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 research failure. Show all posts
Showing posts with label research failure. Show all posts

Monday, October 5, 2026

Effects of acute and long-term exercise modalities and doses on brain-derived neurotrophic factor in patients with stroke: a Bayesian network meta-analysis

 A FAILURE by not creating EXACT EXERCISE PROTOCOLS  to deliver the EXACT amount of BDNF  needed! You need better mentors and senior researchers because they should be fired for incompetence!

Effects of acute and long-term exercise modalities and doses on brain-derived neurotrophic factor in patients with stroke: a Bayesian network meta-analysis


  • 1. Department of Physical Education, Tongji University, Shanghai, China

  • 2. Shanghai Normal University Tianhua College, Shanghai, China

Abstract


Objective: 


To systematically evaluate the effects of exercise interventions on brain-derived neurotrophic factor (BDNF) in patients with stroke, and to examine the dose–response relationships associated with acute and long-term exercise.


Methods: 


PubMed, Embase, Web of Science, the Cochrane Library, and APA PsycINFO were searched for studies of exercise interventions in patients with stroke that reported BDNF outcomes. Risk of bias was assessed using RoB 2.0 and ROBINS-I. A network dose–response meta-regression was conducted within a Bayesian random-effects framework.


Results: 


Twenty-three studies involving 903 participants were included, comprising 14 randomized controlled trials, 8 non-randomized studies, and 1 randomized crossover trial. Acute overall exercise showed a modest positive trend at lower dose levels; however, at a dose of 250 METs⋅min/week, the 95% credible interval included zero, indicating substantial uncertainty regarding whether a single bout of low-dose exercise produces a reliable increase in BDNF. For long-term overall exercise, posterior estimates generally favored a positive BDNF response as dose increased. The 95% credible interval first no longer included zero at 1300 METs⋅min/week, and estimates at 1700, 2000, 2300, and 2700 METs⋅min/week remained compatible with positive effects. However, these findings should be interpreted cautiously because the evidence base was limited and precision varied across dose levels. Clear differences were also observed across long-term exercise modalities. Multicomponent exercise showed the most favorable directional pattern across the 1700–2700 METs⋅min/week range, although several estimates were imprecise and the apparent advantage of this modality should be regarded as exploratory. By contrast, walking, cycling, and exercise combined with cognitive training all showed positive directional trends, but the 95% credible intervals included zero across dose levels, indicating substantial uncertainty regarding these modality-specific effects.


Conclusion: 


The effects of exercise on BDNF in patients with stroke are jointly shaped by intervention duration, dose level, and exercise modality. Compared with acute exercise, long-term exercise at moderate-to-high doses, particularly multicomponent exercise, may be associated with a more favorable BDNF response. However, because the certainty of evidence was mostly moderate to low or very low and publication bias was detected, these findings should be considered preliminary and hypothesis-generating rather than definitive exercise prescription recommendations.


Systematic review registration:

https://www.crd.york.ac.uk/PROSPERO/view/CRD420261350793, identifier CRD420261350793.

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Monday, June 29, 2026

Dynamic functional reorganization in post-stroke aphasia: a state-of-the-art fMRI review from disease evolution to intervention

 You didn't put together recovery solutions; SO COMPLETELY FUCKING USELESS! You're all fired! The whole point of stroke research is recovery and you miserably failed!

Dynamic functional reorganization in post-stroke aphasia: a state-of-the-art fMRI review from disease evolution to intervention


  • 1. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

  • 2. Department of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

Abstract

Post-stroke aphasia (PSA) is a common and disabling consequence of stroke, characterized by substantial heterogeneity in language impairment and recovery trajectories. In recent years, functional magnetic resonance imaging (fMRI) has markedly advanced our understanding of the neural mechanisms underlying PSA recovery by revealing dynamic changes in regional activation, functional connectivity, and large-scale network coordination. This review provides a state-of-the-art synthesis of fMRI studies on functional reorganization in PSA across two intersecting dimensions: the temporal evolution of the disease course (acute, subacute, and chronic stages) and the major categories of rehabilitation intervention, including behavioral therapies, neuromodulation, and combined treatment approaches. Current evidence suggests that PSA recovery is a stage-dependent and network-based neuroplastic process. In the early phase after stroke, recovery is strongly influenced by the rapid recruitment of domain-general cognitive control systems, whereas later recovery is increasingly shaped by the reorganization of residual left-hemisphere language networks, with contralesional and cerebellar contributions becoming more prominent in patients with extensive left-hemisphere damage. However, important controversies remain regarding the functional role of right-hemisphere activation and the relative significance of perilesional restoration versus compensatory recruitment. Furthermore, the field is limited by substantial heterogeneity in patient characteristics, lesion profiles, study design, and imaging methodology, which constrains comparability across studies and hinders clinical translation. By integrating current evidence, unresolved debates, and emerging trends, this review highlights key research gaps and outlines future directions for biomarker-guided, stage-adapted, and individualized rehabilitation strategies in PSA.

