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. Did your doctor somehow miss the recovery protocol that Pedro Bach-y-Rita used to recover fully back in 1958 with only a partial brain?

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.

Showing posts with label netherlands. Show all posts
Showing posts with label netherlands. Show all posts

Thursday, September 30, 2021

Surf therapy: a growing movement to address mental health

I'll guess you'll have to have your stroke and rehab in the Netherlands. This will never get approved in the US. Eventually I'll get around to stand up paddleboarding. The only surfing around here is in winter in Lake Michigan and Superior and that would require a 5mm wetsuit, totally impossible to get on one-handed.

Surf therapy: a growing movement to address mental health

 

September 29, 2021 | Surfing
Surf therapy: an established form of therapeutic support for mental and physical health worldwide | Photo: The Wave Project

Surf therapy is a method of health intervention that combines surfing and surf instructing alongside structured group or individual activities that promote psychological, physical, and psychosocial well-being.

Over the past ten years, this type of therapy has become an established form of therapeutic support for mental and physical health worldwide.

In the United Kingdom, it is recognized by the National Health Service (NHS) as an effective form of therapy for children and young people at risk of mental illness.

Surf therapy has also been used to support veterans in the United States, stroke victims in the Netherlands, deprived communities in South Africa, and adults with psychological conditions in Australia and South America.

In 2021, it's safe to say that surf therapy has become a truly global movement.

Surf therapy: it promotes positive attitudes, better communication skills, a healthier lifestyle, and progress in education | Photo: The Wave Project

Mounting Research Shows Evidence-Based Health Benefits

While it's easy to find people who are able to talk about the transformational impact surf therapy has had on their lives, these positive effects are increasingly backed up by research.

Several studies now show the beneficial, tangible impact of surf therapy on mental and emotional health.

For example, independent research commissioned by The Wave Project - the surf therapy charity I founded for children and young people based in the UK - revealed a statistically significant change to the well-being of participants after our intervention.

A peer-review by the journal Community Practitioner, published in January 2015, found that The Wave Project intervention resulted in a significant and sustained increase in health and happiness levels and behavior change.

Seventy-nine percent of parents reported a more positive attitude, and sixty-two percent revealed better communication skills in their children.

Fifty-six percent thought they showed a healthier lifestyle after participation, and 46 percent knew of progress in education since the course.

The conclusions from this analysis were clear.

When delivered in a supportive environment, with opportunities for continuation and volunteering, surfing provides profound and long-term benefits to the well-being of children facing social and emotional isolation.

The Wave Project: surfing provides profound and long-term benefits to the well-being of children facing social and emotional isolation | Photo: The Wave Project

Surfing Against Post-Conflict Mental Health Disorders

There is interesting evidence to show the profound impact of surf therapy on young people in post-conflict settings.

Young people in post-conflict and post-epidemic contexts such as Sierra Leone face many mental health challenges as part of their daily lives.

A recent study involving surf therapy pilots run by five youth-focused and community development organizations around Freetown found that participation in the organization's intervention generated large positive effects on mental health.

A separate study alongside Waves for Change in neighboring Liberia suggests that such positive effects are down to safe spaces, positive social connections, and respite from negative emotions inherent within surf therapy delivery.

These elements were identified as often lacking in participants' wider lives within a challenging post-conflict environment.

Increasingly, surf therapy interventions are used to provide support to those operating in "blue light" services - namely, the police, fire services, and emergency responders.

In 2017, two police sergeants, Sam Davies and James Mallows set up Surfwell, a health promotion project that uses a recreational surfing adventure experience to promote workplace mental health within the police force, after an officer they supervised was left traumatized by an attack.

The program is specifically designed to address the escalating mental health crisis in the UK emergency services linked to workplace stress.

A 2016 online poll conducted by the charity MIND found that one in four emergency service workers in the UK had contemplated suicide, and two-thirds had considered leaving their job.

In many instances, traditional clinical interventions had failed to help, showing a clear need for other forms of support for police officers and other emergency services workers.

Surf therapy: five days of intensive surfing during the chronic phase of stroke or trauma has an impressive, positive effect on functional outcomes, participation levels, and mental well-being | Photo: The Wave Project

Surf Therapy for Neurological Disorders

There is also increasing interest in the beneficial impact of surf therapy interventions on those who have experienced strokes and other neurological disorders.

In The Netherlands, surf therapist Tijs van Bezeij founded the surftherapie.nl foundation after an experience working with a 20-year-old boy who had been hospitalized for rehabilitation after a major stroke.

