Wednesday, February 13, 2013

Top 10 life after stroke ‘research’ priorities

http://www.strokefoundation.com.au/blog/?p=2255
From the Australian Stroke Foundation, at least they tried.
For this list of top 10 research priorities, 548 treatment uncertainties were gathered. These came from: 15 stroke groups and clubs, 22 individual survivors, four health professional groups, 61 individual health professonals and three guidelines/ research recommendations in Scotland in 2012.
Top 10 life after stroke ‘research’ priorites.
1. What are the best ways to improve cognition after stroke?
2. What are the best ways of helping people come to terms with the long term consequences of stroke?
3. What are the best ways to help people recover from aphasia?
4. What are the best treatments for arm recovery and function, including visual feedback, virtual reality, bilateral training, repetitive task training, imagery/mental practice, splinting, electromechanical and robot-assisted arm training and botulinum toxin.
5. What are the best ways to treat visual problems after stroke?
6. What are the best ways to manage and/or prevent fatigue?
7. What are the best treatments to improve balance, gait and mobility, including physiotherapy, gait rehabilitation, visual and auditory feedback, electrical stimulation, different types of ankle foot orthoses and electromechanical assisted gait training?
8. How can stroke survivors and families be helped to cope with speech problems?
9. What are the best ways to improve confidence after stroke, including stroke clubs/groups, offering support, one-to-one input and re-skilling?
10. Are exercise and fitness programs beneficial at improving function and quality of life and avoiding subsequent stroke?
Here is an article from the Guardian UK about the research project.

Groups do not necessarily produce the best work as written up in the book, Quiet: The Power of Introverts in a World That Can't Stop Talking by Susan Cain. 
I will argue that all of these are incorrect. The ability to neuroplastically recover these deficits is not understood and not truly repeatable via a standard protocol. What needs to be done is back up to an earlier point in time, during the hyperacute phase and stop the neuronal cascade of death. This would result in less dead and damaged neurons and possibly the current therapies could correct those deficits.
All these are focused on current survivors and that research would require understanding exactly how neuroplasticity works.

I see two possibilities, do you believe in good or evil neurons?
1. One neuron calls for help to neighboring neurons and they altruistically go to help.
2. One neuron sends out signals that wipe functionality from neighboring neurons and instructs them to copy the sending message.

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