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Thursday, February 19, 2026

High relative cerebral blood volume strongly predicts early neurological improvement and good functional outcome in ischemic stroke patients undergoing mechanical thrombectomy

 Are these a solution? You mean your incompetent? doctor and hospital have nothing to deliver better blood flow and oxygen to your brain immediately post stroke! And your board of directors is so incompetent they don't recognize incompetence in their hospital?

  • cerebral blood flow (51 posts to December 2015)
  • oxygen delivery (41 posts to June 2016)

    • High relative cerebral blood volume strongly predicts early neurological improvement and good functional outcome in ischemic stroke patients undergoing mechanical thrombectomy


    Paweł Wrona, Dominik Wróbel, Julia Staniszewska, Gabriela Kapral, Milena Derechowska, Gabriela Turaj, Tadeusz Popiela, Agnieszka Słowik, Wojciech Turaj
    DOI: 10.5603/pjnns.106870
    Pubmed: 41705962

    Abstract

    Aim of the study. Despite advancements in mechanical thrombectomy (MT) in the treatment of acute ischemic stroke (AIS) due to large vessel occlusion, nearly half of patients with successful recanalization do not achieve good functional outcome (GFO). We aimed to analyze the association between novel perfusion-based biomarkers and prognosis after AIS.Clinical rationale for the study. The role of perfusion imaging biomarkers, particularly relative cerebral blood volume (rCBV), as an indicator of tissue-level collateral circulation and a predictor of post-MT clinical trajectory remains insufficiently explored.

    Material and methods. This single-center retrospective study included patients with anterior circulation AIS who achieved successful recanalization following MT at the Comprehensive Stroke Center, University Hospital, Krakow, between January 2019 and July 2023. We evaluated the predictive value of rCBV for early neurological improvement (ENI) and long-term GFO and compared its prognostic utility with other perfusion-based parameters. Furthermore, we assessed the extent to which the effect of rCBV on GFO was mediated by its influence on ENI. Early neurological improvement was defined as a ≥ 4-point reduction in the National Institutes of Health Stroke Scale score or complete symptom resolution within 24 hours post-admission. GFO was defined as a modified Rankin Scale score of < 3 at 90 days.

    Results. Relative cerebral blood volume was an independent predictor of 90-day GFO after multivariable adjustment (adjusted odds ratio [aOR] = 1.38; 95% confidence interval [CI]: 1.19–1.6; p < 0.001). Additionally, total hypoperfusion volume (T6max) independently contributed to GFO prediction when included alongside rCBV (aOR = 0.96 per 10 mL increase; 95% CI: 0.94–0.99; p = 0.019), enhancing prognostic accuracy. Relative cerebral blood volume was also a strong predictor of ENI (aOR = 1.35; 95% CI: 1.19–1.54; p < 0.001), with 35% (4–67%; p = 0.029) of its effect on GFO mediated through its impact on ENI.

    Conclusion and clinical implications. Relative cerebral blood volume is a robust predictor of both early neurological recovery and long-term functional outcome following MT. Moreover, T6max provides independent prognostic value when assessed in conjunction with rCBV, suggesting that these parameters complement each other. Their combined assessment provides a more comprehensive understanding of ischemic tissue fate, aiding clinical decision-making in patients selected for MT.

    (My conclusion, you completely failed in your research; DIDN'T CREATE A PROTOCOL TO DELIVER THE BETTER BLOOD FLOW!)

    Keywords: mechanical thrombectomycomputed tomography perfusionacute ischemic strokerelative cerebral blood volume

    Article available in PDF format

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    Thursday, December 25, 2025

    Revitalizing recovery: the impact of acute exercise on stroke survivors through a physical therapy lens

     How the fuck do you expect stroke survivors to do proper exercise without having the EXACT 100% recovery protocols for them? You're putting the cart before the horse!

