Showing posts with label not repeatable. Show all posts
Showing posts with label not repeatable. Show all posts
Friday, May 8, 2026
Friday, December 12, 2025
Sonomyography accurately captures joint kinematics during volitional and electrically stimulated motion in healthy adults and an individual with cerebral palsy
If your incompetent? doctor isn't getting an objective damage diagnosis like this; THERE IS NO FUCKING WAY TO CREATE REPEATABLE PROTOCOLS THAT DELIVER RECOVERY EVERY TIME!
Or maybe like this:
I expect your stroke doctor to OBJECTIVELY know the damage. Like the number of dead neurons, dead myelinated fibers, dead synapses! Without that knowledge your doctor can never correlate what protocols fix them.
I would just flat out ask your doctor why they are so fucking incompetent that they know nothing objective about your damage! Quoting NIHSS or Barthel is the height of stupidity!
NIHSS and the Barthel Index ARE NOT DAMAGE DIAGNOSES, they do not give you the 3d location of your dead and damaged neurons. In my opinion, they are FUCKING WORTHLESS to getting you recovered!)
The latest here:
Sonomyography accurately captures joint kinematics during volitional and electrically stimulated motion in healthy adults and an individual with cerebral palsy
Abstract
Background
Despite significant advances in biosignal extraction techniques for studying neuromotor disorders, there remains an unmet need for a method that effectively links muscle structure and dynamics to muscle activation. Addressing this gap could improve the quantification of neuromuscular impairments and pave the way for precision rehabilitation. In this study, we demonstrate the proof of concept of recording multimodal signals from the brain, muscles, and resulting limb kinematics. We also explore the use of ultrasound imaging to extract limb kinematics.
Methods
We collected data from three healthy volunteers and one individual with cerebral palsy during single degree-of-freedom ankle and wrist movements. Participants performed range of motion (ROM) tasks at approximately 1-second intervals, either volitionally or through functional electrical stimulation. We simultaneously recorded electroencephalography, surface electromyography (EMG), continuous ultrasound imaging, and motion capture data. Joint kinematics were computed from ultrasound imaging using a technique called sonomyography (SMG), and we evaluated the technical feasibility of estimating joint kinematics from both sonomyography and surface EMG signals.
Results
The technical feasibility study evaluated joint angle prediction using EMG and SMG under volitional (FES-OFF) and electrically stimulated (FES-ON) conditions. Root mean squared error (RMSE) between predicted and measured joint angles was computed for multiple methods of extracting kinematics from EMG and SMG. EMG-based RMSE ranged from 0.34 to 0.57 (FES-OFF) and 0.43–0.51 (FES-ON). SMG-based RMSE ranged from 0.10 to 0.25 across all conditions and methods. Linear regression analysis produced
values between 0.31 and 0.81 depending on joint, condition, and method. No significant RMSE difference was found between FES-ON and FES-OFF conditions within SMG. SMG RMSE values were also comparable to previously reported values (10-25%) in prior literature.
Conclusion
Our findings suggest that sonomyography can be used as a noninvasive method for estimating joint kinematics when the joint movement is driven either by volition or by functional electrical stimulation. This technique can potentially be be useful in evaluating altered muscle dynamics and driving assistive and rehabilitation devices in individuals with neuromotor disorders such as cerebral palsy.
Saturday, December 6, 2025
Cognitive Recovery After Stroke: How to Restore Cognitive Functions by Flint Rebab
Ask your competent? doctor if they will guarantee this will recover your 5 lost years of brain cognition due to your stroke? NO? So they are fuckingly incompetent in their job to get you recovered? And you are paying them to be incompetent?
Everything here is mostly useless generalities. Demand your doctor give you an EXACT PROTOCOL; you don't want to waste your time on generalities and guidelines!
Cognitive Recovery After Stroke: How to Restore Cognitive Functions
Over half of all stroke survivors experience cognitive changes within a year of their stroke, making cognitive recovery after stroke an essential component of the rehabilitation process. Individuals experiencing post-stroke cognitive impairment may have trouble with memory, organization, attention and other cognitive skills. Focusing on cognitive recovery after stroke can help survivors restore cognitive skills and improve their quality of life. This article will describe the potential effects of post-stroke cognitive impairment and outline what pursuing cognitive recovery after stroke may entail. Please use the links below to jump directly to any section of this article. What is a post-stroke cognitive impairment? Importance of pursuing cognitive recovery after stroke Achieving cognitive recovery after stroke Learning to manage cognitive changes
What is a Post-Stroke Cognitive Impairment?
