Gait analysis assisted by robotic walker in patients with post-stroke hemiparesis

What a novel idea. Objective analysis of a post-stroke gait. Why hasn't this been done and taught in PT schools? If you don't objectively know what the problems are you can never tell if those problems are resolved and exactly what protocols corrected them. This is just a microcosm of all the problems in stroke rehab. 

Gait analysis assisted by robotic walker in patients with post-stroke hemiparesis

Flávia Loterio^* and Teodiano Bastos-Filho

• * Corresponding author: Flávia Loterio

Author Affiliations

Universidade Federal do Espírito Santo, Vitória, ES, Brazil

For all author emails, please log on.

BMC Proceedings 2014, 8(Suppl 4):P267  doi:10.1186/1753-6561-8-S4-P267

The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1753-6561/8/S4/P267

Published:

1 October 2014

© 2014 Loterio and Bastos-Filho; licensee BioMed Central Ltd.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Poster presentation

Stroke is the leading cause of motor dysfunction in adults worldwide. The motor impairment, characteristic of a post-stroke patient, is the hemiparetic gait. This paper proposes a gait analysis assisted by a robotic walker in patients with post-stroke hemiparesis. The test group will have two categories: the first consisting of healthy subjects, and the second one by subjects with post-stroke hemiparesis. Both groups will perform an initial trajectory without the aid of a walker, and another one with its assistance. This route is a straight line, in a flat ground. After training with the walker, volunteers participating repeat the trajectory using the device. The robotic walker is equipped with 3D force sensors in the forearm support, which can confirm the correct weight applied to it. It also can deduce the subject's movement intentions, through the efforts made by his/her upper limbs. Spatio-temporal parameters of gait using inertial sensors will be analyzed. These sensors will be placed in specific points of the subject's legs, and a laser scanning sensor will be located in the center of the walker in order to get distances to the legs. Electromyography (EMG) electrodes will be also placed on the subject's legs to evaluate the muscle activity and energy consumption during the gaits. After analyzing the data, the results will be compared between the two groups and between the gaits before and after the training. The results might be useful for the process of rehabilitation of post-stroke patients, and in normal and hemiparetic gait.

Let’s stop the unnecessary treatment of heart disease

While this is for heart disease the exact same 80% preventable is bandied about  for stroke. And with the generic stroke prevention tips we get it is really not helpful for our doctors to tell us this.
Let’s stop the unnecessary treatment of heart disease

Stroke prevention below.
Cleveland Clinic tips here:
http://my.clevelandclinic.org/health/diseases_conditions/stroke/hic_The_Role_of_Nutrition_in_the_Prevention_and_Treatment_of_Stroke
http://my.clevelandclinic.org/health/diseases_conditions/stroke/stroke

Mayo Clinic here:
http://www.mayoclinic.org/diseases-conditions/stroke/basics/prevention/con-20042884

National Stroke Association here:
http://www.stroke.org/site/PageServer?pagename=PREVENT

American Stroke Association here:
Guidelines for the Prevention of Stroke in Women
Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack
http://blog.heart.org/new-heart-disease-and-stroke-prevention-guidelines-released/

World Stroke Organization here:
World Stroke Day: We Can Prevent Stroke

Here are my ideas on stroke prevention: Never, ever follow me.
Like my 11 Stroke risk reduction ideas.

Look at all of these objectively and realistically tell me these are useful. There will always be something in there that you didn't do correctly so the 'Blame the Patient' game can proceed in high dungeon.

Innovative Stroke Patient Management System Reduces Hospital Stay by Over 25 Percent

They never say whether the one usable statistic they should be using from this is that patients have an objectively better recovery. I'd be willing to bet a lot of money that this is just a faster way to push patients out of the hospital. Not better results, more pressure on the caregivers to accept the patients supposedly because they were involved in the care/rehabilitation decisions.  When you have the whole medical staff arrayed against you you are going to cave.

YOU are going to have to demand results and stand up to the pressure.

Big f*cking whoopee.

Article on it here:

Innovative Stroke Patient Management System Reduces Hospital Stay by Over 25 Percent

Press release here:

Innovative stroke patient management system cuts hospital bed usage by more than 25 percent

Contact: Amanda Bates amanda@curvecommunications.com
604-684-3170 Heart and Stroke Foundation of Canada @TheHSF 

'Win-win' program in Kelowna, BC, provides better care to patients and hospital savings of up to $800,000

An innovative patient management system at the acute stroke unit of Kelowna (BC) General Hospital has reduced the number of stroke patient bed days by more than 25 per cent, according to a study of the system presented at the annual Canadian Stroke Congress in Vancouver.
In total, it is estimated the new system is saving the 380-bed hospital more than 1,000 bed days per year. This represents annual savings of up to $800,000, all achieved without the need for any new investment in devices, treatments or personnel.
"It's a win-win situation," says Dr. John B. Falconer, director of the transient ischemic attack (TIA) and stroke clinic at the hospital, and author of the study. "Patients are better and more efficiently treated, the hospital saves resources and the morale of the whole unit is much better."
The program is called Proprietary Physician, or Pro-MD. It involves assuring that one of the hospital's five neurologists is always designated as primarily responsible for best bed usage and patient flow on the acute stroke unit.
"The ward becomes "that doctor's" ward; they have a propriety interest in it functioning well," says Dr. Falconer. Each doctor's assignment as Pro-MD could last several weeks or a month.
A crucial component of the program is that beyond the normal care to the patients by their own neurologist and other caregivers, the Pro-MD makes twice-weekly rounds of all patients with the full care team. This includes the ward head nurse, physiotherapist, occupational therapist, social worker, transition nurse, pharmacist, rehabilitation ward head nurse and – very importantly according to Dr. Falconer – the patient's family.
"This brings everyone who needs to have input into decisions about a patient's care together to agree on the action needed," says Dr. Falconer. "This is very advantageous compared to formerly having to compare written notes from one another and wait for input from others."
The meetings take only 30-45 minutes to discuss the usual half-dozen patients, but result in everyone agreeing on the course of care, including the family. This is crucial, particularly when discussing the timing and terms of a patient's discharge from hospital.
A further benefit, added Dr. Falconer, has been a huge boost in staff morale on the ward. "We're now the primo ward of the hospital, with staff enjoying the team-based collaboration," he says.
The program is actually very simple but has proven very effective. "It could perhaps be used in other areas of the hospital, but it's particularly relevant to stroke care because of the many players involved and the crucial role the patient and family play in rehabilitation."

