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.

Monday, October 12, 2026

A 30-day plank plan to build a stronger core

 What is your objective measurement of core strength? Oh, Your doctor doesn't have one, right?

PURE INCOMPETENCE! 
And surely without any measurement there is no exercise protocol to build one correctly either, right? 

Because my doctor was a complete failure at curing my hand spasticity; didn't even try, I can only do forearm ones and still not very good. Pictures and videos at link.

A 30-day plank plan to build a stronger core

Medically reviewed by Amy Kwan, PT

  • Why this matters: The plank plan can improve core strength and posture, essential for overall fitness and health.
  • What you can do: Start the 30-day plank plan to progressively strengthen your core.
  • The payoff: Consistently practicing planks can increase your core stability, improve posture, and support long-term fitness.

Want to build your core endurance? This 30-day plan combines plank holds with moving variations, gradually increasing your time and rounds while including scheduled rest days.

What to Expect From This 30-Day Plank Plan

This 30-day plan gradually builds your core strength and endurance by increasing how long you hold a plank and introducing different plank variations. You’ll start with 30-second intervals and work your way up to one-minute holds, with some days combining multiple exercises into a single workout.

The plan includes scheduled rest days to give your muscles time to recover. You can also shorten intervals or modify exercises to match your fitness level. Focus on maintaining good form rather than holding a plank for longer than you comfortably can.

To track your progress, record how long you can hold a plank with good form on Day 1. After completing the plan, repeat the same plank variation to see whether your endurance has improved. Allow extra recovery time before retesting if needed.

30-Day Plank Plan Schedule

Days 1–6

  • Day 1: Hold a plank for as long as you can maintain good form. Record your time.
  • Day 2: Hold a plank for 30 seconds, then do rocking planks for 30 seconds.
  • Day 3: Hold a plank for 30 seconds, then do plank hip dips for 30 seconds.
  • Day 4: Hold a plank for 30 seconds, then do plank up-downs for 30 seconds.
  • Day 5: Complete one circuit: plank, rocking planks, plank hip dips, and plank up-downs for 30 seconds each.
  • Day 6: Rest.

Days 7–11

  • Day 7: Hold a plank for 30 seconds, then do rocking planks for 30 seconds. Complete two rounds.
  • Day 8: Hold a plank for 30 seconds, then do plank hip dips for 30 seconds. Complete two rounds.
  • Day 9: Hold a plank for 30 seconds, then do plank up-downs for 30 seconds. Complete two rounds.
  • Day 10: Complete two rounds of this circuit: plank, rocking planks, plank hip dips, and plank up-downs for 30 seconds each.
  • Day 11: Rest.

Days 12–16

  • Day 12: Hold a plank for 45 seconds, then do rocking planks for 45 seconds.
  • Day 13: Hold a plank for 45 seconds, then do plank hip dips for 45 seconds.
  • Day 14: Hold a plank for 45 seconds, then do plank up-downs for 45 seconds.
  • Day 15: Complete one circuit: plank, rocking planks, plank hip dips, and plank up-downs for 45 seconds each.
  • Day 16: Rest.

Days 17–21

  • Day 17: Hold a plank for 45 seconds, then do rocking planks for 45 seconds. Complete two rounds.
  • Day 18: Hold a plank for 45 seconds, then do plank hip dips for 45 seconds. Complete two rounds.
  • Day 19: Hold a plank for 45 seconds, then do plank up-downs for 45 seconds. Complete two rounds.
  • Day 20: Complete two rounds of this circuit: plank, rocking planks, plank hip dips, and plank up-downs for 45 seconds each.
  • Day 21: Rest.

Days 22–26

  • Day 22: Hold a plank for one minute, then do rocking planks for one minute.
  • Day 23: Hold a plank for one minute, then do plank hip dips for one minute.
  • Day 24: Hold a plank for one minute, then do plank up-downs for one minute.
  • Day 25: Complete one circuit: plank, rocking planks, plank hip dips, and plank up-downs for one minute each.
  • Day 26: Rest.

