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, January 25, 2026

Perfect world of stroke rehab - running again

I know most of you don't think this is possible, but for those who want to try, you can see some successes here.  This is obviously something our therapists need to set up a protocol for.  I doubt I'll ever be able to run again until my spasticity is cured, and my left foot actually points straight ahead.

ACTUALLY Running Free! Yeah, She Did it!



Advocate Condell Stroke Survivor Set to Run Chicago Marathon

Stroke survivor clocks 1000 kilometres 
Have your therapist lay out a step by step process(That's called a protocol, not a guideline!) for you to accomplish this if you want to. Challenge them to use their neurons in a new and exciting way.

I bet there is zero chance your doctor and therapists have any protocol to get you running again. But if you are willing to try this dangerous activity on your own, I'd suggest the book; 'Teaching Me to Run' by Tommye-K. Mayer. Don't do this without your doctor's prescription. 


 
A year after a stroke, Mundelein man calls marathon ‘the ultimate test of my recovery’
Stroke survivor recovers to run the NYC Marathon

Saturday, January 24, 2026

New Study Shows These Proteins Are Crucial For Building Muscle & Losing Fat* by mindbodygreen

 What is your competent? doctors EXACT PROTOCOL to prevent sarcopenia(muscle loss)! NOTHING?

Let's see how long everyone related to stroke has been incompetent!

  • sarcopenia (29 posts to March 2016) (Almost a decade and managed not to get fired? Your board of directors is woefully incompetent!)

  • Of course, your competent? doctor already prescribed you the correct amounts of dairy fat, right?

    The latest here:

    New Study Shows These Proteins Are Crucial For Building Muscle & Losing Fat*

    ISC 2026: Previewing Advances in Post-Stroke Care

     

    'Care' is NOT RECOVERY!

    This is the whole problem in stroke enumerated in one word; 'care'; NOT RECOVERY! 

    Our non-existent stroke leadership should be demanding RECOVERY NOT 'CARE'!

    My god, anyone in the business world would be fired immediately for managing or caring about something rather than delivering RESULTS. And this is why this is a complete fucking failure! This does nothing to guarantee recovery for survivors!

    If your stroke medical 'professional'/hospital is touting 'care' it means they are a failure because they are delivering 'care'; NOT RECOVERY! I would never go to a failed hospital! Anytime I see the word 'care' associated with a stroke hospital; I immediately think fucking failure!

    YOU have to get involved and change this failure mindset of 'care' to 100% RECOVERY! Survivors want RECOVERY, NOT 'CARE'!

    I see nothing here that states going for 100% recovery! You need to create EXACT PROTOCOLS FOR THAT!

    ASK SURVIVORS WHAT THEY WANT, THEY'LL NEVER RESPOND 'CARE'! This tyranny of low expectations has to be completely rooted out of any stroke conversation! I wouldn't go there because of such incompetency as not having 100% recovery protocols!

    RECOVERY IS THE ONLY GOAL IN STROKE!

    GET THERE!

    Leaders solve the BHAG(Big Hairy Audacious or (Assed) Goals in stroke! The only goal in stroke is 100% recovery. GET THERE!

    ISC 2026: Previewing Advances in Post-Stroke Care


    DISCLOSURES
     Annie J. Ferris, MD, suggests that post-stroke care(NOT RECOVERY!), despite its importance, is neglected relative to acute stroke treatment. She is particularly interested in recent advances such as vagus nerve stimulation(This has been out there since July 2012 and YOU STILL HAVEN'T WRITTEN A PROTOCOL ON IT, HAVE YOU?) and wants to know whether this or similar technologies can help with post-stroke depression, aphasia, or vision loss.(Well then, DO SOMETHING ABOUT IT! RESEARCH! WRITE PROTOCOLS! Don't just spout off uselessly!)

