Does the backrest shape of the wheelchair influence the asymmetric posture of patients with hemiparesis? A single institution pilot study

They really need to check out and compare lever powered wheelchairs. Why doesn't your hospital use lever wheelchairs? Incompetence? Don't even know about it? Don't care?

Does the backrest shape of the wheelchair influence the asymmetric posture of patients with hemiparesis? A single institution pilot study

GRIT Freedom Chair - a better wheelchair

If your hospital does not have these they are fucking incompetent on what would actually help survivors. Survivors legs recover faster because they are constantly used for walking. Using these levers on the wheelchair to get around would vastly increase the recovery of your stroke disabled arm. But never mind, your hospital will DO NOTHING. You may have to velcro your hand to the lever but you likely will not need to release it that fast.

GRIT Freedom Chair - a better wheelchair

Videos here to see it in action.

Triciclos Freeway 125cc Wheelchair Motorcycle (Only available in Brazil)

Maybe you want to look up the wheelchair car:
Stuff is out there if only we had a decent stroke association that listed all the possibilities for powered movement. Why hasn't your doctor or therapist given you these possibilities? They are supposed to know everything about stroke rehab.

Texas lawyer building hatchback cars made for people in wheelchairs

Or one of these:

electric attachable handbikes

Turn your wheelchair into a motorcycle

Or this segway like wheelchair:

http://www.wimp.com/newdevice/

 

Triciclos Freeway 125cc Wheelchair Motorcycle (Only available in Brazil)

Quick Overview

Approximately $12,000. Only Available in Brazil. United States DOT & EPA bureaucracies make import impossible. We have already "gone down that road". 45-50 mph, 125 cc, 13" tires.
Does the freedom of the open road call to you? Soon the wind could be whipping through your hair, your cheeks flapping from the ridiculous big smile on your face.

Rice University students build custom chair for teen with arthrogryposis - rowing motion

This would force upper body use a lot which walking does for the lower body.  Stroke survivors would definitely benefit from this if we had a great stroke association to go to to get this built and pushed out to rehab departments. But we have crap for stroke associations.
https://www.youtube.com/watch?v=oh-zDizzhFg&feature=youtu.be

Mountain Biking Without Working Legs

Why settle for boring wheelchairs.
http://mpora.co/MountainBikingWithoutWorkingLegs

Machine-Based, Self-guided Home Therapy for Individuals With Severe Arm Impairment After Stroke

I would be willing to bet that the rowing based wheelchair propulsion would provide more repetitions than any other therapy. But hell it won't be applied because it changes the status quo.
Rowing wheelchair

http://nnr.sagepub.com/content/29/5/395?etoc

1. Daniel K. Zondervan, PhD1
2. Renee Augsburger2
3. Barbara Bodenhoefer1
4. Nizan Friedman, PhD1
5. David J. Reinkensmeyer, PhD1
6. Steven C. Cramer, MD1

1. ¹University of California at Irvine, CA, USA
2. ²UC Irvine Medical Center, CA, USA

1. Daniel Zondervan, PhD, Department of Mechanical and Aerospace Engineering, UC Irvine, 2402 Calit2 Building, Irvine, CA 92697, USA. Email: dzonderv@uci.edu

Abstract

Background. Few therapeutic options exist for the millions of persons living with severe arm impairment after stroke to increase their dose of arm rehabilitation. This study compared self-guided, high-repetition home therapy with a mechanical device (the resonating arm exerciser [RAE]) to conventional therapy in patients with chronic stroke and explored RAE use for patients with subacute stroke. Methods. A total of 16 participants with severe upper-extremity impairment (mean Fugl-Meyer [FM] score = 21.4 ± 8.8 out of 66) >6 months poststroke were randomized to 3 weeks of exercise with the RAE or conventional exercises. The primary outcome measure was FM score 1 month posttherapy. Secondary outcome measures included Motor Activity Log, Visual Analog Pain Scale, and Ashworth Spasticity Scale. After a 1-month break, individuals in the conventional group also received a 3-week course of RAE therapy. Results. The change in FM score was significant in both the RAE and conventional groups after training (2.6 ± 1.4 and 3.4 ± 2.4, P = .008 and .016, respectively). These improvements were not significant at 1 month. Exercise with the RAE led to significantly greater improvements in distal FM score than conventional therapy at the 1-month follow-up (P = .02). In a separate cohort of patients with subacute stroke, the RAE was found feasible for exercise. Discussion. In those with severe arm impairment after chronic stroke, home-based training with the RAE was feasible and significantly reduced impairment without increasing pain or spasticity. Gains with the RAE were comparable to those found with conventional training and also included distal arm improvement.

What would provide me the best recovery from my next stroke?

There are lots of things that could be done. Of course none of these are clinically proven so don't listen to me. I would tell your doctor to read all these and don't come back until stroke protocols are written up.
0.  Try to stop the neuronal cascade of death in the first week. None of these are proven so you won't get your doctor to help save your dying neurons. Unless you can figure out a way to charge your doctor $1 for every neuron that dies in the first week. That would be around $950,000 a minute

What I am going to insist I get after my next stroke

1. I would make sure I have a decent stroke diet.  My ideas here:

What would a post-stroke diet look like?