Days 27–30

  • Day 27: Hold a plank for one minute, then do rocking planks for one minute. Complete two rounds.
  • Day 28: Hold a plank for one minute, then do plank hip dips for one minute. Complete two rounds.
  • Day 29: Hold a plank for one minute, then do plank up-downs for one minute. Complete two rounds.
  • Day 30: Complete four one-minute plank holds, resting 60 seconds between holds. After your final hold, rest as needed, then do plank jacks for one minute.

Optional Day 31 progress check: Repeat your Day 1 plank using the same variation. Record how long you can hold it with good form and compare your times. If you still feel fatigued from Day 30, save this check for after you’ve recovered.

How to Use the Plank Schedule

  • Plank choice: Choose a straight-arm or forearm plank and stick with it through the whole plan. For the moving exercises, repeat the movement for the listed time.
  • Two-move workouts: Rest 10–30 seconds between exercises.
  • Four-move circuits: Move from one exercise to the next without a planned break, but pause if you need to reset your form.
  • Multiple rounds: Complete the full sequence once to finish one round. Rest 60 seconds before starting the next.
  • Time targets: Shorten an interval or use an easier variation if you cannot maintain control. Keep breathing throughout each exercise.

How To Do the Plank Exercises

Straight-arm Plank

Credit: Rozalynn S. Frazier

The straight-arm plank gives you a foundation for this plan: supporting your body on your hands and toes while keeping your middle steady. You’ll also use this position to start plank up-downs.

How to do it:

  1. Start on all fours with your wrists under your shoulders.
  2. Step your feet back one at a time until your legs are extended.
  3. Hold this position for the planned interval.
  4. Lower your knees to the floor to finish.

Focus on: Keep your hips in line with your shoulders and heels.

Make it easier: Place your hands on a sturdy countertop instead of the floor.

Make it harder: Bring your feet closer together to narrow your base of support.

Forearm Plank

Credit: Rozalynn S. Frazier

The forearm plank is another option for the plan’s timed holds. It also sets you up for rocking planks, hip dips, and plank jacks.

  1. Lie on your stomach with your forearms on the floor and elbows under your shoulders.
  2. Tuck your toes under.
  3. Lift your torso and hips off the floor.
  4. Hold this position for the planned interval.
  5. Lower your body to the floor with control.

Focus on: Keep your lower back from sagging as you hold.

Make it easier: Keep your knees on the floor, with your body aligned from your head to your knees.

Make it harder: Bring your feet closer together while keeping your hips steady.

Rocking Plank

Rocking planks add a small forward-and-back movement to your hold. The challenge is to keep your trunk steady as your weight shifts.

  1. Start in a forearm plank with your elbows under your shoulders.
  2. Shift your body forward a few inches over your toes.
  3. Push back through your toes to move your body slightly behind the starting position.
  4. Continue rocking forward and back for the planned interval.
  5. Lower your knees to the floor to finish.

Focus on: Move your shoulders and hips together as one unit.

Make it easier: Use a smaller rocking motion.

Make it harder: Pause briefly at the forward position before rocking back.

Plank Hip Dips

Hip dips introduce controlled rotation to the plan. You’ll practice moving your pelvis from side to side while supporting your upper body on your forearms.

  1. Start in a forearm plank.
  2. Rotate your pelvis to lower your right hip toward the floor.
  3. Return to the center plank position.
  4. Rotate your pelvis to lower your left hip toward the floor.
  5. Continue alternating sides, returning to center between dips.

Focus on: Control each dip instead of dropping your hip toward the floor.

Make it easier: Reduce how far you lower your hips.

Make it harder: Pause just above the floor on each side without resting your hip.

Plank Up-Downs

Plank up-downs challenge you to keep your trunk steady while changing your arm support. They add upper-body work as you move between forearm and straight-arm planks.

  1. Start in a straight-arm plank with your feet slightly wider than hip-width apart.
  2. Lower onto your right forearm, followed by your left.
  3. Plant your right palm beneath your shoulder.
  4. Press up onto your right hand, then your left, returning to a straight-arm plank.
  5. Repeat the sequence, switching which arm leads each time.

