Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, October 16, 2014

In-Hospital Stroke Patients Wait Longer for Care

Once again we have doctors/researchers that don't keep up with published research. This was written up in May, 2013.

In-hospital strokes get worse care than those presenting to ER, study finds

Pretty much the same study in Canada

In-Hospital Stroke Patients Wait Longer for Care

Up to 17% of strokes occur in patients already hospitalized, but a new Canadian study shows that they wait longer for neuroimaging and thrombolysis than those who have a stroke at home and are brought to the emergency department (ED).
Doctors in hospitals should keep stroke on their radar in the same way that they do for a heart attack, lead study researcher, Alexandra Saltman, MD, resident, core internal medicine, University Health Network, University of Toronto, Ontario, Canada, told Medscape Medical News. "They should keep an open mind that some subtle symptoms may represent stroke, and if they're worried, they should act on it quickly."
Dr Saltman presented the study at the Canadian Stroke Congress in Vancouver, British Columbia.
"Shocking Difference"
For the study the investigators gathered data from charts for all adults with stroke at 11 regional stroke centers in Ontario, Canada, from 2003 to 2012. This included 1048 patients who were admitted to the hospital with another condition and had a stroke while there, and 32,227 who were brought to the hospital after sustaining a stroke. Most hospitalized patients were admitted for medical reasons (30%) or surgery other than cardiac (30%).
The mean age for the entire cohort was 73 years.
To compare "in hospital" and "community-onset" strokes, the authors used the Heart and Stroke Foundation's Canadian stroke best practice recommendations and the American Heart Association (AHA) best practice guidelines for stroke care.
The study results showed that in-hospital patients waited an average of 4.5 hours from the time symptoms were recognized to undergo computed tomography compared with 1.3 hours for patients brought to the ED.
"To me that's a shocking difference," said Dr Saltman.
About 29% of in-hospital stroke patients met the "benchmark" best practice of getting thrombolysis within 90 minutes of symptom onset compared with 72% of patients coming from the community, said Dr Saltman.
In addition, the in-hospital group was less likely to receive thrombolysis (12%) than the group admitted after having a stroke outside the hospital (19%), even if they were eligible for this intervention, she added.
In-hospital patients stayed longer in the hospital (17 days vs 8 days), were more likely to be discharged to a rehabilitation facility (40% vs 32%), and were less likely to be sent home (35% vs 44%).
Although the "in-hospital" patients had more vascular risk factors and comorbidities than the "in-community" group, researchers adjusted for these factors. "We accounted for age, sex, all the vascular comorbidities, stroke severity, and type of stroke, and even when we account for those factors, the in-hospital patients still did worse," said Dr Saltman.

Another page at the link.

The Adult Brain Makes New Neurons, and Effortful Learning Keeps Them Alive

You will need to DEMAND your doctor comes up with a protocol that will keep those new neurons alive. This is the minimum your doctor needs to do for you.
http://cdp.sagepub.com/content/23/5/311.abstract?
  1. Tracey J. Shors
  1. Behavioral and Systems Neuroscience, Department of Psychology, and W. M. Keck Center for Collaborative Neuroscience, Rutgers University
  1. Tracey J. Shors, Behavioral and Systems Neuroscience, Department of Psychology, Rutgers University, 152 Frelinghuysen Rd., Piscataway, NJ 08854-8020 E-mail: shors@rutgers.edu

Abstract

The brain continues to produce new neurons throughout life. For instance, the hippocampus (a brain region necessary for select learning processes) produces thousands of new neurons each day. However, a significant number of them die and do so within just a few weeks of their birth. Laboratory animals that are trained to learn a new skill between one and two weeks after the new cells are generated retain most cells that would have otherwise died. The types of skills that keep new cells alive are not limited to those that depend on the hippocampus but rather include those that are effortful to learn, requiring more training trials or time spent training. Importantly, training alone is not sufficient to increase cell survival; animals that are trained but do not learn do not retain more cells than animals that are not trained. Therefore, learning increases the survival of newly generated cells in the hippocampus as long as the learning experience is new, effortful, and successful. Once rescued, the vast majority of these cells differentiate into neurons, thereby forming synapses and generating action potentials as they become incorporated into the existing architecture and functional circuitry of the adult brain.

Wednesday, October 15, 2014

Drug helps old brains learn new tricks, and heal

Currently only in mice.
http://scopeblog.stanford.edu/2014/10/15/drug-helps-old-brains-learn-new-tricks-and-heal/
If a version of the decoy protein could work in people, then kids born with cataracts in countries with limited access to surgery could potentially have their cataracts removed later, receive a drug, and be able to see. Similarly, the window could be briefly opened to help people recover from stroke or other conditions. - See more at: http://scopeblog.stanford.edu/2014/10/15/drug-helps-old-brains-learn-new-tricks-and-heal/#sthash.WNVoI7gv.dpuf
 If a version of the decoy protein could work in people, then kids born with cataracts in countries with limited access to surgery could potentially have their cataracts removed later, receive a drug, and be able to see. Similarly, the window could be briefly opened to help people recover from stroke or other conditions.

More at link
If a version of the decoy protein could work in people, then kids born with cataracts in countries with limited access to surgery could potentially have their cataracts removed later, receive a drug, and be able to see. Similarly, the window could be briefly opened to help people recover from stroke or other conditions. - See more at: http://scopeblog.stanford.edu/2014/10/15/drug-helps-old-brains-learn-new-tricks-and-heal/#sthash.WNVoI7gv.dpuf

The ROI of mobile stroke units

These people pushing this are f*cking idiots if they don't see that these mobile stroke units will soon become obsolete. The Qualcomm Tricorder X Prize will make this totally obsolete. And with tPA having a 88% failure rate, it seems doubly stupid to go down this route. Does absolutely no one read any current news on stroke at all? This may be the best they can do for now but it seems they are determined to have a failed short term project. I really don't care how famous these hospitals are, they still are stupid.
http://www.healthcarefinancenews.com/news/roi-mobile-stroke-units
In stroke care, swift treatment is key to preventing death and disability, and health systems looking to get ahead on incentives for population health might consider new investing .
The Cleveland Clinic and University of Texas Health are using the nation’s first mobile stroke units to treat stroke patients sooner, and both show promise in preserving patients’ quality of life and saving a great deal of money for the U.S. healthcare system.
Currently, when someone experiencing stroke symptoms makes a 911 call, they are not fully evaluated until they enter the hospital, and if they’re suffering an ischemic stroke, it takes on average 62 minutes for them to receive the clot-busting, brain-saving tPA (tissue plasminogen activator) therapy, said Stephanie Parker, RN, project manager of UTHealth’s Mobile Stroke Unit in Houston.
In other words, that’s a loss of around one hundred and twenty million neurons, since two million die every minute during a stroke.
[See also: Mobile health vans' value proposition.]
In contrast, mobile stroke units can be dispatched to the scene and literally bring the ER to the patient’s driveway. Inside a unit, a portable CT scanner images the patient’s brain, providing immediate results for determination of whether the patient should be treated with tPA.
“We can bring a highly trained team of individuals with no other distractions directly to the scene,” said Peter Rasmussen, MD, director of Cleveland Clinic’s Cerebrovascular Center. And via telemedicine, "[the stroke unit] can bring a world caliber expert, a clinical neurologist, to the home, versus a patient going to the local hospital,” he added.
“The mobile stroke unit provides faster time-to-treatment and also reduces costs,” Rasmussen said. “Most of the cost is in the cost of caring, in rehabilitation. The best way to reduce the cost is to introduce treatment as quickly as possible.”
According to Rasmussen and Parker, mobile stroke units may be able to reduce the need and costs for acute care and improve outcomes to the extent that rehabilitation services become unnecessary or are significantly lessened.
If the Cleveland Clinic and UTHealth show that’s possible, mobile stroke units have the potential to save billions of dollars if they are incorporated into ambulance fleets throughout the country. And Rasmussen indicated that there is interest from many academic and non-academic healthcare centers throughout the United States.
Currently, the mobile stroke unit is undergoing a two-year study at UTHealth, the home of the nation’s first unit. The study aims to ascertain if administering tPA faster improves patient outcomes, and then measure cost effectiveness, Parker said.