    Dr Ferris is concerned that many patients miss the critical neuroplasticity window before their first recovery clinic visit, which reduces the effectiveness of therapies such as constraint-induced movement therapy and prism adaptation for spatial neglect. She therefore urges better ways to connect patients with recovery devices and a standardized system to reliably convey stroke recovery options and principles.(Well yeah, you don't know that the best way to do that is: WRITE EXACT REHAB PROTOCOLS! GET GOING, time is a wasting!) 

    Ferroptosis in neurological diseases: moving towards therapeutic intervention

     

    Your doctor, if competent at all, should have already known about ferroptosis from this research from September 2017.  And should have initiated stroke treatment interventions from it. But I bet incompetence prevailed! No excuses are allowed, call that president and have these incompetent doctors fired!

     Dementia research leads to potential new stroke treatment

    The latest here:

    Ferroptosis in neurological diseases: moving towards therapeutic intervention


    Abstract

    Ferroptosis is a regulated cell death driven by iron-dependent lipid peroxidation and has been implicated in major neurological diseases. The brain is enriched in polyunsaturated fatty acids (PUFAs) and iron, which makes it particularly susceptible to lipid peroxidation, leading to ferroptosis. In neurological diseases such as Alzheimer’s disease (AD) and stroke, such mechanisms are dysregulated and contribute to neuronal loss. Physiologically, the lipid peroxidation resistance systems in the brain, including defenses (such as SOD, CAT, Prxs, GPxs) and repair systems (such as GPx4, FSP1), prevent ferroptosis and repair damaged phospholipid membranes. However, the efficacy of endogenous resistance systems is often compromised in pathological states, positioning exogenous antioxidants as promising therapeutic candidates. Future research(If your doctors and hospital can't get this further research done, then it's time to keel haul them!) could optimize the delivery of these compounds and explore new candidates that specifically target the ferroptosis signaling pathway to prevent neurodegeneration occurring in neurological diseases.

    This is a preview of subscription content, access via your institution


    Microglial P2RY12 mediates migration to and protection of cerebral microvasculature after ischemia–reperfusion via Caveolin-1

     Have your competent? doctor and hospital either get the EXACT PROTOCOL or get further research done to create such protocol!

    Do you prefer your doctor, hospital and board of director's incompetence NOT KNOWING? OR NOT DOING? Your choice; let them be incompetent or demand action!

    Microglial P2RY12 mediates migration to and protection of cerebral microvasculature after ischemia–reperfusion via Caveolin-1


    https://doi.org/10.1016/j.expneurol.2026.115662Get rights and content

    Highlights

    • P2RY12 mediates microglia migration and protects the blood-brain barrier.
    • The role of microglial P2RY12 in modulating microvascular protection via Cav-1.
    • P2RY12 interacts with the scaffolding domain of Cav-1.

    Abstract

    Disruption of blood-brain barrier (BBB) integrity after cerebral ischemia-reperfusion (I/R) injury contributes to neuroinflammation and neuronal damage. Microglia plays a significant role in the repair processes of the BBB, and the G protein-coupled receptor P2RY12 is involved in microglial chemotactic migration. However, its precise function and associated downstream mechanisms are unclear. Caveolin-1 (Cav-1), a membrane scaffold protein, plays a key role in signal transduction and cellular motility. This study employed in vivo and in vitro experimental models to explore the functional role of the P2RY12-Cav-1 interaction after ischemic stroke. Blocking P2RY12 with PSB0739 worsened neurological deficits and BBB disruption. In contrast, the P2RY12 agonist 2MeSADP attenuated I/R injury, promoted Bv2 cell migration. Disrupting lipid rafts with methyl-β-cyclodextrin (MβCD) abolished these benefits. Co-immunoprecipitation verified P2RY12 interacts with the scaffolding domain of Cav-1. These findings reveal a possible mechanism by which the P2RY12-Cav-1 signaling axis regulates microglial chemotaxis for microvascular protection, offering a potential therapeutic target for the treatment of ischemic stroke.

