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, September 7, 2026

ENTF Neuromodulation Yields Reduced Disability After Stroke: An Individual Participant-Level Data Meta-Analysis

 Acknowledging A COMPLETE FUCKING FAILURE by not getting to 100% recovery! For that tyranny of low expectations; you're all fired! Even rock star stroke researchers like Steven C. Cramer aren't getting this right!

Let's check how long your doctor and hospital have been incompetent in not having ENTF!

  • ENTF (6 posts to October 2025) Almost a year and those involved should be keel hauled!

ENTF Neuromodulation Yields Reduced Disability After Stroke: An Individual Participant-Level Data Meta-Analysis


Abstract

BACKGROUND:

Electromagnetic network-targeted field (ENTF) brain stimulation therapy is a promising approach to reduce poststroke disability. Two pilot, randomized, sham-controlled trials showed safety and signals of efficacy. The aim of this study was to perform a pooled analysis with greater statistical power to characterize with precision the effect of ENTF in promoting recovery and reducing disability.

METHODS:

We pooled individual patient-level data from 2 double-blind, randomized, sham-controlled studies, BQ3 (BrainQ3 Trial; Unique identifier: NCT04039178) and EMAGINE 1 (Electromagnetic Field Ischemic Stroke-Novel Subacute Treatment Trial; NCT05044507). Key entry criteria in both trials were (1) 4 to 21 days post-ischemic stroke and (2) Fugl-Meyer assessment-upper extremity score of 10 to 45. For EMAGINE 1, an additional criterion was a study entry modified Rankin Scale (mRS) score of 3 to 4. The primary outcome for this pooled analysis was freedom-from-disability (mRS score, 0–1) at 8 to 12 weeks. Secondary outcomes were level of disability (ordinal mRS score distribution), disability change (delta mRS score) change from entry to 8 to 12 weeks, and 2 focused upper extremity motor end points.

RESULTS:

Altogether, 124 patients were included (active n=65; sham n=59). The mean age was 58.2±13.1 years, 31% were female, the study entry Fugl-Meyer assessment-upper extremity score was 25.3 (±10.6), and the therapy started 14.5 (±4.9) days poststroke. The study entry mRS score was 3.9 (±0.36), and 123/124 (99.2%) had a study entry mRS score of 3 to 4. Study entry features were well-balanced across treatment groups. At 8 to 12 weeks, freedom-from-disability was higher with active ENTF than sham stimulation (33.8% versus 11.9%; P=0.005). Ordinal shift across 3 disability strata (mRS score, 0–1, 2, and >2) also favored ENTF (P=0.009). Focused upper extremity motor end points nonsignificantly favored ENTF. Safety analyses showed no device- or procedure-related serious adverse events.

CONCLUSIONS:

In pooled data from 2 randomized, sham-controlled trials, treatment with ENTF compared with sham for patients with subacute ischemic stroke with moderate-severe study entry disability yielded increased(NOT RECOVERY!) achieved freedom-from-disability, greater disability improvement from study entry, and reduced(NOT RECOVERY!)final disability level. These findings, together with an attractive safety profile, support ENTF as a promising therapy for stroke recovery.(Which means you are accepting failure as Ok; survivors don't accept that!)

Graphical Abstract

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Compared With Body Mass Index, Abdominal Fat Better Predicts Cardiovascular Risk

 Is your doctor competent on this?

Your do-it-yourself calculation.