Battle Of The Booze: Is Fine Wine Over Good Beer Really A Healthy Choice?

I don't care, I'm doing both. However don't follow me, I've been known to do stupid things. Just was at a Nebbiolo wine party on Sunday, couldn't stay late to overinduldge.
http://www.medicaldaily.com/battle-booze-fine-wine-over-good-beer-really-healthy-choice-307036

Breakthrough Replicates Human Brain Cells for Use in Alzheimer’s Research

Our stroke associations should be able to copy this work and support scientists that can create 'Stroke in a dish'. With that they could see what works to save neurons from the neuronal cascade of death. And listen to signals between neurons so we can find out exactly how damaged neurons can be repaired. Yet I doubt any one will look at this and see how it can be reused for stroke.  We must have complete idiots in charge of stroke strategy. Or worse yet, no strategy at all.
http://www.nytimes.com/2014/10/13/science/researchers-replicate-alzheimers-brain-cells-in-a-petri-dish.html?
For the first time, and to the astonishment of many of their colleagues, researchers created what they call Alzheimer’s in a Dish — a petri dish with human brain cells that develop the telltale structures of Alzheimer’s disease. In doing so, they resolved a longstanding problem of how to study Alzheimer’s and search for drugs to treat it; the best they had until now were mice that developed an imperfect form of the disease.
The key to their success, said the lead researcher, Rudolph E. Tanzi of Massachusetts General Hospital in Boston, was a suggestion by his colleague Doo Yeon Kim to grow human brain cells in a gel, where they formed networks as in an actual brain. They gave the neurons genes for Alzheimer’s disease. Within weeks they saw the hard Brillo-like clumps known as plaques and then the twisted spaghetti-like coils known as tangles — the defining features of Alzheimer’s disease.
The work, which also offers strong support for an old idea about how the disease progresses, was published in Nature on Sunday. Leading researchers said it should have a big effect.

More at link.

Neuro-Acupuncture and Stroke

An excellent deconstruction of why stroke acupuncture doesn't have any research to back it up.
http://www.sciencebasedmedicine.org/neuro-acupuncture-and-stroke/?utm_source=rss&utm_medium=rss&utm_campaign=neuro-acupuncture-and-stroke

Plasma magnesium and risk of ischemic stroke among women

If we had anything approaching a great stroke association all these research trials would be followed up on and reported. Then they would contact all the stroke hospitals with the results and changed protocols. But no, we have nothing like that. So you have to follow up on your own and keep training your own doctor on their job.
http://www.ncbi.nlm.nih.gov/pubmed/25116874

Abstract

BACKGROUND AND PURPOSE:

Lower plasma magnesium levels may be associated with higher blood pressure and endothelial dysfunction, but sparse prospective data are available for stroke.

METHODS:

Among 32 826 participants in the Nurses' Health Study who provided blood samples in 1989 to 1990, incident ischemic strokes were identified and confirmed by medical records through 2006. We conducted a nested case-control analysis of 459 cases, matched 1:1 to controls on age, race/ethnicity, smoking status, date of blood draw, fasting status, menopausal status, and hormone use. We used conditional logistic regression models to estimate the multivariable adjusted association of plasma magnesium and the risk of ischemic stroke and ischemic stroke subtypes.

RESULTS:

Median magnesium levels did not differ between ischemic stroke cases and controls (median, 0.86 mmol/L for both; P=0.14). Conditional on matching factors, women in the lowest magnesium quintile had a relative risk of 1.34 (95% confidence interval, 0.86-2.10; P trend=0.13) for total ischemic stroke compared with women in the highest quintile. Additional adjustment for risk factors and confounders did not substantially alter the risk estimates for total ischemic stroke. Women with magnesium levels <0.82 mmol/L had significantly greater risk of total ischemic stroke (multivariable relative risk, 1.57; 95% confidence interval, 1.09-2.27; P=0.01) and thrombotic stroke (multivariable relative risk, 1.66; 95% confidence interval, 1.03-2.65; P=0.03) compared with women with magnesium levels ≥0.82 mmol/L. No significant effect modification was observed by age, body mass index, hypertension, or diabetes mellitus.

CONCLUSIONS:

Lower plasma magnesium levels may contribute to higher risk of ischemic stroke among women.


Anti-inflammatory drugs and risk of Alzheimer's disease: An updated systematic review and meta-analysis

I guess we still know nothing definite about this. Don't start NSAID use based on this.
http://www.mdlinx.com/internal-medicine/newsl-article.cfm/5566342/ZZF307965849E94474BB34FC062CEC0F93/?
In the past 20 years, substantial evidence from laboratory and epidemiologic studies has suggested that anti–inflammatory medications could defer or prevent the occurrence of Alzheimer's disease (AD). However, several studies do not corroborate these findings. In this systematic review and meta–analysis, researchers evaluated the association between anti–inflammatory drug use and the incidence of AD. They concluded that while observational studies support the use of NSAIDs for prevention of AD, a randomized controlled trial (RCT) did not. They argue that well–designed studies and innovative approaches are required to illuminate the exact relationship between NSAID use and AD risk, as well as the appropriate dosage and duration of use to maximize benefit and safety.
Methods
  • Pubmed, Embase, and Cochrane Library databases were searched up to March 2014.
  • Studies evaluating the association between use of anti–inflammatory drugs and AD risk were included.
  • Relative risks (RRs) with 95% confidence intervals (CIs) were meta–analyzed using random effects models, and were grouped by anti–inflammatory type and duration of drug use.
Results
  • In observational studies, use of non–steroidal anti–inflammatory drugs (NSAIDs) was significantly associated with a reduced risk of AD (RR, 0.72; 95% CI, 0.62–0.84) compared to no use of NSAIDs, especially in long–term users (RR, 0.36; 95% CI, 0.17–0.74); the risks of AD were also lower in both aspirin (RR, 0.77; 95% CI, 0.63–0.95) and non–aspirin NSAID users (RR, 0.65; 95% CI, 0.47–0.88) compared with nonusers; whereas the use of corticosteroids showed no significant association (RR, 0.62; 95% CI, 0.26–1.46).
  • In the single RCT, NSAID use showed no significant effect on AD risk among dementia–free individuals (P<0.05).