    Introduction

    Stroke, a leading global cause of both mortality and neurological disability, is predominantly characterized by the ischemic subtype, which accounts for approximately 87% of cases (Martin et al., 2025). The associated disease burden continues to escalate (Radak et al., 2017; Rathore et al., 2002). Disruption of the structural integrity and function of the blood-brain barrier (BBB) constitutes a pivotal event in the pathological progression of ischemic brain injury (del Zoppo et al., 2007). While vascular recanalization remains the cornerstone of clinical intervention, reperfusion-induced BBB damage contributes to vascular leakage and secondary brain injury, thus posing a significant limitation to patient prognosis (Krueger et al., 2015). Furthermore, the BBB directly regulates the trans-barrier delivery efficiency of neuroprotective agents (Wang et al., 2024; Yang et al., 2024). Consequently, maintaining BBB integrity carries substantial therapeutic implications, both for preventing further injury and for optimizing the efficacy of neuroprotective treatments.
    Microglia, the resident immune cells of the brain, established connections with the vascular wall via morphological extensions, contributing to vascular homeostasis under physiological conditions (Bisht et al., 2021). Together with neurons and blood vessels, microglia constitute the neurovascular unit and play a critical role in maintaining BBB integrity (Thion et al., 2018; Prinz et al., 2019; Halder and Milner, 2020; Halder and Milner, 2019). P2RY12, a G protein-coupled purinergic receptor first identified in platelets, is a widely studied clinical target in cardiovascular and cerebrovascular diseases (Hollopeter et al., 2001). Its function is cell-type dependent: in platelets, it promotes thrombosis via Gi/o signaling, whereas in microglia, it mediates chemotactic migration (Davalos et al., 2005). By specifically recognizing purinergic signaling molecules (e.g., ATP/ADP) released at injury sites (Davalos et al., 2005). P2RY12-mediated chemotaxis of microglial processes is required for the rapid closure of the BBB, and it protects neurons from damage by forming microglia-neuron connections and plays a significant role in cerebral blood flow regulation (Cserép et al., 2020; Lou et al., 2016). Our preliminary investigations utilizing single-cell scRNA-seq datasets, the R package Cell Chat, and confirmatory experiments suggest that P2RY12 may function as a key trigger molecule through which microglia influence the cerebral microvasculature in ischemic brain injury (Wang et al., 2023). Nevertheless, its precise role and underlying mechanisms remain unclear.
    As a key member of the caveolin protein family, Cav-1 functions as both a pivotal architectural protein for the formation of caveolae structures in the cell membrane and as an essential scaffold protein that maintains the structural integrity of specific functional domains within the cell membrane. It plays a crucial role in regulating cell membrane curvature and lipid raft assembly while integrating multiple transmembrane signaling pathways (Liu et al., 2002). In tumor biology, Cav-1 modulates cellular migration and invasion through molecular interactions, signaling pathways, and structural changes in cells (Singh et al., 2024; Du et al., 2009; Martínez et al., 2019; Chanvorachote et al., 2014; Lin et al., 2005; Li et al., 2018; Xiong et al., 2017; Sun et al., 2009). Research has demonstrated that the purinergic receptor P2Y family and Cav-1 regulate the structural and functional coupling between nucleotide receptors on the cell membrane and their downstream effectors, thereby affecting the efficiency of extracellular nucleotide signal transduction (Martinez et al., 2016). Notably, the lipid raft microdomain, serving as the functional platform for caveolae, the ability of Gαi (downstream of the P2Y12 receptor) to potentiate ADP-mediated platelet aggregation is highly dependent upon its localization to lipid rafts (Liu et al., 2022; Quinton et al., 2005). Furthermore, Cav-1 knockdown has been shown to reduce overall microglial migration, suggesting its potential involvement in microglial dynamics relevant to injury responses (Niesman et al., 2013). However, the specific role of Cav-1 in regulating P2RY12-mediated microglial function, particularly its chemotactic migration towards injured vasculature and microvascular protection within the central nervous system (CNS) during ischemic injury, remains unexplored.
    This study employs an integrated approach to explore the regulatory mechanisms of the P2RY12/Cav-1 signaling axis in ischemic brain injury. Initially, the functional role of P2RY12 will be investigated through pharmacological inhibition with the antagonist PSB0739. This approach will assess the impact of P2RY12 blockade on cerebral I/R injury outcomes, evaluating its effects on microvascular integrity. Complementary in vitro studies using Bv2 microglial cells will further define the contribution of P2RY12 to microglial migration. Subsequently, both in vivo and in vitro models will be used to elucidate the mechanisms governing microglial chemotactic migration, employing the P2RY12 agonist 2MeSADP and the lipid raft disruptor methyl-β-cyclodextrin (MβCD).Finally, the study will experimentally determine the interaction between Cav-1 and P2RY12.
    As a purinergic receptor uniquely expressed in microglia, the signaling network mediated by P2RY12 and its molecular regulatory mechanisms remain incompletely elucidated. Cav-1 may act as a critical molecular hub, potentially involved in P2RY12-induced microglial chemotactic migration. This research elucidates the molecular mechanisms by which microglial P2RY12 regulates the microcirculatory system during stroke pathology. The findings not only expand the theoretical framework of ischemic brain injury but also provide experimental evidence for developing potential therapeutic strategies focused on neurovascular unit protection.