Focus on: Keep your hips from swaying side to side.

Make it easier: Perform the movement with your knees on the floor.

Make it harder: Bring your feet closer together while keeping your pelvis steady.

Plank Jacks

Plank jacks add a jumping movement to the final workout. Your goal is to keep your trunk steady while your feet move apart and together.

  1. Start in a forearm plank with your feet close together.
  2. Hop both feet out wider than hip-width apart.
  3. Hop your feet back to the starting position.
  4. Continue hopping out and in for the planned interval.
  5. Lower your knees to the floor to finish.

Focus on: Keep your hips at a steady height as your feet move.

Related video: Start mat Pilates at home! Simple beginner moves for core strength (Natasa Boucher)

Make it easier: Step one foot out at a time, then step each foot back in.

Make it harder: Gradually increase your pace while keeping your landings controlled.

After the Plan

Keep using your favorite plank variations as part of your regular strength workouts. Choose a hold and a moving variation, using a duration you can complete with control. Progress by extending your time or trying a harder variation—one change at a time.

Read the original article on Health

Microvascular Measure Gives Clues to Poor Response to Successful Thrombectomy

 You've known of 100% recovery failure after thrombectomy for a long long time! WHEN ARE YOU GOING TO DO SOMETHING ABOUT THAT?

Or just sit with your heads up your asses? That doesn't help.

Microvascular Measure Gives Clues to Poor Response to Successful Thrombectomy

Capillary bed perfusion could point to a treatment target, proof-of-concept study suggests

Microvascular hemodynamics might provide an early marker of poor recovery despite successful large-vessel thrombectomy in acute ischemic stroke, an imaging study suggested.

Poor capillary bed perfusion as indicated by relative transit time heterogeneity around the infarct on immediate post-thrombectomy perfusion MRI predicted substantial infarct progression (≥10 mL, OR 1.4 per 10% increase, 95% CI 1.0-2.0, P=0.04), with a stronger association than seen for baseline infarct volume (OR 1.1 per 1 mL, 95% CI 1.0-1.2).The microvascular measure also outperformed baseline stroke severity as an independent predictor of poor 90-day functional outcome, defined as a modified Rankin Scale score over 2 (OR 1.4 per 10% increase, 95% CI 1.0-1.9, P=0.03, vs OR 1.2 per 1-point increase on the NIH Stroke Scale, 95% CI 1.0-1.2).

In contrast, conventional post-thrombectomy perfusion parameters, such as cerebral blood flow and volume and time to maximum residue function, failed to predict outcomes, "demonstrating their insensitivity to microvascular dysfunction," reported Yannan Yu, MD, of the University of California San Francisco, at the American Society of Functional Neuroradiology meeting in Newport Beach, California.

Despite acute stroke treatment advances, "still a significant portion of the stroke patients have a bad outcome even though they have successful thrombectomy and have reperfusion of the tissue," Yu said.

While no reflow in these cases isn't well understood, animal models have shown that microvascular hemodynamic failure is one mechanism, she noted.

"In routine practice, what people get [for imaging] is maybe 24 to 48 hours after the stroke treatment, and when you evaluate no-reflow on that time point, a lot of things may have already happened," she said. "They may have late recanalization, they may have early reocclusion. ... But in this immediate post-thrombectomy MRI, we're hoping that this MRI will reflect the truth of what happened immediately after we recanalize the vessel."

The researchers aren't proposing that centers switch from their routinely done diffusion MRI to the perfusion MRI as done in this study. Rather, the findings serve as proof of concept that the microvasculature can be measured and matters in this setting.

It's one of the pieces of the puzzle to sort out what's happening to these no-reflow patients to move toward finding better treatment for them, Yu said.

"Currently our limitation is that this is a pretty small sample size. There's not a lot of analysis we can do with such a small sample size," she said. "A larger cohort will be important to validate the scientific factuality of the findings. And then after that, if we're able to validate that, I think then it could potentially become a treatment target."