Tuesday, October 14, 2014

'Like Being Buried Alive': Woman Recalls Experience Of Being Awake But Unable To Move For Weeks

Our stroke doctors really need to be remedially trained in bedside manners. You never discuss negative items anywhere within earshot of your patients.  Kates' blog here;
Stroke Recovery Tips - Kate Allatt

http://www.opposingviews.com/i/health/being-buried-alive-woman-recalls-experience-being-awake-unable-move-weeks
In 2010, Australian woman Kate Allatt was placed in a coma after she suffered a stroke. She regained consciousness after 10 days under, but her problems were far from over. As she lay conscious in her bed, it quickly became apparent to her that she was completely unable to communicate. Her mind had woken up, it seemed, but her body had not. This condition, which Allatt compares to being buried alive, is called Locked In Syndrome.
“Locked in syndrome is like being buried alive,” Allatt tells MailOnline. “You can think, you can feel, you can hear, but you can communicate absolutely nothing.”
Two weeks later, thanks to what Allatt says was a relentless inner drive to regain control of her body, Allatt regained consciousness. She says the conversations she overheard during her transitive state were truly the stuff of nightmares.
“It was so scary,” she says. “I can’t tell you. The fear, the anxiety, the terror… They thought I was in a vegetative state. I couldn’t move a muscle. There was no signal I was in there. I was on life support and they might have turned it off. I couldn’t breathe for myself but I could hear conversations that I didn’t want to hear.”
Now, four years later, Allatt has made a full recovery from both her stroke and the ensuing terrifying experience. She now spends her days raising awareness on the need for more medical training to handle situations like the one she was in. She notes that it was friends, not doctors, who were initially able to recognize signs of consciousness in her.
“Doctors are meant to do the Glasgow Coma Scale Test, which checks consciousness. Did they do that enough?” she asks. “Were there enough scans to check for brain activity? I feel so strongly that people who are minimally conscious, like I was, need to be assessed properly. We need a nurse trained in ICU who can, when someone is minimally conscious, sit with them two or three times a week. To establish communication if possible. To try and calm the patient and alleviate their fears.”
Allatt says people in her life have told her to move on from the experience, but she’s not willing to do that yet. She feels that, in her words, she needs to “beat the drum” for those who can’t do it for themselves.
“I need to talk about it because that’s how you learn to make improvements,” she says. “For the people who can't do it themselves - I need to beat the drum for them.”
- See more at: http://www.opposingviews.com/i/health/being-buried-alive-woman-recalls-experience-being-awake-unable-move-weeks#sthash.TwobnXvx.dpuf
 In 2010, Australian woman Kate Allatt was placed in a coma after she suffered a stroke. She regained consciousness after 10 days under, but her problems were far from over. As she lay conscious in her bed, it quickly became apparent to her that she was completely unable to communicate. Her mind had woken up, it seemed, but her body had not. This condition, which Allatt compares to being buried alive, is called Locked In Syndrome.

“Locked in syndrome is like being buried alive,” Allatt tells MailOnline. “You can think, you can feel, you can hear, but you can communicate absolutely nothing.”

Two weeks later, thanks to what Allatt says was a relentless inner drive to regain control of her body, Allatt regained consciousness. She says the conversations she overheard during her transitive state were truly the stuff of nightmares.

“It was so scary,” she says. “I can’t tell you. The fear, the anxiety, the terror… They thought I was in a vegetative state. I couldn’t move a muscle. There was no signal I was in there. I was on life support and they might have turned it off. I couldn’t breathe for myself but I could hear conversations that I didn’t want to hear.”

Now, four years later, Allatt has made a full recovery from both her stroke and the ensuing terrifying experience. She now spends her days raising awareness on the need for more medical training to handle situations like the one she was in. She notes that it was friends, not doctors, who were initially able to recognize signs of consciousness in her.

“Doctors are meant to do the Glasgow Coma Scale Test, which checks consciousness. Did they do that enough?” she asks. “Were there enough scans to check for brain activity? I feel so strongly that people who are minimally conscious, like I was, need to be assessed properly. We need a nurse trained in ICU who can, when someone is minimally conscious, sit with them two or three times a week. To establish communication if possible. To try and calm the patient and alleviate their fears.”

Allatt says people in her life have told her to move on from the experience, but she’s not willing to do that yet. She feels that, in her words, she needs to “beat the drum” for those who can’t do it for themselves.

“I need to talk about it because that’s how you learn to make improvements,” she says. “For the people who can't do it themselves - I need to beat the drum for them.”
In 2010, Australian woman Kate Allatt was placed in a coma after she suffered a stroke. She regained consciousness after 10 days under, but her problems were far from over. As she lay conscious in her bed, it quickly became apparent to her that she was completely unable to communicate. Her mind had woken up, it seemed, but her body had not. This condition, which Allatt compares to being buried alive, is called Locked In Syndrome.
“Locked in syndrome is like being buried alive,” Allatt tells MailOnline. “You can think, you can feel, you can hear, but you can communicate absolutely nothing.”
Two weeks later, thanks to what Allatt says was a relentless inner drive to regain control of her body, Allatt regained consciousness. She says the conversations she overheard during her transitive state were truly the stuff of nightmares.
“It was so scary,” she says. “I can’t tell you. The fear, the anxiety, the terror… They thought I was in a vegetative state. I couldn’t move a muscle. There was no signal I was in there. I was on life support and they might have turned it off. I couldn’t breathe for myself but I could hear conversations that I didn’t want to hear.”
Now, four years later, Allatt has made a full recovery from both her stroke and the ensuing terrifying experience. She now spends her days raising awareness on the need for more medical training to handle situations like the one she was in. She notes that it was friends, not doctors, who were initially able to recognize signs of consciousness in her.
“Doctors are meant to do the Glasgow Coma Scale Test, which checks consciousness. Did they do that enough?” she asks. “Were there enough scans to check for brain activity? I feel so strongly that people who are minimally conscious, like I was, need to be assessed properly. We need a nurse trained in ICU who can, when someone is minimally conscious, sit with them two or three times a week. To establish communication if possible. To try and calm the patient and alleviate their fears.”
Allatt says people in her life have told her to move on from the experience, but she’s not willing to do that yet. She feels that, in her words, she needs to “beat the drum” for those who can’t do it for themselves.
“I need to talk about it because that’s how you learn to make improvements,” she says. “For the people who can't do it themselves - I need to beat the drum for them.”
- See more at: http://www.opposingviews.com/i/health/being-buried-alive-woman-recalls-experience-being-awake-unable-move-weeks#sthash.TwobnXvx.dpuf