Why And How Healthcare Institutions Should Prepare For IBM Watson

This would require innovative people in each stroke hospital getting together and bringing in Dr. Watson to solve all the stroke problems. That will never occur. If we had a great stroke association that could lead we could solve this for all stroke hospitals. But under current leadership this is still somebodys elses problem to solve.  So trillions upon trillion of neurons will continue to die each day.  Hope some of those neurons aren't yours or your parents or kids.
http://scienceroll.com/2014/10/06/why-and-how-healthcare-institutions-should-prepare-for-ibm-watson/

Oral creatine monohydrate supplementation improves brain performance

Ask your doctor if this research from 2003 is important enough to be following. No self-precscription.
http://rspb.royalsocietypublishing.org/content/270/1529/2147.short

1. Caroline Rae¹,^*,
2. Alison L. Digney¹,
3. Sally R. McEwan¹ and
4. Timothy C. Bates²

+ Author Affiliations

1. ¹Discipline of Biochemistry, School of Molecular and Microbial Biosciences G08, The University of Sydney, Sydney, NSW 2006, Australia
2. ²Macquarie Centre for Cognitive Science, Macquarie University, NSW 2109, Australia

1. *Author for correspondence (c.rae@mmb.usyd.edu.au).

Abstract

Creatine supplementation is in widespread use to enhance sports–fitness performance, and has been trialled successfully in the treatment of neurological, neuromuscular and atherosclerotic disease. Creatine plays a pivotal role in brain energy homeostasis, being a temporal and spatial buffer for cytosolic and mitochondrial pools of the cellular energy currency, adenosine triphosphate and its regulator, adenosine diphosphate. In this work, we tested the hypothesis that oral creatine supplementation (5 g d^-1 for six weeks) would enhance intelligence test scores and working memory performance in 45 young adult, vegetarian subjects in a double–blind, placebo–controlled, cross–over design. Creatine supplementation had a significant positive effect (p < 0.0001) on both working memory (backward digit span) and intelligence (Raven's Advanced Progressive Matrices), both tasks that require speed of processing. These findings underline a dynamic and significant role of brain energy capacity in influencing brain performance. 

Full article here:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1691485/pdf/14561278.pdf 

351 days to read my blog

at 6328 posts * 5 minutes per post  + 3.5 links per post *10 minutes per link = 253,120 minutes or 4218.667 hours.
At 12 hours a day it will only take 351 days to read it all

No wonder I sometimes have a hard time remembering what I've already written about.
Which is why a good friend has told me I need to write a whole slew of eBooks, 70-80 pages each.
Her comment was that I have too much information out there to really be useful.

Z-score LORETA Neurofeedback as a Potential Rehabilitation Modality in Patients with CVA

If you think this is that good write it up as a protocol and do what you are supposed to do to get this delivered to all the stroke rehab centers around the world. There is such a process, ISN'T THERE? Or do really expect all the stroke centers to read the Journal of Neurology & Stroke and know that this is to be followed. But this won't be rolled out because everything in stroke is somebody elses fucking problem. Who gives a shit if survivors don't recover very well. Take some responsibility and make it your problem to solve.  Sorry for the rant but it is Saturday night and I'm at work. 

Z-score LORETA Neurofeedback as a Potential Rehabilitation Modality in Patients with CVA

Introduction
EEG biofeedback also called neurofeedback (NFB) has been shown to be a promising modality in neurorehabilitation including stroke [1-4]. Recent progress in computer technology and development of newer imaging and NFB techniques including
low resolution electromagnetic tomography analysis (LORETA) as well as Z-score NFB prompted me to apply this therapy in stroke patients. The potential advantage of LORETA Z-score NFB is ability to achieve even faster results than standard one or two channel neurotherapy [5,6]. Deep structures such as the anterior
cingulate cortex [7], insula and mesial temporal lobes [8] can be correctly localized with LORETA. In Z-score biofeedback real-time comparisons to an age matched reference population of healthy
or normal subjects are used as a guide or “compass” to increase specificity and provide a uniform direction and threshold for the
biofeedback process [9]. Prior to Z score biofeedback clinicians had to guess about what threshold to set for a given frequency
or location to trigger the feedback signal or reinforcer signal [9].
Z score biofeedback greatly simplifies and standardizes EEG biofeedback by reducing many different metrics (absolute power, relative power, ratios, coherence, phase) to a single or common
metric of the Z score or a standard deviation with respect to the EEG from a group of age matched healthy normal subjects [9].
Surface Z scores improve specificity by isolating dysregulated locations and rhythms, especially when using the Laplacian transform and LORETA Z scores are even more specific. For example, LORETA Z score biofeedback often also produces
results in one 20 minute session because EEG source localization has accuracies of about 1 cm to 3 cm and thus is much more specific than is surface EEG [9].
In Z-Score NFB, a real-time comparison to an age-matched population of healthy subjects is used for data acquisition, simplifying protocol generation and allowing clinicians to target
modules and hubs that indicate dysregulation and instability innetworks related to symptoms. Z-score NFB increases specificity in operant conditioning, providing a guide that links extreme
Z-score outliers to symptoms, and then reinforcing Z-score shifts toward states of greater homeostasis and stability. The goal is increased efficiency of information processing in brain networks
related to the patient’s symptoms [10].
A recently introduced method called Low Resolution Electromagnetic Tomography (LORETA) Z-score NFB is capable of targeting specific dysregulated anatomical structures, many
of which are in deep cortical locations [11-13]. For example, the insula and anterior cingulate have been identified as potential NFB target sites for improving pain control in patients who
display electrical dysregulation of these areas [12].
In my clinic, we have completed Z-score LORETA therapy with more than 250 patients with different neuropsychiatric conditions including five patients suffering from stroke. One of the patients who was diagnosed with occipital cerebrovascular
accident (CVA) and complained of visual problems due to homonymous hemianopia completed only 3 NFB sessions and reported subjective improvement of his vision. However, no follow up visual fields study was completed. In this paper, I
will present four patients with their rehabilitation outcomes that completed longer courses of Z-score LORETA NFB due to ischemic or hemorrhagic stroke.

