Enriched environments in stroke rehabilitation

Well fuck, you mean you didn't read, comprehend and implement this enriched environment talked about by Dr. Dale Corbett in 2011?  Wasn't good enough for clinical application? So you have wasted 7 years that could have helped survivors? The incompetence displayed in all of stroke is world class.

https://www.eventbrite.co.uk/e/enriched-environments-in-stroke-rehabilitation

by London ACPIN

£30 – £50

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Enriched environments in stroke rehabilitation

Sat 1 December 2018, 09:30 – 15:30 GMT

£30 – £50

Event Information

Description

London ACPIN are delighted to present a fantastic study day with Heidi Janssen, exploring environmental enrichment (EE) in acquired brain injury.

Heidi Janssen is a Physiotherapist and Researcher at the Hunter Medical Research Institute, Newcastle, NSW, Australia.

Heidi will be speaking about about the theory of enriched environments, animal models, evidence base, in community and inpatient environments. Click HERE for link to article

This study day aims to;

Provide evidence in animal models of acquired brain injury regarding the anatomical, molecular and behavioural effects of exposure to enriched environments.

Outline the main hypotheses concerning the underlying mechanisms of effect

Discuss barriers and enablers to activity and implementing enriched environments from both perspective of patient with ABI and staff, based on delegates’ experiences and research findings.

Present published evidence for the use of enriched environments with people recovering from or living with an ABI: in the Acute, Sub-acute and Chronic stages

09:00 registration for 9:30 start

Location

Basement Lecture Theatre
The Clinical Neuroscience Centre
33 Queen Square
London
WC1N 3BG
United Kingdom
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Refund Policy

Refunds up to 7 days before event

Diagnosis of DWI-negative acute ischemic stroke

Absolutely no clue what this means or how it could be used to get stroke survivors to 100% recovery. More wasted research.
http://www.neurology.org/content/early/2017/06/14/WNL.0000000000004120.short?rss=1

A meta-analysis

1. Brian L. Edlow, MD,
2. Shelley Hurwitz, PhD and
3. Jonathan A. Edlow, MD

+Show Affiliations

| + Show Full Disclosures

1. Correspondence to Dr. Edlow: bedlow@mgh.harvard.edu

1. Published online before print June 14, 2017, doi: http:/​/​dx.​doi.​org/​10.​1212/​WNL.​0000000000004120 Neurology 10.1212/WNL.0000000000004120

• Abstract
• Full Text (PDF)

1. Also available:
2. Data Supplement

Abstract

Objective: To determine the prevalence of diffusion-weighted imaging (DWI)–negative acute ischemic stroke (AIS) and to identify clinical characteristics of patients with DWI-negative AIS.

Methods: We systematically searched PubMed and Ovid/MEDLINE for relevant studies between 1992, the year that the DWI sequence entered clinical practice, and 2016. Studies were included based upon enrollment of consecutive patients presenting with a clinical diagnosis of AIS prior to imaging. Meta-analysis was performed to synthesize study-level data, estimate DWI-negative stroke prevalence, and estimate the odds ratios (ORs) for clinical characteristics associated with DWI-negative stroke.

Results: Twelve articles including 3,236 AIS patients were included. The meta-analytic synthesis yielded a pooled prevalence of DWI-negative AIS of 6.8%, 95% confidence interval (CI) 4.9–9.3. In the 5 studies that reported proportion data for DWI-negative and DWI-positive AIS based on the ischemic vascular territory (n = 1,023 AIS patients), DWI-negative stroke was strongly associated with posterior circulation ischemia, as determined by clinical diagnosis at hospital discharge or repeat imaging (OR 5.1, 95% CI 2.3–11.6, p <0.001).

Conclusions: A small but significant percentage of patients with AIS have a negative DWI scan. Patients with neurologic deficits consistent with posterior circulation ischemia have 5 times the odds of having a negative DWI scan compared to patients with anterior circulation ischemia. AIS remains a clinical diagnosis and urgent reperfusion therapy should be considered even when an initial DWI scan is negative.

• Received January 21, 2017.
• Accepted in final form April 20, 2017.

• © 2017 American Academy of Neurology

Effects of transferring to the rehabilitation ward on long-term mortality rate of first-time stroke survivors: a population-based study

With no measurement of 30day deaths among these groups this research wasted a useful research point.
http://www.archives-pmr.org/article/S0003-9993%2817%2930244-7/abstract

Chien-Min Chen, MDCorrespondence information about the author MD Chien-Min ChenEmail the author MD Chien-Min Chen

,

Yao-Hsu Yang, MD

,

Chia-Hao Chang, PhD

,

Pau-Chung Chen, MD, PhD

DOI: http://dx.doi.org/10.1016/j.apmr.2017.03.020

Article Info

• Abstract

Abstract

Objective

To assess the long-term health outcomes of acute stroke survivors transferred to the rehabilitation ward.

