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.

Monday, June 19, 2023

Proactive outcome monitoring and standardisation of physiotherapy stroke rehabilitation — A retrospective functional outcomes analysis of Accelerated Stroke Ambulation Programme (ASAP)

No mention of recovering your walking 100%, so they immediately lowered the bar with the tyranny of low expectations, so you wouldn't question your lack of recovery and thus wouldn't correctly blame them for you not getting recovered.  You are not at fault for not recovering, that fault lies explicitly on your doctors and therapists.

 Proactive outcome monitoring and standardisation of physiotherapy stroke rehabilitation — A retrospective functional outcomes analysis of Accelerated Stroke
Ambulation Programme (ASAP)

Bryan Ping Ho Chung *,‡ and Titanic Fuk On Lau†
Physiotherapy Department, Tai Po Hospital
11 Chuen On Road Tai Po, New Territories, Hong Kong
*taipobryan@yahoo.com
†laufo@ha.org.hk
Received 26 July 2022; Accepted 23 March 2023; Published 31 May 2023
Background:  
 
A clinical quality improvement programme named Accelerated Stroke Ambulation
Programme (ASAP) was piloted in Physiotherapy Department of Tai Po Hospital from 1st October 2019 to 30th September 2020 and executed as a standard practice afterwards. The goal of ASAP was to facilitate early maximal walking ability of stroke patients in early rehabilitation phase. ASAP featured (1) proactive outcome monitoring and standardised process compliance monitoring by a patient database — Stroke Registry; (2) standardised mobility prediction by Reference Modified Rivermead Mobility Index (MRMI) Gain and (3) standardised intervention database — Stroke Treatment Library. Objective: To investigate the effectiveness of ASAP in an inpatient rehabilitation setting for stroke patients in terms of functional outcomes. Methods: The design was a retrospective comparative study to analyse the di®erence in functional outcomes of Pre-ASAP Group (1st October 2018 - 30th September 2019) and Post-ASAP Group (1st October 2020–30th September 2021). The primary outcome measures were MRMI, Berg's Balance Scale(BBS), Modified Barthel Index (MBI), MRMI Gain, BBS Gain, MBI Gain, MRMI Effciency, BBS Effciency and MBI Effciency. Results: There 348 subjects in Pre-ASAP Group and 281 subjects in Post-ASAP Group.
Both groups had highly significant within group improvement in MRMI, BBS and MBI (p < 0:001). The
MRMI Gain of Pre-ASAP Group and Post-ASAP Group was 6.32 and 7.42, respectively; and the di®erence was significant (p < 0:05). The BBS Gain of Pre-ASAP Group and Post-ASAP Group was 8.17 and 9.70, respectively; and the difference was in margin of significance (p ¼ 0:069). The MBI Gain of Pre-ASAP Group
‡Corresponding author.
Copyright@2023, Hong Kong Physiotherapy Association. This is an Open Access article published by World Scienti ̄c Publishing
Company. It is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 (CC BY-
NC-ND) License which permits use, distribution and reproduction, provided that the original work is properly cited, the use is
non-commercial and no modi ̄cations or adaptations are made.
Hong Kong Physiotherapy Journal
Vol. 43, No. 2 (2023) 1–11
DOI: 10.1142/S1013702523500130
1Hong Kong Physiother. J. Downloaded from www.worldscientific.comby 166.198.28.8 on 06/02/23. Re-use and distribution is strictly not permitted, except for Open Access articles.
and Post-ASAP Group was 10.69 and 11.96, respectively; but the di®erence was non-signi ̄cant (p ¼ 0:280).
The MRMI E±ciency, BBS E±ciency and MBI E±ciency of Post-ASAP Group were higher than Pre-ASAP
Group but the difference was nonsignificant. The results of this study reflected that stroke rehabilitation
programme with proactive outcome monitoring, standardised process compliance monitoring, standardised mobility prediction and standardised intervention database was practical in real clinical practice with better functional outcomes than traditional physiotherapy practice which were dominated by personal preference and experience of therapists.  
 
Conclusion: 
 
 Proactive outcome monitoring, standardised process compliance monitoring, standardised mobility prediction and standardised intervention database may enhance the effectiveness in terms of functional outcomes of stroke rehabilitation programme.
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