Exercise Can Improve Memory in People Over 60

What exact stroke exercise protocol is your doctor prescribing to prevent your memory problems? ANYTHING AT ALL?
Or are you on your own like everything else in stroke rehab?
http://www.biosciencetechnology.com/news/2014/10/exercise-can-improve-memory-people-over-60?
A new study, in which researchers from Karolinska Institutet participated, shows that physical activity can improve memory performance in older people through increasing volume and blood flow in an area of the brain called hippocampus. It is the first time these connections are being studied in people over 60 years of age. The results are published in the journal Molecular Psychiatry.
The hippocampus is a brain structure located deep in the temporal lobe and is important for memory and learning. Previous research shows that aerobic exercise can, among other things, increase blood flow in hippocampus among younger people. The present study, which was led by a research team from Magdeburg in Germany, is the first that also links these changes to improved memory functioning.
During a three month period, the researchers studied a group of individuals, aged 60 and older, who exercised during a personalized thirty-minute session on a treadmill three times a week. In the comparison group, participants performed stretching and muscle relaxation exercises. In both groups, measurements were taken of episodic memory (memory for personal experiences), volume and blood flow in hippocampus, and participants' physical fitness as measured by maximal oxygen uptake.
“We could then see that participants' fitness level had improved, which was related to changes in memory, hippocampal volume, and blood flow in hippocampus,” said Lars Bäckman, professor of cognitive neuroscience at Karolinska Institutet and affiliated to the Aging Research Center in Stockholm.
Increased blood flow
The researchers tested various models to explore the relationships among the findings. It was revealed that the increase in hippocampal volume in those participants who underwent the exercise program can largely be explained by increased blood flow. According to the researchers, it is probably due to an increase in vascular plasticity, i.e., the ability to expand and form new blood vessels, rather than to the formation of more neurons in hippocampus after physical activity.
“Thus, one point is that it may be the increase in blood volume and oxygenation that underlies improved memory, rather than an increase in the size of hippocampus itself,” said Martin Lövdén, professor in the cognitive neuroscience of aging at Karolinska Institutet and also working at the Aging Research Center.
Younger elderly persons
The findings in this study apply to persons between 60 and 70 years, thus younger elderly persons. Among participants over 70, the same effects of the exercise were not observed, which suggests there may be an age limit for this type of plasticity in the brain. The team will now continue with its work and study if it is possible to combine physical exercise with cognitive training in order to achieve even higher plasticity among older persons.

What is a Stroke? - Dr. Paul Knoepflmacher Diplomate of the American Board of Internal Medicine

Shit, they don't tell you the following.

If you just had a stroke, You are F*cking screwed


The prevention ideas are so generic as to be useless. Here are my ideas on stroke prevention: Never, ever follow me.
Like my 11 Stroke risk reduction ideas.


What is a Stroke? - Dr. Paul Knoepflmacher Diplomate of the American Board of Internal Medicine
3.5 minutes and absolutely nothing new presented and pretty much totally worthless. But then I'm stroke-addled and my opinion of most stroke medical personnel is pretty damn low.

A Johns Hopkins Scientist is Using Virtual Dolphins to Rehab Stroke Patients [Video]

Will your doctor ever try anything newer than medical school?

I don't know I still like stomping roaches to get some aggression out.

A Johns Hopkins Scientist is Using Virtual Dolphins to Rehab Stroke Patients [Video]


"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," Johns Hopkins University neuroscientist John Krakauer said when delivering his presentation "Motor Recovery After Stroke in Mice and Men" at a brain science research seminar. The rehabilitation therapies we use nowadays are medieval, he continued on to say, making it loud and clear that now, "it's time for a revolution."
The 47-year-old, whose medical career is nothing to be scoffed at, is ready to accept the challenge of redefining the world of physical therapy, too, with the creation of a new kind of healer equipped with a set of fins.
Krakauer, who studies movement and human obsession with movement, worked with Johns Hopkins software architects Omar Ahmad and Promit Roy as well as Baltimore artist Kat McNally to develop the video game "I Am Dolphin," which he believes could have applications in therapy, especially for stroke victims.
An accomplished neuroscientist, Krakauer first joined Johns Hopkins in 2010 to set up a center for stroke recovery research, including the BLAM lab (an acronym which stands for brain, learning, animation and movement), which explains why he would want to create a more effective post-stroke rehabilitation solution. His advanced knowledge of the disease that afflicts nearly 800,000 people across the United States each year and understanding of the economic burden associated with stroke victims (just about $37 billion in care a year) makes him the man best fit for the job.
That paired with his appreciation for "the beauty and braininess" of movement is what led Krakauer to create a simulated dolphin named Bandit for healing purposes.
Bandit is based on three real bottlenose dolphins housed in the National Aquarium that were studied for hundreds of hours and then transformed into digital form. According to National Geographic, the simple movement of a stroke patient's arm in a robotic sling will alter the movement of the virtual dolphin on the screen, allowing Bandit to swim, catch fish and then swallow its dinner just like a real dolphin in the wild.
The player feels as if they're one with the dolphin, Omar Ahmad, director of the Kata Project behind "I Am Dolphin," explained to National Geographic. "It's visceral feedback; every subtle movement you do is reflected in the dolphin," he said. Fair warning: it's addictive, too.
As for how an aquatic video game could help with brain healing, Krakauer says an injured brain from a stroke can reconfigure itself, but only during a sensitive post-stroke period window that lasts one to three months. (He may be smart but he's totally wrong here) So in the clinical trials with Bandit, the game will be used during that critical time of plasticity when the brain is actually capable of self-repair. And if successful in helping stroke patients recover lost motor function faster than traditional therapy used today, Krakauer's dream of revolutionizing conventional physical therapy practices could very well become a reality.
This isn't the first time video games has been used in rehab. In fact, another member of the Johns Hopkins community, Ph.D. student Xiaoxu Kang, launched her own startup Rehabtics in October 2012 that uses virtual technology to make the physical therapy experience more fun.
Rehabtics' new software program called ArmSPOT leverages gaming technology to better engage patients and make them more interested in their rehab exercises. Motion cameras transform patients into avatars onto their computer screens, allowing them to do their physical therapy routines in a relaxing atmosphere, like on the beaches of St. Lucia or in a jungle safari.
So perhaps there is promise for "I Am Dolphin." Try it out for yourself by purchasing the game released through iTunes October 9 for $2.99.

Damage to Brain ‘Hubs’ Causes Extensive Impairment

How is your doctor proposing to repair these problems if they occur? Anything at all? Or just throw the hands up in the air and repeat the f*ckingly stupid mantra, 'All strokes are different, all stroke recoveries are different'. Or in other words, 'I know jackshit about this'.
http://www.biosciencetechnology.com/news/2014/10/damage-brain-%E2%80%98hubs%E2%80%99-causes-extensive-impairment?
Injuries to six brain areas are much more devastating to patients’ abilities to think and adapt to everyday challenges than damage to other parts of the brain, scientists at Washington University School of Medicine in St. Louis have learned.
 
Brain mapping highlighted the regions, which are “hubs” where multiple brain networks come together. The networks make it possible for parts of the brain to work with each other to complete cognitive tasks.
 
The findings offer a new perspective on how injury impairs brain function. This may help better predict the effects of strokes, trauma and other brain damage and one day could lead to reassessment of the risks of some brain surgeries. 
 
“This isn’t ready for application in the clinic yet, but as we get a better feel for where these and other hubs are found in the brain, they may factor into surgical decision-making,” said co-senior author Steven Petersen, the James S. McDonnell Professor of Cognitive Neuroscience in Neurology. “The risks of surgeries to these sites could include significant impairment of attention, memory, language, speech and many other cognitive functions.”
 
Petersen noted that some psychological disorders, such as schizophrenia, disrupt a similarly broad range of brain functions. He speculated that problems with the sites highlighted by the new study may contribute to these conditions. 
 
The findings are available online from the Proceedings of the National Academy of Sciences.
 
Petersen and his colleagues at Washington University School of Medicine identified the sites by mapping brain networks, which make it possible for parts of the brain to work with each other to complete cognitive tasks. 
 