When a stroke compromises the blood supply in the brain, survivors may experience a number of physical and cognitive changes depending on the area of the brain affected. While the physical effects of stroke may be more readily apparent, cognitive changes may also significantly affect a survivor’s daily life. According to the American Heart Association, approximately 60% of stroke survivors experience cognitive changes in the first year after their stroke. Every stroke is unique, and therefore the specific cognitive changes that each survivor experiences vary widely and range in intensity from mild to severe. Regardless of the specific cause or severity, any cognitive impairment noted after a stroke is considered a post-stroke cognitive impairment.Some of the most common functions that may be affected among those with post-stroke cognitive impairment include: Memory: forming new memories and retrieving previously stored information Attention: focusing the senses on a specific target, while tuning out other information Language: cognitive components of language include the processes of comprehension and mentally formulating language. Perceptual-motor skills: the combination of sensory and motor skills required to interact with one’s surroundings, such as hand-eye coordination, body awareness, and spatial relations Executive function: high-level cognitive skills required to modulate one’s behavior, such as planning and organizational skills, working memory, judgment, and impulse control Post-stroke cognitive impairment is most likely following damage to the left frontotemporal lobes, the left thalamus, and the right parietal lobe. This is because these areas of the brain are highly involved in cognitive functions. It is important for survivors and their loved ones to understand post-stroke cognitive impairment and be aware of its prevalence in order to promptly address it. Not all cognitive changes occur immediately after stroke, so it is essential to talk with the survivor’s medical team regarding any potential changes in cognition. While it is possible to continue recovering even years after stroke, pursuing rehabilitation early on can promote an optimal cognitive recovery after stroke.Importance of Pursuing Cognitive Recovery After Stroke
In addition to affecting cognitive functions, post-stroke cognitive impairment can impact survivors’ independence with daily activities and their ability to return to work. Furthermore, survivors often report psychological changes such as depression, as well as a diminished quality of life. With the appropriate rehabilitation methods, many stroke survivors can progress toward cognitive recovery after stroke. While approximately 1 in 5 survivors with mild post-stroke cognitive impairment achieve a full recovery, many others make significant gains. There are a number of ways to optimize cognitive recovery after stroke, including using early cognitive screening to identify potential cognitive impairments and actively participating in cognitive rehabilitation as soon as possible. Early detection and rehabilitation for post-stroke cognitive impairment are ideal to achieve an optimal recovery. This is because during the first few months following a stroke, the brain enters a heightened state of neuroplasticity. Through neuroplasticity, the brain has the ability to adaptively rewire itself, transferring control of affected functions to healthy areas of the brain. This allows functions that were previously lost or impaired to be restored. Neuroplasticity is activated through repetitive practice. When a task is performed over and over, the brain perceives a demand for the functions associated with that task, and subsequently creates and strengthens the related neural pathways. Although neuroplasticity may be activated at any point of recovery, taking advantage of enhanced neuroplasticity in the initial stages of recovery can boost cognitive recovery after stroke.Achieving Cognitive Recovery After Stroke
There are a number of pharmacological and nonpharmacological strategies to work toward achieving cognitive recovery after stroke. Depending on the individual’s needs, doctors may recommend a combination of the following treatments:1. Cognitive Rehabilitation
Cognitive rehabilitation focuses on repetitively practicing tasks to enhance cognitive functions. Frequent practice of cognitive exercises and activities activates neuroplasticity, allowing the brain to recover through adaptive rewiring.Cognitive rehabilitation strategies vary depending on which functions have been affected. For example, interventions may include memory games, visual scanning practice, music-based therapies, or functional activity simulations. These interventions are often carried out by a speech language pathologist, occupational therapist or psychologist.
2. Physical Exercise
In addition to practicing cognitive rehabilitation exercises, physical exercise may(NOT GOOD ENOUGH!) boost cognitive recovery after stroke. Numerous studies have found that exercise, particularly aerobic exercise, can play a role in improving cognitive performance. In fact, participation in an aerobic exercise program is recommended for most stroke survivors due to its many benefits.
Physical exercise improves physiological processes within the brain. For example, exercise increases the production of brain-derived neurotropic factor (BDNF), a growth factor that promotes neuroplasticity, which is essential for stroke recovery.
Furthermore, exercise can improve depression and other secondary complications of stroke that often occur in those with post-stroke cognitive impairment. Although physical exercise alone can improve cognition, it is most effective to combine exercise with cognitive rehabilitation.
3. Cognitive Rehabilitation Technology
Since consistent, repetitive practice is essential to activate neuroplasticity(NO ONE IN THE WORLD KNOWS HOW TO MAKE NEEDED NEUROPLASTICITY REPEATABLE ON DEMAND!), it is important that stroke survivors continue to practice therapeutic tasks even outside of therapy sessions. Many digital therapeutic tools and computer-assisted cognitive rehabilitation devices for home use have been developed specifically to promote cognitive recovery after stroke.