Life-Changing Therapy Now Available For Stroke and Spinal Cord Injury Patients As MyndTec Launches MyndMove™

I'm sure this will take 30 years to get to your hospital unless YOU call the president to get on the stroke department heads ass. I refuse to be polite, our hospitals have been failing us for decades and they will continue to do so unless YOU start getting mad.
http://www.newswire.ca/en/story/1422362/life-changing-therapy-now-available-for-stroke-and-spinal-cord-injury-patients-as-myndtec-launches-myndmovetm
MyndTec, an award-winning, Canadian medical technology company announced today the launch of its first commercial product, a revolutionary, new therapy for the treatment of arm and hand paralysis caused by stroke or spinal cord injury. MyndMove™ therapy is based on advanced non-invasive functional electrical stimulation and uses electrical stimulation to create new neural pathways for the recovery of voluntary function following injury to the brain or spinal cord.
Over the coming week, MyndTec will unveil MyndMove at two rehabilitation conferences in Toronto, the National Spinal Cord Injury Conference (Oct 3–4) and the American Congress of Rehabilitation Medicine (Oct 8-10).  
"This is truly a landmark moment in the evolution of FES therapy," said MyndTec Founder Dr. Milos R. Popovic.  "Multiple clinical studies have demonstrated the safety and efficacy of FES therapy for the treatment of paralysis and we can now offer this life-changing therapy to patients that might benefit".
"What makes MyndMove therapy so exciting is that the recovery of arm and hand function means that patients become more independent in performing routine activities of daily living such as eating, grooming, dressing and bathing," said Diana Pliura, CEO of MyndTec.  "With increased independence, patients gain dignity and the burden on families and our healthcare system is decreased."
Today's launch marks MyndTec's entrance into the neurorehabilitation market and MyndMove therapy will initially be available at designated physiotherapy clinics across Ontario.

Stroke Victims Lose 'Crucial Functions' Because Hospitals Don't Properly Rehabilitate Them

This is so fucking bloody obvious. Stroke rehab is a complete and utter failure, only 10% get to almost full recovery.

From  John Krakauer  

"If you have a stroke in the United States in 2014, you're better off if you're a rodent than if you're a human being."

Though humans unquestionably get excellent care(NOT RECOVERY!) at the time of a stroke with the delivery of clot-busting drugs and surveillance for complications, in Krakauer's opinion, standard post-stroke care(NOT RECOVERY!) for humans is intolerably backward.

Current rehabilitation therapies are medieval, Krakauer, a professor of neurology and neuroscience at Hopkins, told the audience of science writers. "It's time for a revolution."

And because rehab is so fucking bad the only solution is to stop a lot of the damage by stopping the neuronal cascade of death.

It's so damned simple, why can't the stroke medical world see it? Are they all brain damaged worse than the stroke survivors they are supposed to be treating? 

Whom the hell is going to take on this problem and solve it? It has only been festering for the last 30 years.

Stroke Victims Lose 'Crucial Functions' Because Hospitals Don't Properly Rehabilitate Them

Alcohol intake, wine consumption and the development of depression: the PREDIMED study

With our high rate of depression post-stroke, how long will it take before your doctor starts prescribing wine?  Don't follow me, I prescribe myself wine on at least a weekly basis, accompanied by lots of social contact and laughter. 

Alcohol intake, wine consumption and the development of depression: the PREDIMED study

Gea A¹, Beunza JJ, Estruch R, Sánchez-Villegas A, Salas-Salvadó J, Buil-Cosiales P, Gómez-Gracia E, Covas MI, Corella D, Fiol M, Arós F, Lapetra J, Lamuela-Raventós RM, Wärnberg J, Pintó X, Serra-Majem L, Martínez-González MA; PREDIMED GROUP.

Collaborators (186)

Author information

Abstract

BACKGROUND:

Alcoholic beverages are widely consumed. Depression, the most prevalent mental disorder worldwide, has been related to alcohol intake. We aimed to prospectively assess the association between alcohol intake and incident depression using repeated measurements of alcohol intake.

METHODS:

We followed-up 5,505 high-risk men and women (55 to 80 y) of the PREDIMED Trial for up to seven years. Participants were initially free of depression or a history of depression, and did not have any history of alcohol-related problems. A 137-item validated food frequency questionnaire administered by a dietician was repeated annually to assess alcohol intake. Participants were classified as incident cases of depression when they reported a new clinical diagnosis of depression, and/or initiated the use of antidepressant drugs. Cox regression analyses were fitted over 23,655 person-years.

RESULTS:

Moderate alcohol intake within the range of 5 to 15 g/day was significantly associated with lower risk of incident depression (hazard ratio (HR) and 95% confidence interval (95% CI) = 0.72 (0.53 to 0.98) versus abstainers). Specifically, wine consumption in the range of two to seven drinks/week was significantly associated with lower rates of depression (HR (95% CI) = 0.68 (0.47 to 0.98)).

CONCLUSIONS:

Moderate consumption of wine may reduce the incidence of depression, while heavy drinkers seem to be at higher risk.

Dear Mr. Matt Lopez, as Next CEO of National Stroke Association

Dear Sir, If you really want to build a national platform for the stroke community, you will need to get out from whatever insular culture exists at the national headquarters and talk to survivors. Reach out to the bloggers and they can put you in touch with hundreds of survivors. You need a strategic plan and we can help you define the best one available. You'll have to break away from the failures of the past and forge your own way.

You might want to get your name, phone number and email address on the NSA website, it's hard to reach you otherwise.
Sincerely,
Survivor Dean Reinke, writer of Deans' Stroke Musings

Joe Namath: Experimental Oxygen Treatment Has Helped Brain Heal

Sounds like placebo to me. Its not easy sorting out the competing claims. What precisely does your doctor have to say about this? And not one affiliated with HBOT.
Other writeups here;

A failed HBOT trial here

Peter Levine talking about problems of HBOT here:

Stroke and Hyperbaric Oxygen Therapy

Or maybe mimic high altitude which has been proven to be useful for  angiogenesis. Training the Brain to Survive Stroke

Hyperbaric Oxygen Therapy Can Improve Post Concussion Syndrome Years after Mild Traumatic Brain Injury - Randomized Prospective Trial

TAU Research Team Discovers New Treatment for Stroke 

Can Hyperbaric Oxygen Repair the Damaged Brain?

hbot as stroke therapy - quackery?

Long Course Hyperbaric Oxygen Stimulates Neurogenesis and Attenuates Inflammation after Ischemic Stroke

Hyperbaric Oxygen Induces Late Neuroplasticity in Post Stroke Patients - Randomized, Prospective Trial

This is a fascinating idea, treat your recently oxygen starved brain with more reduced oxygen supply.

