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.

Saturday, June 3, 2023

How to choose the best care after mom or dad has a stroke

They have a high reputation but you'll notice 'care' NOT RESULTS OR RECOVERY!  So in my opinion they aren't that good for stroke rehab, otherwise they would give us factual statistics on percentage fully recovered.

Memorial Hermann Earns Top Recognition by U.S. News & World Report. TIRR Memorial Hermann Hospital ranked No. 3 among the country's top rehabilitation hospitals in the U.S.

How to choose the best care after mom or dad has a stroke


How to choose the best care after mom or dad has a stroke

Benefits of Inpatient Stroke Rehab
Benefits of Inpatient Stroke Rehab (no copyright)

Friday, June 2, 2023

The Bobath Recommendation in the New UK Stroke Guidelines 2023

Why was Bobath even talked about?

Bobath should have been shitcanned since 2003.

My best therapist supposedly used it but I really think her competence came from her knowledge of anatomy.

Physiotherapy Based on the Bobath Concept for Adults with Post-Stroke Hemiplegia: A Review of Effectiveness Studies 2003 

The latest here:

The Bobath Recommendation in the New UK Stroke Guidelines 2023

In reading this you can hear the excuses and justifications for using stuff that doesn't work. I have no sympathy for them.

Acupuncture for Poststroke Depression: Can It Help Improve Symptoms?

 How?

Impossible to have effects except as a placebo. Energy meridians have never been proven to exist.
No mechanism of action is possible. 

But if you believe, have at it, recognizing these possible side effects;

acupuncture side effects

he latest here:

Acupuncture for Poststroke Depression: Can It Help Improve Symptoms?

Acupuncture with repetitive transcranial magnetic stimulation appeared to be the most effective therapy with the highest probability in improving poststroke depression.

Acupuncture used alone or in combination with other therapies has demonstrated effectiveness for the treatment of poststroke depression, according to findings from a systematic review and meta-analysis published in BMC Psychiatry.

Individuals who experience poststroke depression report feelings of anxiety, unwillingness to communicate, hopelessness, and insomnia, all of which might have a negative effect on their activities of daily living and their rehabilitation following stroke. Among survivors of stroke, poststroke depression has been associated with an increased risk for mortality as well.

Using the network meta-analysis method, researchers sought to evaluate the true impact of acupuncture in alleviating the symptoms of poststroke depression. Additionally, they sought to explore the difference in effectiveness between the use of acupuncture combined with various pharmacotherapies and nonpharmacotherapies, in an effort to offer optimized guidance and advice for clinicians.

From inception through March 2023, the researchers conducted a search of 6 databases and 3 clinical trials. All studies that compared the use of needle-based acupuncture (either alone or in combination with other therapies) with pharmacotherapy, other nonpharmacotherapy, or invalid groups (eg, placebo, waitlist, and blank control) were included. Study inclusion criteria, based on the PICOS (Population [P], Intervention [I], Comparison [C], Outcomes [O], and Study [S]) design, were as follows:

  • P: Participants ≥18 years of age who had been clinically diagnosed with stroke and exhibited any degree of stroke impairment severity
  • I: Acupuncture treatments alone or combined with other treatments
  • C: Pharmacotherapy, other nonpharmacotherapy, or invalid groups
  • O: Primary outcome was efficacy of poststroke depression evaluated on scales that measured symptoms of depression; secondary outcomes included effectiveness for neurologic function and quality of life
  • S: Only a randomized controlled trial (RCT)
This is the first review to compare the effectiveness of acupuncture with other therapies for PSD using a net­work meta-analysis, which may provide novel and useful guidance for clinicians and readers.

Ultimately, a total of 62 studies involving 5,500 participants, all of which were published between 2003 and 2022, were included in the review. All of the studies had been conducted in China. Other than usual care, there were 12 different treatments included:

Development of a Gait Feature–Based Model for Classifying Cognitive Disorders Using a Single Wearable Inertial Sensor

I've had a gait disorder for 17 years because my doctors and therapists completely failed at getting me recovered. I have no cognitive disorder and won't have one for as long as I live. No thanks to any of my medical specialists. 

Development of a Gait Feature–Based Model for Classifying Cognitive Disorders Using a Single Wearable Inertial Sensor

Jeongbin Park, Hyang Jun Lee, Ji Sun Park, Chae Hyun Kim, Woo Jin Jung, Seunghyun Won, Jong Bin Bae, Ji Won Han, Ki Woong Kim

Abstract

Background and Objectives: Gait changes are potential markers of cognitive disorders (CD). We developed a model for classifying older adults with CD from those with normal cognition using gait speed and variability captured from a wearable inertia sensor and compared its diagnostic performance for CD with that of the model using the Mini-Mental State Examination (MMSE).

Methods: We enrolled community-dwelling older adults with normal gait from the Korean Longitudinal Study on Cognitive Aging and Dementia and measured their gait features using a wearable inertia sensor placed at the center of body mass while they walked on a 14-m long walkway thrice at comfortable paces. We randomly split our entire dataset into the development (80%) and validation (20%) datasets. We developed a model for classifying CD using logistic regression analysis from the development dataset and validated it in the validation dataset. In both datasets, we compared the diagnostic performance of the model with that using the MMSE. We estimated optimal cutoff score of our model using receiver operator characteristics analysis.