Compared With Body Mass Index, Abdominal Fat Better Predicts Cardiovascular Risk

 Central adiposity is a stronger predictor of adverse cardiovascular outcomes than BMI alone, underscoring the importance of considering the entire BMI spectrum during screening.Compared with body mass index (BMI) alone, increased central adiposity, including among individuals with a BMI in the normal and overweight range, is a better predictor of cardiovascular risk, according to a news release from the American College of Cardiology (ACC). The study, which was published in the Journal of the American College of Cardiology, found that not accounting for waist circumference (WC) or waist-to-hip ratio (WHR) can lead to misclassification of cardiovascular disease (CVD) risk. “Indeed, it appears that WC and WHR reclassify risk defined by traditional BMI thresholds,” said Michael J Blaha, MD, MPH, senior author of the study, in the news release. “We saw individuals with clinically determined normal weight who had elevated central adiposity and high WHR, associating them with higher risk across most outcomes.” Researchers sought to determine if adding WC and WHR to BMI better predicted future cardiovascular risk. The analysis included more than 260,000 individuals over an average time period of 20 years who had WC or WHR data and at least 1 of the 9 following outcomes: Time to first fatal and nonfatal myocardial infarction; Fatal and nonfatal stroke; Heart failure; Atrial fibrillation; Total coronary heart disease (CHD); Total CVD; CHD mortality; CVD mortality; and/or, All-cause mortality.7nbsp;Among participants with “normal” weight based on BMI, 5% had high WC and 18% had high WHR. Of those with overweight, 39% had high WC and 40% had high WHR. Among participants with obesity, 9% had low WC and 45% had low WHR. We encourage clinicians to consider central adiposity distribution across the entire BMI spectrum when evaluating cardiovascular risk in primary prevention settings. Normal weight or overweight and clinically defined high WC or WHR were associated with a 15% to 50% increased risk for most of the 9 outcomes. Individuals with obesity and low WC, compared with those with “normal” weight, did not have a significantly different risk for outcomes, except for all-cause mortality, in which the risk was significantly decreased.  A limitation of this study is that it did not include measures of physical activity, diet, or genetic obesity risk, which have a role in the development of CVD. In addition, only 1 assessment of WC and WHR was included, which may limit understanding of how changes in central fat accumulation over time affect the risk of CVD. “Our findings emphasize the critical role of identifying elevated central adiposity, even in individuals with a normal BMI or with a BMI in the overweight range,” said Zeina A Dardari, PhD, MS, lead author, in the news release. “Relying solely on BMI may result in misclassification of cardiovascular risk across a wide range of cardiovascular outcomes. We encourage clinicians to consider central adiposity distribution across the entire BMI spectrum when evaluating cardiovascular risk in primary prevention settings.”

References:

Abdominal fat predicts heart disease risk better than BMI. News Release. Washington, DC: American College of Cardiology; August 11, 2026. https://www.acc.org/About-ACC/Press-Releases/2026/08/11/14/59/Abdominal-Fat-Predicts-Heart-Disease-Risk-Better-Than-BMI

Vitamin D3 Shows Greater Benefits Than D2 for Muscle and Heart Health: ICMR Study

 Will your competent? doctor ever give you EXACT PROTOCOLS on your supplement use? NO? So, your INCOMPETENT DOCTOR doesn't acknowledge the need or have the ability to do it?

Vitamin D3 Shows Greater Benefits Than D2 for Muscle and Heart Health: ICMR Study

Gut Microbiome Linked to Brain Aging, Study Explores the Connection

 Will your competent? doctor have EXACT PROTOCOLS to ensure this occurs? Nope? INCOMPETENCE PREVAILED!

Gut Microbiome Linked to Brain Aging, Study Explores the Connection

Healthy aging: Training the mind and emotional skills helps keep the brain healthy

 Does your competent? doctor have EXACT PROTOCOLS to restore the cognitive reserve you lost because of your stroke? Doesn't even know of the need? 

PURE INCOMPETENCE!

Healthy aging: Training the mind and emotional skills helps keep the brain healthy



Two studies from SISSA show that cognitive reserve built over a lifetime, together with emotional resources, helps preserve mental abilities in adults over 65

Peer-Reviewed Publication

Scuola Internazionale Superiore di Studi Avanzati, intellectually stimulating work, and an active lifestyle help preserve cognitive abilities in adults over 65, leading to more effective verbal expression and stronger cognitive performance. But there is another important factor: emotions. The way we recognize and interpret them can significantly influence the efficiency of cognitive processes as we age.

These findings emerge from two new studies conducted by the laboratory of Professor Raffaella Rumiati at theScuola Internazionale Superiori di Studi Avanzati (SISSA) in Trieste, Italy, recently published in Neuropsychology and Brain Sciences. The researchers examined how a group of adults over the age of 65 performed on various tasks to identify factors that help preserve cognitive function later in life.

The first authors of the two studies, Elisabetta Pisanu and Stefania Lucia, focused in particular on the role of cognitive reserve—the set of mental resources accumulated throughout life through education, professional experience, and intellectually engaging leisure activities. The first study found that individuals with greater cognitive reserve performed better in language tasks, showing a greater ability to express themselves and retrieve the right words. Positive emotions also contributed to better language performance.

The second study showed that cognitive reserve also plays a key role in supporting working memory—the ability to temporarily retain, process, and use information to complete a task. Emotions also influence these cognitive processes: they not only improve performance, but also shape the way we respond to different stimuli. In particular, higher emotional intelligence, i.e. the ability to recognize, understand, and use emotions to guide thinking, behaviour, and relationships, was found to significantly influence participants' responses to emotional stimuli.