Various technologies, including online treatment programs, phone applications, virtual reality interventions, computer-based software, and video games, have been used to create programs that supplement conventional cognitive rehabilitation. The gamified approach to rehabilitation provided by these technologies can be very motivating. Furthermore, these programs can often adapt to an individual’s skill level to provide appropriately challenging tasks.
One example of a phone app focused on cognitive rehabilitation is the CT Speech and Cognitive Therapy app. This app was designed by speech therapists to include beginner to advanced-level exercises targeting a variety of cognitive skills, including attention, memory, and reasoning. Talking with a therapist may help survivors discover which technological cognitive rehabilitation program may be most beneficial.
4. Pharmacological Strategies
Pharmacological treatments for post-stroke cognitive impairment are continuing to be studied. However, taking blood-pressure lowering medications can improve(NOT GOOD ENOUGH!) cognitive outcomes, as managing hypertension has been shown to minimize cognitive decline. Cognitive stimulants may also be prescribed to boost cognitive recovery after stroke.
There are a number of other types of medications that have been considered to improve cognition after stroke, including cholinesterase inhibitors (like donepezil, rivastigmine, and galantamine) and the N-methyl-D-aspartate (NMDA) receptor antagonist memantine. However, these have been primarily studied among those with vascular dementia, rather than less severe post-stroke cognitive impairments.
Other potential pharmacological options that may(NOT GOOD ENOUGH!) be beneficial to promote cognitive recovery include citicoline, nimodipine, Ginkgo biloba, and long-chain omega-3 polyunsaturated fatty acids (O-3-FAs). However, more research is needed to determine the effectiveness of these medications and supplements. For more personalized information, survivors should talk with their doctors regarding the benefits of pharmacological treatments for cognitive recovery after stroke.
5. Emerging Treatments
New treatments to improve cognitive recovery after stroke are consistently being examined among researchers. Emerging treatment options include:
- Growth hormone therapy: Growth hormones have been shown to promote the formation of new neurons (brain cells) and blood vessels. With these benefits in mind, studies have demonstrated that growth hormone therapy may(NOT GOOD ENOUGH!) improve cognitive outcomes after stroke.
- Non-invasive brain stimulation: The use of non-invasive brain stimulation may promote many cognitive functions after stroke, particularly attention and working memory.
- Acupuncture: The use of Traditional Chinese medicine, including acupuncture, has been shown to potentially boost cognitive recovery after stroke.
While more evidence is needed to determine their effectiveness, these emerging treatments may(NOT GOOD ENOUGH!) be worth considering and discussing with one’s medical team. Since there is no “one size fits all” treatment for cognitive recovery after stroke, using a combination of the rehabilitative strategies above tends to yield the best results.
Managing Cognitive Changes After Stroke
Although addressing the underlying cause of post-stroke cognitive impairment through rehabilitative treatments is considered ideal, there are a number of techniques that individuals use to complete daily tasks despite cognitive changes. These strategies, referred to as compensatory techniques, allow individuals to manage their cognitive deficits in order to maximize their independence and quality of life.
Depending on which cognitive functions have been affected, the best compensatory strategies may vary. However, here are some of the most commonly recommended compensation techniques:
- Use reminders. This may include noting important tasks and appointments on a calendar or in a planner, strategically placing sticky notes to jog one’s memory, and setting alarms to remember specific activities.
- Minimize distractions. Reducing excess noise and clutter can be particularly helpful for individuals who struggle with attention.
- Write in a notebook. Using a journal or notebook can help individuals remember day-to-day events and conversations. Additionally, writing down one’s thoughts can aid in decision making and mental organization.
Although compensatory techniques can serve as a great stepping stone, they can also impede cognitive recovery. This is because using these techniques reduces the need to exercise targeted cognitive skills. For example, always working in a silent area free of distractions does not allow individuals to practice filtering out excess stimulation to improve their attention. Therefore, as individuals progress toward cognitive recovery, it is important to try to wean off of using compensatory strategies.
Understanding Cognitive Recovery After Stroke
Post-stroke cognitive impairment is a relatively common secondary effect of stroke. Changes in cognition can affect the ability to participate in daily activities and may reduce survivors’ quality of life.
There are a number of treatment options to promote cognitive recovery after stroke, including practicing cognitive rehabilitation exercises, participating in regular physical exercise, and using pharmacological treatments. These treatments can promote neuroplasticity, or the brain’s ability to rewire itself.