Results: In total, 595 participants were enrolled, 101 of them had CD. Our model included both gait speed and temporal gait variability and exhibited good diagnostic performance for classifying CD from normal cognition in both the development (area under the receiver operator characteristic curve [AUC] = 0.788, 95% confidence interval [CI] = 0.748–0.823, p < 0.001) and validation datasets (AUC = 0.811, 95% CI = 0.729–0.877, p < 0.001). Our model showed comparable diagnostic performance for CD to that of the model using the MMSE in both the development (difference in AUC = 0.026, standard error [SE] = 0.043, z statistic = 0.610, p = 0.542) and validation datasets (difference in AUC = 0.070, SE = 0.073, z statistic = 0.956, p = 0.330). The optimal cutoff score of the gait-based model was > -1.56.

Discussion: Our gait-based model using a wearable inertia sensor may be a promising diagnostic marker of CD in older adults.

Classification of Evidence: This study provides Class III evidence that gait analysis can accurately distinguish cognitive disorders from healthy controls in older adults.

  • Received August 25, 2022.
  • Accepted in final form March 17, 2023.

Northlander Tom Porter credits Essentia Health St. Mary’s award-winning team for getting him back on his feet after a stroke

NOT GOOD ENOUGH! I consider this a complete failure since full recovery was not achieved.The tyranny of low expectations was forced upon him by his stroke medical 'professionals'.

Northlander Tom Porter credits Essentia Health St. Mary’s award-winning team for getting him back on his feet after a stroke

According to the Centers for Disease Control and Prevention (CDC), every year about 795,000 people suffer a stroke. The alarming number includes one in every six deaths from cardiovascular disease attributed to a stroke.

It’s something 79-yearold Hermantown resident Tom Porter is thankful to have survived. He had a stroke in December 2022.

Porter was experiencing some mobility issues with his foot, but wasn’t having any other stroke symptoms. However, when his foot continued to bother him the next day, his wife, Eleanor, drove him to the emergency department at Essentia Health-St. Mary’s Medical Center.

Porter explained to his care team what he had been experiencing. That conversation, along with a CT scan, indicated that he had a stroke. Porter would spend four days in the hospital for monitoring.

“Everyone that cared for me over those four days was so kind and careful with my care,” Porter said thankfully of his stay at St. Mary’s. “They are very good at what they do, and I had complete trust in them.”

The stroke caused Porter to lose some mobility in the right side of his body, mainly his leg. He needed a wheelchair and was referred to Essentia’s stroke rehabilitation program.

Stroke rehab is offered at several Essentia facilities. Patients can reclaim their independence by regaining skills, strength and abilities through proven methods provided by physical and occupational therapists, and others on the care team.

“They know exactly what they are doing. I’d even try and cheat on it sometimes,” he joked, “but they are on top of it and made sure I was doing exactly what I needed to regain my mobility.”

For the next several weeks, Porter routinely went to his rehab appointments and was able to ditch the wheelchair, and then a walker.

“I’m proud to call Essentia my hometown hospital,” Porter said.

Essentia’s award-winning stroke care program comes with a variety of treatment options for patients, starting with their high-tech NASCAR room— which stands for Neuro Angio-Suite for Cerebral Arterial Reperfusion. There, specialists can perform an emergent stroke thrombectomy, a procedure in which a catheter is inserted in a groin or arm artery and navigated with expert precision to the brain to remove potentially deadly blood clots.

Our stroke thrombectomy treatment can be provided up to 24 hours from symptom onset, and in some cases longer. Done in a timely manner, stroke thrombectomy can prevent profound neurological deficits, such as paralysis, loss of language function, inability to speak or swallow and even death.

Dr. Vikram Jadhav (Dr. Vic), an interventional neurologist at Essentia, says taking care of your body is one of the surest ways to prevent a stroke. High blood pressure, high cholesterol, smoking and diabetes are the leading causes of stroke, with one in three U.S. adults having at least one of these conditions or habits, according to the CDC. Dr. Vic says it’s important to monitor your health and minimize risk factors by eating healthy and staying physically active.

One of the surest ways to prevent long-term side effects associated with a stroke is to act fast when signs and symptoms occur. Symptoms include sudden numbness or weakness in the face, arm or leg, confusion or trouble speaking, loss of or blurry vision, dizziness and a sudden severe headache. The acronym BEFAST is a useful tool. It stands for:

• Balance: Does the person have sudden loss of
balance?
• Eyes: Has the person
lost vision in one or both
eyes?
• Face: Smile. Does one
side of the face droop?
• Arms: Raise both arms.
Does one arm drift downward? • Speech: Repeat a simple
phrase. Is speech slurred
or strange?
• Time: If you observe any
of these signs, it’s time to
call 911 right away.

Essentia Health-St. Mary’s Medical Center’s Advanced Thrombectomy Capable Stroke Center is a nationally accredited care unit. Certified by the Joint Commission, St. Mary’s is the only facility in the Northland certified to remove clots from blood vessels in the brain to re-establish blood flow. This certification requires that Essentia offer 24-7 stroke care with the most stringent standards.

Essentia Health’s mission is to make a healthy difference in people’s lives. They relentlessly pursue that mission at their 14 hospitals, 78 clinics, six long-term care facilities, three assisted living facilities, three independent living facilities, seven ambulance services and one research institute. Essentia has about 15,000 employees, including 2,200 physicians and advanced practitioners who provide expert, compassionate care.