Design

Long-term mortality rates of first-time stroke survivors during hospitalization were compared among the following sets of patients: patients transferred to the rehabilitation ward (RR), patients receiving rehabilitation without being transferred to the rehabilitation ward (NtR), and patients receiving no rehabilitation (NoR).

Setting

We conducted a five-year, nationwide, population-based, retrospective, cohort study, using data from the Longitudinal Health Insurance Database 2005 in Taiwan.

Participants

A total of 11,419 patients with stroke from 2005 to 2008 were initially assessed for eligibility. After propensity score matching, 390 first-time stroke survivors were included.

Intervention

None.

Main Outcome Measures

The Cox proportional hazards regression model was used to assess differences in 5-year post-stroke mortality rates.

Results

Based on adjusted hazard ratios (HR), the NtR (adjusted HR = 2.20; 95% confidence interval (CI): 1.36–3.57) and NoR (adjusted HR = 4.00; 95% CI: 2.55–6.27) groups had significantly higher mortality risk than the RR group. Mortality rate of these stroke survivors was affected by age ≥ 65 years (compared to age < 45 years, adjusted HR = 3.62), men (adjusted HR = 1.49), ischemic stroke (adjusted HR = 1.55), stroke severity (Stroke Severity Index (SSI) ≥20, compared to SSI <10, adjusted HR = 2.68), and comorbidity (Charlson–Deyo Comorbidity Index (CCI) ≥3, compared to CCI = 0, adjusted HR = 4.23).

Conclusions

First-time stroke survivors transferred to the rehabilitation ward had a 5-year mortality rate 2.2 times lower than those who received rehabilitation without transfer to the rehabilitation ward and 4 times lower than those who received no rehabilitation.

Rob Benedict Announces New Clothing Campaign Benefiting National Stroke Association

Oh, oh,oh, wonderful conscience laundering. And since the NSA does nothing for stroke survivors the money raised will be wasted.

Rob Benedict Announces New Clothing Campaign Benefiting National Stroke Association

Relationship between the threshold of sole cutaneous sense and functional balance and mobility tests in patients with chronic hemiparesis

So they found a correlation, So what? What is your proposed solution to this problem? Don't just tell me what the problem is, tell me how you are going to solve it. If we had a strategy we wouldn't have wasted money and time on research like this.
http://mrj.tums.ac.ir/browse.php?a_id=5408&sid=1&slc_lang=en
Author(s): Soheila Fallah , Ghorban Taghizade , Laleh Lajavardi , Mohammad Ali Sanjari , Ali Ashraf Jamshidi , Mehdi Ebrahimpoor

MSc, Department of Occupational Therapy, School of Rehabilitation, Iran University of Medical Sciences. Lecturer, Department of Occupational Therapy, School of Rehabilitation, Iran University of Medical Sciences , gh-taghizade@yahoo.com Assistant Professor, Department of Occupational Therapy, School of Rehabilitation, Iran University of Medical Sciences Assistant Professor, Department of Basic Rehabilitation Sciences and Rehabilitation Research Center, School of Rehabilitation, Iran University of Medical Sciences Associate Professor, Department of Physiotherapy and Rehabilitation Research Center, School of Rehabilitation, Iran University of Medical Sciences MSc, Department of Occupational Therapy, School of Rehabilitation, Iran University of Medical Sciences Study Type: Research | Subject: Special | Received: 2016/02/16 - Accepted: 2016/02/16 - Published: 2016/02/16 Abstract:   (26 View) Background and Aim: One of the impaired senses in patients with chronic hemiparesis is the sole cutaneous sense. The role of this sense in maintaining the functional balance and mobility is still controversial in these patients. The aim of this study was to investigate the relationship between the threshold of sole cutaneous sense and functional balance and mobility tests in patient with chronic hemiparesis. Material and Methods: In this correlational study, seventeen chronic stroke patients by mean age of 59.10 (13.31) years and mean time after injury of 31.70 (23.61) months were selected by simple non– probability method. Functional Reach with ankle and hip strategy (FR), Step Test (ST) in affected and non- affected foot, Bend– Reach test (BR), Timed Up and Go test (TUG) and Berg Balance Scale (BBS) were used for assessment of functional balance and mobility and Semmes- Weinstein monofilaments test was used to measure the cutaneous sense of seven different points of sole in affected and non– affected foot. Results: The main effect of foot (affected and non– affected foot) and points (seven different points of sole) of cutaneous sense threshold was significant (P<0.0001) and interaction effect of foot ˣ points not significant (P=0.2). The cutaneous sense threshold in all seven points of affected sole showed significant (p<0.05) low to high correlation (r= 0.24-0.81) with all of functional balance and mobility tests. There was not significant correlation between cutaneous sense threshold in seven points of non- affected foot and any of functional balance and mobility tests, with the exception of cutaneous sense threshold of the little toe floor with total, dynamic and static score of BBS, FR with ankle and hip strategy and TUG; cutaneous sense threshold of big toe with static score of BBS and FR with hip strategy; and medial border of sole with static score of BBS and FR with ankle strategy. Conclusion: The cutaneous sense threshold of affected sole has a more correlation with functional balance and mobility tests. The cutaneous sense threshold of sole in big toe and medial border points has a significant role in functional balance and mobility tests in patients with hemiparesis. Keywords: Functional balance and mobility, Cutaneous sense threshold, Hemiparesis Keywords: Functional balance and mobility, Cutaneous sense threshold, Hemiparesis, Full text [PDF 416 kb]   (20 Download)    (20 Download)