Although remediating cognitive functions is ideal, individuals may also utilize compensatory strategies to promote independence despite changes in cognition. While not all individuals achieve a full cognitive recovery after stroke, there is always hope for recovery through neuroplasticity.
Flint Rehab is leading the way in neuro-rehabilitation with products that are backed by research and clinically proven to help you recover more effectively from stroke, TBI, and SCI.
Trusted by over 300+ rehab facilities and 10,000+ home customers.
Tuesday, August 19, 2025
Scientists map the genes behind diet and dementia risk
While MIND and Mediterranean diets are science backed, there is nothing specific in them that makes their benefits repeatable.
Scientists map the genes behind diet and dementia risk
Scientists reveal a new genetic resource from the MIND diet trial, opening the door to precision nutrition strategies for protecting cognitive function in aging adults.
Data Descriptor: Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) Trial: Genetic Resource for Precision Nutrition. Image Credit: crystal light / Shutterstock
A recent Data Descriptor study published in the journal Nutrients described the genotyping, quality control (QC), and imputation procedures for generating a new genetic resource from participants in the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) trial.
Dementia prevalence is projected to increase due to progressive aging of the global population. Age-related cognitive decline varies among individuals. The MIND diet is a hybrid of the dietary approaches to stop hypertension (DASH) and Mediterranean diets with select modifications. The MIND diet emphasizes berries, green leafy vegetables, beans, nuts, seafood, whole grains, wine, olive oil, poultry, and limited fat intake.
Studies suggest that adherence to the MIND diet may slow cognitive decline and reduce the risk of Alzheimer’s disease. However, the primary MIND clinical trial itself found no significant differences in cognitive change after three years when compared to a calorie-restricted control diet.
This result is a key motivation for the current genetic study. Variation in the metabolism of MIND diet constituents between individuals may enhance or limit their efficacy and ultimately impact response to the diet. Therefore, knowledge on genetic factors contributing to this variation could be valuable in identifying subgroups who especially benefit from this diet and exploring the mechanisms underlying the relationship between cognitive health and the MIND diet.
About the study
In the present study, researchers in the United States described genotyping, QC, and imputation procedures for generating genetic data of the MIND trial participants. The MIND trial was a phase III randomized controlled trial (RCT) on the effects of the calorie-restricted MIND diet on cognitive decline compared to a usual diet with a similar caloric restriction. Participants were older, overweight, and cognitively unimpaired adults with a suboptimal diet and family history of dementia.
Blood samples were collected at several time points. Genomic DNA was extracted from whole blood and serum samples. Notably, the researchers had to overcome challenges, including the closure of a laboratory due to the COVID-19 pandemic, which necessitated using serum for DNA extraction in many cases where whole blood was unavailable. Apolipoprotein E (APOE) genotyping was performed using whole-blood and serum samples.
Single-nucleotide polymorphisms (SNPs) with call rates > 95%, Hardy-Weinberg equilibrium (HWE) p > 1 × 10-6, and minor allele frequency (MAF) > 0.05 were used for sample QC. Mismatches between self-reported and genetically inferred sex were identified.
Relatedness (kinship) among trial samples and the effects of DNA specimen, study site, and array batch were examined. Further, sample ancestry was genetically inferred using principal component analysis (PCA). For SNP QC, genotype concordance was evaluated between duplicate pairs to estimate the reproducibility of genotyping.
For the second sample QC, the team calculated heterozygosity and differentiated samples of poor quality from those of naturally low heterozygosity using statistical models to identify outliers.
Further, they performed a second SNP QC to retain chromosome X and autosomal variants with MAF > 0.01, HWE p > 1 × 10-6, and call rates > 95%. A second PCA was performed per ancestry using a pruned set of autosomal biallelic SNPs with MAF > 0.05 and call rates > 98%. Further, genotype imputations were performed for each ancestry using the Haplotype Reference Consortium (HRC) and 1,000 Genomes Project Phase 3 (1000G) reference panels.
APOE genotype of participants was initially determined by sequencing rs7412 and rs429358 SNPs at APOE exon 4. Furthermore, the APOE genotype was derived using imputed SNPs, and concordance was assessed using the sequenced APOE genotype. To validate the genetic data quality, the researchers sought to replicate known associations from genome-wide association studies (GWASs) with diet-related biomarkers.
Findings
DNA concentrations ranged between 0.12 ng/μL and 4.14 ng/μL in serum samples and 4.4 ng/μL and 277.8 ng/μL in whole-blood samples. Genetic data were generated for 602 trial samples. Excluding samples pre-QC with call rates < 90% and SNPs with MAF < 0.01 resulted in 573 participants with genotype data for over 1.01 million SNPs. In total, 630,959 SNPs were used for sample QC checks. Two samples with mismatches between self-reported and genetically inferred sex were excluded.