The study included 47 acute ischemic stroke patients (mean 72 years, 62% women) treated for anterior circulation large vessel occlusion from 2015 through 2020 who had complete or near-complete brain tissue reperfusion (modified Thrombolysis in Cerebral Infarction score ≥2c) after thrombectomy. Participants needed to have had diffusion-weighted imaging (DWI) and dynamic susceptibility contrast perfusion MRI both pre-treatment and within 2 hours after thrombectomy as well as 24-48 hour follow-up DWI.

Among them, 43% (20 of 47) had substantial infarct progression, and the same proportion had poor functional outcomes.

Relative capillary transit time heterogeneity was calculated as the ratio of the standard deviation of mean transit time to the mean transit time of red blood cells across a capillary bed.

Allied’s Wilkes-Barre rehab hospital treats neuro patients with new 3-in-1 machine

 With no mention of 100% recovery this is still a failure! WHEN THE HELL do we get survivor needs worked on? Survivors in charge would only focus on 100% recovery protocols.  I'd fire anyone doing prediction, biomarkers, prognostication or 'assessments'. None of them do a damn thing getting survivors recovered! All they do is turn on anxiety and depression!

Allied’s Wilkes-Barre rehab hospital treats neuro patients with new 3-in-1 machine


Pediatric therapist Sarah Prebich helps her patient Liam in the Rise&Walk.
Submitted by Allied Services
Pediatric therapist Sarah Prebich helps her patient Liam in the Rise&Walk.

Allied Services has been marking “Rehab Week” for a half century – longer, even, than the nation itself.

What started as a company-wide picnic for staff, patients, residents and families in 1976 became the inspiration for an annual September commemoration, now known as National Rehabilitation Awareness Week.

This year, Allied marked Rehab Week as it was approaching another milestone: More than 30,000 steps taken by patients on its new machine, the Rise&Walk rehabilitation station, at Allied Services Wilkes-Barre Rehab Hospital.

“Rehab week just allows us to highlight the dedicated people that we have here day in and day out, helping patients achieve their goals and their milestones," said Jennifer Lutkowski, the director of rehabilitation at the hospital.

"Whether it's just something small, like a basic activity of daily living, or climbing 24 steps, or getting back into a big rig, that is just an opportunity for all of us to just highlight each other and get recognition for something that we all do here 24/7,” Lutkowski said.

Lackawanna County-based Allied provides rehabilitation, skilled nursing, behavioral health, 

Pediatric therapist Sarah Prebich helps her patient Liam in the Rise&Walk.
Submitted by Allied Services
Pediatric therapist Sarah Prebich helps her patient Liam in the Rise&Walk.

Allied Services has been marking “Rehab Week” for a half century – longer, even, than the nation itself.

What started as a company-wide picnic for staff, patients, residents and families in 1976 became the inspiration for an annual September commemoration, now known as National Rehabilitation Awareness Week.

This year, Allied marked Rehab Week as it was approaching another milestone: More than 30,000 steps taken by patients on its new machine, the Rise&Walk rehabilitation station, at Allied Services Wilkes-Barre Rehab Hospital.

“Rehab week just allows us to highlight the dedicated people that we have here day in and day out, helping patients achieve their goals and their milestones," said Jennifer Lutkowski, the director of rehabilitation at the hospital.

"Whether it's just something small, like a basic activity of daily living, or climbing 24 steps, or getting back into a big rig, that is just an opportunity for all of us to just highlight each other and get recognition for something that we all do here 24/7,” Lutkowski said.

Lackawanna County-based Allied provides rehabilitation, skilled nursing, behavioral health, home care services and more.

Rise&Walk

The Rise&Walk, developed by Healing Innovations is a 3-in-1 neurorehabilitative piece of equipment that Allied started using towards the end of this summer. The machine features seated, supported standing and walking modes.

“When patients do suffer a neurological event, sometimes the connections between the brain and the body are affected, and your body has to find other ways to readjust and to get those pathways working again,” Lutkowski said. “If you think about it like a roadblock, you have to find different detours, different avenues, so your body is able to do that through a repetitive motion or repetitive movement.”