    Revitalizing recovery: the impact of acute exercise on stroke survivors through a physical therapy lens


    Opeyemi Adeloye* [1]

    ,

    Anahita Ali [2]

    ,

    Seyi Akindolie [3]

    Author Affiliations

    1Department of Exercise Science, Springfield College, Massachusetts, MA 01109-3739, USA.

    2Department of Lifestyle Medicine, School of Public Health, 01109 Geneva, Switzerland.

    3Department of Physiotherapy, PhysioDoc Consult, Lagos 23423, Nigeria.

    *Correspondence to oadeloye@springfieldcollege.edu

    Abstract

    Stroke is a predominant cause of long-term disability globally, frequently leading to motor, cognitive, and cardiovascular deficits that profoundly impact quality of life. Physical therapy is fundamental to stroke rehabilitation, and acute exercise therapies have demonstrated the potential to improve recovery outcomes. This review examines the effects of acute exercise on stroke survivors, emphasizing enhancements in their motor function, cardiovascular health, and neuroplasticity. A comprehensive evaluation of peer-reviewed research, encompassing randomized controlled trials, cohort studies, and case–control designs, was performed. Where the data allowed, we explored the sex-specific responses and found that the improvements were generally comparable between males (n = 780) and females (n = 546), with some studies reporting slightly greater variability in the gains in heart rate in males. Aerobic and task-specific exercises significantly boost motor function and activities of daily living, whereas resistance training improves muscle strength and reduces physical restrictions. Aerobic exercise routines produced cardiovascular benefits, including enhanced blood pressure control and heart rate variability. Moreover, neuroplastic changes, indicated by increased cortical activity and functional connectivity, suggest that acute exercise may promote brain recovery. Despite these promising results, the small sample sizes, variability in the intervention methods, and limited long-term follow-up remain challenges. Although aquatic exercise was not a primary focus of the studies included, some evidence suggests that water-based rehabilitation may improve joint mobility, reduce spasticity, and enhance balance in stroke survivors while maintaining cardiovascular stimulus. Future research(So, your research was a failure?) should investigate how the buoyancy and resistance of water may support motor recovery and safety in acute interventions. Overall, tailored acute exercise regimens should be integrated into physical therapy to expedite the recovery and enhance the health outcomes for stroke survivors.

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    Tuesday, August 5, 2025

    Prognostic value of albumin-based malnutritional indices on short-term outcome in acute ischemic stroke patients undergoing reperfusion therapy

    Prognostication DOES NOTHING TO GET SURVIVORS RECOVERED! Are you that blitheringly stupid that you think this research is good for anything? Creating a protocol to prevent this is what's needed! AND YOU COMPLETELY FAILED AT THAT!

    This earlier research could have led you correctly but obviously you knew nothing about it!

  • albumin (5 posts to October 2011)

    •  Prognostic value of albumin-based malnutritional indices on short-term outcome in acute ischemic stroke patients undergoing reperfusion therapy


    Junle Zhao&#x;Junle Zhao1†Mingjie Chen&#x;Mingjie Chen1†Junning Mo&#x;Junning Mo1†Yutong ZhongYutong Zhong1Jiamin QiuJiamin Qiu1Yanjiao QiuYanjiao Qiu1Youjia LiYoujia Li1*Xiaoyan Han,Xiaoyan Han1,2*
    • 1Department of Neurology, First People’s Hospital of Zhaoqing, Zhaoqing, China
    • 2Clinical Research Center, First People’s Hospital of Zhaoqing, Zhaoqing, China

    Background: The malnutrition and inflammatory status are dependently associated with an increased risk of poor prognosis in patients with acute ischemic stroke (AIS). However, the evidence surrounding the prognostic significance of albumin-based malnutritional indices in AIS patients receiving reperfusion therapy remains insufficient. We aimed to explore prognostic value of the controlling nutritional status score (CONUT), prognostic nutritional index score (PNI), and neutrophil percentage-to-albumin ratio (NPAR) on short-term outcome of AIS patients undergoing reperfusion therapy.