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    Study Explores Predictive Modeling to Assess Functional Independence in Older Stroke Patients During Subacute Recovery

     Who approved this stupid predictive research? Nothing here gets survivors recovered! You're all fired!

    Study Explores Predictive Modeling to Assess Functional Independence in Older Stroke Patients During Subacute Recovery

    A recent study has provided new insights into the recovery process of older patients following a subacute stroke. Researchers utilized an anchor-based adjusted predictive modeling approach to analyze functional independence and identify key indicators of clinically meaningful changes during rehabilitation. The findings shed light on critical factors influencing recovery outcomes in this patient population.

    The research focused on understanding how specific measures can predict functional gains and guide rehabilitation strategies for stroke survivors. By employing advanced modeling techniques, the study examined patterns of improvement in functional independence, offering a detailed perspective on what constitutes significant progress during the subacute phase of stroke recovery. The results aim to inform future approaches to optimizing care(NOT RECOVERY!) for older adults recovering from strokes.

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    Key Functional Gains in Subacute Stroke Patients

     SO FUCKING WHAT! NO protocols were referenced about HOW TO EXACTLY RECOVER!

    Referencing 'care' NOT RECOVERY means you don't belong in stroke!

    I will against my better nature hope all of you discover schadenfreude when you have your stroke and DON'T RECOVER!

    Send me personal hate mail on this: oc1dean@gmail.com. I'll print your complete statement with your name(If you can't stand by your name don't bother replying anonymously) 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 were trained to be incompetent with NO EXCUSES!

    Key Functional Gains in Subacute Stroke Patients

    New research has revealed significant insights into the recovery journey of older patients who have endured a subacute stroke. By employing a sophisticated anchor-based adjusted predictive modeling approach, researchers have delved deep into the nuances of functional independence and the critical measures that indicate clinically meaningful change during the rehabilitation phase. The study, conducted by Uchida, Shirakawa, Ishii, and their colleagues, aims to illuminate the pathways through which elderly patients can regain independence following a stroke, ultimately enhancing their quality of life and aiding healthcare providers in their rehabilitation efforts.

    As the population ages, the incidence of strokes among the elderly continues to rise, presenting unique challenges in healthcare management. Stroke recovery is a complex process, especially for older individuals who may have pre-existing comorbidities that complicate their rehabilitation. The research underscores the importance of understanding the subtleties of functional changes, emphasizing that what might seem like minor improvements can hold significant implications for patients’ lives. By quantifying these changes using an anchor-based approach, the researchers provide a framework that could potentially transform rehabilitation strategies for subacute stroke patients.