About 17 patients have used the machine so far, taking about 33,000 steps in total. The machine helps therapists to target parts of the body that need to build back strength.

“They actually have sensors in the footplates now, so people know how much they weigh. Especially if you have somebody with a stroke, oftentimes the weakness is all down one side of their body, so they might put all their weight onto their strong side, or all their weight might be falling onto the weak side,” said Ashlynn Fitzgerald, a physical therapist at Allied’s Wilkes-Barre Rehab Hospital.

The Rise&Walk provides 10 different levels of assistance based on a patient’s ability and can offer a challenge to patients that need less assistance. There’s also arm bars that allow patients to move as if on an elliptical workout machine. And, it can go in reverse. Allied purchased a pediatric component to the machine so it can adjust for younger patients.

“Pretty much every person that we have put on here, when they come off of the machine, if their gait speed or their walking speed isn't improving, the quality of their walking is at least improving in some aspect,” Fitzgerald said.

“We get some people who can't move a leg on their own or they can't stand up on their own, and then they're coming off this machine and they're standing more upright. They're moving their walkers themselves. They're moving their legs themselves again. We're seeing a lot of that kind of translation, they get off the machine and then things are rebooted and working a little better,” she continued.

Importance of tech in physical therapy 

The physical therapists notice hesitation in some of their neuro patients during rehab. The Rise&Walk provides a sense of security with the harness that alternate physical therapy methods might not.

From left, Allied physical therapists Rosa Bartoletti, Sarah Prebich, Ashlynn Fitzgerald and Jennifer Lutkowski, director of rehabilitation use the Rise&Walk on some of their patients.
Submitted by Allied
From left, Allied physical therapists Rosa Bartoletti, Sarah Prebich, Ashlynn Fitzgerald and Jennifer Lutkowski, director of rehabilitation use the Rise&Walk on some of their patients.

“We want to get them walking as early and as often as we can. Sometimes the extent of a neurological injury can prevent us from getting them walking over ground and really getting repetition. Having a safe environment to get a ton of repetitions that someone may not have the opportunity to get over ground really pushes people,” Fitzgerald said.

Allied therapists appreciate having the technology to supplement their work, adding that they don’t believe there are any other similar machines operating yet in the region.

“There's a lot of research out there now in the therapy world that high-intensity gait, which is that quick-moving continuously, has shown to have a lot of great results … That's a big component of this piece of equipment. I think it really has been kind of a driving force behind us getting it and the importance of having newer pieces of technology that focus on those types of things,” Lutkowski said.

Fitzgerald and her fellow physical therapists see patients get faster results, and a confidence boost, when they use the Rise&Walk.

“It's indescribable, honestly, how well it worked. We're always looking for new tools in the toolbox and as clinicians we even have our limits. When you're physically having to help somebody move, and you go maybe 30 feet, and then you watch them come out of this machine, and you don't have to move their legs anymore, and they're going 50 feet or more. Like the first time it happened, I had chills, honestly, because I did not believe it at first. It means a lot to be able to provide new opportunities for these patients,” she said.

The Rise&Walk by Healing Innovations is a 3-in-1 rehab machine.
Submitted by Allied Services
The Rise&Walk by Healing Innovations is a 3-in-1 rehab machine.
ABOUT NATIONAL REHABILITATION AWARENESS WEEK

● In 1976, Allied Services organized what would become Rehabilitation Week as a company-wide picnic for staff, patients, residents and families.

● Through continued advocacy by Allied Services leadership and the formation of the National Rehabilitation Awareness Foundation, the movement gained broader recognition.

● President Bill Clinton in 1993 issued a presidential proclamation that would designate the third week in September each year as National Rehabilitation Week.

● In 1996, Allied Services acted as the national sponsor of Rehab Week when it coincided with the Paralympic Games in Atlanta.

Sources: Allied Services, staff research

Rise&Walk

The Rise&Walk, developed by Healing Innovations is a 3-in-1 neurorehabilitative piece of equipment that Allied started using towards the end of this summer. The machine features seated, supported standing and walking modes.