2.  I would have music constantly playing.

1.  Exploring a Neuroplasticity Model of Music Therapy

2.  Revealed: The Type of Music That Makes You Feel Most Powerful

3. 11 Problems Music Can Solve

4. How playing an instrument benefits your brain - Anita Collins

5. Why does music therapy work? The Science Behind the Music.

6. Musical Training Can Increase Blood Flow in Brain

7.  Listening to classical music ameliorates unilateral neglect after stroke

8. Music brings memories back to the brain injured 

9.  Plasticity in the sensorimotor cortex induced by Music-supported therapy in stroke patients: a TMS study

10.  Moderating variables of music training-induced neuroplasticity: a review and discussion

11. Hand-Clapping Songs Improve Motor and Cognitive Skills, Research Shows

12. Music listening enhances cognitive recovery and mood after middle cerebral artery stroke

13. Intensive musical therapy may help improve speech in stroke patients 

The classical music one;

 Classical Music’s Surprising Effect on Genes Vital to Memory and Learning

3. I would give cognitive training, making survivors smarter should help their recovery even though it might lead to a higher chance of depression. Its been proven that smarter people die less from stroke.

Mind expanding: 7 ways to fine-tune your brain

Improving fluid intelligence with training on working memory

Gaming improves multitasking skills Study reveals plasticity in age-related cognitive decline.

NUS study revealed that Vajrayana meditation techniques associated with Tibetan Buddhism can enhance brain performance

Rehabilitation for post-stroke cognitive impairment: an overview of recommendations arising from systematic reviews of current evidence 

Video Game Training Improves Cognitive Control in Older Adults

The Art and Science of Cognitive Rehabilitation Therapy

Towards a Smart Population: A Public Health Framework for Cognitive Enhancement

Want to Slow Mental Decay? Play a Video Game

4. I know of little for fatigue.

Vitamin D and Chronic Fatigue Syndrome continued

Does oral Coenzyme Q10 plus NADH supplementation improve fatigue and biochemical parameters in Chronic Fatigue Syndrome? 

Management of fatigue in persons with multiple sclerosis

>Psychological Associations of Poststroke Fatigue

3 Strategies for Combating Post-stroke Fatigue

Randomized Controlled Trial of Light Therapy for Fatigue Following Traumatic Brain Injury

Cognitive basis proposed for fatigue after stroke

Does Your Brain Burn More Calories When You Think Hard?

Biological Coordinates of Post stroke Fatigue

Physical factors associated with fatigue after stroke: An exploratory study.

 5. I know of little for spasticity

Strengthening a Spastic Muscle. Why the Kerfuffle?

Apparatus for reduction of spasticity in male and female patients having spinal cord injury as well as obtaining semen from males by stimulation of ejaculatory nerves 

S2-3 Improvements in spasticity and motor function using a foot bath for people with chronic hemiparesis following stroke

Neurons in human muscles emphasize stimulation from the outside world

6. There would be thousands of hours of gifs of movements for action observation.

Action observation

New research supporting stroke rehabilitation   Nov. 2014.

Plasticity and Response to Action Observation   Oct. 2014.

Motor imagery during action observation modulates automatic imitation effects in rhythmical actions   Mar. 2014.

Clinical feasibility of action observation training for walking function of patients with post-stroke hemiparesis: a randomized controlled trial   Mar. 2014.

Training Videos Help Restore Motor Function, May Aid in Stroke Rehabilitation Mar. 2014.

 Using action observation to study superior motor performance: a pilot fMRI study  Jan. 2014.

Multiple roles of motor imagery during action observation  Jan. 2014.

Motor imagery ability in stroke patients: the relationship between implicit and explicit motor imagery measures  Dec. 2013.

From action representation to action execution: exploring the links between cognitive and biomechanical levels of motor control  Oct. 2013.

Action observation as a stroke therapy  June 2013.

Action-Observation In Stroke Rehabilitation  June 2013.

Exercise for stroke patients' brains  June 2013.

Watching object related movements modulates mirror-like activity in parietal brain regions  March 2013.

Watching object related movements modulates mirror-like activity in parietal brain regions  May 2012.

Action observation and mirror neuron network: a tool for motor stroke rehabilitation.  April 2012.

Modulating the motor system by action observation: Implications for stroke rehabilitation  Feb. 2012.

7. The wheelchair would be lever powered, this would force  the affected side to do a lot of work similar to what walking does for legs.