    The methodology employed in the study is noteworthy, incorporating predictive modeling that takes various factors into account, including the patient’s baseline functional status, age, social support, and clinical interventions received. This comprehensive approach allows for a nuanced understanding of how these factors interact to influence recovery outcomes. Interestingly, the findings suggest that certain thresholds of functional improvement are more relatable to patients and caregivers, making it easier to set realistic goals during the treatment process.

    Functional independence is not merely a statistic; it encapsulates a patient’s ability to perform daily activities without assistance. The adjustments made to the predictive model serve as a pivotal tool for clinicians, enabling them to identify which aspects of recovery are most crucial for patient satisfaction and functional capability. The study showcases that beyond clinical assessments, there are subjective experiences of patients that significantly influence their overall satisfaction with rehabilitation outcomes.

    One of the key messages emerging from this research is the individualized nature of stroke rehabilitation. Each patient’s journey is marked by unique challenges and milestones, requiring tailored interventions that consider personal goals and aspirations(You are missing that the only goal in stroke is 100% recovery!). The researchers advocate for an integrated rehabilitation approach that accommodates these diverse needs(There are no diverse needs; ONLY 100% RECOVERY! Are you that blitheringly stupid?), potentially leading to more effective recovery paths for older adults recovering from stroke.

    Furthermore, the study highlights the impact of societal and familial support structures on patient recovery. Social networks can provide motivation, emotional support, and practical assistance throughout the rehabilitation process. The researchers call attention to the role that caregivers play in fostering an environment conducive to recovery, suggesting that healthcare providers should not only focus on the clinical aspects but also consider the psychosocial dimensions of patient care(NOT RECOVERY!).

    The findings add to the growing body of evidence supporting the implementation of personalized care(NOT RECOVERY!) plans in stroke rehabilitation. By leveraging advanced techniques to track functional independence, clinicians can refine their approaches, moving away from a one-size-fits-all mentality toward more customized strategies that cater to individual patient needs. This could enhance engagement and adherence to rehabilitation protocols, ultimately leading to better outcomes.

    One intriguing aspect of the research is the notion of “minimal important change.” This concept refers to the smallest change in a treatment outcome that patients perceive as beneficial. Establishing a clear understanding of this threshold is crucial for clinicians aiming to set achievable and measurable goals for their patients. The predictive modeling approach employed in the study offers clinicians a valuable resource for quantifying these changes, thus facilitating more constructive dialogue with patients about their progress.

    Moreover, the study emphasizes the importance of continuous monitoring and evaluation during rehabilitation. By regularly assessing functional independence and adapting interventions as necessary, healthcare providers can ensure that patients remain on track toward their goals. This responsive approach not only enhances patient autonomy but also instills a sense of agency in older adults, fostering resilience during their recovery journey.

    The implications of this research extend beyond individual patient care(NOT RECOVERY!). As healthcare systems grapple with the increasing prevalence of stroke among older adults, implementing evidence-based practices derived from this study could inform policy decisions and resource allocation in rehabilitation services. It highlights the necessity for training programs that equip healthcare professionals with the skills to utilize predictive modeling techniques in their practice, ensuring that all patients receive the most effective care(NOT RECOVERY!) possible.

    In conclusion, the work of Uchida and colleagues sets a new standard in understanding the complex dynamics of recovery from subacute stroke among older patients. Their anchor-based adjusted predictive modeling approach not only provides a robust framework for measuring functional independence but also emphasizes the need for personalized care(NOT RECOVERY!) in rehabilitation. As the healthcare landscape continues to evolve, such research underscores the importance of a holistic view of patient recovery—one that values the interplay between clinical outcomes and the lived experiences of patients.

    This groundbreaking study holds the promise of informing future research and enhancing rehabilitation practices, ultimately fostering a culture of recovery that is both patient-centered and evidence-based. By advancing our understanding of the key factors that contribute to meaningful changes in functional independence, we can ensure that older stroke survivors are equipped with the resources and support they need to thrive in their post-stroke lives.