Thursday, June 1, 2023

Monocyte-derived IL-6 programs microglia to rebuild damaged brain vasculature

 Sounds great. WHOM is doing the followup research to create protocols for survivor recovery using this?

Monocyte-derived IL-6 programs microglia to rebuild damaged brain vasculature

Abstract

Cerebrovascular injury (CVI) is a common pathology caused by infections, injury, stroke, neurodegeneration and autoimmune disease. Rapid resolution of a CVI requires a coordinated innate immune response. In the present study, we sought mechanistic insights into how central nervous system-infiltrating monocytes program resident microglia to mediate angiogenesis and cerebrovascular repair after an intracerebral hemorrhage. In the penumbrae of human stroke brain lesions, we identified a subpopulation of microglia that express vascular endothelial growth factor A. These cells, termed ‘repair-associated microglia’ (RAMs), were also observed in a rodent model of CVI and coexpressed interleukin (IL)-6Ra. Cerebrovascular repair did not occur in IL-6 knockouts or in mice lacking microglial IL-6Ra expression and single-cell transcriptomic analyses revealed faulty RAM programming in the absence of IL-6 signaling. Infiltrating CCR2+ monocytes were the primary source of IL-6 after a CVI and were required to endow microglia with proliferative and proangiogenic properties. Faulty RAM programming in the absence of IL-6 or inflammatory monocytes resulted in poor cerebrovascular repair, neuronal destruction and sustained neurological deficits that were all restored via exogenous IL-6 administration. These data provide a molecular and cellular basis for how monocytes instruct microglia to repair damaged brain vasculature and promote functional recovery after injury.

This is a preview of subscription content, access via your institution

The impact of bilateral therapy on upper limb function after chronic stroke: a systematic review

Almost 14 years and still no protocols on use of this for survivor recovery. THAT IS HOW FUCKING INCOMPETENT THE STROKE MEDICAL WORLD IS!

 The impact of bilateral therapy on upper limb function after chronic stroke: a systematic review

 Disability and Rehabilitation, 2010; 32(15): 1221–1231
 CHRISTOPHER PAUL LATIMER, JUSTINE KEELING, BRODERICK LIN,MEREDITH HENDERSON & LEIGH ANNE HALE
Centre for Physiotherapy Research, University of Otago, Dunedin, New Zealand
Accepted November 2009

Abstract

Purpose.
 
To determine the evidence for bilateral therapy interventions aimed at improving upper limb (UL) function inadults with a range of UL activity limitations due to a first time chronic stroke.
 
Method.
 
 Seven databases were searched prior to 2008 for articles reporting experimental studies investigating bilateral UL interventions on functional outcome in participants with a first stroke, 6 or more months prior. Included articles were evaluated with the quality index, a tool which evaluates the quality of both randomised and non-randomised studies. Data relating to study design and functional outcome were extracted.
 
Results.
 
 Nine articles were included; three reported on randomised controlled trials (RCT) and six on cohort studies. Eight studies incorporated a mechanical device as their bilateral intervention. Bilateral arm training with rhythmic auditory cueing(BATRAC) was the most commonly used mechanically based intervention, and three of the four uncontrolled BATRAC studies reported significant improvements in UL function post-intervention, however these results were not substantiated by a RCT study of the BATRAC intervention. One study demonstrated significant functional improvements after 6 days of training with a non-mechanical bilateral task. Of the four studies that performed a follow-up assessment, three reportedsignificant improvement in UL function. Quality index ratings of the included studies ranged from 18 to 25 out of 27.
 
Conclusion.
 
 There is some evidence that bilateral therapy improves function in adults with chronic stroke, however more quality RCTs are required to strengthen this evidence.

New Blood Biomarker Can Predict if Cognitively Healthy Elderly Will Develop Alzheimer’s Disease

With your risk of dementia post stroke it is imperative your doctor performs this test on you and have protocols in place to prevent your likely chances of dementia.

 

Your risk of dementia, has your doctor told you of this?  Your doctor is responsible for preventing this! Which means your doctor has to get you 100% recovered to be able to do these aerobic exercises.

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:

 

New Blood Biomarker Can Predict if Cognitively Healthy Elderly Will Develop Alzheimer’s Disease

Astrocyte reactivity as an important upstream event linking amyloid-β (Aβ) with initial tau pathology, which may have implications for the biological definition of preclinical Alzheimer’s disease (AD) and for selecting cognitively unimpaired individuals for clinical trials, according to a study

By testing the blood of more than 1,000 cognitively unimpaired elderly people with and without amyloid pathology, Tharick Pascoal, MD, University of Pittsburgh, Pittsburgh, Pennsylvania, and colleagues found that only those who had a combination of Aβ and blood markers of abnormal astrocyte activation, or reactivity, would progress to symptomatic Alzheimer’s in the future.

“Our study argues that testing for the presence of brain amyloid along with blood biomarkers of astrocyte reactivity is the optimal screening to identify patients who are most at risk for progressing to Alzheimer’s disease,” said Dr. Pascoal. “This puts astrocytes at the centre as key regulators of disease progression, challenging the notion that amyloid is enough to trigger Alzheimer’s disease.”