 And the latest news here;

Joe Namath: Experimental Oxygen Treatment Has Helped Brain Heal

‘Mini-stroke’ may lead to post-traumatic stress disorder

This seems unlikely since a regular stroke has a PTSD following stroke of 23% 
But see what protocol your doctor is using to prevent PTSD.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=145776&CultureCode=en 
About 30 percent of transient ischemic attack or “mini-stroke” patients had symptoms of post-traumatic stress disorder (PTSD) in a new study.Those with PTSD had more depression, anxiety and reduced mental and physical quality of life. Patients overestimating their stroke risk and who don’t cope with their mini-stroke well are at higher risk to develop PTSD.
A “mini-stroke” may increase your risk of developing post-traumatic stress disorder (PTSD), according to new research in the American Heart Association journal Stroke.
Transient ischemic attack (TIA), like stroke, is caused by restricted blood supply to the brain. A TIA is temporary and often lasts less than five minutes, without causing permanent brain damage.
“We found one in three TIA patients develop PTSD,” said Kathrin Utz, Ph.D., a study author and post-doctoral researcher in the Department of Neurology at the University of Erlangen-Nuremberg in Germany.
“PTSD, which is perhaps better known as a problem found in survivors of war zones and natural disasters, can develop when a person experiences a frightening event that poses a serious threat.”
The study is the first to analyze whether a TIA and the knowledge of an increased risk for stroke can lead patients to develop psychiatric problems.
After examining data from 108 TIA patients with no prior history of stroke and reviewing participants’ answers to a series of questionnaires that evaluated their mental state, German and British researchers found:

• About 30 percent of patients with TIA disclosed symptoms of PTSD.
• About 14 percent of all TIA patients showed significantly reduced mental quality of life and 6.5 percent had reduced physical quality of life.
• Those with PTSD showed higher signs of depression, anxiety and reduced quality of life.

Patients’ fear of having a stroke and poor coping behaviors after a TIA may be partially to blame for them developing PTSD.
“While their fear is partly justified, many patients may be overestimating their risk and increasing their chances of developing PTSD,” Utz said.
“When experienced together, the symptoms from TIA and depression pose a significant psychological burden on the affected patient; therefore, it comes as no surprise that we also found TIA patients with PTSD have a measurably lower sense of quality of life.”
Even a brief neurological disorder, which in itself doesn’t lead to a chronic disability, can be just as traumatic as an event like a traffic accident or natural disaster, researchers said. The way a patient normally responds to stressful situations may help determine their risk of developing PTSD after a TIA.
“Patients who use certain types of coping strategies, such as denying the problem, blaming themselves for any difficulties or turning to drugs for comfort, face a greater risk of developing PTSD after TIA,” Utz said.
 “It is not yet entirely clear why some people develop PTSD following a TIA, but others do not. However, what we do know at this stage is that younger patients and patients who in general find it difficult to cope with stress are more likely to develop psychological problems following a TIA.”
Utz suggests providing patients better risk counselling and more positive adaptive strategies to cope with TIA.
http://newsroom.heart.org/news/mini-stroke-may-lead-to-post-traumatic-stress-disorder?preview=27a22b972d948f405e7e4a5f1e78be82

FTC: Caffeinated Undergarment Will Not Help You Shed Pounds

This is not the way to attempt to get your caffeine. It's not the caffeine alone that is good for you, it is all the other stuff in your coffee. And spilling coffee on your pants is not a suggested solution.

FTC: Caffeinated Undergarment Will Not Help You Shed Pounds

Your Ancestors Didn’t Sleep Like You – Are We Doing It Wrong?

Is your hospital short circuiting your sleep patterns by giving you sleeping pills? Sleep is incredibly important to survivors. Are we doing it wrong? What research is your doctor following to prescribe you the best sleep?

http://www.collective-evolution.com/2014/10/02/your-ancestors-didnt-sleep-like-you-are-were-doing-it-wrong/
What is the precise sleep stroke protocol your doctor has given you? None? Does your doctor even know about any of this?

1. Sleep Recruits Multiple Brain Areas to Help Consolidate Motor Learning

2.  Brain may flush out toxins during sleep

3. Sleep to protect your brain

4. Sleeping too much or too little linked to chronic diseases

5. Lost Sleep Leads to Lost Neurons

6. Sleeping more than 8 hours is a risk factor for cognitive impairment in over 65s

Stroke protocol, Stroke protocol, Stroke protocol

I keep hammering on these needs because until our stroke medical teams pull their heads out of their asses and stop believing in 'All strokes are different, all stroke recoveries are different'. Whenever we stop that belief and start writing up defined and published stroke protocols will we finally join the modern world of medicine. Until then we may as well try adjusting the four humors and bleed stroke survivors. I bet that would produce a 10% full recovery rate also. Get With the Guidelines and Joint Commission standards do not count, they are not public and do not deal with rehab.
Arghh!!!

Stroke Patients Boost Survival by Getting Statins in Hospital

This then joins the earlier research on statins for cardioembolic stroke.
Statins improve survival in patients with cardioembolic stroke
How f*cking long is it going to take to get a stroke protocol rolled out on this to every hospital?  It's the survivors neurons being saved, call up your hospital president and ask,
'When the hell is this going to occur?'
http://www.bloomberg.com/news/2014-09-22/stroke-patients-boost-survival-by-getting-statins-in-hospital.html
Cholesterol-lowering statins such as Pfizer Inc.’s Lipitor helped boost survival in patients who had a stroke caused by bleeding in the brain, a study from Kaiser Permanente showed.
Hemorrhagic stroke patients given a statin while in the hospital had about double the chance of survival compared to those not given the drugs, according to research today in the journal JAMA Neurology. Those already taking the drugs and who stayed on them in the hospital were three times more likely to survive after a stroke than those whose medicine was stopped.
Doctors have been concerned that statins could make bleeding worse in hemorrhagic strokes. The review of 3,481 patients over 10 years showed the opposite. Taking a statin improved survival and discharge to home or to a rehabilitation facility, said Randolph Marshall, who wrote an accompanying editorial in the journal. An earlier study by the same group of researchers found statins also helped patients who had an ischemic stroke, where blood can’t reach part of the brain.
“It is a new concept for most clinicians that statins are actually safe to use and actually beneficial in the setting of ischemic stroke and hemorrhagic stroke,” said Marshall, a professor of neurology and chief of the Stroke Division at Columbia University Medical Center in New York. “My hope is that doctors will take this to heart and understand the potential benefits of statins moving forward.”
Further study would be needed to confirm the findings, he said.