    Subject of Research: Changes in functional independence among older patients with subacute stroke.

    Article Title: Clinically meaningful changes in functional independence among older patients with subacute stroke: estimating the minimal important change using an anchor-based adjusted predictive modeling approach.

    Article References:

    Uchida, H., Shirakawa, T., Ishii, K. et al. Clinically meaningful changes in functional independence among older patients with subacute stroke: estimating the minimal important change using an anchor-based adjusted predictive modeling approach.
    Eur Geriatr Med (2026). https://doi.org/10.1007/s41999-025-01401-x

    Image Credits: AI Generated

    DOI: 23 January 2026

    Keywords: Functional independence, stroke recovery, predictive modeling, elderly patients, rehabilitation strategies.

    Relationship between anterior–posterior ground reaction force patterns and immediate effect of different types of ankle–foot orthoses in individuals with post-stroke hemiparesis: a cross-sectional study

     Relationships don't get anyone recovered! You need EXACT REHAB PROTOCOLS FOR THAT!

    But I guess you are that blitheringly stupid! You'll have lots of fun recovering when you are the 1 in 4 per WHO that has a stroke!

    Relationship between anterior–posterior ground reaction force patterns and immediate effect of different types of ankle–foot orthoses in individuals with post-stroke hemiparesis: a cross-sectional study

    You have full access to this open access article

    Journal of NeuroEngineering and Rehabilitation Aims and scope Submit manuscript
    Relationship between anterior–posterior ground reaction force patterns and immediate effect of different types of ankle–foot orthoses in individuals with post-stroke hemiparesis: a cross-sectional study

      We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

      Abstract

      Background

      Ankle–foot orthoses (AFOs) are commonly prescribed to improve gait after stroke; however, their effectiveness varies among individuals. Limited evidence exists on how AFOs specifically influence ground reaction force (GRF) patterns during gait. This study investigated how baseline anterior–posterior GRF (A–P GRF) patterns, reflecting braking and propulsive abilities, influence the immediate effects of distinct AFO designs.

      Methods

      This retrospective cross-sectional study included 66 community-dwelling individuals with hemiparesis who underwent gait analysis under three conditions: without AFO (noAFO), with oil-damper AFO (odAFO), and with plastic AFO (pAFO). A–P GRF impulse and mean were assessed across four stance phase bins (Bin 1: initial double support following heel contact, Bin 2: first half of the single support, Bin 3: second half of the single support, Bin 4: terminal double support preceding toe-off), alongside gait speed and limb kinematics. Hierarchical cluster analysis identified distinct A–P GRF patterns based on the impulse from Bins 1–4 during the baseline noAFO condition; immediate AFO effects were compared across clusters.

      Results

      Both AFO types significantly but modestly increased gait speed overall, with variable responses across clusters. Three baseline A–P GRF patterns were identified: favorable propulsion (Cluster 1, n = 19), moderate impairment (Cluster 2, n = 27), and poor propulsion with excessive braking (Cluster 3, n = 20). Participants with the poorest gait function (Cluster 3) demonstrated the most significant improvements in gait speed with both AFO types (odAFO: p < 0.001; pAFO: p = 0.006), through different biomechanical mechanisms: odAFO improved propulsive forces in Bin 4 (impulse: p < 0.001; mean: p = 0.012), whereas pAFO reduced excessive braking forces in Bin 1 (impulse: p < 0.001; mean: p = 0.048). Participants with favorable baseline A–P GRF patterns showed minimal immediate effects.

      Conclusion

      AFO effectiveness depends on baseline A–P GRF patterns, with the greatest benefits observed in participants exhibiting poor propulsive forces and excessive braking, through different biomechanical mechanisms. These findings highlight the importance of considering individual A–P GRF patterns when prescribing orthotic interventions in post-stroke rehabilitation.