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.

Wednesday, January 17, 2024

Management of Spasticity Post Stroke, From Stretching to Surgical Options: Harmony Sierens, MD

NO, NO, NO! Survivors want it cured NOT 'managed'! 

Your competent? doctor has had over 15 years  to remove stretching from your stroke rehab! Is your doctor still incompetently recommending it?

The Effects of Stretching in Spasticity: A Systematic Review

The latest here:

Management of Spasticity Post Stroke, From Stretching to Surgical Options: Harmony Sierens, MD

The medical director of the Inpatient Rehabilitation Unit at Ascension Genesys Hospital explored the various interventions for managing spasticity after stroke, from stretching exercises to surgical procedures. [WATCH TIME: 3 minutes]
Duration 3:38
 
"We have to weigh the risk and benefits of management, considering interventions like stretching, monitoring, and bracing before delving into more aggressive measures such as oral medications or botulinum toxin injections. Spasticity is a unique aspect of medicine that requires an artful approach, recognizing that not all instances of spasticity are undesirable; sometimes, it contributes to a patient's ability to stand and walk."

One of the most frequent and disabling clinical manifestations of patients who experience stroke is spasticity.1 In the clinical practice, diagnosis and assessment of spasticity are based on clinical examination, particularly in resistance to passive movement and abnormal involuntary muscle contraction. For managing this condition, nonpharmacologic and pharmacologic treatments are commonly combined with stretching approaches. According to a review of a study published in Physical Medicine and Rehabilitation Clinics of North America, evidence supports the effectiveness and safety of most medications commonly used to treat spasticity.2

The most frequent type of medications used to manage spasticity are taken orally, which some clinicians consider a more conservative or first-line strategy for treatment.3 Regarding the use of oral medications, researchers noted that the decision to prescribe them to patients is complicated further by the fact that several different agents have been used for many different specific diagnoses. If medications or nonpharmacological therapies work for the patient, there is also the option of surgical treatment. These procedures aim at reducing spasticity by interrupting the stretch reflex or attempting to increase the centrally mediated inhibitory influence on the pool of motor neurons.4

To dive deeper into this, Harmony Sierens, MD, a physiatrist and the medical director at Ascension Genesys Inpatient Rehab Unit, recently sat down in an interview with NeurologyLive® to discuss how healthcare professionals balance the use of more conservative interventions like stretching and bracing with the potential need for aggressive measures in managing spasticity. Sierens talked about the factors that influence the decision to choose specific treatments in addressing spasticity, and additionally, about how the medical community navigates the complexity of spasticity, recognizing its variable nature and sometimes beneficial role in a patient's functional abilities.

REFERENCES
1. Gomez-Cuaresma L, Lucena-Anton D, Gonzalez-Medina G, Martin-Vega FJ, Galan-Mercant A, Luque-Moreno C. Effectiveness of Stretching in Post-Stroke Spasticity and Range of Motion: Systematic Review and Meta-Analysis. J Pers Med. 2021;11(11):1074. Published 2021 Oct 24. doi:10.3390/jpm11111074
2. Bethoux F. Spasticity Management After Stroke. Phys Med Rehabil Clin N Am. 2015;26(4):625-639. doi:10.1016/j.pmr.2015.07.003
3. Watanabe TK. Role of oral medications in spasticity management. PM R. 2009;1(9):839-841. doi:10.1016/j.pmrj.2009.07.014
4. Smyth MD, Peacock WJ. The surgical treatment of spasticity. Muscle Nerve. 2000;23(2):153-163. doi:10.1002/(sici)1097-4598(200002)23:2<153::aid-mus3>3.0.co;2-4

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