Deans' stroke musings: Factors influencing the willingness to participate in rehabilitation in patients with subacute 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.

Saturday, September 9, 2023

Factors influencing the willingness to participate in rehabilitation in patients with subacute stroke

Motivation is extremely easy to understand and implement.

Write up 100% recovery protocols on this and survivors will do the millions of reps needed, no external motivation required. You don't understand one goddamn thing about stroke survivors, DO YOU? The problem is stroke researchers are not motivated to solve stroke. What the fuck is your solution to that failure? We still don't know how to motivate stroke medical 'professionals' to solve stroke to 100% recovery!

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https://doi.org/10.1016/j.jocn.2023.09.001 Get rights and content

Abstract

Objective

The aim of this study was to examine the parameters that may influence the willingness of patients to participate in post-stroke rehabilitation.

Methods

Patients in the subacute phase of stroke who underwent inpatient rehabilitation for one month were included in this study. The primary outcome measure was the level of rehabilitation participation as measured on the Pittsburgh Rehabilitation Participation Scale (PRPS). Other outcome measures evaluated were Mini-Mental State Examination (MMSE) for cognitive functions, Brunnstrom stage for motor recovery, modified Rankin Scale (mRS) for disability, Functional Independence Measure for functionality, Pittsburgh Sleep Quality Index for sleep quality, and Beck Depression Inventory for emotional state.

Results

A total of 38 patients with first-time stroke were studied. A negative correlation was found between the participation in rehabilitation and body mass index (BMI) (r: −0.398p = 0.012), myocardial infarction (MI) history (r: −0.387p = 0.015) and mRS (r: −0.351p = 0.031), while a positive correlation was determined with MMSE (r: 0.432P = 0.007). A 1-unit increase in BMI, MI history, and mRS resulted in a 0.176, 0.673, and 0.294-unit decrease in participation in rehabilitation, respectively. In addition, a 1-unit increase in MMSE provided an increase of 0.606-unit in participation.

Conclusion

BMI within normal limits, prevention/treatment of cardiovascular diseases, and well-being of physical and cognitive functions might be the factors that positively influence participation in rehabilitation process. We consider that it would be appropriate to evaluate these parameters with particular emphasis in stroke patients in the subacute period to be rehabilitated.

Introduction

Stroke is one of the most common diseases that cause disability and dependency [1], [2]. Its incidence and prevalence gradually increase with age [3], [4]. It is known that men are at a higher lifetime risk of both ischemic and hemorrhagic stroke than women [5], [6]. Pregnancy and use of oral contraceptives, on the other hand, increase the risk in young women [7], [8], [9].

While 10% of stroke patients recover spontaneously within a month, 10% do not benefit from treatment. Approximately 80% of mild and moderately disabled patients can benefit from the rehabilitation program [10]. The main purpose of rehabilitation is to ensure the individual's maximum independence from all aspects (physical, cognitive, social, etc.). In this respect, the participation of patients in rehabilitation is vital for recovery.

With the mobilization studies initiated in the acute period after stroke, significant increases can be achieved in the functional recovery of patients [11]. It was determined that the neurological functions of stroke patients who were mobilized within 24–48 h after hospitalization increased, and the complication rates decreased with early and intensive rehabilitation [12], [13].

Through clinical experience, we are aware of the value of early rehabilitation, but we have found that in some cases patients were less motivated to participate in rehabilitation and we planned to research the causes behind this to raise awareness and contribute to the literature.

Rehabilitation is an approach in which the benefit is greater when administered to the patient interactively rather than passively. Therefore, based on the principle that the treatment of stroke patients is “not for the patient”, but “with the patient” as in other areas of rehabilitation [14], this study was carried out to draw attention to this issue by examining the parameters that may influence the participation of patients in rehabilitation.