Wasted research when systematic reviews fail to provide a complete and up-to-date evidence synthesis

This is completely true in stroke. So much so that I wonder if our researchers even read other research in the field.
http://www.mdlinx.com/internal-medicine/medical-news-article/2016/01/26/lung-cancer/6505672/?newsdt=012616&subspec_id=0&utm_source=DailyNL&utm_medium=newsletter&utm_content=general-article&utm_campaign=article-section&category=daily-digest&page_id=1
Multiple treatments are frequently available for a given condition, and clinicians and patients need a comprehensive, up–to–date synthesis of evidence for all competing treatments. Authors aimed to quantify the waste of research related to the failure of systematic reviews to provide a complete and up–to–date evidence synthesis over time. They illustrate how systematic reviews of a given condition provide a fragmented, out–of–date panorama of the evidence for all treatments. This waste of research might be reduced by the development of live cumulative network meta–analyses.

Methods

• Authors performed a series of systematic overviews and networks of randomized trials assessing the gap between evidence covered by systematic reviews and available trials of second–line treatments for advanced non–small cell lung cancer.
• They searched the Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, MEDLINE, EMBASE, and other resources sequentially by year from 2009 to March 2, 2015.
• They sequentially compared the amount of evidence missing from systematic reviews to the randomized evidence available for inclusion each year.
• They constructed cumulative networks of randomized evidence over time and evaluated the proportion of trials, patients, treatments, and treatment comparisons not covered by systematic reviews on December 31 each year from 2009 to 2015.

Results

• They identified 77 trials (28,636 patients) assessing 47 treatments with 54 comparisons and 29 systematic reviews (13 published after 2013).
• From 2009 to 2015, the evidence covered by existing systematic reviews was consistently incomplete: 45 % to 70 % of trials; 30 % to 58 % of patients; 40 % to 66 % of treatments; and 38 % to 71 % of comparisons were missing.
• In the cumulative networks of randomized evidence, 10 % to 17 % of treatment comparisons were partially covered by systematic reviews and 55 % to 85 % were partially or not covered.

Baseline predictors of treatment gains in peak propulsive force in individuals poststroke

Another wasted research effort. Because we have NO stroke leadership or strategy, we get useless things like predictions rather than solutions to problems in stroke.   Who gives a shit about propulsive force? Come up with a solution to generate more if needed.
http://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-016-0113-1

• HaoYuan HsiaoEmail author,
• Jill S. Higginson and
• Stuart A. Binder-Macleod

Journal of NeuroEngineering and Rehabilitation201613:2

DOI: 10.1186/s12984-016-0113-1

©  Hsiao et al. 2016

Received: 16 September 2015

Accepted: 10 January 2016

Published: 15 January 2016

Abstract

Background

Current rehabilitation for individuals poststroke focuses on increasing walking speed because it is an indicator of community walking ability and quality of life. Propulsive force generated from the paretic limb is critical to walking speed and may reflect actual neural recovery that restores the affected neural systems. A wide variation across individuals in the improvements in paretic propulsive force was observed following an intervention that targeted paretic propulsive force. This study aimed to determine if specific baseline characteristics can be used to predict patients who would respond to the intervention.

Methods

Participants (N  = 19) with chronic poststroke hemiparesis walked at their self-selected and maximal walking speeds on a treadmill before and after a 12-week gait training program. Propulsive forces from the paretic limb were analyzed. Pearson correlation coefficient was used to determine the relationships between (1) treatment gains in walking speed and propulsive force following intervention, and (2) treatment gains in propulsive force and baseline propulsive forces.

Results

Treatment gains in self-selected walking speed were correlated to treatment gains in paretic propulsive force following intervention. In addition, changes in paretic propulsive force between self-selected and maximal walking speeds at baseline were strongly correlated to treatment gains in paretic propulsive force.

Conclusions

The capacity to modulate paretic propulsive force, rather than the absolute propulsive force during self-selected or maximal walking speed, predicted treatment gains in propulsive force following the intervention. Findings from this research could help to inform clinicians and researchers to target the appropriate patient population for rehabilitation interventions.(What a weasaly statement.)