“When patients do suffer a neurological event, sometimes the connections between the brain and the body are affected, and your body has to find other ways to readjust and to get those pathways working again,” Lutkowski said. “If you think about it like a roadblock, you have to find different detours, different avenues, so your body is able to do that through a repetitive motion or repetitive movement.”

About 17 patients have used the machine so far, taking about 33,000 steps in total. The machine helps therapists to target parts of the body that need to build back strength.

“They actually have sensors in the footplates now, so people know how much they weigh. Especially if you have somebody with a stroke, oftentimes the weakness is all down one side of their body, so they might put all their weight onto their strong side, or all their weight might be falling onto the weak side,” said Ashlynn Fitzgerald, a physical therapist at Allied’s Wilkes-Barre Rehab Hospital.

The Rise&Walk provides 10 different levels of assistance based on a patient’s ability and can offer a challenge to patients that need less assistance. There’s also arm bars that allow patients to move as if on an elliptical workout machine. And, it can go in reverse. Allied purchased a pediatric component to the machine so it can adjust for younger patients.

“Pretty much every person that we have put on here, when they come off of the machine, if their gait speed or their walking speed isn't improving, the quality of their walking is at least improving in some aspect,” Fitzgerald said.

“We get some people who can't move a leg on their own or they can't stand up on their own, and then they're coming off this machine and they're standing more upright. They're moving their walkers themselves. They're moving their legs themselves again. We're seeing a lot of that kind of translation, they get off the machine and then things are rebooted and working a little better,” she continued.

Importance of tech in physical therapy 

The physical therapists notice hesitation in some of their neuro patients during rehab. The Rise&Walk provides a sense of security with the harness that alternate physical therapy methods might not.

From left, Allied physical therapists Rosa Bartoletti, Sarah Prebich, Ashlynn Fitzgerald and Jennifer Lutkowski, director of rehabilitation use the Rise&Walk on some of their patients.
Submitted by Allied
From left, Allied physical therapists Rosa Bartoletti, Sarah Prebich, Ashlynn Fitzgerald and Jennifer Lutkowski, director of rehabilitation use the Rise&Walk on some of their patients.

“We want to get them walking as early and as often as we can. Sometimes the extent of a neurological injury can prevent us from getting them walking over ground and really getting repetition. Having a safe environment to get a ton of repetitions that someone may not have the opportunity to get over ground really pushes people,” Fitzgerald said.

Allied therapists appreciate having the technology to supplement their work, adding that they don’t believe there are any other similar machines operating yet in the region.

“There's a lot of research out there now in the therapy world that high-intensity gait, which is that quick-moving continuously, has shown to have a lot of great results … That's a big component of this piece of equipment. I think it really has been kind of a driving force behind us getting it and the importance of having newer pieces of technology that focus on those types of things,” Lutkowski said.

Fitzgerald and her fellow physical therapists see patients get faster results, and a confidence boost, when they use the Rise&Walk.

“It's indescribable, honestly, how well it worked. We're always looking for new tools in the toolbox and as clinicians we even have our limits. When you're physically having to help somebody move, and you go maybe 30 feet, and then you watch them come out of this machine, and you don't have to move their legs anymore, and they're going 50 feet or more. Like the first time it happened, I had chills, honestly, because I did not believe it at first. It means a lot to be able to provide new opportunities for these patients,” she said.

The Rise&Walk by Healing Innovations is a 3-in-1 rehab machine.
Submitted by Allied Services
The Rise&Walk by Healing Innovations is a 3-in-1 rehab machine.
ABOUT NATIONAL REHABILITATION AWARENESS WEEK

● In 1976, Allied Services organized what would become Rehabilitation Week as a company-wide picnic for staff, patients, residents and families.

● Through continued advocacy by Allied Services leadership and the formation of the National Rehabilitation Awareness Foundation, the movement gained broader recognition.

● President Bill Clinton in 1993 issued a presidential proclamation that would designate the third week in September each year as National Rehabilitation Week.

● In 1996, Allied Services acted as the national sponsor of Rehab Week when it coincided with the Paralympic Games in Atlanta.

Sources: Allied Services, staff research