Their maps highlighted hubs, regions where the boundaries of multiple networks come together in one spot. Scientists had not previously identified the regions as areas that made important contributions to brain function.
 
“We wondered, though, if the hubs were sites where all the different networks talk to each other,” Petersen said. “If that’s true, damage in these areas could disrupt several networks, impairing multiple mental functions.”
 
To test their theory, the researchers collaborated with colleagues at the University of Iowa, including Daniel Tranel and David Warren. Tranel heads the Iowa Neurological Patient Registry, a database of patients who suffered strokes and other brain injuries. 
 
In addition to noting the location of damage, the database includes detailed information on behavioral and cognitive effects of the injuries. The information includes findings from tests of memory, speech and reasoning, and assessments of the patients’ abilities to deal with “real-world” problems such as holding a job, getting along with family members and going through daily routines. The latter were measured via questionnaires and reports from patients’ family members.
 
The scientists identified 19 patients with brain injuries centered on one of six hubs. The researchers compared them to 11 patients with similarly sized injuries in one of two areas of the brain far from any hubs.
 
“The patients with injuries to a hub had considerably more impairment,” Petersen said. “For example, 18 of the 19 patients with harm to a hub experienced ‘real-world’ problems, while less than half of the group with injuries far from hubs had such difficulties.” 
 
According to Petersen, the findings may help explain anecdotal reports of patients who suffered relatively small brain injuries yet experienced surprisingly significant disabilities and impairments. 
 
“It would have been very difficult to identify these hubs based solely on studies of patients, because injuries that only affect a hub are relatively rare,” he said. “But our basic research studies led us straight to them, and the information in the Iowa database and the efforts of their researchers allowed us to test our theory.”
 
The researchers are using the database to investigate other potential brain hubs.
 
Source: WUSTL

Do You Take Any of These 11 Dangerous Statins or Cholesterol Drugs?

This may be somewhat alarmist but your doctor should be able to answer all your questions.
http://www.theepochtimes.com/n3/1017971-do-you-take-any-of-these-11-dangerous-statins-or-cholesterol-drugs/
details at link.
  1. Advicor (lovastatin with niacin) – Abbott
  2. Altoprev (lovastatin) – Shionogi Pharma
  3. Caduet [atorvastatin with amlodipine (Norvasc)] – Pfizer
  4. Crestor (rosuvastatin) - AstraZeneca
  5. Lescol (fluvastatin) – Novartis
  6. Lipitor (atorvastatin) - Pfizer
  7. Mevacor (lovastatin) – Merck
  8. Pravachol (pravastatin) – Bristol-Myers Squibb
  9. Vytorin (ezetimibe/simvastatin) – Merck/Schering-Plough
  10. Simcor (niacin / imvastatin) – Abbott
  11. Zocor (simvastatin) – Merck

How sleep acts as a cleaning system for the brain

Does your doctor know anything about how important sleep is to your recovery?  
Like these six:
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 
Like maybe you need a stroke protocol for sleep?

How sleep acts as a cleaning system for the brain


Here’s one more reason why getting a good night’s sleep is critical to your health. As neuroscientist Jeff Iliff, PhD, explains in this just released TEDMED video, the brain has a specialized waste-disposal system that’s only active when we’re slumbering. Watch the talk above to learn how this system clears the brain of toxic metabolic byproducts that could lead to Alzheimer’s disease and other neurological disorders. - See more at: http://scopeblog.stanford.edu/2014/10/13/how-sleep-acts-as-a-cleaning-system-for-the-brain/#sthash.gwysCek5.dpuf
 Here’s one more reason why getting a good night’s sleep is critical to your health. As neuroscientist Jeff Iliff, PhD, explains in this just released TEDMED video, the brain has a specialized waste-disposal system that’s only active when we’re slumbering. Watch the talk above to learn how this system clears the brain of toxic metabolic byproducts that could lead to Alzheimer’s disease and other neurological disorders. - See more at: http://scopeblog.stanford.edu/2014/10/13/how-sleep-acts-as-a-cleaning-system-for-the-brain/#sthash.gwysCek5.dpu
Here’s one more reason why getting a good night’s sleep is critical to your health. As neuroscientist Jeff Iliff, PhD, explains in this just released TEDMED video, the brain has a specialized waste-disposal system that’s only active when we’re slumbering. Watch the talk above to learn how this system clears the brain of toxic metabolic byproducts that could lead to Alzheimer’s disease and other neurological disorders. - See more at: http://scopeblog.stanford.edu/2014/10/13/how-sleep-acts-as-a-cleaning-system-for-the-brain/#sthash.gwysCek5.dpuf

Stroke Rounds: Light Therapy Flopped in Acute Stroke

This is why negative results are rarely published. We need a stroke association to follow up on all stroke research and report on them. But they won't, it is too much like work.
http://www.medpagetoday.com/Cardiology/Strokes/48074?
Details of the failed pivotal NEST 3 trial outline just how little impact transcranial laser therapy had on ischemic stroke.
The rate of good functional outcome at 90 days came out similar with application of the near-infrared frequency laser soon after stroke compared with a sham treatment (49.6% versus 49.3% modified Rankin Scale 0 to 2), Werner Hacke, MD, PhD, of Ruprecht-Karl University of Heidelberg, Germany, and colleagues found.
The adjusted odds ratio was 1.024 after inclusion of all 630 randomized patients (95% confidence interval 0.705-1.488), the group reported in the November issue of Stroke.
"We conclude that transcranial laser therapy does not have a measurable neuroprotective effect in patients with acute ischemic stroke when applied within 24 hours after stroke onset," they concluded.
The initial phase II results had looked promising, but the phase IIb trial, dubbed NEST-2, failed.
The NEST 3 trial was stopped in October 2012 after the interim analysis suggested futility.
MedPage Today reported dim prospects for release of the trial data earlier this year, as all financial support for the trial was immediately withdrawn and the company dissolved after the futility determination.
"Proper termination of the trial was difficult but was finally achieved through special efforts by former employees of PhotoThera, the clinical research organization Parexel, and members of the steering and the safety committees," Hacke's group explained.
NEST 3 had been intended to randomize 1,000 patients with acute ischemic stroke not treated with thrombolytic therapy to either active or sham transcranial laser treatment within 24 hours after stroke onset.
There are near-infrared light therapy devices FDA approved for musculoskeletal pain indications, although in these indications these may simply act as a heat source.
The technology has also been investigated for use in traumatic brain injury, Alzheimer's disease, Parkinson's disease, and some other neurological conditions.

Sexuality Within Stroke Rehabilitation

A research thesis. Have at it.
Why you should be doing it;

Frequent orgasms may protect against heart attacks

Sexual activity counteracts the suppressive effects of chronic stress on adult hippocampal neurogenesis and recognition memory

The joy of sex: new guidelines for heart attack and stroke victims

Or maybe the bad side.