Three pairs of first-degree relatives were identified. The principal component 1 (PC1) separated White individuals from Black participants. The three Asian participants and one “other” participant clustered closer to White individuals. The team used PC1 to define a subset of participants of European ancestry as self-identified White individuals within six standard deviations (SDs) of PC1 means.
Similarly, a smaller subset of African-ancestry participants was determined. The ancestry of eight other participants could not be confidently inferred, so their genetic data were excluded from the final dataset.
Genotype concordance rates ranged between 98.1% and 99.8%, indicating high consistency. After sample QC, 58 and 494 unrelated samples of inferred African and European ancestries were retained, respectively. After a second PCA, the population sub-structure remained evident in the European ancestry group. Further, after all QC procedures, 809,442 and 772,662 variants were retained for 494 and 58 inferred European and African ancestry participants, respectively.
Following imputation with the 1000G panel, around 47.1 million variants were obtained for each ancestry. HRC imputation, performed only for European-ancestry participants, resulted in 39.1 million variants. HRC imputation demonstrated a higher quality for low-frequency and common variants. The APOE genotype concordance was 98.2% between 1000G-imputed and sequenced genotypes.
Compared to sequencing data, the imputed genotypes misclassified five non-carriers as E4 carriers and two E4 carriers as non-carriers. Similarly, HRC imputation yielded genotypes identical to those with the 1000G panel. The team replicated at least one SNP previously linked to adiponectin, alpha-linolenic acid, coffee intake, beta-carotene, alpha-tocopherol, tea intake, and docosahexaenoic acid in the 1000G imputed data. Results were comparable with HRC-imputed data.
Conclusions
In sum, the study presents a genetic resource from the first RCT of the MIND diet targeting cognitive outcomes. The findings highlight the adequacy of serum as an alternative source of DNA. Although serum DNA extraction and genotypic performance were inferior to those of whole blood, serum remains attractive in cases of missing or insufficient whole blood. The HRC and 1000G reference panels yielded high-quality imputed data for African and European ancestry populations.
Concordance was high between imputed and sequenced APOE genotypes. Moreover, the researchers replicated known GWAS associations with diet-related biomarkers.
The authors also noted several limitations to provide context for future research. These include that the study population was predominantly of European ancestry, which may limit the generalizability of findings, and that the specific participant criteria (e.g., overweight, family history of dementia) mean the resource is not representative of the general population. They also advise that potential batch effects from specimen type and study site should be accounted for in future analyses.
This genetic resource enables analyses of genetic contributions to variability in cognitive responses to the MIND diet, supporting integrative analysis with other data types to delineate underlying biological mechanisms. The data will be made available to other researchers via The National Institute on Aging Genetics of Alzheimer’s Disease Data Storage Site (NIAGADS).
These efforts could ultimately inform precision nutrition strategies and help promote cognitive health.
Thursday, July 31, 2025
Are Carbs Healthy? A 30-Year Study Reveals the Truth
Apply the science to your diet. Or you could allow your competent? doctor to tell you what to do. I'd rather trust the science even if I have to decipher it myself. While MIND and Mediterranean diets are science backed, there is nothing specific in them that makes their benefits repeatable.
Are Carbs Healthy? A 30-Year Study Reveals the Truth
Monday, June 23, 2025
Effects of pressure garments of varying designs on upper extremity sensorimotor functions and quality of life after stroke: Study protocol for a multicenter, double-blind, prospective randomized controlled trial
Of course your incompetent? doctors therapists and hospital DID NOTHING with this previous one. And will continue to prove incompetence with this newest research!
Regent Suit and stroke rehabilitation March 2011
In my opinion competence is immediately installing protocols upon published research. Does your incompetent? doctor think that is too high a bar? FIRE THEM! And if your doctor is still there after doing nothing your board of directors is completely incompetent!
The latest here:
Effects of pressure garments of varying designs on upper extremity sensorimotor functions and quality of life after stroke: Study protocol for a multicenter, double-blind, prospective randomized controlled trial
nd, prospective
randomized controlled trial
Zhenkun Xu1, Siaw Chui Chai
1*, Shin Ying Chu2, Kuicheng Li3
1 Center for Rehabilitation and Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan
Malaysia, Kuala Lumpur, Malaysia, 2 Center for Health Ageing and Wellness, Faculty of Health Sciences,
Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia, 3 School of Rehabilitation Medicine, Shandong
Second Medical University, Weifang, China
* sc.chai@ukm.edu.my
Abstract
Rationale
Stroke often results in extensive neurological damage, leading to a wide range of
rehabilitation needs and challenges, with upper extremity dysfunction being particu
larly prevalent. Although pressure garments have been used in the rehabilitation of
children with cerebral palsy to reduce muscle tone, their therapeutic effects have not
been thoroughly investigated in the field of stroke.