Rowing wheelchair

8.  Meditation You should be able to do this while you wait for your therapists to finally show up.

See Amys' posts here:

Kundalini Yoga

Why I Do What I Do Part Two…..Meditation

Meditation and Breathwork

Meditation and Chanting

Yoga Breathing

Rowing wheelchair

Powered by a rowing motion. This would seem to be the way to go for survivors, it would force use of the affected arm and get you to thousands of repetitions much faster. But don't worry your doctor and therapists will not change and try something new for at least 50 years. And if we had anything approaching innovation from our stroke associations we could put together this rowing one with this mountain trike one.
http://www.yankodesign.com/2010/08/30/stand-up-wheelchair/

This post is about a wheelchair project which allows the user to stand up easily. “The Leeding E.D.G.E” also features easy drive handles with different gearing options to promote accessibility and combat shoulder injury generally caused by traditional wheeling techniques. Designer Time Leeding proposes this wheelchair alleviates pressure sores and makes moves toward closing social boundaries which “inhibit the lives of the disabled day to day.”
It is a world that I do not pretend for a moment to understand, that being the world that a person that must be in a wheelchair lives in. I believe that each person lives a different life, and that each person deals differently with a situation that they might not find ideal, for example becoming confined to a wheelchair partway through life. Does allowing a person with no use of legs the ability to stand up temporarily work toward a better life for that person?
That question asked, this wheelchair seems to me to be quite the fabulous looking bit of engineering. “The Leeding E.D.G.E” features “dynamic drive” handles that work with a rowing sort of motion. More energy efficient and less strenuous than traditional techniques. The chair features geared hubs featuring 2:1 drive, 1:1 drive, neutral and revers gears, and of course, that excellent standing mode.

Read more at http://www.yankodesign.com/2010/08/30/stand-up-wheelchair

 

Obama in a Wheelchair designed by Kaitlin Reed, from Massachusetts, during the 2015 White House Science Fair March 23, 2015

Mountain Trike - The All Terrain Wheelchair Company The Active Chair For Active People

Has your doctor even shown you anything other than the boring standard ones? Or even any of the other ones I've written about?
Which of these previous reported wheelchairs will be compared to see what is the best for certain conditions?
I'll take the RipChair;

People with paralysis could drive this wheelchair using their tongues & a smartphone 

electric attachable handbikes

Turn your wheelchair into a motorcycle

Other mobility possibilities here:
Or maybe you'd prefer one of these other ones

http://www.wimp.com/newdevice/

 or Hondas;

 Honda's "mind-controlled" UNI-CUB β

Or this;

intelligent wheelchair system for older adults with cognitive impairments

Or this cool one;

Deep sea diving … in a wheelchair

Or this;

wheelchair like Segway

Or a:

standard wheelchair that is almost impossible to drive one-handed 

http://inhabitat.com/equal-a-compact-electric-vehicle-specially-designed-for-people-with-disabilities/

Extreme Offroad Tracked Wheelchair the Original Ripchair 2.0 

The latest here:

http://www.mountaintrike.com/

Snow

Mud

Robot centered research aids in stroke rehab, wheelchair guidance

Which of these previous reported wheelchairs will be compared to see what is the best for certain conditions?
I'll take the RipChair;

People with paralysis could drive this wheelchair using their tongues & a smartphone 

electric attachable handbikes

Turn your wheelchair into a motorcycle

Other mobility possibilities here:
Or maybe you'd prefer one of these other ones

http://www.wimp.com/newdevice/

 or Hondas;

 Honda's "mind-controlled" UNI-CUB β

Or this;

intelligent wheelchair system for older adults with cognitive impairments

Or this cool one;

Deep sea diving … in a wheelchair

Or this;

wheelchair like Segway

Or a:

standard wheelchair that is almost impossible to drive one-handed 

http://inhabitat.com/equal-a-compact-electric-vehicle-specially-designed-for-people-with-disabilities/

Extreme Offroad Tracked Wheelchair the Original Ripchair 2.0 

The latest here:

 Robot centered research aids in stroke rehab, wheelchair guidance

 

 

electric attachable handbikes

Another wheelchair option in case your doctor doesn't keep up with new stuff.
http://www.rollick.biz/

Many other options here that I'm sure your doctor and hospital know nothing about;

Turn your wheelchair into a motorcycle

Turn your wheelchair into a motorcycle

Batec E-Handbike - Electric powered front wheel that attaches to your wheelchair
You will have to run it thru Google translate here;
https://translate.google.com/translate?sl=auto&tl=en&js=y&prev=_t&hl=en&ie=UTF-8&u=http%3A%2F%2Fbatec-mobility.com&edit-text=

Connect and disconnect your BATEC - www.batec-mobility.com video here

The Spanish version here if you want to practice your Spanish.
http://batec-mobility.com

Other mobility possibilities here:
Or maybe you'd prefer one of these other ones

http://www.wimp.com/newdevice/

 or Hondas;

 Honda's "mind-controlled" UNI-CUB β

Or this;

intelligent wheelchair system for older adults with cognitive impairments

Or this cool one;

Deep sea diving … in a wheelchair

Or this;

wheelchair like Segway

Or a:

standard wheelchair that is almost impossible to drive one-handed 

http://inhabitat.com/equal-a-compact-electric-vehicle-specially-designed-for-people-with-disabilities/

Extreme Offroad Tracked Wheelchair the Original Ripchair 2.0 

 

Sue Austin: Deep sea diving … in a wheelchair