The center is predicated on the understanding that challenging therapy in a rigorous, high-intensity environment generates the best results for stroke rehabilitation.

A pilot study by the foundation shows that five days of intensive surfing during the chronic phase of stroke or trauma has an impressive, positive effect on functional outcomes, participation levels, and mental well-being.

The study represents the participants' experience, demonstrates the continued recovery of the brain and the acceleration of recovery through challenging activities such as surfing.

What Next for Surf Therapy?

Increasingly, independent research is confirming what many of us engaged in surf therapy witness all the time: surf therapy works.

As a surf therapist, the challenge now is to build on this research surf therapy reaches more people who really need it.

At the 2021 International Surf Therapy Organization conference, surf therapy practitioners - including speakers from the organizations mentioned above - will join academics and campaigners in the UK's surfing hotspot Cornwall to discuss what lies ahead for surf therapy as a mental health intervention.

Hosted by The Wave Project, the theme of the very first International Surf Therapy Organization conference to be held in Europe is "Building Trust."

For many people who participate in surf therapy, this is a crucial element of their recovery.

The conference aims to bring together leading surf therapy organization heads to build on best practices, learn from one another and discuss how to broaden accessibility and improve our services.

For tickets to the 2021 International Surf Therapy Organization Conference on October 6-8, please visit The Wave Project website at www.waveproject.co.uk.


Words by Joe Taylor | CEO and Founder of The Wave Project

Tuesday, December 1, 2020

Prehospital Stroke Screening Showdown Crowns Two Tools

This line way down in the article is where I would prefer research being done. 

In any case, future advances in prehospital stroke triage might depend more on technology, according to the editorialists. 

Just validate which of these fast diagnosis tools is the best.

Maybe one of these much faster possibilities?

Hats off to Helmet of Hope - stroke diagnosis in 30 seconds   February 2017

 

Microwave Imaging for Brain Stroke Detection and Monitoring using High Performance Computing in 94 seconds March 2017

 

New Device Quickly Assesses Brain Bleeding in Head Injuries - 5-10 minutes April 2017

 

The latest here:

Prehospital Stroke Screening Showdown Crowns Two Tools

 

Investigators externally validate stroke scales in the field

Paramedics evaluate an elderly man on his front porch

Two prehospital prediction scales were better than others at identifying stroke patients who might be candidates for mechanical thrombectomy in the Netherlands, though results might vary in other countries and regions.

The most accurate large vessel occlusion (LVO) prediction scales were the Los Angeles Motor Scale (LAMS) and Rapid Arterial Occlusion Evaluation (RACE) tool, with estimated accuracy rates of 89% and 88%, respectively, according to Nyika Kruyt, PhD, of Leiden University Medical Center, the Netherlands, and colleagues reporting online in JAMA Neurology.

These two scales significantly outperformed other prediction scales tested:

  • Cincinnati Stroke Triage Assessment Tool (C-STAT)
  • Prehospital Acute Stroke Severity (PASS)
  • Gaze-face-arm-speech-time (G-FAST)
  • Field Assessment Stroke Triage for Emergency Destination (FAST-ED)
  • Gaze, facial asymmetry, level of consciousness, extinction/inattention (GACE)

For the study, paramedics filled in a page of 10 to 13 neurologic observations on-site or during transport of each stroke code patient in the Leiden and The Hague regions. Investigators then retrospectively reconstructed and tested seven LVO prediction scales from this data on 2,007 adults with suspected stroke.

Prevalence of symptomatic, anterior circulation LVO [sLAVO] was 7.9% in this cohort.

"In practice, the preferred sLAVO prediction scale will depend on the local context, which will include such factors as prevalence of sLAVO, differences in transport times between hospitals, in-hospital performance metrics, and local policies," according to Kruyt and colleagues.

Thus, results of their head-to-head comparison of stroke scales -- in the setting of a Dutch population counting approximately 2 million people with two EMS systems, three comprehensive stroke centers, and four primary stroke centers -- may not be reproduced in other places.

All seven prehospital triage scales demonstrated good accuracy, high specificity (80%-93%), and low sensitivity (38%-62%) in identifying candidates for endovascular thrombectomy.

"Of course, given their universally low sensitivities by design, application of any of these scales is expected to lead to a high rate of false positives. And the consequence for patients with false positives is a high level of overtriage to thrombectomy stroke centers or to comprehensive stroke centers," commented Kori Zachrison, MD, MSc, of Massachusetts General Hospital and Harvard Medical School in Boston, and Pooja Khatri, MD, MSc, of University of Cincinnati, Ohio.