Aims
To determine the effects of pressure garments with varying designs on stroke
patients’ sensorimotor function and quality of life.
Sample size estimate
A total of 165 participants is required (55/group) with an effect size of 0.125, power of
0.80, alpha level of 0.05, and adjusted for a dropout rate of 20%.
Methods and design
This is a multicenter, double-blind, prospective randomized controlled, three-group
trial. At three hospitals in Shandong, China, 165 patients within 1−12 months of
stroke are randomly assigned (1:1:1) to receive Dorsal-Double-layered 10% cir
cumferential reduction (DD-10, intervention), Single-layered 10% circumferential
reduction (S-10, intervention), or Single-layered 0% circumferential reduction (S-0,
placebo) pressure garments. Pressure garments are worn for 3 hours in the morning, 3 hours in the afternoon, and 8 hours at night daily for 8 weeks. During the first 4
weeks, patients also receive 30-min occupational therapy sessions.
Study outcomes
The primary outcome is the Fugl-Meyer Assessment of Upper Extremity to assess
motor control. Secondary outcomes are the Box and Block Test (BBT) for assessing
dexterity, Modified Ashworth Scale (MAS) for assessing muscle tone, Visual Ana
logue Scale for assessing pain, Disabilities of Arm, Shoulder, and Hand (DASH) for
assessing self-perceived upper extremity function, and 36 Item Short Health Survey
(SF-36) for assessing quality of life. Measurements are taken at Time 1(Baseline),
Time 2 (Week 4), and Time 3 (Week 8). (None of these are objective, so any results you get are not repeatable!)
Discussion
The expected outcome of this study is that it can determine the design of pressure
garments best suited to improve sensorimotor function and the quality of life of stroke
patients. It can also extend the clinical value of pressure garments and help health
care professionals make more targeted treatment choices for stroke patients.
Trial registration
ClinicalTrials.gov Identifier: NCT06587308.
Introduction
Stroke is a challenging neurological disorder worldwide and remains the second
leading cause of death and disability in the world [1]. In China, the estimated prev
alence, incidence, and mortality rate of stroke among adults aged 40 years or older
in 2020 were 2.6%, 505.2/100,000 person-years, and 343.4/100,000 person-years,
respectively [2]. Stroke often results in extensive neurological damage, leading to a
wide range of rehabilitation needs and challenges, with upper extremity dysfunction
being prevalent [3–5]. This dysfunction includes impaired sensorimotor function with
abnormal muscle tone, pain, poor dexterity, etc., eventually affecting quality of life.
A pressure garment is an external tool made of elastic material, commonly Lycra,
that applies pressure to improve swelling, inhibit scarring, and enhance motor perfor
mance [6,7]. In sports, moderate pressure may enhance blood circulation and reduce
poor venous return and muscle fatigue, increasing comfort and athletic performance
[8]. Concerning muscle tone, pressure garments are thought to provide neutral heat
by reducing spasms through prolonged stretching and skin irritation from tight skin
contact [9]. By reducing the high muscle tone of the spastic muscles, the application
of pressure to the damaged limb allows for better control of the antagonistic muscles
[7]. The uniform pressure applied by pressure garments may also modulate sensory
input and improve joint position sense and body awareness by stimulating mechano
receptors [10]. Although it is used in the rehabilitation of children with cerebral palsy
2 / 10
PLOS One | https://doi.org/10.1371/journal.pone.0326680 June 23, 2025
for the reduction of muscle tone [11], its therapeutic effects have not been fully confirmed in the field of stroke. Cerebral
palsy and stroke, although they may exhibit the characteristics of elevated spasticity and dyskinesia, create similar prob
lems with upper extremity function; application of evidence gathered from cerebral palsy to stroke rehabilitation requires
cautious attention. Since cerebral palsy involves still-developing muscles, stroke involves fully matured muscles [12], a
specific research on stroke is essential to ensure safe and effective pressure garment applications in stroke rehabilitation.
The effects of pressure garments on upper extremity functions after stroke are limited and controversial. Gracies et al.