Largest Study

Today’s findings are the largest ever such study, according to the researchers. While the primary use for statins is to lower cholesterol, the drugs can also improve blood flow and reduce inflammation, which may be beneficial in stroke patients, Marshall said in a telephone interview.
Researchers included patients who were admitted to 20 Kaiser Permanente hospitals in Northern California with a hemorrhagic stroke over a 10-year period. They looked at patient survival and discharge 30 days after the stroke.
Of patients who weren’t already on statins and got the drugs at the hospital after a stroke, 18 percent were dead after 30 days, compared with 39 percent of those who didn’t get a statin at all. Patients given the cholesterol treatments were discharged to home or a rehabilitation facility more than half the time, versus 35 percent of those not given the statin.
“If a patient is taking a statin when they come into a hospital with a hemorrhagic stroke, they should strongly consider not stopping the statin immediately in the hospital,” said lead study author Alexander Flint, a stroke specialist at Kaiser Permanente in Redwood City, California, in a telephone interview.
Future studies need to look at how long patients need to remain on these statin therapies, he said.
The study also showed that patients already taking statins who stopped after arriving at the hospital following a stroke had a 58 percent chance of dying with 30 days, compared with 19 percent for those whose statin therapy was continued. Those whose therapy was continued were discharged home or to a rehabilitation facility about half the time, compared with 22 percent of those whose medicine was stopped.

New learning mechanism for individual nerve cells

This is so cool that one nerve cell can control something. It might blow this earlier post of mine out of the water. Which way does your doctor think and how is s/he using that knowledge in your recovery protocols?
The single neuron insufficiency principle


New learning mechanism for individual nerve cells
The traditional view is that learning is based on the strengthening or weakening of the contacts between the nerve cells in the brain. However, this has been challenged by new research findings from Lund University in Sweden. These indicate that there is also a third mechanism – a kind of clock function that gives individual nerve cells the ability to time their reactions.
“This means a dramatic increase in the brain’s learning capacity. The cells we have studied control the blink reflex, but there are many cells of the same type that control entirely different processes. It is therefore likely that the timing mechanism we have discovered also exists in other parts of the brain”, said Professor of neurophysiology Germund Hesslow.
Professor Hesslow and colleagues and Dan-Anders Jirenhed have used ‘conditioned reflexes’ for the research. The principle comes from the Russian researcher Ivan Pavlov, who, around the turn of the last century, taught dogs to associate a certain sound with food so that they began to drool on hearing the sound.
In the present experiment, the researchers studied animals that learnt to associate a sound with a puff of air in the eye that caused them to blink. If the time between the sound and the puff of air was quarter of a second, the animals blinked after quarter of a second even if the puff of air was removed. If the time was changed to half a second, the animals blinked after half a second, and so on.
The prevalent theories in brain research state that this learnt timing mechanism is a result of strengthening or weakening of the contacts – or synapses – throughout a network of nerve cells. However, using super-thin electrodes, the Lund group have now shown that no networks are needed: one single cell can learn when it is time to react.
The cells which the researchers have studied are called Purkinje cells and are located in the cerebellum. The cerebellum is the part of the brain responsible for posture, balance and movement, and the researchers focused on those cells that control blinking.
This work is basic research, but possible future applications could include rehabilitation following a stroke, which often affects a patient’s movements. The findings could also have a bearing on conditions such as autism, ADHD and language problems, in which the cerebellum is believed to play a part.
“Intelligible speech is dependent on correct timing, so that the pauses between the sounds are right”, explained Germund Hesslow.
The new findings have already attracted attention in the research community: the internationally renowned memory researcher Charles Gallistel came all the way from Rutgers University in the spring to study the group’s work. Work is now continuing to study what transmitter substance and what receptor on the surface of the cell are responsible for the newly discovered timing mechanism.

http://www.pnas.org/content/early/2014/09/24/1415371111.abstract?sid=73daabbb-8004-460f-8c4b-0f7b9be4e367

British Psychological Society news release - New understanding of emotional impact of stroke

I still hate research like this. It describes a problem but offers no solutions or therapy to solve the problem.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=145766&CultureCode=en
The physical challenges associated with recovery from a stroke are well documented however the impact of a stroke on emotion is less well understood.
New research from the University of Aberdeen, published today (Wednesday 1 October 2014) in the British Journal of Clinical Psychology has identified key areas in which stroke can impair emotion regulation and found  that these difficulties continued 18 months after the stroke.
The findings of this study have implications for the long-term treatment and recovery of stroke patients and may help pave the way to help guide treatment interventions following stroke.
Every year there are approximately 152,000 strokes in the UK, which equates to one stroke every three and a half minutes*. 
Dr Clare Cooper, Lecturer in Health Psychology at The University of Aberdeen, led the study, which was funded by the Chief Scientist Office said:
“Emotion regulation is really important for all of us - we all use it every second of every day.  It is about recognising what we are feeling and what we can do to cope if we feel distressed. For example we might count to ten or rant to a friend, thereby enabling us to continue with our daily lives.  Following stroke, emotion regulation may be impaired and patients may struggle to understand and cope with their own emotions.  Following a stroke, patients can sometimes experience their emotions as overwhelming and feel as if their emotions are running them rather than other way round. This can seriously limit the degree to which patients are able to live their life to the fullest.
“This study is the first of its kind to examine in detail how emotion regulation is affected by a stroke and explore how this may influence people’s social participation following stroke.”
Researchers interviewed stroke patients six weeks after their stroke then again at 18 months into their recovery and compared their answers to individuals who had not experienced a stroke.  The volunteers were asked questions about their ability to regulate their emotions, which included questions about topics like impulsivity and emotion awareness.  Patients were also asked about how much they engage in social activities such as seeing friends and family, engaging in social events and working.  Results were then analyzed to find any links between emotion regulation and social participation. 
Dr. Cooper added:
“Our results showed that at six weeks post-stroke, patients showed impairments in emotion regulation that were related to reduced social participation compared to a control group.
“At 18months post-stroke there was still an association between the ability to regulate emotion and social participation, which was apparent even when other factors such as low mood and mobility problems had been accounted for.
“These findings show that following a stroke, some patients can have long-term difficulties with emotional regulation and that this may affect their ability to participate socially.  Although more research is needed we now have a clear starting point for follow-up research to better understand how emotion regulation is affected, how we might help patients cope with this, and whether this leads to a more socially active and fulfilling life.  Research suggests that by giving patients strategies to recognize feelings and control emotions they can focus on recovery and eventually engage more fully with work and family.”