Overall, the findings confirm that an intellectually stimulating life helps preserve cognitive function as we grow older. They also suggest that cognitive and emotional resources do not operate independently but work together to support healthier and more efficient cognitive ageing. Both studies were carried out as part of Age-It: Ageing Well in an Ageing Society, a major Italian research programme investigating the challenges and opportunities associated with population ageing.

Finding the right words: Cognitive reserve and emotions shape language in later life

Cognitive reserve helps preserve language abilities as we age. The study published in Neuropsychology found that older adults with greater cognitive reserve maintained better language performance than their peers.

“Our findings show that older adults with higher cognitive reserve achieve language performance comparable to that of younger adults,” explains Elisabetta Pisanu, first author of the study. “In our experiments, we focused on what happens during the first ten seconds of a verbal fluency task, when people search for the right words to express their thoughts. This brief time window captures the fastest and most automatic processes involved in word retrieval, without the need for the traditional one-minute test. We found that these first ten seconds are already sufficient to reveal the effects of both ageing and cognitive reserve on language performance.”

The researchers observed that a decline in performance is already detectable during these initial moments in adults over 65. However, this decline is greatly reduced, and may even disappear, in individuals with high cognitive reserve. “In other words,” the researchers explain, “cognitive reserve helps keep the brain ‘young’, at least when it comes to language and word retrieval.”

The study also found that not all words are equally easy to retrieve. According to Pisanu: “Older adults retrieve words associated with positive emotions more easily than those linked to negative emotions. These findings suggest that, alongside the protective role of cognitive reserve, the emotional valence of words also contributes to language performance.”

Ageing and working memory: Experience and emotions support cognition in different ways

As we grow older, working memory—the ability to temporarily hold, process, and use information to complete a task—also tends to become less efficient. The study published in Brain Sciences investigated how cognitive reserve and emotional intelligence contribute to working memory, particularly when emotions are relevant to the task at hand.

To address this question, the researchers asked a group of adults over the age of 65 to complete a working memory task in which, depending on the condition, they had to focus either on the emotional expression or on the age of the faces presented to them. “We wanted to understand whether cognitive reserve and emotional intelligence play different roles depending on whether emotions are relevant—or irrelevant—to a working memory task,” explains Stefania Lucia, first author of the study.

The findings showed that cognitive reserve improves performance regardless of the type of task. “Our results indicate that cognitive reserve enhances performance accuracy independently of the experimental condition,” says Lucia. “This suggests that it plays a fundamental role in supporting the ability to maintain and manipulate the information needed to carry out a task.” The role of emotions also emerged clearly. “When the task involves emotional content, older adults perform better: they appear to become more efficient,” Lucia observes. Emotional intelligence, in turn, influences the way people process information and respond to the task.

“It affects how individuals process information and generate a response, ultimately shaping their performance. For example, people with higher emotional intelligence take longer to respond to emotional stimuli, probably because they devote greater attentional and cognitive resources to processing them. This does not reflect greater difficulty, but rather deeper and more thorough processing of emotional information.”

Raffaella Rumiati: Understanding cognitive ageing is a scientific and societal challenge

“Both of these studies were carried out as part of Age-It: Ageing Well in an Ageing Society, an ambitious national research programme that has laid the foundations for a research and data infrastructure dedicated to the study of ageing from multiple perspectives, including socio-economic, biomedical, and technological dimensions,” says Raffaella Rumiati, neuroscientist at SISSA and principal investigator of both studies.

“Italy is one of the world's longest-lived countries, together with Japan. While this is an extraordinary achievement, it also brings new challenges. As the older population continues to grow, so does the demand for healthcare and long-term care services. Understanding how to preserve cognitive abilities for as long as possible is therefore essential—not only to improve people's quality of life, but also to help ensure the sustainability of healthcare and social welfare systems.” According to Rumiati, cognitive decline and the strategies to counteract it are among the major challenges of an ageing society.“Our research can contribute in two important ways: by improving the methodological tools used to study cognitive ageing, and by identifying the factors that help protect cognitive functions as people grow older.”