[13] designed a crossover trial that included a total of 16 patients (36–85 years old; > 3 weeks of stroke) with hemiparesis
and upper extremity spasticity and found that wearing a Lycra garment for 3 hours improved wrist posture and reduced
wrist and finger flexor spasticity. Conversely, Ooi et al. (2020) [14] found no difference in arm spasticity and function after
6 hours per day, 6-week pressure garment applications. However, verbal feedback informed that the pressure garment
allows greater finger extension to facilitate grasping and releasing movements. According to Ooi et al. (2020) [14], this fail
ure is likely due to insufficient wearing time, inappropriate design, and small sample size. For future studies, besides using
larger sample size, they also suggested to add an extra Lycra on the pressure garment’s dorsal aspect, extending the
coverage proximally beyond the elbow joint, and prolonging its wearing time to improve the extension force [14]. According to this recommendation [14], our study is designed to gather more substantiate evidence to support pressure garment clinical usage in stroke rehabilitation.
Objectives
The primary objective of this study is to determine the effects of pressure garments with varying designs (i.e., Dorsal-
Double-layered 10% circumferential reduction; Single-layered 10% circumferential reduction; and Single-layered 0%
circumferential reduction) on sensorimotor function, including motor control, dexterity, muscle tone, pain, self-perceived
upper extremity function and quality of life in stroke patients after 8 weeks of intervention.
Hypotheses
There is a difference between the effects of DD-10, S-10, & S-0 PG on motor control, dexterity, muscle tone, pain,
self-perceived upper extremity function as measured by Fugl-Meyer Assessment of Upper Extremity [15], Box and Block
Test (BBT), Modified Ashworth Scale (MAS), Visual Analogue Scale, Disabilities of Arm, Shoulder, and Hand (DASH), and
36 Item Short Health Survey (SF-36), respectively, among stroke patients during 8 weeks of application. Having an extra
piece of fabric on the dorsal side, DD-10 is expected to provide stronger power of extension to the patient’s hand, wrist,
and elbow, thus helping open the flexed upper extremity for better sensorimotor performance.
More at link.
Thursday, June 19, 2025
Facing a stroke: What you need to know
Everything in stroke is a shitshow! NO protocols to 100% recovery! No one knows anything specific, including how to make neuroplasticity repeatable on demand. Ask your stroke medical 'professionals'; THEY CAN TELL YOU NOTHING SPECIFIC ON HOW TO RECOVER! You'll get the completely fucking useless statement; 'All strokes are different; all stroke recoveries are different'! That is supposed to absolve them of their FAILURE TO GET YOU RECOVERED!
I've seen nothing in the 19 years since my stroke that stroke recovery has improved!
Facing a stroke: What you need to know
A Q&A with Dr. Catherine Legault, co-director of the Stroke Programme at The Neuro
Every minute counts when it comes to a stroke. Despite a stroke’s sudden onset, its effects can last a lifetime. At The Neuro, a specialized centre for stroke, with a dedicated Stroke Receiving Area and team that provides rapid care for incoming patients.
The multidisciplinary team of neurologists, neurosurgeons, nurses, technologists, and other health professionals works together to quickly diagnose and treat strokes, helping save lives and preserve brain function.
We spoke with Dr. Catherine Legault, neurologist and co-director of the Stroke Programme at The Neuro, to better understand what happens during a stroke, how to recognize the signs, what treatments are available, and what recovery can look like.
What happens to the brain during a stroke?
Dr. Legault: When natural blood flow to the brain is disrupted for whatever reason, a stroke can occur. By far, the most common type is an ischemic stroke, which is an interruption in blood flow often caused by a blocked artery in the brain. There are also hemorrhagic strokes in which a blood vessel in the brain ruptures, causing bleeding.
A TIA (Transient Ischemic Attack), often called a mini-stroke, involves stroke-like symptoms that resolve completely within minutes to hours. This usually indicates a temporary blockage in an artery that the body clears on its own. Even if symptoms disappear, the underlying causes and risk of a future stroke remain. That’s why we treat TIAs with the same urgency—we conduct imaging and blood tests and may prescribe blood thinners to prevent recurrence.
What are the physical symptoms of a stroke?
Dr. Legault: Common symptoms include:
- Weakness on one side of the body,
- Facial asymmetry (such as a crooked smile),
- Arm or leg weakness,
- Speech difficulties like slurred speech or inability to speak (aphasia).
Other symptoms may include sudden vision changes, dizziness, difficulty understanding language or rare symptoms that can include double vision, difficulty swallowing, or isolated imbalance.
Remember the FAST algorithm:
FACE drooping
ARM weakness
SPEECH difficulty
TIME note the time when the symptoms first appeared and call 911
What should someone do if they suspect they’ve had a TIA?
Dr. Legault: Ideally, patients should see a neurologist or stroke specialist within a few days of a TIA. In Montreal, most hospitals can handle initial assessments and will refer patients to specialized clinics like the Rapid TIA Access Clinic at the Montreal General Hospital. If symptoms are recent or ongoing, it's best to go to the emergency room immediately.