Astrocytes are specialised cells abundant in the brain tissue. Just as other members of the glia, astrocytes support neuronal cells by supplying them with nutrients and oxygen and protecting them from pathogens. But because glial cells don’t conduct electricity and, at first, didn’t seem to play a direct role in how neurons communicate with one another, their role in health and disease had been overlooked. The current research changes that.

“Astrocytes coordinate the brain amyloid and tau relationship like a conductor directing the orchestra,” said Bruna Bellaver, PhD, University of Pittsburgh. “This can be a game-changer to the field, since glial biomarkers in general are not considered in any main disease model.”

The researchers tested blood samples from participants in 3 independent studies of cognitively unimpaired elderly people for biomarkers of astrocyte reactivity -- glial fibrillary acidic protein (GFAP) -- along with the presence of pathological tau. The study showed that only those who were positive for both amyloid and astrocyte reactivity showed evidence of progressively developing tau pathology, indicating predisposition to clinical symptoms of Alzheimer’s disease.

The findings have direct implications for future clinical trials for Alzheimer’s drug candidates. In aiming to halt disease progression sooner, trials are moving to earlier and earlier stages of pre-symptomatic disease, making correct early diagnosis of Alzheimer’s risk critical for success. Because a significant percentage of amyloid-positive individuals will not progress to clinical forms of Alzheimer’s, amyloid positivity alone is not enough to determine an individual’s eligibility for a therapy.

Inclusion of astrocyte reactivity markers, such as GFAP, in the panel of diagnostic tests will allow for improved selection of patients who are likely to progress to later stages of Alzheimer’s and, therefore, help fine-tune selection of candidates for therapeutic interventions who are more likely to benefit.

Reference: https://www.nature.com/articles/s41591-023-02380-x

SOURCE: University of Pittsburgh

Prevalence of Antiphospholipid Antibodies May Signal Future Risk of MI, Stroke

With your risk of dementia post stroke it is imperative your doctor performs this test on you and have protocols in place to prevent your likely chances of dementia.

Your risk of dementia, has your doctor told you of this?  Your doctor is responsible for preventing this!

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:

Prevalence of Antiphospholipid Antibodies May Signal Future Risk of MI, Stroke

Seemingly healthy people whose blood contained antibodies associated with antiphospholipid syndrome (APS) were significantly more likely to experience a cardiovascular event, according to a study published in JAMA Network Open.

“In this population-based cohort study including 2,427 participants, the prevalence


of any antiphospholipid antibodies tested by solid-phase assays at a single time point was 14.5%, with approximately one-third of those detected at a moderate or high titre,” reported James de Lemos, MD, University of Texas Southwestern, Dallas, Texas, and colleagues. “The IgA [immunoglobulin A] isotypes of anticardiolipin and anti-beta-2 glycoprotein I were associated with future atherosclerotic cardiovascular disease events.”

The research team tested blood that had been collected from study participants between 2007 and 2009 and looked for the presence and amounts of 8 different antiphospholipid antibodies. They analysed these data along with questionnaire responses gathered during a follow-up period that averaged 8 years to see which participants experienced a cardiovascular event, including myocardial infarction (MI), stroke, coronary bypass surgery, or death from cardiovascular disease.

The researchers detected antiphospholipid antibodies in about 14.5% of the 2,427 study participants. About a third of those had antibody levels that were considered moderate or high. Over the follow-up period, 125 individuals experienced cardiovascular events.

After adjusting for risk factors such as age, sex, race, body mass index, smoking history, cholesterol levels, and diabetes, the researchers found that the presence of 2 particular antiphospholipid antibodies -- aCL IgA and ab2GPI IgA -- was associated with a future cardiovascular event. In participants with relatively higher levels of these 2 antibodies, this connection was even stronger.

Dr. de Lemos noted that because antibody levels can be transient and blood samples were done on a single visit, more studies are needed to better understand whether antiphospholipid antibodies remain elevated in people without diagnosed APS and how this might relate to heart disease.

Ravi Sarode, MD, University of Texas Southwestern, said that if further research supports the study’s initial findings, labs would be able to test patients for antiphospholipid antibodies.

“These antibodies are easy to test; we test them all the time in our lab for certain patients,” said Dr. Sarode. “It is very important to note that very few labs test for these specific antibodies. However, we would need more information to use them in the right clinical setting for patients who may be at higher risk of MI or stroke.”

Reference: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2803031

SOURCE: University of Texas Southwestern Medical Center

4 Key Benefits of Exercise for Older Adults

Does your doctor believe in this and provide you with EXACT REHAB PROTOCOLS to get you exercising again? If not, you don't have a functioning stroke doctor or hospital.

4 Key Benefits of Exercise for Older Adults

June 3 is National Health and Fitness Day, which reminds and encourages people to get out and be active. As we age, prioritizing our health and well-being becomes increasingly essential, and exercise is a natural way to strengthen both. In this article, we will explore the remarkable benefits of exercise for older adults, encouraging them to embrace an active lifestyle and enjoy their golden years to the fullest.

 

Enhanced physical health

Engaging in regular exercise offers a multitude of physical benefits for older adults. Firstly, it helps maintain a healthy weight and prevent chronic conditions such as heart disease, diabetes, and osteoporosis. Exercise also boosts cardiovascular health by strengthening the heart and improving blood circulation, reducing the risk of heart-related ailments.