Such overtriage could lead to longer transport times and delays in alteplase (Activase) administration for eligible patients, the distancing of patients from families and support networks, and unnecessary crowding at comprehensive stroke centers, they warned in an accompanying editorial.

"Even so, in the long run, some overtriage is likely justified, and resources may need to be allocated to allow for this, given the unprecedented but time-sensitive benefit of endovascular thrombectomy on patient morbidity and mortality," they wrote.

The study included people with EMS-activated stroke codes after initial FAST testing in 2018-2019. Mean age was 71.1 years, and 50.9% of the patients were men. The median NIH Stroke Scale score was 4.

Among the screening tools tested, RACE had a relatively low 78.1% feasibility rate, or the proportion of acute stroke codes for which the prehospital scale could be reconstructed. The most frequently missing item was motor deficit in the legs.

In contrast, the PASS scale had the best feasibility at 87.9%, which the authors suggested was due to the scale having fewer items that needed to be assessed compared with the other scales.

"[I]t is important to take feasibility into account before implementing a prediction scale in the field because focused training could substantially increase these rates," Kruyt's group said.

"The authors appropriately recognized that, in addition to accuracy, consideration of feasibility is critical when evaluating scales for the prehospital setting. Implementation should not place an undue burden on paramedics in the uncontrolled prehospital environment and amidst the various demands of the on-scene evaluation and transport of a patient who is in critical condition," according to Zachrison and Khatri.

Kruyt's team cautioned that paramedics did not fill out the observation sheet in 26.7% of acute stroke codes, which were excluded from the study. Furthermore, the study was limited in that it did not test all available prediction scales.

In any case, future advances in prehospital stroke triage might depend more on technology, according to the editorialists.

"Perhaps noninvasive sensors will turn out to be more efficient at identification of large strokes than these simple prehospital screening tools. Or perhaps we should consider more mathematically complex decision models easily made widely accessible by smartphone applications; such models may deal with uncertainty, consider probabilities, weigh various transport options, and even incorporate live traffic patterns to drive decision-making using artificial intelligence," Zachrison and Khatri wrote.

Monday, February 17, 2020

Alcohol consumption in later life and reaching longevity: The Netherlands Cohort Study

Your doctor can reconcile the vast difference between these two studies.  I'm doing alcohol for the great social connections made which will prevent my dementia.  

Safest level of alcohol consumption is none, worldwide study shows

The latest here:

Alcohol consumption in later life and reaching longevity: The Netherlands Cohort Study

Age and Aging — van den Brandt PA, et al. | February 11, 2020

Researchers focused on the link of alcohol drinking characteristics with the likelihood to reach 90 years of age, utilizing data from the Netherlands Cohort Study. The individuals that took part in the study were born in 1916–1917 (n = 7,807) and were asked to complete a questionnaire in 1986 (age 68–70 years). These people were observed for vital status until the age of 90 years (2006–07). Findings revealed that both men and women demonstrated statistically significant positive links between baseline alcohol consumption and the possibility of reaching 90 years. A positive link of wine consumption with longevity was observed (notably in women), whereas liquor was positively related to longevity in males and inversely in females. Those without and with a history of selected diseases showed a link between alcohol intake and longevity. Overall, participants drinking 5– < 15 g alcohol/day showed the highest probability of reaching 90 years. Although not significant, the risk estimates also suggest to avoid binge drinking.
Read the full article on Age and Aging


Thursday, September 26, 2019

Outcome measures in physiotherapy management of patients with stroke: a survey into self-reported use, and barriers to and facilitators for use

This is chapter 6 in a 236 page thesis. You can read it yourself and see that PTs in the Netherlands don't follow the Dutch clinical practice guidelines. So even if we were to get actual protocols we would be lucky to get someone who actually implements them. 

Outcome measures in physiotherapy management of patients with stroke: a survey into self-reported use, and barriers to and facilitators for use

Saturday, June 29, 2013

3-D Body Suit Put to Use in Healthcare Research

And using this our therapists could objectively determine all the muscles and joints that need correcting.

3-D Body Suit Put to Use in Healthcare Research


The suit, called MVN BIOMECH from Xsens out of Enschede, The Netherlands, is a 3-D human kinematic, camera-less measurement system with integrated small tracking sensors placed on the joints. Each sensor on the suit consists of three components: an accelerometer, magnetometers and a gyroscope. All together it gives information on each of the joints, the body segments between the joints and the 3-D movements. The technology sends the information a computer using a wireless signal which is then reconstructed into movements on the screen.

More at link.
 3-D Body Suit Put to Use in Healthcare Research