National Stroke Association Appoints Matt Lopez as Next CEO

Maybe a step forward. I challenge him to invite all survivors to contact him with an open door policy.
And if he really wants to know what's going on he'll surround himself with survivors.
http://www.digitaljournal.com/pr/2225087
National Stroke Association, the only national nonprofit dedicated 100 percent to stroke, has appointed  veteran business and marketing executive Matt Lopez as CEO. Lopez brings 20 years leadership and business experience working with national and global markets and international brands.
Lopez has held a variety of executive leadership positions working to build brands and transform organizations. He comes to National Stroke Association from EB Brands UK, where he served as CEO. He held prior leadership positions with De Beers, Universal Studios, and Mattel.
For the last 30 years National Stroke Association has provided significant impact to the stroke community through programs of prevention, treatment, and post-stroke care and empowered survivors and their circle of care to thrive after stroke. Lopez, a stroke survivor, will lead the organization in its next phase of strategic growth that includes building a national platform for the stroke community.
"Lopez brings a personal perspective to stroke, having experienced one himself, and years of experience in leading national and international organizations to achieve success and exceed goals. We know that this impressive combination of talents will lead our organization to the next stage of growth," said Dr. Michael D. Walker, Chairman of National Stroke Association Board of Directors.
Lopez experienced a stroke in 2011 on a business trip flying from Miami to London. He collapsed on a plane at Heathrow Airport as a blood clot had moved from his leg to the back of his brain. Lopez had a family history of stroke but was not prepared for what happened that day. He was lucky to have been diagnosed quickly and rushed to a team of doctors who were able to save his life.
"Like so many other stroke survivors, my stroke was unexpected and very personal," said Lopez. "I am humbled and excited to be able to give back to the stroke community using my personal experience as a stroke survivor as well as my leadership and business experience to build upon National Stroke Association's legacy and strengthen its reach and impact through strategic growth."
Following his stroke, Lopez became a committed advocate for stroke care, including the reorganization of stroke services for the National Health Services (NHS) London and the UK Secretary of State for Health's Strategic Planning Committee for Long Term Stroke and Cardiovascular Care.
"I am aware of the stroke community's growing, critical need—from general awareness of the disease and its impact, to recognition of life-saving stroke warning signs, to tools and resources that guide survivors and their support systems along their unique road to recovery. We will not only work towards filling these needs, but will also continue to identify and address the ever-changing needs of this underserved community," added Lopez.
"I am ecstatic that someone of Lopez's caliber rose to the top of the list and I am very confident that he will have a tremendous impact on the stroke community," said George Davis, Vice Chairman National Stroke Association.


Read more: http://www.digitaljournal.com/pr/2225087#ixzz3F2iL4ILw

St. Joseph Mercy Hospital Ann Arbor Recognized For Stroke Care

I'm sorry but I think these back patting demonstrations are a pile of steaming crap. I don't give a damn about how well you do the fucking processes, I want to know your results. You'd be fired in no time under my leadership if you tried to pass off crap like this for your performance evaluations.
http://m.wemu.org/?utm_referrer=#mobile/52238


Dr. Steinberg says receiving the certification as a stroke rehabilitation center of excellence is recognition that St. Joseph Mercy Hospital Ann Arbor is a state leader in using evidence-based practices and best practices to treat stroke patients. (Notice nothing about how low their 30 day death rate is or how many 100% recovered)

Big f*cking whoopee.
The measurements say nothing about 30-day deaths or 100% recovery so as such are useless for survivors. You can check out Joint Commission standards here:
http://www.jointcommission.org/assets  I saw absolutely nothing about what should be done the first week or anything about measuring 30-day deaths and 100% recovery.  God, these people are worse than worthless. Complacent good-for-nothings.

Study: Lift weights, improve your memory

I bet this still won't be enough to convince your stroke doctor to set up an exercise protocol  for improving memory. Lazy bastards, waiting for somebody else to solve the problem.
http://www.rdmag.com/videos/2014/10/study-lift-weights-improve-your-memory?et_cid=4186817&et_rid=584444078&location=top

Another reason why it’s a good idea to hit the gym: it can improve memory. A new Georgia Institute of Technology study shows that an intense workout of as little as 20 minutes can enhance episodic memory, also known as long-term memory for previous events, by about 10% in healthy young adults.

The Georgia Tech research isn’t the first to find that exercise can improve memory. But the study, which was just published in the journal Acta Psychologica, took a few new approaches. While many existing studies have demonstrated that months of aerobic exercises such as running can improve memory, the current study had participants lift weights just once two days before testing them. The Georgia Tech researchers also had participants study events just before the exercise rather than after workout. They did this because of extensive animal research suggesting that the period after learning (or consolidation) is when the arousal or stress caused by exercise is most likely to benefit memory.

The study began with everyone looking at a series of 90 photos on a computer screen. The images were evenly split between positive (i.e. kids on a waterslide), negative (mutilated bodies) and neutral (clocks) pictures. Participants weren’t asked to try and remember the photos. Everyone then sat at a leg extension resistance exercise machine. Half of them extended and contracted each leg at their personal maximum effort 50 times. The control group simply sat in the chair and allowed the machine and the experimenter to move their legs. Throughout the process, each participant’s blood pressure and heart rate were monitored. Every person also contributed saliva samples so the team could detect levels of neurotransmitter markers linked to stress.

The participants returned to the lab 48 hours later and saw a series of 180 pictures—the 90 originals were mixed in with 90 new photos. The control group recalled about 50% of the photos from the first session. Those who exercised remembered about 60%.

“Our study indicates that people don’t have to dedicate large amounts of time to give their brain a boost,” said Lisa Weinberg, the Georgia Tech graduate student who led the project.

Although the study used weight exercises, Weinberg notes that resistance activities such as squats or knee bends would likely produce the same results. In other words, exercises that don’t require the person to be in good enough to shape to bike, run or participate in prolonged aerobic exercises.

While all participants remembered the positive and negative images better than the neutral images, this pattern was greatest in the exercise participants, who showed the highest physiological responses. The team expected that result, as existing research on memory indicates that people are more likely to remember emotional experiences especially after acute (short-term) stress.

But why does it work? Existing, non-Georgia Tech human research has linked memory enhancements to acute stress responses, usually from psychological stressors such as public speaking. Other studies have also tied specific hormonal and norepinephrine releases in rodent brains to better memory. Interestingly, the current study found that exercise participants had increased saliva measures of alpha amylase, a marker of central norepinephrine.

“Even without doing expensive fMRI scans, our results give us an idea of what areas of the brain might be supporting these exercise-induced memory benefits,” said Audrey Duarte, an associate professor in the School of Psychology. “The findings are encouraging because they are consistent with rodent literature that pinpoints exactly the parts of the brain that play a role in stress-induced memory benefits caused by exercise.”