 

Moreover, regular physical activity can enhance flexibility, balance, and coordination, reducing the likelihood of falls and fractures. Strength training exercises, in particular, play a vital role in preserving muscle mass, bone density, and joint flexibility, mitigating the effects of age-related muscle loss and promoting an active, independent lifestyle.

 

Mental sharpness and emotional well-being

Exercise isn't just good for the body; it also has incredible mental benefits. Research consistently demonstrates that physical activity stimulates the brain, improving cognitive function and mental acuity in older adults. Regular exercise has been linked to a reduced risk of cognitive decline, dementia, and age-related memory loss.

 

Additionally, exercise releases endorphins, also known as "feel-good" hormones, which can combat stress, anxiety, and depression. Participating in physical activities, whether walking, swimming or even dancing, can significantly boost mood and overall emotional well-being, leading to a more positive outlook on life.

 

Social connection and engagement

Participating in exercise programs for older adults can foster social connections and combat feelings of isolation. Group fitness classes, walking clubs, or even gym sessions can create opportunities for older adults to connect with like-minded individuals, form new friendships and combat loneliness. The sense of belonging and community support gained through exercise can profoundly impact mental health and overall quality of life.

 

Increased independence and quality of life

One of the most significant benefits of exercise for older adults is preserving independence and the ability to carry out daily activities. Regular physical activity strengthens muscles and improves endurance, enabling older adults to maintain functional abilities such as climbing stairs, lifting objects, or performing household tasks independently.

Furthermore, exercise promotes a good night's sleep, which is crucial for overall health and vitality. By improving sleep quality, older adults can wake up feeling refreshed, energized, and ready to embrace the day.

 

Incorporating regular exercise into the daily routine of older adults yields a wide array of benefits that enhance both physical and mental well-being. By embracing an active lifestyle, seniors can improve their quality of life, maintain independence, and truly enjoy the golden years. So, dust off your sneakers, stretch your muscles, and embark on a journey toward better health, happiness, and longevity.

Wednesday, May 31, 2023

F82 The 10th Annual Upper Limb Neurorehabilitation Course

I see nothing in either day that remotely suggests they are providing EXACT PROTOCOLS FOR RECOVERY!  Useless blathering amongst themselves, nothing that will concretely help survivors. Prove me wrong, I dare you.

F82 The 10th Annual Upper Limb Neurorehabilitation Course

Event Information

The 10th Annual Upper Limb Neurorehabilitation Course
Dates of Event
29th June 2023 – 30th June 2023
Last Booking Date for this Event
28th June 2023

Description

UCL Centre for Neurorehabilitation and the National Hospital for Neurology and Neurosurgery present:

 

The 10th Annual Upper Limb Neurorehabilitation Course

Treating patients with upper limb deficit: Integrating research into practice

 

Thursday 29th June and Friday 30th June 2023

 

This two-day course provides an up-to-date overview of current research in treatment and rehabilitation options for the neurological patient with upper limb deficit. The course looks at the practical, real-life translation of scientific evidence into clinical practice and discusses the ingredients that make an upper limb therapy effective. Delegates will have the opportunity to trial novel devices and robotic technology. Course lecturers are leading clinicians and researchers in the field of upper limb rehabilitation in neurological patients. Full programme can be found under ‘more info’ tab.

 

Standard fee: £250 (includes catering)

Student fee: £125 (includes catering)

Enquiries to: cnr@ucl.ca.uk


Attendee CategoryCost   

CLCH Remaining Payment.£62.50[Read More]

Standard.£250.00[Read More]

Student Rate.£125.00[Read More]

More Information

DAY 1

Time

Title

Speaker

08:55-09:00

Introduction

Nick Ward

09.00-09.45 

Upper limb recoverythe state of play (1)           

Nick Ward

09:45-10:30

Integrated approach to UL rehabilitation              

Fran Brander & Kate Kelly

10.30-11.00 

Coffee break & Exhibitors          

 

11.00-11:45 

Recognising and treating the painful shoulder    

Ben Beare & Zeina Ghanem

11:45-12:15

Arm preparation – dealing with spasticity             

Amanda Strawson & Hannah Martin

12:15-13.00

Assessing Motor control

Steve Scott

13.00-14.00 

Lunch & Exhibitors & Demonstrations 

 

14.00-14:45 

Case Study #1  

Amanda Strawson & Helen Stancombe

14.45-15.15 

The role of priming in a rehabilitation service      

Fran Brander & Kate Kelly            

15.15-15:45 

Coffee break & Exhibitors

 

15.45-16.30  

Severe arm – keeping it in the game 

Emma Playfair & Hannah Griffiths            

16.30-17.00

Discussion

 

17.00-19.00

Wine & Chat & Exhibitors

 

 

DAY 2

Time

Title

Speaker

09.00-09.45 

The role of self-management in recovery

Fiona Jones & Scott Ballard-Ridley

09:45-10:30

Upper limb recoverythe state of play (1)           

Nick Ward

10.30-11.00 

Coffee break & Exhibitors          

 

11.00-11:45 

Don’t forget about sensation

Kathleen O’Keeffe & Mags Bean

11:45-12:30

The role of electrical stimulation 

Georgina Masters & Emma Playfair

12.30-13.30 

Lunch & Exhibitors & Demonstrations 

 

13.30-14:15

Creative splinting for function                                    

Elisha O’Brien & Amanda Strawson

14.15-15.00

Case Study #2 

Jess Steel & Mags Bean

15.00-15:30 

Coffee break & Exhibitors

 

15.30-16.15  

Gaming your way to recovery

Mireia Coll

16.15-17.00

Case Study #3

Zeina Ghanem & Emma Playfair

17:00-17:30

Closing discussion

 

17.30-19.00

Wine & Chat & Exhibitors

 

National Stroke Awareness Month: Vagus Nerve Stimulation Post-Stroke

 She may be certified and much more professionally trained than me but still has NO protocol written up on this. Survivors demand better!