Ischaemic stroke provoked by sexual intercourse

 

 

 

[PDF] SEXUALITY WITHIN STROKE REHABILITATION

Section A is a broad review of the literature relating to post-stroke sexuality and how this
has been addressed to date within stroke rehabilitation. Initially a contextual overview is
given followed by a review of the literature concerning the impact of a stroke on sexuality.
Following this the literature relating to how sexuality has been approached within stroke
rehabilitation and available interventions are reviewed. The review concludes with
recommendations for future research.
Section B presents a grounded theory of the process by which healthcare professionals
within stroke rehabilitation engage with the sexual concerns of their patients. A conceptual
model is outlined. Ten healthcare professionals (HCPs) working within stroke rehabilitation
were interviewed. The differing ways in which HCPs engage with patients in relation to
sexual issues is presented. A process is suggested by which HCPs personal level of comfort
around sexuality interacts with a series of personal, societal and organisation barriers to
limit the action they choose to take. The findings are presented in relation to existing
evidence and policy, and the implications for clinical interventions for patients and staff are
discussed, alongside directions for future research.
Section C contains the appendices of the first two sections.

Warfarin use and fracture risk: an evidence-based mechanistic insight

Something for your doctor to maybe warn you about.
http://link.springer.com/article/10.1007/s00198-014-2912-1
This is an excerpt from the content
Dear Editor,
There is a long-standing debate on the association between use of warfarin, prescribed to millions of people to decrease their risk of clotting, and fracture risk [1]. In a large population-based cohort in the UK, Misra and colleagues [2] found that warfarin use was not linked to an increase in fracture risk. Here, we would like to present an evidence-based, reasonable insight into the mechanisms by which this drug affects bone strength.
Osteocalcin, the most abundant non-collagenous protein in bone, is incorporated into bone through vitamin K-dependent γ-carboxylation. Warfarin, a vitamin K antagonist, decreases osteocalcin content in bone and impairs bone material hardness in rats [3], which is consistent with data in mice that osteocalcin deficiency causes a decrease in bone tissue hardness [4]. Consistently, in older patients undergoing chronic therapy with oral vitamin K antagonists [5], undercarboxylated osteocalcin levels in blood were inversely related to cortical ul ...

Disputed theory on Parkinson's origin strengthened

I wish we had some good news on stroke at least once a year.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=146158&CultureCode=en
Parkinson's disease may start in the gut
Parkinson's disease is strongly linked to the degeneration of the brain’s movement center. In the last decade, the question of where the disease begins has led researchers to a different part of the human anatomy. In 2003, the German neuropathologist Heiko Braak presented a theory suggesting that the disease begins in the gut and spreads to the brain. The idea has since, despite vocal critics, gained a lot of ground. Researchers at Lund University in Sweden now present the first direct evidence that the disease can actually migrate from the gut to the brain.
The so-called Braak’s hypothesis proposes that the disease process begins in the digestive tract and in the brain's center of smell. The theory is supported by the fact that symptoms associated with digestion and smell occur very early on in the disease.
Researchers at Lund University have previously mapped the spread of Parkinson’s in the brain. The disease progression is believed to be driven by a misfolded protein that clumps together and "infects" neighboring cells. Professor Jia-Yi Li's research team has now been able to track this process further, from the gut to the brain in rat models. The experiment shows how the toxic protein, alpha-synuclein, is transported from one cell to another before ultimately reaching the brain’s movement center, giving rise to the characteristic movement disorders in Parkinson’s disease.
“We have now been able to prove that the disease process actually can travel from the peripheral nervous system to the central nervous system, in this case from the wall of the gut to the brain. In the longer term, this may give us new therapeutic targets to try to slow or stop the disease at an earlier stage”, says Professor Jia-Yi Li, research group leader for Neural Plasticity and Repair at Lund University.
The research team will now carry out further studies in which the mechanisms behind the transport of the harmful protein will be examined in detail. The current study suggests that the protein is transferred during nerve cell communication. It is at this point of interaction that the researchers want to intervene in order to put a stop to the further spread of the disease.
http://link.springer.com/article/10.1007/s00401-014-1343-6

Aluminium and its likely contribution to Alzheimer’s disease

I've had people anecdotally tell me that relatives got Alzheimers and they thought Aluminum was the cause. If this is testable then test it.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=146151&CultureCode=en
A world authority on the link between human exposure to aluminium in everyday life and its likely contribution to Alzheimer’s disease, Professor Christopher Exley of Keele University, UK, says in a new report that it may be inevitable that aluminium plays some role in the disease.
He says the human brain is both a target and a sink for aluminium on entry into the body – “the presence of aluminium in the human brain should be a red flag alerting us all to the potential dangers of the aluminium age. We are all accumulating a known neurotoxin in our brain from our conception to our death. Why do we treat this inevitability with almost total complacency?”
Exley, Professor in Bioinorganic Chemistry, Aluminium and Silicon Research Group in The Birchall Centre, Lennard-Jones Laboratories at Keele University, writes in Frontiers in Neurology about the ‘Aluminium Age’ and its role in the ‘contamination’ of humans by aluminium.
He says a burgeoning body burden of aluminium is an inevitable consequence of modern living and this can be thought of as ‘contamination’, as the aluminium in our bodies is of no benefit to us it can only be benign or toxic.
Professor Exley says: “The biological availability of aluminium or the ease with which aluminium reacts with human biochemistry means that aluminium in the body is unlikely to be benign, though it may appear as such due to the inherent robustness of human physiology. The question is raised as to ‘how do you know if you are suffering from chronic aluminium toxicity?’ How do we know that Alzheimer’s disease is not the manifestation of chronic aluminium toxicity in humans?
“At some point in time the accumulation of aluminium in the brain will achieve a toxic threshold and a specific neurone or area of the brain will stop coping with the presence of aluminium and will start reacting to its presence. If the same neurone or brain tissue is also suffering other insults, or another on-going degenerative condition, then the additional response to aluminium will exacerbate these effects. In this way aluminium may cause a particular condition to be more aggressive and perhaps to have an earlier onset - such occurrences have already been shown in Alzheimer’s disease related to environmental and occupational exposure to aluminium.”
Professor Exley argues that the accumulation of aluminium in the brain inevitably leads to it contributing negatively to brain physiology and therefore exacerbating on-going conditions such as Alzheimer’s disease. He suggests that this is a testable hypothesis and offers a non-invasive method of the removal of aluminium from the body and the brain. He says the aluminium hypothesis of Alzheimer’s disease will only be tested if we are able to lower the body and hence brain burden of aluminium and determine if such has any impact upon the incidence, onset or aggressiveness of Alzheimer’s disease.
Professor Exley adds: “There are neither cures nor effective treatments for Alzheimer’s disease. The role of aluminium in Alzheimer’s disease can be prevented by reducing human exposure to aluminium and by removing aluminium from the body by non-invasive means. Why are we choosing to miss out on this opportunity? Surely the time has come to test the aluminium hypothesis of Alzheimer’s disease once and for all?”
The link for the paper is:
http://journal.frontiersin.org/Journal/10.3389/fneur.2014.00212/abstract

Startup Ischemia Care raises $1.9M for stroke detection technology

This seems to be more useful as a way to know how to prevent future strokes than as a fast diagnosis of bleed vs. clot.
http://medcitynews.com/2014/10/startup-ischemia-care-raises-1-9m-stroke-detection-technology/?
image from link;

An illustration of how Ischemia Care's blood test works to detect the origin of strokes.