She concludes: “Our findings show that an intellectually stimulating life helps preserve a wide range of cognitive functions, from language to working memory. They also highlight the important role of emotions, which, as our studies suggest, make a significant contribution to the efficiency of cognitive processes. Taken together, these findings indicate that cognitive reserve and emotional skills contribute to healthier and more efficient cognitive ageing. These are promising results that we intend to explore further in future studies.”

Sunday, September 6, 2026

Intervention Design for Individual Behavior Change in Stroke Prevention Trials

 This is simple! You don't HAVE EXACT PROTOCOLS!

Your survivors know you don't have any clue what you are doing by just having guidelines/suggestions!

Intervention Design for Individual Behavior Change in Stroke Prevention Trials


Abstract

Stroke prevention requires that patients follow recommended health behaviors. However, few stroke behavioral interventions have been shown to produce clinically significant behavior change in clinical trials, likely thwarted in the design process by limited application of behavioral theoretical models and insight into mechanistic underpinnings during intervention testing. The National Institutes of Health Stage Model for Behavioral Intervention Development provides a systematic, nonlinear, iterative framework for advancing behavioral interventions from theory to practice. Here, we provide an overview of methods from behavioral medicine research that can be applied to improve the development of successful stroke preventive behavioral interventions. Behavioral change theories can provide a conceptual basis for theoretical frameworks for behavioral interventions as they identify individual-level influences on health behaviors using specified constructs tied to underlying psychosocial mechanisms. For example, interventions targeting self-efficacy behaviors for self-management after stroke may be guided by Social Cognitive Theory to deliver patient-centered care. Mixed methods that integrate qualitative and quantitative findings can be useful for identifying key patient barriers to target while designing behavioral interventions, and for evaluating intervention effects, including the extent to which they target putative behavioral mechanisms. Adaptive clinical trial methods such as SMART (Sequential Multiple Assignment Randomized Trials) for identifying optimal intervention sequences and JITAI (Just-in-Time Adaptive Interventions) that leverage real-time contextual data to tailor components can improve potency and personalization of theoretically supported behavioral interventions. Overall, in accordance with the National Institutes of Health Stage Model, successful behavioral trials to advance stroke prevention should be grounded in behavioral theory for intervention development, informed by design methods that enable assessment of behavioral mechanistic targets, and conducted with adaptive clinical trial methodologies to tailor interventions.

Graphical Abstract

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New injectable treatment helps the brain rebuild after stroke

 Have your competent? doctor and hospital ensure that human testing occurs and EXACT PROTOCOLS ARE CREATED!  

Not doing so IS PURE INCOMPETENCE!

New injectable treatment helps the brain rebuild after stroke

Date:
September 3, 2026
Source:
Duke University
Summary:
Duke researchers developed an injectable scaffold that helped stroke-damaged brains grow new blood vessels, support nerve regrowth, and recover movement in mice. The treatment appears to work partly by recruiting the body’s own immune cells, including neutrophils that may switch from damaging to helpful under the right conditions.

A Clinical Trial of Trontinemab in Participants With Early Symptomatic Alzheimer's Disease

 With your extra risk of Alzheimers is your competent? doctor knowledgeable about this? 

NO? So, PURE INCOMPETENCE! 

Good to know to get rid of him/her now!

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.

2. Then this study came out and seems to have a range from 17-66%. December 2013.`    

3. A 20% chance in this research.   July 2013.

4. Dementia Risk Doubled in Patients Following Stroke September 2018 

The latest here:

A Clinical Trial of Trontinemab in Participants With Early Symptomatic Alzheimer's Disease 

Study Overview

Brief Summary
The purpose of this study is to assess the efficacy and safety of trontinemab in participants with early symptomatic Alzheimer's disease (AD) (mild cognitive impairment [MCI] to mild dementia due to AD).
Official Title
A Phase III, Multicenter, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Efficacy and Safety Study of Trontinemab in Participants With Early Symptomatic Alzheimer's Disease (MCI to Mild Dementia Due to AD)
Conditions
Alzheimers Disease
Intervention/Treatment
  • Drug: Trontinemab
  • Other: Placebo
Other Study ID Numbers
  • WN45447
Study Start (Actual)
2025-11-12
Primary Completion (Estimated)
2028-06-07
Study Completion (Estimated)
2028-06-07
Enrollment (Estimated)
800
Study Type
Interventional
Phase
Phase 3

Contacts and Locations

This section provides contact details for people who can answer questions about joining this study, and information on where this study is taking place.

To learn more, please see the Contacts and Locations section in How to Read a Study Record.