National Stroke Awareness Month: Vagus Nerve Stimulation Post-Stroke

Written By: Liza Meiksins PT, DPT
Board Certified Specialist in Neurologic Physical Therapy
Certified Lymphedema Therapist

 

Many patients and therapists would likely agree that one of the most challenging aspects of stroke rehab is improving upper extremity function and recovery. As a former patient once said, “I would be happy with my recovery if this arm just wasn’t so stubborn!” But with few options to promote upper extremity recovery, there has been a lot of talk recently about the use of vagus nerve stimulation. So, what exactly is vagus nerve stimulation and how does it impact upper extremity recovery post-stroke?

Invasive vagus nerve stimulation (i-VNS) has been widely accepted to improve upper extremity function post-stroke, but this requires a surgical procedure and is not appropriate nor encouraged for many patients1. However, in recent years, transcutaneous vagus nerve stimulation (t-VNS) has been shown to activate similar vagal nerve projections as i-VNS and is generally safe and well-tolerated1. t-VNS can be carried out through auricular VNS in the ear or cervical branch VNS in the neck and has been shown to elicit the following responses:

 

 

Physiologic Changes with t-VNS1,2:

  • Cholinergic & monoaminergic modulation of motor cortex neurons
  • Reduced systemic inflammation
  • Reduced blood-brain barrier breakdown
  • Increased angiogenesis
  • Reduced excitotoxicity
  • Improved axon regeneration & reorganization
 

Example of auricular transcutaneous VNS device4

Functional Outcomes with t-VNS1,2,3:

  • Significant improvement in immediate and long-term upper extremity outcomes when t-VNS was applied in conjunction with intensive, task-specific rehabilitation (quantified using the UE Fugl-Meyer scale, Wolf Motor Function Test, Stroke Impact Scale, and Motor Activity Log)
  • Most research has been done on patients with moderate-severe UE impairment
  • Results consistent in both sub-acute and chronic strokes
  • Most studies have examined the use of t-VNS immediately prior to rehab interventions and used auricular VNS as the method of delivery

 

Further research(EXACTLY WHOM is doing that? So we can follow up and make sure it gets done.) continues to be carried out to expand our understanding of dosing, optimal patient selection, laterality, and auricular vs cervical stimulation, among other variables to optimize outcomes. There is also the potential to utilize t-VNS for other impairments besides motor function, including: dysphagia, dysphasia, cognition, and visual field dysfunction1.

While many questions surrounding transcutaneous vagus nerve stimulation still abound, it remains an extremely promising intervention to potentiate rehabilitation-driven neuroplasticity and improve functional outcomes for our patients post-stroke!

 

Explore online continuing education courses from Liza below:

Clinical Application of Neuromuscular Electrical Stimulation (NMES) for Neurologic Conditions

High-Intensity Gait Training for Stroke and Spinal Cord Injury Patients

 

Visit summit-education.com for more information.

 

References:

Baig SS, Kamarova M, Ali A et al. Transcutaneous vagus nerve stimulation (tVNS) in stroke: the evidence, challenges and future directions. J Autonom Neurosci. 2022;237.

Dawson J, Liu CY, Francisco GE, et al. Vagus nerve stimulation paired with rehabilitation for upper limb motor function after ischaemic stroke (VNS-REHAB): a randomised, blinded, pivotal, device trial. The Lancet. 2021;397(10284):1545-1553.

Hamer HM, Bauer S. Lessons learned from transcutaneous vagus nerve stimulation (tVNS). Epilepsy Research. 2019;153:83-84.

Lui Y, Zhang L, Zhang X, et al. Effect of Combined Vagus Nerve Stimulation on Recovery of Upper Extremity Function in Patients with Stroke: A Systematic Review and Meta-Analysis. J Stroke Cerebrovas Dis. 2022;31(6)

Study found long-term brain damage associated with COVID-19, not vaccine | Fact check by USA Todaay

In case you are getting bamboozled by vaccine claims. I'm much more worried about brain damage from COVID-19 than the vaccine. I already have enough brain damage, I'm preventing more.

 Study found long-term brain damage associated with COVID-19, not vaccine | Fact check

A May 12 Instagram post (direct link, archive link) shows a screenshot of a now-deleted tweet.

"BREAKING: A European study has found COVID vaccines could be causing 'long-term brain damage,'" reads the tweet.

The post garnered more than 200 likes in five days. Similar versions of the claim have been shared on Instagram and Twitter.

Follow us on Facebook! Like our page to get updates throughout the day on our latest debunks

Our rating: False

The study explored the long-term neurological effects of being infected with the COVID-19 virus, not the vaccine.