Cholesterol Drugs Haunted By Ghosts Of Past, Present, And Future

I really wish people would work on understanding cause and effect. Cholesterol does not cause atherosclerosis, heart disease or stroke. Cholesterol is grabbed by the inflammation on the arterial walls and packed into the plaque. Solve the correct problem you f*cking idiots.
Stop the inflammation!
The drug companies won't solve the real problem because their profits are generated by not understanding the situation.


http://www.forbes.com/sites/larryhusten/2014/10/02/cholesterol-drugs-haunted-by-ghosts-of-past-present-and-future/?partner=yahootix


You can see a video of how plaque forms here:
Inflammation In Atherosclerotic Plaque Formation

Stroke victims recover use of weakened limbs by exercising unaffected limbs, research finds

This is only 2 years old, has any of this been implemented in your rehabilitation center? Or 120 years from the original discovery. Is that enough time for even the most ossified doctor to find and use?
http://blogs.vancouversun.com/2012/12/10/stroke-victims-recover-use-of-weakened-limbs-by-exercising-unaffected-limbs-research-finds/

Stroke victims can make astonishing gains in strength in weakened limbs by training the unaffected limbs on the other side of their body, according to new research by the University of Victoria.
Neuroscientist Paul Zehr and PhD candidate Katie Dragert designed “ridiculously simple” devices made of wooden boards and cloth straps that stroke victims used to strengthen the muscles in their legs and ankles. Patients completed a six-week high-intensity training regime — not with the limbs weakened by the stroke, but with the limbs that were less affected or unaffected.
What happened surprised even the researchers.
Patients gained as much strength in the weakened leg as they did in the leg that did the exercises. Patients achieved strength gains of about 30 per cent in both the trained and untrained legs, a far more dramatic effect than previous research on healthy people had achieved.
The finding promises to be a boon to patients whose limb strength is so impaired by stroke that they can’t lift or train the affected parts at all.
“Weakness is a big part of what happens after a stroke and if you can do something to increase people’s strength, you can help them get walking and all kinds of stuff,” said Zehr.
Patients in the study suffered their stroke on average about 80 months before training. That suggests patients can benefit from the program years after a debilitating event.
Study participant Barb Oliver suffered from weakness in her left leg after a stroke 10 years ago, but continues to make gains through UVic’s experimental programs.
“I couldn’t walk at all and they didn’t think I would ever walk again,” said Oliver. “Now, I get around with a cane.”
Zehr and Dragert employed a mostly forgotten 1894 discovery by Yale University researchers who found that when people train one arm, the other arm also gained strength.
“The arm that they trained got stronger, but the other arm got stronger, too, even though it wasn’t trained,” Zehr explained. “Over the years people have looked at cross-education of strength on different parts of the body, upper and lower limbs, and it pretty much shows up everywhere to a greater or lesser degree.”
Most of the research found that the untrained limb gains about half as much strength as the trained limb.
“A 30-per-cent gain on the trained side usually results in a 15-per-cent gain on the untrained side,” he said. “We thought that with all the damage caused by the stroke that we might see a five- or 10-per-cent gain in our patients’ untrained limbs.”
But the strength gains recorded in the UVic study of stroke victims were twice as high as the gains achieved by healthy people in past studies.
Much of the training gain in strength and skill that people achieve through exercise takes place in the brain and the nervous system rather than the muscles themselves, Zehr said.
The surprising strength of the cross-education effect suggest the training program may be tapping into communication pathways between the left and right sides of the brain and activating built-in — but little used — duplications in the neural wiring that controls movement, he said.
The study will be published in the journal Experimental Brain Research and has been published by that journal online.

Regular Fish Consumption and Age-Related Brain Gray Matter Loss

I bet this isn't enough to actually get your hospital diet plan changed to include fish.

You wouldn't want to do anything innovative at all. Sad.

Regular Fish Consumption and Age-Related Brain Gray Matter Loss

Cyrus A. Raji, MD, PhD

,

Kirk I. Erickson, PhD

,

Oscar L. Lopez, MD

,

Lewis H. Kuller, MD, DrPH

,

H. Michael Gach, PhD

,

Paul M. Thompson, PhD

,

Mario Riverol, MD, PhD

,

James T. Becker, PhD

Published Online: July 29, 2014

DOI: http://dx.doi.org/10.1016/j.amepre.2014.05.037

• Abstract
• Full Text
• Images
• References

Background

Brain health may be affected by modifiable lifestyle factors; consuming fish and antioxidative omega-3 fatty acids may reduce brain structural abnormality risk.

Purpose

To determine whether dietary fish consumption is related to brain structural integrity among cognitively normal elders.

Methods

Data were analyzed from 260 cognitively normal individuals from the Cardiovascular Health Study with information on fish consumption from the National Cancer Institute Food Frequency Questionnaire and brain magnetic resonance imaging (MRI). The relationship between fish consumption data collected in 1989–1990 and brain structural MRI obtained in 1998–1999 was assessed using voxel-based morphometry in multiple regression analyses in 2012. Covariates were age, gender, race, education, white matter lesions, MRI-identified infarcts, waist–hip ratio, and physical activity as assessed by the number of city blocks walked in 1 week. Volumetric changes were further modeled with omega-3 fatty acid estimates to better understand the mechanistic link between fish consumption, brain health, and Alzheimer disease.

Results

Weekly consumption of baked or broiled fish was positively associated with gray matter volumes in the hippocampus, precuneus, posterior cingulate, and orbital frontal cortex even after adjusting for covariates. These results did not change when including omega-3 fatty acid estimates in the analysis.

Conclusions

Dietary consumption of baked or broiled fish is related to larger gray matter volumes independent of omega-3 fatty acid content. These findings suggest that a confluence of lifestyle factors influence brain health, adding to the growing body of evidence that prevention strategies for late-life brain health need to begin decades earlier.

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

Have your doctor get some of these. If I had a defined exercise for my upper arm I would have spent hours rehabbing it. Like a stroke protocol. You should be able to ask for a success rating for each stroke protocol you are given. This is not rocket science.
http://nnr.sagepub.com/content/early/2014/09/29/1545968314550368?papetoc

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.

