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.

Sunday, August 31, 2025

Optimizing Stroke Rehabilitation: Towards Closed-loop Phase-shifted Electrical Stimulation for Reduced Muscle Fatigue and Enhanced Arm/Hand Control

 Have your competent? doctor translate this into understandable English and see what can be used to get survivors recovered.  I have no clue what this means

Optimizing Stroke Rehabilitation: Towards Closed-loop Phase-shifted Electrical Stimulation for Reduced Muscle Fatigue and Enhanced Arm/Hand Control


Semester

Summer

Date of Graduation

2025

Document Type

Dissertation (Campus Access)

Degree Type

PhD

College

School of Medicine

Department

Not Listed

Committee Chair

Sergiy Yakovenko

Committee Member

Valeriya Gritsenko

Committee Member

Loren Rieth

Committee Member

James W. Lewis

Committee Member

Marco Capogrosso

Abstract

Movement is the most sophisticated function arising from the cooperation between body and mind. Yet, the central nervous system (mind) faces the challenge of coordinating complex movements in a highly dimensional musculoskeletal system (body), known as the motor redundancy problem. To address this problem, we designed a neural network solution to computationally solve the inverse kinematics problem using raw motion capture recordings, as described in Chapter 2. Another solution to the redundancy problem can be observed through the reduced dimensionality of the neural control space, a concept known as muscle synergies or motor primitives. Although various mathematical methods applied to differently structured datasets obtain low-dimensional control space solutions, their neuromuscular or biomechanical underpinnings are unclear. Therefore, in Chapter 3, we investigate the link between muscle synergies and limb dynamics (forces) through two components: 1) a gravity component for supporting the limb against gravity and 2) a dynamic component for propelling and orienting the hand. We further examine these two components in the context of stroke. Poststroke, the outputs from the primary motor cortex to motoneurons are disrupted in patterns unique to individuals. While each stroke is different, common patterns of abnormal muscle activations are frequently observed. In Chapter 4, we find how gravity and dynamic components are differentially affected during the sub-acute and chronic stages of stroke recovery and how this knowledge can inform personalized rehabilitation using neuromuscular electrical stimulation. Chapter 5 focuses on the surface neuromuscular electrical stimulation to reduce rapid muscle fatigue, improve non-linear “all-or-none” recruitment of muscle fibers, and alleviate pain and paresthesia – critical factors for the long-term application of electrical stimulation. There, we leverage a phase-shifted stimulation approach, in which pulses of electrical current alternate between two or more electrode pairs. This approach minimizes fatigue, discomfort, and sensory issues while enabling more effective control of muscle contractions. By combining these approaches, we aim to develop a closed-loop stimulation system to support the hemiparetic arm against gravity and assist in the rehabilitation of reaching and grasping movements, as discussed in the final chapter.

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