    Methods: A total of 612 AIS patients were enrolled. The association of the malnutritional indices and 3-months poor prognosis was accessed by multivariable logistics regression model. We further performed a logistic regression model with restricted cubic splines to examine the potential nonlinear correlations between the malnutritional indices and short-term poor prognosis. Subgroup analysis and reclassification indexes were also conducted to enhance the robustness of the findings. Additionally, mediation analyses were performed to examined the potential mediating effects of early neurological deterioration (END) presence on the associations of malnutrition with 3-months unfavorable outcomes.

    Results: 256 patients developed poor prognosis at 3-month follow-up. Malnutrition was associated with the risk of 3-month poor functional outcome for CONUT (per 1-point increased, adjusted OR 1.59, 95%CI 1.40–1.82), for PNI (per 1-point increased, adjusted OR 0.86, 95%CI 0.82–0.90), and the NPAR (per 1-SD increased, adjusted OR 23.97, 95%CI 7.15–85.72). The PNI exhibited nonlinear association with the 3-month poor prognosis. These three indices in addition to other clinical risk factors improved the model discrimination. Compared to the NPAR, the net reclassification improvement of PNI (0.579, 95%CI 0.418–0.739) and CONUT (0.631, 95%CI 0.470–0.792) were higher in predicting short-term poor prognosis. The findings were further supported by subgroup analyses, and END had no significant mediated effects on the associations of malnutrition and 3-month unfavorable outcome.

    Conclusion: Albumin-based malnutritional indices are reliable and feasible prognostic indicators in AIS patients, predicting short-term outcome independent of the type of reperfusion treatment. The applicability of these objective malnutritional indices may improve risk stratification and guide nutritional interventions at clinical setting in this vulnerable ischemic stroke population.(Like creating an EXACT PROTOCOL TO PREVENT THE PROBLEM! But you FAILED AT THAT! You're fired!)

    1 Introduction

    Acute ischemic stroke (AIS) is triggered by abrupt interruption of cerebral blood flow causing devastating brain damage and severe neurological deficits (1, 2), and it continues to rank as a primary cause of death and persistent disability globally (3). Rapid blood flow reperfusion therapy using intravenous thrombolysis (IVT) or/and endovascular thrombectomy (EVT) has greatly advanced the treatment of AIS. However, approximately 1 of 4 patients have poor outcome despite technically successful intervention (4). Therefore, strategies for the accurate prediction of neurological outcomes in at-risk individuals hold substantial clinical significance, potentially presenting an alternative framework for patient monitoring and improving post-reperfusion therapy outcomes.

    The incidence of premorbid malnutrition risk was around 34% among AIS patients at admission (5, 6), and has been consistently associated with unfavorable outcome in both short- and long-term period (7–9). Beyond the cerebral deficits induced by the ischemic insult, inflammation and oxidative stress exert a pivotal role in the cascade of cerebral ischemic reperfusion injury (10). Particularly among patients undergoing IVT or EVT, the pre-existing nutritional status deteriorates rapidly after stroke onset due to stress associated with severe catabolism (11), and the interaction between post-stroke inflammatory injury and malnutrition is likely to be more pronounced (12, 13). Thus, early prognostic immuno-nutritional assessment is of critical importance among AIS patients, facilitating timely risk stratification and targeted nutritional intervention.

    However, malnutrition in AIS patients is frequently overlooked by clinicians. The challenges in the assessment of nutritional status among AIS patients may account for this scenario. Aphasia, confusion and immobile symptoms of stroke patient may pose a considerable challenge to conventional nutritional assessments, such as body mass index (BMI) and nutritional assessment tool depending on the dietary history (14). Notably, the objective nutritional markers forecasting neurological outcomes during the early stage of stroke have attracted attention in recent years. The controlling nutritional status score (CONUT), the prognostic nutritional index score (PNI), and the neutrophil percentage-to-albumin ratio (NPAR) which can be easy to calculate using blood-based parameters and could be feasible to reflect balance of immune-nutritional status in clinical practice (15, 16). Previous studies on the prognostic significance of PNI and CONUT in AIS patients have primarily focused on individuals who did not undergo reperfusion therapy (17, 18), or patients treated with IVT or EVT alone (5, 7, 15, 19). As an emerging biomarker for assessing immune and systemic nutritional conditions, NPAR is increasingly being used in studies on disease risk and prognosis. Recently a few studies have indicated that NPAR is associated with stroke recurrence at 3-month follow-up (20), and early neurological improvement in AIS patients after IVT (21). Collectively, these findings suggested a potential association between albumin-based indicators integrating inflammation and nutritional status and the prognosis of AIS patients undergoing reperfusion therapy.