CI therapy is beneficial to patients which chronic low-functioning hemiparesis after stroke

I remember a PT friend who worked at the hospital I was at telling me about constraint induced therapy. Considering I had very limited arm movement and zero use of the hand I replied they would never do that to me.  I'm not sure how you get any use at all without hand movement.
But I'm willing to be convinced otherwise.
http://journal.frontiersin.org/Journal/10.3389/fneur.2014.00204/abstract

Annette Sterr^1*, darragh o'neill², Philip Dean¹ and Katherine Herron³

• ¹Psychology, University of Surrey, United Kingdom
• ²School of Life and Medical Sciences, University of Surrey, United Kingdom
• ³Pain Management Center, National Hospital For Neurology and Neurosurgery, United Kingdom

CI therapy is effective in patients with relatively good levels of residual arm function but its applicability to patients with low functioning hemiparesis is not entirely clear. In the present study we examined the feasibility and efficacy of the CI therapy concept in patients with very limited upper arm function prior to treatment, and further tested how the length of daily shaping training and constraining the good arm affects treatment outcome. In a baseline-controlled design, 65 chronic patients were treated with 2 weeks of modified CI therapy. Patients were randomly allocated to four treatment groups receiving 90 or 180 minutes of daily shaping training applied with or without constraint respectively. Outcome was measured through the Reliable Change Index, which was calculated for parameters of motor function, health and psychological wellbeing. Follow-up data were collected at 6 and 12 months. Two analyses were conducted, a whole-group analysis across all 65 participants and a subgroup analysis contrasting the four treatment variants. The whole-group analysis showed a significant treatment effect, which was largely sustained after one year. The subgroup analysis revealed a mixed picture: while improvements against the baseline period were observed in all four subgroups, 180 minutes of daily shaping training coupled with the constraint yielded better outcome on the MAL but not the WMFT, while for 90 minutes of training the level of improvement was similar for those who wore the constraint and those who did not. Together these results suggest that, at least in those patients available for follow up measures, modified CI therapy induces sustained improvements in motor function in patients with chronic low-functioning hemiparesis. The absence of clear differences between the four treatment variants points to a complex relationship between the length of daily shaping training and the constraint in this patient group which is likely to be mediated by fatigue and

Keywords: motor rehabilitation, Arm, constraint, motor practice, motor activity log, Wolf motor function test, Frenchay arm test, modified CI therapy
Citation: Sterr A, o'neill d, Dean P and Herron K (2014). CI therapy is beneficial to patients which chronic low-functioning hemiparesis after stroke. Front. Neurol. 5:204. doi: 10.3389/fneur.2014.00204
Received: 25 Jun 2014; Accepted: 27 Sep 2014.

Edited by:
Ashfaq Shuaib, University of Alberta, Canada

Reviewed by:
Ru-Lan Hsieh, Shin Kong Wu Ho-Su Memorial Hospital, Taiwan
Roshini Prakash, University of California, Los Angeles, USA  

Copyright: © 2014 Sterr, o'neill, Dean and Herron. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Prof. Annette Sterr, University of Surrey, Psychology, Guildford, United Kingdom, a.sterr@surrey.ac.uk

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Risk of stroke among patients with rhinosinusitis: A population-based study in Taiwan

Is your doctor treating sinusitis as one of your risk factors?
http://www.ingentaconnect.com/content/ocean/ajra/2012/00000026/00000004/art00008

Authors: Wu, Chin-Wen; Chao, Pin-Zhir; Hao, Wen-Rui; Liou, Tsan-Hon; Lin, Hui-Wen

Source: American Journal of Rhinology & Allergy, Volume 26, Number 4, July/August 2012, pp. 278-282(5)
Publisher: OceanSide Publications, Inc

$49.50 plus tax (Refund Policy)

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Abstract:

Background:

Research has found evidence that chronic inflammation may promote atherosclerotic disease. The purpose of this study was to test the hypothesis that rhinosinusitis is a risk factor for stroke.

Methods:

This prospective cohort study comprised patients recorded on the Taiwan Longitudinal Health Insurance Database 2005 (LHID2005) who had received a diagnosis of rhinosinusitis (n = 53,653) between January 1, 2004 and December 31, 2005. A control group (1:4) drawn from the same database was matched for age and gender (n = 214,624). Each patient was followed up using data entered until the end of 2006. Cox proportional hazard regressions were performed to evaluate the hazard ratios (HRs) after adjusting for potential confounding factors.

Results:

We found that patients with rhinosinusitis were more likely to suffer strokes than the control population, after adjusting for potential confounders (adjusted HR, 1.39; 95% confidence interval [CI], 1.28∼1.50). The HR of stroke was 1.39 (95% CI, 1.28∼1.51) for acute sinusitis patients, and 1.34 (95% CI, 1.04∼1.74) for chronic sinusitis patients.

Conclusion:

Both acute and chronic sinusitis are risk factors or markers for stroke that is independent of traditional stroke risk factors. Further research in this important area of epidemiology is warranted.

Neuroticism and Long-Time Stress Linked to Alzheimer's in Women

You will need to make sure your doctor  stops the stress in your life like your chances of  PTSD following stroke or TIA of 23%. And the stress of your doctor having no clue how to get you to 100% recovery.


http://news.yahoo.com/neuroticism-long-time-stress-linked-alzheimers-women-201745693.html 

Women who feel anxious, moody and distressed for significant amounts of time during middle age may be at an increased risk of developing Alzheimer's disease later in life, a new study suggests.

In the study, researchers followed 800 women over 38 years. At the study's start, their  average age was 46. The researchers assessed the women's levels of distress and neuroticism, which is a personality trait that psychologists describe as the tendency to feel negative emotions when you are threatened or frustrated. The researchers also examined the women's memory abilities, and looked at how extroverted or introverted they were.

During the study, 153 women developed some type of dementia, including 104 who developed Alzheimer's disease. The researchers found that the women with the highest levels of neuroticism who also experienced long-standing distress were twice as likely to develop Alzheimer's disease as the women with the lowest levels of neuroticism.

This is badly written, no way of even finding out where the study was published.

More at link.

Mind expanding: 7 ways to fine-tune your brain

I'm sure your doctor will not be training you in this to increase your cognitive abilities post-stroke. But demand your doctor do something like this, you should easily be able to become smarter than her/him. At least regarding your stroke.
http://www.newscientist.com/special/mind-guide?

10 Surprising Signs of Stroke Risk

Damned generic crap. But read at your leisure.
http://blogs.naturalnews.com/10-surprising-signs-stroke-risk/

Migraines

Hispanic Ethnic Origin

Regular Consumption of Processed Meats

Sedentary Lifestyle

Diabetes

African Ethnic Origin

Overuse of Alcohol

Anemia

Obesity

Poor Diet

Memory Loss Associated with Alzheimer’s Reversed for First Time

Send your damned doctor to get the study protocols. Even if it is anecdotal you might want to have your doctor try it on your stroke memory loss. What is the downside?
http://neurosciencenews.com/alzheimers-memory-loss-reversal-1377/
The study is the first to suggest that memory loss in patients may be reversed, and improvement sustained, using a complex, 36-point therapeutic program that involves comprehensive changes in diet, brain stimulation, exercise, optimization of sleep, specific pharmaceuticals and vitamins, and multiple additional steps that affect brain chemistry.

More at link.