Study Contact

Name: Reference Study ID Number: WN45447 https://forpatients.roche.com/ No attachments to email below.

Phone Number: 888-662-6728

Email: global-roche-genentech-trials@gene.com

Study Contact Backup

Name: Fastest response: use the inquiry form. https://www.gene.com/contact-us/submit-medical-inquiry

This study has 150 locations

Utility-Weighted Analysis of the Modified Rankin Scale: An Updated Review of Methods, Challenges, and Future Directions

 

mRS and the Berthel Index ARE NOT DAMAGE DIAGNOSES, they do not give you the 3d location of your dead and damaged neurons. In my opinion, they are FUCKING WORTHLESS to getting you recovered! 

I consider the Rankin scale useless, not objective except for #6, dead? You can't use it to objectively point to the EXACT STROKE PROTOCOLS  needed.  The exact same deficit could have 9 causes.

See this example of nine reasons for a movement disability:

 

You can't tell me these all have the same solution, I'm not that stupid.
1. Penumbra damage to the motor cortex.
2. Dead brain in the motor cortex.
3. Penumbra damage in the pre-motor cortex.
4. Dead brain in the pre-motor cortex.
5. Penumbra damage in the executive control area.
6. Dead brain in the executive control area.
7. Penumbra damage in the white matter underlying any of these three.
8. Dead brain in the white matter underlying any of these three.
9. Spasticity preventing movement from occurring.

The latest here: 

Utility-Weighted Analysis of the Modified Rankin Scale: An Updated Review of Methods, Challenges, and Future Directions


Abstract

The utility-weighted approach to analyzing the modified Rankin Scale (mRS) is increasingly being utilized in acute stroke clinical trials. This analytic approach assigns a patient-centered utility weight—the desirability or value of a health state to patients—to each level of the mRS. The utility-weighted-mRS analysis converts the mRS from a scale reflecting only the rank order of functional outcome after stroke into one that quantifies the value of each poststroke mRS health state from patients’ perspectives. The ability of the utility-weighted-mRS analysis to capture the unequal difference in patient health-related quality of life between each level of the mRS makes it an appealing patient-centered end point for acute stroke clinical trials. However, several concerns have historically raised skepticism regarding its value as a trial end point. Unfamiliarity with how utility weights are derived and used poses challenges to its use for shared decision-making between patients and clinicians. There are valid concerns that social, geographic, and demographic factors that differ between countries influence the mRS utility weights, so that use of uniform weights across all settings mildly reduces the precision of utility quantification, particularly in multinational stroke clinical trials. This narrative review aims to provide the clinical and research stroke community with a practical overview of key methodology in the utility-weighted-mRS analysis to aid in its interpretation, considers the advantages and challenges of using the utility-weighted-mRS analysis, and suggests future areas of study.

Graphical Abstract

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Meditation May Slow the Aging Process and More by Super Age

 Of course your incompetent? doctor failed at providing meditation protocols for well over a decade! 

FIREABLE INCOMPETENCE!

meditation (67 posts to January 2012)

Meditation May Slow the Aging Process and More

Novel Nutritional Formulations for Post-Stroke Rehabilitation: Scientific Potential and Clinical Application

All this earlier research on diet AND NO ONE HAS THE BRAINS TO CREATE A PROTOCOL!

food (40 posts to December 2011)

diet protocol (219 posts to July 2015)

diet supplements (13 posts to August 2013)

 Novel Nutritional Formulations for Post-Stroke Rehabilitation: Scientific Potential and Clinical Application

Citation: Christina Rahm. “Novel Nutritional Formulations for Post-Stroke Rehabilitation: Scientific Potential and Clinical Applications". PriMera Scientific Surgical Research and Practice 8.3 (2026): 21-28. Copyright: © 2026 Christina Rahm. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Abstract 

 
Stroke is a major cause of mortality and long-term disability in most countries of the world, with about 795,000 Americans developing stroke every year. The conventional post-stroke re habilitation has been based on the use of pharmaceuticals and physical therapy. However, major gaps still exist to maximize the outcomes of neurological recovery and functional outcomes. This white paper will discuss a new patent-pending treatment protocol that utilizes three proprietary nutritional formulations that are being used under a structured dosing schedule to treat post-stroke rehabilitation. The strategy combines zeolite extracts, amino acids, polyphenolic compounds, and the use of different bioactive components, which may stimulate neural repair, lower inflammation, and functional restoration. This paper assesses the scientific rationale of every element of the formulation, the possible action mechanisms, and the prospects of making contributions to the development of stroke rehabilitation research and clinical practice.

