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, August 2, 2025

Stronger policy, improved recovery: Closing gaps in stroke rehabilitation could improve lives

WOW!  A policy statement; NOT A STRATEGY TO GET TO 100% RECOVERY! This is precisely why I consider the ASA a fucking failure of a stroke association! All these supposedly smart people and still not one useable brain cell amongst them!

You do have stroke in your name; it should mean you're trying to solve stroke to 100% recovery! But alas! That's obviously too fucking hard for you. Wait until you're the 1 in 4 per WHO that has a stroke and there is nothing for 100% recovery, that will become your problem. And every single fucking failure of a stroke association IS RUNNING AWAY! COWARDS! 

Send me personal hate mail on this: oc1dean@gmail.com. I'll print your complete statement with your name and my response in my blog. Or are you afraid to engage with my stroke-addled mind? No excuses are allowed! You're medically trained; it should be simple to precisely state EXACTLY WHY you haven't worked at all on 100% recovery with NO EXCUSES! Your definition of competence in stroke is obviously much lower than stroke survivors' definition of your competence! Swearing at me is allowed, I'll return the favor. Don't even attempt to use the excuse that brain research is hard.

 Stronger policy, improved recovery: Closing gaps in stroke rehabilitation could improve lives

Stroke remains a leading cause of long-term disability in the United States, and while treatments have advanced, systems designed to support stroke survivors in recovery continue to fall short of the needs of patients. A new policy statement from the American Heart Association, a relentless force changing the future of health for everyone everywhere, highlights major gaps in U.S stroke rehabilitation and identifies needed improvements in public policies and performance measures to incentivize optimal patient care. The policy statement was published today in Stroke.

Stroke is currently one of the most expensive medical conditions covered by Medicare. The economic burden of stroke is expected to increase by more than five-fold between 2020 and 2050, from $67 billion to $423 billion, the largest absolute increase in costs among various types of cardiovascular disease.

Despite the growing cost burden of stroke, access to stroke  care is often not determined by clinical need, with large gaps in care based on race, geography, insurance type and . Some patients, including those in rural areas, face steep barriers to accessing post-acute rehabilitation services, widening the disability gap compared to  in urban areas.

"Clinical guidelines from the American Heart Association and American Stroke Association recommend that discharge planning and rehabilitation decisions be based on a stroke survivor's functional needs," said Nneka L. Ifejika, MD, MPH, FAHA, American Heart Association and American Stroke Association volunteer, chair of the policy statement writing committee and chief scientific officer at Ochsner Health System in New Orleans, LA.

"However, research shows that non-clinical factors including the size and scope of a hospital network, a patient's insurance status and rehabilitation provider availability during the acute stroke hospitalization can limit access to appropriate care, resulting in poorer outcomes and higher long-term costs."

The policy statement outlines key measures to improve stroke care, including:

  • Advance research that reflects real-world stroke recovery challenges by prioritizing patient-centered studies, addressing caregiving needs,  and long-term outcomes such as quality of life, return to work and community reintegration.
  • Develop a national data infrastructure to track rehabilitation service utilization, costs (direct and indirect) and patient outcomes across diverse populations and care settings.
  • Evaluate and compare rehabilitation models for their clinical effectiveness and cost-efficiency to determine what works best for stroke survivors.
  • Study the impact of systemic factors—such as insurance coverage, geography,  and payment models—on rehabilitation quality and patient recovery to inform improvements in care delivery.
  • Enhance care coordination and discharge planning by expanding staff training and addressing the unique needs of patients and their caregivers from varied social and economic backgrounds.

"The quality of one's recovery from stroke should not depend on their ZIP code, insurance status or the cultural competency of their health care providers when describing the importance of post-acute care," Ifejika said. "Every stroke survivor should be evaluated to receive high-quality, patient-centered rehabilitation, and should have equitable access if post-acute care is needed."

The American Heart Association is committed to advancing public policies at the federal and state levels that create optimal systems of care for stroke treatment, including rehabilitation and recovery.

The  was prepared by the volunteer writing group on behalf of the American Heart Association Advocacy Coordinating Committee. American Heart Association policy statements position the Association on issues of public policy that will impact cardiovascular health and mortality, guide our advocacy work at all levels of government, allow us to support the important work of others, and inform policymakers, practitioners, health care professionals, researchers, the media and the public.

More information: Nneka L. Ifejika et al, Improving Access to Stroke Rehabilitation and Recovery: A Policy Statement From the American Heart Association/American Stroke Association, Stroke (2025). DOI: 10.1161/STR.0000000000000493

Journal information: Stroke 

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