant side, while that of the nonparetic side was higher than that of the dominant side of controls. Finally, patients used their paretic side almost exclusively in bimanual activities. During bimanual activities, the intensity with which they used their affected side was much lower than that of the nonaffected side.
Conclusion:
Our data show considerable nonuse of the paretic side, both in duration and in intensity, and both during unimanual and bimanual activities in patients with chronic stroke. Patients do compensate for this with increased use of the nonparetic side.