Study focuses on virus, not vaccine

The viral claim appears to stem from a May 9 article published by The People's Voice, formerly known as NewsPunch. The website has a lengthy history of publishing misinformation.

The article references a pre-print study published in April that explored the long-term neurological effects observed in those who had been infected with COVID-19. It claims the study revealed that "spike proteins from mRNA jabs infest the brain tissue of vaccinated people."

But Dr. Ali Ertürk, a co-author of the paper and director of the Institute of Tissue Engineering and Regenerative Medicine in Munich, told USA TODAY the study did not examine the COVID-19 vaccine of its side effects.

"We have done zero experiments using the vaccine, and we have shown and claim zero side effects of the vaccine," said Ertürk in an email. "Our work reports the presence of the spike protein in the skull of deceased individuals long after their COVID-19 infection, suggesting that the spike's persistence may contribute to long-term neurological symptoms."

Fact check: FDA still recommends COVID-19 vaccine, contrary to viral claim

None of the COVID-19 vaccines authorized in the U.S. contain the live virus, according to the Centers for Disease Control and Prevention. Instead, the mRNA in the vaccine teaches the body's cells to make copies of the COVID-19 spike protein so they can later recognize and fight off the virus if they become infected.

"The issue is that during infection, there is an enormous amount of viral replication and spike protein production, which impacts many organs including the brain," Ertürk said.

The COVID-19 vaccine is safe and effective, according to the CDC.

USA TODAY reached out to the users who shared the post for comment but did not immediately receive a response.

The claim has also been debunked by the Associated Press and PolitiFact.

 

$4.5 million grant to fund research exploring link between exercise and slowing Alzheimer's progression

Your risk of dementia, has your doctor told you of this?  Your doctor is responsible for preventing this! Which means your doctor has to get you 100% recovered to be able to do these aerobic exercises.

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:

 

$4.5 million grant to fund research exploring link between exercise and slowing Alzheimer's progression

A $4.5 million groundbreaking grant will fund research to explore a promising link between aerobic exercise and slowing the progression of Alzheimer's disease in a study led by an Arizona State University researcher.

An estimated 6.7 million Americans age 65 and older are living with Alzheimer's disease, according to the Alzheimer's Association's 2023 report. A $4.5 million groundbreaking grant from the National Institute on Aging will fund research exploring a promising link between aerobic exercise and slowing the progression of Alzheimer's.

Alzheimer's is a complex disease with many factors contributing to it, which is part of the reason we haven't found a single cure. Recently though, we've found that modifying lifestyle factors may contribute to slowing the progression of the disease."

Professor Fang Yu, Edson Chair in Dementia Translational Nursing Science at the Edson College of Nursing and Health Innovation

The grant comes from the National Institute on Aging, a division of the National Institutes of Health. Yu and her team will conduct the first-ever sequential, multiple assignment, randomized trial, or SMART, for Alzheimer's disease.

"I think this grant shows what Professor Yu and her team are doing is really cutting edge. This research could impact millions of people, potentially giving them some hope of relief from a terrible disease that steals their very essence. I'm looking forward to the findings and seeing how they develop into real-world interventions," said Edson College Dean Judith Karshmer.

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    This area of research builds on Yu's previous work, which found that a six-month exercise program significantly reduced cognitive decline in comparison to the natural course of changes for Alzheimer's dementia. Specifically, aerobic exercise is effective in reducing white matter hyperintensities progression, which is associated with cognitive decline and the development of dementia.

    The new Phase 2 clinical trial will examine the best exercises to improve aerobic fitness in older adults with early Alzheimer's disease and examine how those exercises impact their memory.

    "The most exciting part of this is trying to reduce the variations in responses to exercise among participants. To this point, we've seen some people improve, while some decline. So, what we're trying to do is to reduce the variability to help people respond positively in some way so we can truly understand if exercise has an impact and for who," Yu said.

    The team is planning to recruit more than 100 participants in Arizona to enroll in the study. They're looking for people who are 65 and older, who have noticed changes in their memory and have someone who knows them to serve as their study partner.

    Arizona State University

    Ear acupuncture with reduced food intake linked to weight loss for adults

    You have got to be kidding:

    Impossible to have effects except as a placebo. Energy meridians have never been proven to exist.
    No mechanism of action is possible. 

    But if you believe, have at it, recognizing these possible side effects;

    acupuncture side effects

     

    Ear acupuncture with reduced food intake linked to weight loss for adults 

    Key takeaways:

    • Men from Japan who underwent auricular acupuncture stimulation followed by a diet lost 8.61 kg of body weight at 3 months.
    • Women who received acupuncture lost a similar amount of weight as men.

    An ear acupuncture intervention using metal beads may help induce weight loss for adults, according to findings from two studies presented at the European Congress on Obesity.

    In data from 81 Japanese men who underwent an auricular acupuncture stimulation, researchers observed decreases in body weight, BMI, waist circumference and body fat. Similar reductions were observed in a study of 81 Japanese women, though women had a greater decrease in body fat and men had a higher increase in muscle mass.

    Auricular acupuncture linked to lower muscle mass and body fat percentage at 3 months.
    Data were derived from Fujimoto T, et al. PO4.085. Presented at: European Congress on Obesity; May 17-20, 2023; Dublin.