Romney legacy expands to brain diseases

A great stroke association leader would be contacting this center to get stroke into the list of diseases needing solutions. If you know the Romneys or Brigham and Women's Hospital contact them to get stroke added. I know the ASA, NSA or WSO will not be doing this.
http://news.yahoo.com/romney-legacy-expands-brain-diseases-041714484--politics.html
Boston's Brigham and Women's Hospital on Tuesday will announce the launch of the Ann Romney Center for Neurologic Diseases, a venture funded by the Romneys and their expansive political network that will assemble scores of the world's most accomplished doctors and scientists to collaborate against five neurological diseases that have no cure: multiple sclerosis, Alzheimer's, ALS, Parkinson's and brain tumors. (Stroke has no cure)

More at link

Monday, October 13, 2014

Cost of informal caregiving associated with stroke among the elderly in the United States

This could be reduced substantially if we had a  great stroke association that was working on solving the neuronal cascade of death. Cause and effect would be a wonderful thing for our stroke medical staff and legislators to learn about.
http://www.neurology.org/content/early/2014/10/10/WNL.0000000000000986.short?rss=1
  1. Guijing Wang, PhD
  1. Correspondence to Dr. Joo: hj528176@gmail.com
  1. Neurology 10.1212/WNL.0000000000000986
  1. Also available:
  2. Data Supplement

Abstract

Objectives: We estimated the informal caregiving hours and costs associated with stroke.
Methods: We selected persons aged 65 years and older in 2006 and who were also included in the 2008 follow-up survey from the Health and Retirement Study. We adapted the case-control study design by using self-reported occurrence of an initial stroke event during 2006 and 2008 to classify persons into the stroke (case) and the nonstroke (control) groups. We compared informal caregiving hours between case and control groups in 2006 (prestroke period for case group) and in 2008 (poststroke period for case group) and estimated incremental informal caregiving hours attributable to stroke by applying a difference-in-differences technique to propensity score–matched populations. We used a replacement approach to estimate the economic value of informal caregiving.
Results: The weekly incremental informal caregiving hours attributable to stroke were 8.5 hours per patient. The economic value of informal caregiving per stroke survivor was $8,211 per year, of which $4,356 (53%) was attributable to stroke. At the national level, the annual economic burden of informal caregiving associated with stroke among elderly was estimated at $14.2 billion in 2008.
Conclusions: Recent changes in public health and social support policies recognize the economic burden of informal caregiving. Our estimates reinforce the high economic burden of stroke in the United States and provide up-to-date information for policy development and decision-making.

Scientists find new stroke recovery pathway in the brain - Astrocytes

This is all over the news so even your doctor might have read about it.
Take this directly to your doctor and DEMAND to know how they are assisting these researchers in finding out how to make this into a stroke protocol.
 http://www.shinyshiny.tv/2014/10/stroke-recovery-pathway-brain.html

Ceiling Effects Prevent Further Improvement of Transcranial Stimulation in Skilled Musicians

This probably doesn't affect us since we probably are no longer considered skilled in fine motor control. But ask your doctor if tDCS could degrade your skills.
http://www.jneurosci.org/content/34/41/13834.short

http://mindblog.dericbownds.net/2014/10/improvement-of-performance-by.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+Mindblog+%28MindBlog%29
Furuya et al. make the interesting observation that the fine motor hand performance of musically untrained people is improved by transcranial direction current stimulation (tDCS) over the primary motor cortices, but the performance of skilled pianists can be degraded.

The Strange and Radical New World of 3-D Printed Body Parts

This is way out there but why not load up the printer with neural stem cells, put them in a scaffold with arterial stem cells and rebuild dead areas that way? Doesn't anybody have any imagination in the stroke world?
http://www.wired.com/2014/10/3d-printed-body-parts/

U.S. Finds Many Failures in Medicare Health Plans

In case your insurer is practicing medicine by denying benefits.
http://www.nytimes.com/2014/10/13/us/us-finds-many-failures-in-medicare-health-plans-.html?_r=0

A doctor blogger dissecting it here:
http://www.medrants.com/archives/7902

Turmeric compound boosts regeneration of brain stem cells

This is injection not oral so don't start self-prescribing. But ask your doctor to get involved in the research.
https://www.youtube.com/watch?v=4E5aPXpXO00#t=146
Lead author of the study, Adele Rueger, said: “While several substances have been described to promote stem cell proliferation in the brain, fewer drugs additionally promote the differentiation of stem cells into neurons, which constitutes a major goal in regenerative medicine. Our findings on aromatic turmerone take us one step closer to achieving this goal.”
* Aromatic-turmerone induces neural stem cell proliferation in vitro and in vivo Joerg Hucklenbroich, Rebecca Klein, Bernd Neumaier, Rudolf Graf, Gereon Rudolf Fink, Michael Schroeter and Maria Adele Rueger Stem Cell Research & Therapy 2014, 5:100
- http://healthresearchreport.me/2014/0...

Sunday, October 12, 2014

How much does your spasticity weigh?

This is an extremely serious question, go ask you doctor for the calculations. Then ask what to do to cure spasticity. I think mine weighs between 15 and 20 pounds for my arm considering what it takes to even out my shoulders. You may have to repeat that demand for a cure thousands of times but everytime you see him/her ask away. They tell you that repetition works in stroke rehab but never give you an exact number. Is your doctors' number 10 or 10 million?  If YOU don't start telling your doctor that they know nothing about stroke rehab they will never even try to figure out what works. And 50 years from now survivors will be no better off than today.

If you just had a stroke, You are F*cking screwed

I don't want to be able to repeat that exact same blog post every year from now until I die. 

Stalin doing well after stroke but Docs unsure he’ll sing properly again

Well duh, of course the doctors aren't going to know how well he will recover. There is no objective diagnosis and with no objective diagnosis you can't match exercise/protocols to recovery. Objective here means that you know exactly a 3d map of the dead area and a 3d map of the penumbra.
Once more a complete f*cking failure in stroke rehabilitation,
http://www.guardian.co.tt/news/2014-10-11/stalin-doing-well-after-stroke-docs-unsure-he%E2%80%99ll-sing-properly-again

Discovered: How The Brain Repairs Itself After a Stroke

A great writeup. Take this directly to your doctor and DEMAND to know how they are assisting these researchers in finding out how to make this into a stroke protocol.
http://www.spring.org.uk/2014/10/discovered-how-the-brain-repairs-itself-after-a-stroke.php
If YOU don't push this with your doctors it is going to take 50 years before it's usable for survivors.  If we had anything approaching a decent stroke association they would be all over this and dedicate a vast majority of their resources to it. But the boards of directors  don't seem to care about solving all the problems in stroke. Lead or get out of the way.

Don’t let stress control you. This Special Health Report will show you how to control it.

How is your doctor helping you handle the stress of not knowing how to recover from a stroke or when you might recover? Do they have stroke protocols in effect to prevent PTSD following stroke of 23%.
I bet your doctor has nothing and doesn't even know about it.  So read up on this for your edification. Since I'm not medically trained everything I say is not to be trusted.