Is it possible to prevent a stroke?
Dr. Legault: Absolutely. Prevention often involves managing cardiovascular risk factors such as:
- high blood pressure
- Diabetes
- high cholesterol
- atrial fibrillation (an irregular heart rhythm)
Some patients are unaware they have it until they experience complications. Fortunately, wearable devices like smartwatches are now helping detect this condition.
For patients who’ve had a stroke or TIA, we conduct a full medical workup and may prescribe blood thinners (like aspirin), anticoagulants, or other treatments to prevent future strokes.
What are the treatments for stroke?
Dr. Legault: If a patient arrives at the hospital quickly—ideally by ambulance—they may be eligible for “hyperacute” treatments. These include
- thrombolysis, which uses a clot-busting medication administered intravenously,
- thrombectomy, a surgical procedure to physically remove the clot from the brain with a catheter.
Not all patients are candidates, but those who are can greatly benefit. These treatments can be life changing. They have transformed stroke care in the last two decades.
When does rehabilitation begin, and what does it involve?
Dr. Legault: Rehabilitation typically begins within the first 48 hours after the stroke, once the patient is medically stable. At that point, a multidisciplinary team—including physiotherapists, occupational therapists, speech-language pathologists, social workers, and nutritionists—starts assessment and care.
If the patient is a candidate for rehab, they’re usually transferred to a rehabilitation centre within 4–7 days. Recovery can last weeks to months and may continue at home or in outpatient clinics.
Recovery depends on the severity, location, and size of the stroke, as well as the age of the patient. Younger patients tend to have better outcomes due to brain plasticity. Some strokes affect only motor function and patients can recover more quickly, while strokes affecting speech or cognition may result in longer recovery periods. Even older patients benefit from rehab, though outcomes may vary. In younger patients, recovery may seem complete on the outside, but cognitive issues like brain fog and fatigue often persist.
Are there technological advancements that support stroke recovery?
Dr. Legault: Yes, although many are still in research phases. Technologies like transcranial magnetic stimulation (TMS) and other neuromodulation techniques are being explored to support cognitive and motor recovery. Over the next 10–15 years, we expect significant changes in how rehabilitation is approached, similar to how acute stroke care has evolved.(I doubt that, there is NO strategy or leadership in stroke that would make that scenario possible! Contact me Dr. Legault and we can discuss how to get to 100% recovery, I'm at oc1dean@gmail.com)
Saturday, May 31, 2025
Psychometric comparisons of 2 versions of the Fugl-Meyer Motor Scale and 2 versions of the Stroke Rehabilitation Assessment of Movement
Measurements NEVER GET ANYONE RECOVERED! I'd have you all fired for incompetency in not solving stroke!
Stroke Rehabilitation Assessment of Movement (STREAM) Nothing objective here!
Using Fugl-Meyer for anything in stroke is the height of stupidity, nothing objective in it, so nothing is repeatable.
Psychometric comparisons of 2 versions of the Fugl-Meyer Motor Scale and 2 versions of the Stroke Rehabilitation Assessment of Movement
Abstract
Objective.
To provide empirical justification for selecting motor scales for
stroke patients, the authors compared the psychometric properties
(validity, responsiveness, test-retest reliability, and smallest real
difference [SRD]) of the Fugl-Meyer Motor Scale (FM), the simplified FM
(S-FM), the Stroke Rehabilitation Assessment of Movement instrument
(STREAM), and the simplified STREAM (S-STREAM).
Methods.
For the
validity and responsiveness study, 50 inpatients were assessed with the
FM and the STREAM at admission and discharge to a rehabilitation
department. The scores of the S-FM and the S-STREAM were retrieved from
their corresponding scales. For the test-retest reliability study, a
therapist administered both scales on a different sample of 60 chronic
patients on 2 occasions.
Results.
Only the S-STREAM had no
notable floor or ceiling effects at admission and discharge. The 4 motor
scales had good concurrent validity (rho ≥ .91) and satisfactory
predictive validity (rho = .72-.77). The scales showed responsiveness
(effect size d ≥ 0.34; standardized response mean ≥ 0.95; P
< .0001), with the S-STREAM most responsive. The test-retest
agreements of the scales were excellent (intraclass correlation
coefficients ≥ .96). The SRD of the 4 scales was 10% of their
corresponding highest score, indicating acceptable level of measurement
error. The upper extremity and the lower extremity subscales of the 4
showed similar results.
Conclusions.
The 4 motor scales showed
acceptable levels of reliability, validity, and responsiveness in stroke
patients. The S-STREAM is recommended because it is short, responsive
to change, and able to discriminate patients with severe or mild stroke.
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