    “By stimulating the auricular acupoints using beads instead of traditional acupuncture needles, we have found that it is possible to support weight-loss treatments,” Takahiro Fujimoto, MD, PhD, of Clinic F in Tokyo, told Healio. “We propose this as a convenient means of supporting weight-loss treatments beyond dietary and exercise therapies.”

    Fujimoto presented data from two studies of an auricular acupuncture stimulation-based weight-loss program. In the first study, researchers enrolled 81 men to receive acupuncture stimulation using metal beads on six points of the ear. Participants received dietary guidance to reduce food intake in half and nutritional supplements to compensate for any nutritional deficiencies. Clinic visits took place twice a week for bead sticking and diet progress monitoring. Body composition measurements were collected over 3 months.

    From baseline to 3 months, the men had an 8.61 kg reduction in body weight, a 2.88 kg/m2 reduction in BMI, a 10.43 cm decrease in waist circumference, a 3.98% decrease in body fat and a 2.11% increase in muscle mass. The cohort also had increases in muscle-to-fat ratio and leg muscle mass and decreases in basal metabolic rate and visceral fat level.

    In the second study, researchers obtained data from 81 women in Japan aged 23 to 74 years from a dataset of participants who underwent the same acupuncture and diet weight-loss program as the men in the first study. Women were matched with men from the first study 1:1, based on age and BMI values at baseline. Body composition measurement changes from baseline to 3 months were compared between men and women.

    From baseline to 3 months, men and women had similar reductions in weight loss, BMI and waist circumference. Men had a greater decrease in muscle mass compared with women (mean change, –5% vs. –2.8%; P < .001) while women had a greater decrease in body fat percentage than men (mean change, –4.5% vs. –4%; P = .04). Basal metabolic rate dropped more in men vs. women (mean change, –101 kcal vs. –66 kcal; P < .001). The ratio of muscle-to-fat also increase more in men vs. women (mean change, 0.26 vs. 0.15; P < .001).

    Fujimoto said future research is needed to examine the mechanisms behind how acupuncture contributes to weight loss in adults.

    “It is likely that the stimulation of the parasympathetic nervous system is involved in the production of leptin, but we would like to conduct further research to gather supporting data,” Fujimoto said.

    Vitamins can make your brain 3 years younger, study says

    But where do we get genuine vitamins?  And this still leaves your doctor to come up with interventions to recover the extra two years.

    The supplements in the US have zero guarantee of purity or efficacy due to the fucking stupidity of the US Congress passing the Dietary Supplement Health and Education Act of 1994 (DSHEA).

    Your doctor should already have interventions to recover your lost 5 cognitive years from your stroke  if they are competent at all.

     

    Vitamins can make your brain 3 years younger, study says

    Peer-reviewed scientific study tracked 3,500 seniors over a three-year span

    Regular vitamins and walks can slow or even reverse the effects of cognitive decline. Getty Images/iStockphoto

    If you’re getting more forgetful as you age — and who among us isn’t? — there are two things you can do about it this Memorial Day weekend.

    Take a multivitamin. And go for a 30-minute walk.

    Then keep both of those practices up.

    So reports a peer-reviewed scientific study out last week, which found that regular vitamins and walks can slow or even reverse the effects of cognitive decline on the aging brain.

    The average effect on the aging brain of a daily multivitamin is the equivalent of being a full three years younger, according to a study conducted by researchers at Columbia and Harvard medical schools and the New York State Psychiatric Institute. “We estimate that the effect of the multivitamin intervention improved memory performance above placebo by the equivalent of 3.1 years of age-related memory change,” the researchers report in the latest issue of the American Journal of Clinical Nutrition.

    This was based on a study of more than 3,500 senior citizens over three years. The participants were randomly assigned either to take a Centrum Silver multivitamin — Centrum is a Pfizer-owned PFE, -1.34% brand — or a placebo every day. They were subjected to various standard brain tests every year, such as tests requiring people to recall as many words as possible from a random list.

    Researchers say the benefits were most pronounced in those with underlying heart disease.

    The benefits of the daily vitamin showed up as early as the first annual exam, and persisted in the years afterward, the researchers said.


    These findings confirm similar findings in a parallel study published last year, which found that a daily multivitamin benefited the whole brain, not just the memory. That study, too, found the effects were most pronounced among those with underlying heart disease.

    Meanwhile another independent study, conducted at the University of Maryland, found that walking for 30 minutes three or four times a week also has a significant beneficial effect on the brains of older people.

    The study involved 33 participants aged between the ages of 71 and 85 who exercised on a treadmill under supervision over a 12-week span. Verbal memory tests and MRI scans showed brain and memory benefits, even that quickly.

    There are so many scientific studies coming out these days — on age-related cognitive decline and more generally — that it’s easy to become inured to them. But cognitive impairment and full-blown dementia are already pandemics way more extensive than COVID-19 even at its most acute stage. Alzheimer’s is currently killing over 6 million Americans (six times as many Americans as died with the coronavirus-borne disease), and the numbers are rising.


    And scientific breakthroughs in terms of medical treatments, let alone cures, are scarce and expensive.

    So it’s good news that there are things we can do on our own. These include not just taking vitamins and walking but eating the right foods, avoiding the wrong ones, studying, doing crosswords and meditating.

    We can hardly do them all at once. But anything is better than nothing.

    Next challenge for those of us getting older? Remember to take the multivitamin every morning. And remembering where we put them.