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

What this blog is for:

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

Thursday, December 8, 2016

A Randomized Controlled Trial of Assisted Intention Monitoring for the Rehabilitation of Executive Impairments Following Acquired Brain Injury

Your doctor is going to have to get this to update your executive functioning protocols. What is the size of your stroke hospitals budget for purchasing research? At $30-40 per article that could run to $30-40,000 a year. I bet there is no budget for research, helping stroke patients get the newest rehab is not in their goals and objectives. But somebody could prove me wrong.
If a stroke survivor can read and understand text messages they already have a high functioning executive level.   Invalid research subjects, way too much cherry picking.
http://nnr.sagepub.com/content/early/2016/12/01/1545968316680484.abstract
  1. Fergus Gracey, ClinPsyD1,2,3⇑
  2. Jessica E. Fish, PhD3,4
  3. Eve Greenfield4
  4. Andrew Bateman, PhD2,3
  5. Donna Malley, MSt3
  6. Gemma Hardy, ClinPsyD3,4
  7. Jessica Ingham, ClinPsyD3,4
  8. Jonathan J. Evans, PhD5
  9. Tom Manly, PhD4
  1. 1University of East Anglia, Norwich Research Park, Norwich, UK
  2. 2Acquired Brain Injury Rehabilitation Alliance, Cambridge, UK
  3. 3Princess of Wales Hospital, Cambridgeshire, UK
  4. 4MRC Cognition and Brain Sciences Unit, Cambridge, UK
  5. 5University of Glasgow, Glasgow, UK
  1. Fergus Gracey, ClinPsyD, Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK. Email: f.gracey@uea.ac.uk

Abstract

Background. Acquired brain injury (ABI) can impair executive function, impeding planning and attainment of intentions. Research shows promise for some goal-management rehabilitation interventions. However, evidence that alerts assist monitoring and completion of day-to-day intentions is limited.  
Objective. To examine the efficacy of brief goal-directed rehabilitation paired with periodic SMS text messages designed to enhance executive monitoring of intentions (assisted intention monitoring [AIM]).  
Methods. A randomized, double-blind, controlled trial was conducted. Following a baseline phase, 74 people with ABI and executive problems were randomized to receive AIM or control (information and games) for 3 weeks (phase 1) before crossing over to either AIM or no intervention (phase 2). The primary outcome was change in composite score of proportion of daily intentions achieved. A total of 59 people (71% male; 46% traumatic brain injury) completed all study phases.  
Results. Per protocol crossover analysis found a significant benefit of AIM for all intentions [F(1, 56) = 4.28; P = .04; f = 0.28; 3.7% mean difference; 95% CI = 0.1%-7.4%] and all intentions excluding a proxy prospective memory task [F(1, 55) = 4.79; P = .033; f = 0.28, medium effect size; 3% mean difference; 95% CI = 0.3%-5.6%] in the absence of significant changes on tests of executive functioning. Intention-to-treat analyses, comparing AIM against control at the end of phase 1 revealed no statistically significant differences in the attainment of intentions.  
Conclusion. Combining brief executive rehabilitation with alerts may be effective for some in improving achievement of daily intentions, but further evaluation of clinical effectiveness and mechanisms is required.
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