    However, which composite indicator is more indicative of short-term adverse outcome risk in AIS patients undergoing reperfusion therapy (IVT/EVT alone or combined strategies) remains unclear and merits further exploration, particularly within the context of ischemic stroke treatment that prioritizes rapid reperfusion therapy. To address these gaps, we employed three objective nutritional indices to predict 3-month outcomes in AIS patients receiving reperfusion therapy and to ascertain which nutritional assessment tool is more suitable to early identify the risk in such stroke population.


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    Tuesday, June 10, 2025

    Recognition and rehabilitation of hand function actions in stroke patients based on pose estimation

    But you failed at the next step. You didn't create EXACT RECOVERY PROTOCOLS based upon your assessment! You're fired along with your mentors and senior researchers! Stroke research is meant to get survivors recovered! THIS COMPETELY FAILED AT THAT!

     Recognition and rehabilitation of hand function actions in stroke patients based on pose estimation

    Shiyi Zhu, Tianyi Sun, Fanglve Yuan, Xiaofeng Lu
    Author Affiliations +
    Proceedings Volume 13644, Fifth International Conference on Applied Mathematics, Modelling, and Intelligent Computing (CAMMIC 2025); 136440U (2025) https://doi.org/10.1117/12.3070418
    Event: 5th International Conference on Applied Mathematics, Modelling, and Intelligent Computing (CAMMIC 2025), 2025, Shanghai, China

    Abstract

    This paper proposes a method for recognizing and assessing hand function actions based on human pose estimation, aiming at the problem of daily assessment of hand function rehabilitation status in stroke patients. First, a pose estimation model based on ResNet-50 and COCO-WholeBody-Hand is used to extract the key points of the hand in the video of stroke patients completing standard movements, and the PoseC3D model is used for training and prediction in order to realize the hand function actions recognition. Next, a geometric feature structure-based assessment method is proposed to further evaluate the rehabilitation degree of the correctly recognized hand function actions. Specific evaluation indexes were designed for each standard movement, and a reasonable threshold was found as a quantitative assessment criterion with PSO algorithm. Experiments were conducted on a self-constructed dataset of hand function actions from stroke patients. The dataset includes nine categories of standard movements. With an accuracy of 99.60% in training progress, the PoseC3D model significantly outperforms traditional methods. Meanwhile, the method achieves an accuracy of over 80% for all movements in our dataset. This proves the effectiveness and accuracy of the recognition and evaluation methods proposed in this paper.(2025) Published by SPIE. Downloading of the abstract is permitted for personal use only.Citation Download Citation
    Shiyi Zhu,  Tianyi Sun,  Fanglve Yuan, and  Xiaofeng Lu "Recognition and rehabilitation of hand function actions in stroke patients based on pose estimation", Proc. SPIE 13644, Fifth International Conference on Applied Mathematics, Modelling, and Intelligent Computing (CAMMIC 2025), 136440U (4 June 2025); https://doi.org/10.1117/12.3070418

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    Saturday, May 25, 2024

    The June 2024 issue of #Stroke is now available!

    You'll notice how fucking useless this is for getting survivors recovered! What a pile of useless shit! Not one piece of research showing EXACTLY HOW TO GET SURVIVORS RECOVERED!

    I'd fire everyone involved and get survivors in charge!

    Send me 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?  You'll want 100% recovery when you are the 1 in 4 per WHO that has a stroke! Explain how you're going to get to 100% recovery if you don't start that research RIGHT NOW!

     

     The June 2024 issue of #Stroke is now available!

    June 2024 Stroke Highlights

    Clinical Trials

    Original Contributions

    Clinical and Population Sciences

    Basic and Translational Sciences

    Brief Reports

    Research Letters

    Stroke Images

    Advances in Stroke

    Centennial Collection

    Topical Reviews

    Comments and Opinions

    Stroke Literature Synopsis

    InterSECT

    Illustrative Teaching Cases

    Clinical Statements and Guidelines

    AHA Scientific Statements

    Exploring the Inclusion of Person-Centered Care Domains in Stroke Transitions of Care Interventions: A Scientific Statement From the American Heart Association
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