Discover the proven self-help techniques you can use to lessen stress and bring calm back to your life.
Stress Management
Read More
Dear dean,
Stress constantly creeps into our lives. It can come from the frustration of a traffic jam or a confrontation with a partner. Stress can be spurred by money worries or spiked by a sudden health scare. It can exact a toll upon you — physically, emotionally, and psychologically.
Stress is a fact of life. But you determine how it affects your life. You can counteract the damaging effects of stress by calling upon your body’s rich potential for self-healing.
Stress Management, a Special Health Report from Harvard Medical School, is packed with strategies you can use to rein in the runaway changes unleashed by stress. These proven techniques can help you repel the consuming effects of stress and reclaim and restore inner peace.
The report will show you how to elicit — at will — the relaxation response. This is the simple, calming opposite of the stress response. And it will introduce you to various methods of producing this response — from focused breathing to tai chi and repetitive prayer.
Stress Management will help you explore cognitive restructuring, a strategy to change the way you look at things. You’ll find how to challenge negative thoughts and avoid jumping to conclusions. And, if you’ve heard about the power of visualization and meditation, but don't know where to start, the report will show you.
The report will help you identify the warning signs of stress. It will alert you to the dynamic roles of nutrition and social support. It will give you tips for coping with caregiver stress, work-related stress, and stress from conflict with others. And you’ll find three rewarding mental exercises that boost happiness.
Plus, a special section will show you how to take the sting out of ten common stressors — everything from being late to feeling burned out. You’ll be briefed on relaxation techniques to use when you have only ten minutes — or even just one. You’ll also get suggestions for communicating better, for learning to nurture yourself, and using mindfulness to reduce workday stress.
You can untie the knots of stress. Let this valuable Special Health Report show you how to ease the tension and once again enjoy abiding peace of mind. Order your copy today.
To your good health,
Anthony Komaroff, M.D.
Professor of Medicine, Harvard Medical School
Senior Physician, Brigham and Women's Hospital
Editor in Chief, Harvard Health Publications
Harvard Medical School offers special reports on over 50 health topics.
Visit our website at http://www.health.harvard.edu to find reports of interest to you and your family.
PHONE ORDERS - please call our toll-free number: 1-877-649-9457.
 

Friday, October 10, 2014

Protocol for a randomized controlled clinical trial investigating the effectiveness of Fast muscle Activation and Stepping Training (FAST) for improving balance and mobility in sub-acute stroke

I think this is the first time I've ever seen the word protocol in any stroke research paper.  Your doctor will have to get the full text so ask for it.
http://7thspace.com/headlines/491036/protocol_for_a_randomized_controlled_clinical_trial_investigating_the_effectiveness_of_fast_muscle_activation_and_stepping_training_fast_for_improving_balance_and_mobility_in_sub_acute_stroke.html
Following stroke, many people have difficulty activating their paretic muscles quickly and with sufficient power to regain their balance by taking quick and effective steps. Reduced dynamic balance and mobility following stroke, or `walking balance?, is associated with reduced self-efficacy and restrictions in daily living activities, community integration, and quality of life.

Targeted training of movement speeds required to effectively regain balance has been largely overlooked in post-stroke rehabilitation. The Fast muscle Activation and Stepping Training (FAST) program incorporates fast functional movements known to produce bursts of muscle activation essential for stepping and regaining standing balance effectively.

The purpose of this study is to: 1) compare the effectiveness of an outpatient FAST program to an active control outpatient physiotherapy intervention in improving walking balance following stroke, and 2) explore potential mechanisms associated with improvements in walking balance.Methods/DesignThis will be an assessor-blinded, parallel group randomized controlled trial design. Sixty participants (30 per group) who have sustained a stroke within the previous six months will be randomly assigned with stratification for lower limb motor recovery to receive twelve 45-minute 1:1 physiotherapy intervention sessions over 6 ? 10?weeks in an outpatient setting of either: 1) FAST intervention - systematic and progressive practice of fast squatting and stepping exercises, or 2) active control - conventional physiotherapy directed at improving balance and mobility that includes no targeted fast movement training.

The same blinded research physiotherapist will assess outcomes at three time points: 1) baseline (prior to intervention), 2) follow up (within one week post-intervention); and 3) retention (one month post-intervention). The primary outcome is dynamic balance assessed using the Community Balance and Mobility Scale.

We will also assess fast and self-selected walking speed, balance self-efficacy, and the ability to respond to internal and external perturbations to balance and associated changes in postural muscle activation.DiscussionThe targeted training of fast functional movements in the FAST program is expected to improve walking balance following stroke compared to the active control intervention. Unique to this study is the investigation of potential mechanisms associated with improvements in walking balance.Trial registrationClinicalTrials.gov NCT01573585

Author: Kimberly J MillerMichael A HuntCourtney L PollockDianne BryantS Garland
Credits/Source: BMC Neurology 2014, 14:187

Thursday, October 9, 2014

Cooking Fish This Way Protects Brain From Gray Matter Loss With Age

I bet you will need to go all the way to the hospital president to get meals like this post-stroke.  You better start calling now because if you wait until you are in the hospital it will be too late to get these meals. Come on people - Pay it forward.

Cooking Fish This Way Protects Brain From Gray Matter Loss With Age

Brain regions responsible for cognition were 14% larger in those who ate fish cooked with this method.
Eating both baked and broiled fish once a week protects the brain from loosing gray matter with age, according to new research.
The findings, published in the American Journal of Preventive Medicine, found no link between eating fried fish and better brain health (Raji et al., 2014).
Dr. Cyrus Raji, who led the study, explained:
“Baked or broiled fish contains higher levels of omega-3s than fried fish because the fatty acids are destroyed in the high heat of frying, so we took that into consideration…”
The data came from 260 people who had their brains scanned and who also provided information on what they had been eating.
They were all part of a 10-year study starting in 1989 which was originally designed to reveal the lifestyle factors important in cardiovascular health.

My diet here:

What would a post-stroke diet look like?

What should be your tough it out speech from your doctor

If you don't hear something like this from your doctor s/he is not being truthful with you. Your doctor then really knows nothing about your recovery,

RUN AWAY!

Dear stroke patient,
You are among the lucky ones who survived a stroke. 33% don't survive.  In the next week or so  a whole bunch of neurons(hundreds of millions to billions) will continue dying due to the neuronal cascade of death and your doctor's fucking incompetence in not solving that! 'There is no clinical research for any neuroprotective treatment in the first week' so for right now we can't do anything about that(And yet your doctor won't apologize for that incompetence!). You may notice some additional deficits cropping up. That is  normal because your incompetent? doctor never prevented the neuronal cascade of death in the first week. Your recovery is going to be a massive amount of hard work on your part. Your therapists can suggest and supervise exercises but you have to do all the work. There are no shortcuts, no magic. The amount of your recovery is completely up to you, if you don't put in the work you'll barely get anything back. From now on everything you do will need to be done the hard slow way if you expect the best recovery. It is not impossible, you can read about Pedro Bach-y-rita and his recovery here;

http://oc1dean.blogspot.com/2011/05/brainstem-stroke-recovery.html

We really know nothing about how to cure your spasticity or fatigue or prevent your upcoming dementia.

Sensory Play Ideas for Babies - What about stroke?

What protocol does your doctor have for environment enrichment?

Dale Corbett wrote about this years ago.   Stimulate senses and stroke rehab

And yes I know Jill Bolte-Taylor wanted complete quiet.


Sensory Play Ideas for Babies - What about stroke?


I especially like the ice water one because by adding a bucket of warm water you get the thermal stimulation from here;
Facilitation of Sensory and Motor Recovery by Thermal Intervention for the Hemiplegic Upper Limb in Acute Stroke Patients
Basically 15 seconds warm 30 seconds cool.

Does your doctor know one damn thing about stroke rehab? Mine didn't.