More at link.

Application of artificial intelligence in prediction and management of stroke rehabilitation

Until 100%recovery research is out there, artificial intelligence isn't going to do much good. Wrong goal: the only goal in stroke is 100% recovery! GET THERE! Predictions and 'management' DO NOTHING FOR RECOVERY! If you are that fucking stupid; you need to be fired!

 Application of artificial intelligence in prediction and management of stroke rehabilitation

Weihua Song1,#, Shuai Si2,#, Yinghui Wang3, Hong Chang1,*, Xiaoying Tang2,* 1. Department of Neurology, Beijing Municipal Geriatric Medical Research Center, Xuanwu Hospital, Capital Medical University, Beijing, China 2. School of Medical Technology, Zhengzhou Academy of Intelligent Technology, Beijing Institute of Technology, Beijing, China 3. Luohe Orthopedic Hospital, Luohe, China Corresponding author: Hong Chang (changhong@xwhosp.org); Xiaoying Tang (xiaoying@bit.edu.cn) # Those authors contributed equally to this work

Abstract: 


Artificial intelligence (AI) is being studied across the stroke care pathway, but evidence from acute diagnosis, early prognosis, rehabilitation-outcome prediction, and long-term management is often discussed without clearly separating these clinical tasks. This structured narrative review adds an integrated framework that maps each application to its decision point, relevance to rehabilitation, validation level, and readiness for clinical use. Unlike previous technology-centred reviews, it explicitly separates acute prognostic evidence from rehabilitation-specific evidence and distinguishes technical performance from transportability, clinical impact, and rehabilitation benefit. Acute imaging and prognostic models may provide baseline information for later rehabilitation planning, but their diagnostic or prognostic performance does not establish rehabilitation efficacy. Most rehabilitation models and robotic, virtual-reality, brain-computer interface, wearable, and home-monitoring applications remain supported mainly by internal validation or early exploratory studies. Small or selected datasets, limited external and prospective validation, uncertain workflow effects, and sparse patient-centred outcomes continue to constrain clinical interpretation

Gait Speed Changes in Stroke Rehabilitation Motor Lower Extremity Randomized Controlled Trials by Intervention and Time Post-Stroke: A Meta-Analysis

 You uselessly described something; but created no protocols for recovery! YOU'RE FIRED! Your comeuppance/screaming when you are the 1 in 4 per WHO that has a stroke  will be soul satisfying. 

Gait Speed Changes in Stroke Rehabilitation Motor Lower Extremity Randomized Controlled Trials by Intervention and Time Post-Stroke: A Meta-Analysis


https://doi.org/10.1016/j.apmr.2026.08.017Get rights and content
Under a Creative Commons license
Open access

Abstract

Objective

To examine gait speed changes in randomized controlled trials (RCTs) of motor lower extremity (LE) stroke rehabilitation across various interventions, compared to conventional care or sham controls, at different time points post-stroke.

Data Sources

A meta-analysis was conducted, in accordance with PRISMA guidelines. Systematic searches in MEDLINE, Embase, CINAHL and PsycINFO, were conducted for RCTs published in English, up to December 2024.

Study Selection

RCTs were included if they examined a LE motor rehabilitation intervention in adults with stroke, used conventional care or sham as control group, and evaluated gait speed.

Data Extraction

Two independent reviewers performed the screening of title/abstract, full-text screening and data extraction, with an independent reviewer available for conflict resolution.

Data Synthesis

A total of 106 RCTs met the inclusion criteria; 63.2% were conducted in the chronic phase post-stroke. Five interventions were evaluated in both the acute/subacute and chronic phases, of which, three, treadmill training, body weight-supported treadmill training, and training with exoskeletons, showed significant benefits in the acute/subacute phases, compared to conventional care, however, none showed any significant benefit in the chronic phase. Of the interventions evaluated solely in the chronic phase, overground walking training, trunk training, mirror therapy, and virtual reality demonstrated significant benefits compared to conventional care. Interventions studied during the acute/subacute phases post-stroke demonstrated significantly greater magnitude of improvement in gait speed compared to those in the chronic phase.

Conclusions

Overall, interventions for LE motor function post stroke evaluated in the acute/subacute phase demonstrated a greater magnitude of effect on gait speed compared to those assessed in the chronic phase, although more RCTs are being conducted in the chronic phase.