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.

Tuesday, December 27, 2016

Considering Material Culture in Assessing Assistive Devices: “Breaking up the Rhythm”

Hopefully your doctors and therapists explain to you the progression from compensation with assistive devices to getting rid of them, this includes canes, AFOs, wheelchairs, braces and getting to 100% recovery. But if not this article is quite good, but you shouldn't read it because all medical info needs to come from your doctor and therapists regardless of how incompetent they are.
Oops, not following Dale Carnegie, 'How to Win Friends and Influence People'.
http://www.mdpi.com/2075-4698/6/2/14/htm
Sharon Anderson 1,*, Kerri Kaiser Gladwin 2, and Nancy Mayo 3,
1
Department of Human Ecology, University of Alberta, 302 Human Ecology Building, Edmonton, AB T6G 2N1, Canada
2
Department of Medicine, University of Alberta, Edmonton, AB T6G 2N1, Canada
3
School of Physical and Occupational Therapy, McGill University, 3654 prom Sir-William-Osler, Montréal, QC H3G 1Y5, Canada
*
Correspondence: Tel.: +1-780-953-5541; Fax: +1-780-492-4821
These authors contributed equally to this work.
Academic Editor: Gregor Wolbring
Received: 24 December 2015 / Accepted: 14 April 2016 / Published: 19 April 2016

Abstract

:
This paper reports on a project that looked at the meaning stroke survivors assigned to assistive devices. Material culture theory served as a framework to help stroke survivors explicitly consider [dis]ability as a discursive object with a socially constructed meaning that influenced how they thought about themselves with impairment. Material culture theory informed the design (taking and talking to their peers about photos of anything that assisted) and analysis of the meaning of the assistive devices project. In our analysis of the narratives, survivors assigned three types of meanings to the assistive devices: markers of progress, symbolic objects of disability, and the possibility of independent participation. Notably, the meaning of assistive devices as progress, [dis]ability, and [poss]ability was equally evident as participants talked about mobility, everyday activities, and services. We discuss how considering [dis]ability as a discursive object in the situation might have enabled stroke survivors to participate.
Keywords:
disability; material culture; stroke; assistive devices

1. Introduction

We live in a material culture [1]. Peoples’ clothing, furniture, transportation, music, art, and technology are chosen to perform a wide range of practical functions, but they also express an individual’s desired identity, as well as the individual’s position and class in society [2,3]. Objects have symbolic authority: “it is difficult to imagine a king without a throne, a judge without a bench… they are literally clothed with the vestment of the positions (p. 15)” [4]. As well, the meaning of all material and discursive objects are continually being created discursively through interactions [5]. In other words, the meaning of the king and the judge has changed with time and as the culture has changed. Meaning (material, social, cultural, linguistic) is a process, not a static product [1,5]. Accordingly, [dis]ability is constantly being defined through the bodily, social, and material cultural experiences of persons within their contexts [6,7].
External objects such as assistive devices can become vestments of self-image for people with bodily impairments ([dis]abilities). Assistive devices are the products, tools, or devices that facilitate participation in desired activities [8,9]. At their best, specialized assistive devices should increase ability by increasing independence, improving quality of life, and reducing the physical and attitudinal barriers between people with and without impairments [10,11]. Correspondingly, assistive devices can contribute to [dis]ability by setting people apart from others and making them feel different [12,13]. People with impairments are subjected to disabling societal attitudes that view them as less valuable, lazy, and/or objects of pity [14,15]. Assistive devices can become part of a person’s self-image, in effect increasing embarrassment, their felt stigma, and exerting a negative impact on one’s self-image [16,17].
While participation may be demanding or even impossible without assistive devices [18], consumers will abandon assistive devices prescribed by health professionals. Abandonment or non-use rates range from 30% in a study of 227 people with a variety of impairments [19] to 76.7% of 126 adults with neurological, lower extremity orthopedic, or complex medical conditions discharged from inpatient-rehabilitation [20]. Abandonment has been attributed to changes in needs (recovery or additional impairment), devices that are not suited to needs (heavy, awkward) [17,21,22] or because the device draws unwanted attention or increases stigma [16]. Only the person using assistive devices can estimate the capacity of those assistive devices to enhance their ability or increase disability.
Consumer involvement, i.e., actively seeking consumers’ experience and opinions, is recommended as the route to a better match between assistive technology and users [18,19,20,23]. Consumers are more likely to use assistive devices if: (1) their opinion is included in the selection of their devices; (2) the device is easy to obtain, reliable, comfortable, and easy to use; (3) the device contributes to personally meaningful activity or self-image; and (4) the device continues to meet consumers’ needs [19,23]. When people with disabilities are given the opportunity to assess their own needs and determine what assistive devices would work best for them, they are less likely to abandon their assistive devices. Involving people in the design, selection, and evaluation of adaptive devices can also be empowering [9]. Health literacy (knowledge about condition, treatments), self-confidence, ability to communicate, and participation in society (activities outside the home, e.g., volunteering) all increase when people are engaged [24,25,26].
The purpose of this paper is to report on employing material culture theory as a framework to help stroke survivors explicitly consider [dis]ability as a discursive object with socially constructed meaning that influences how they think about themselves with impairment. Discursive objects, i.e., words in conversations or texts, have cultural meanings that make a particular response contingently relevant in the situation [27]. Frequently, stroke survivors are unaware of the constructedness of this meaning and the possibilities of thinking about themselves and their environmental contexts in other ways. In specific terms, we report on a project that looked at the meaning stroke survivors assigned to assistive devices. The paper is organized into four sections. First, we situate this meaning of the assistive devices project into the “Getting on With the Rest of Your Life after a Stroke” intervention. Second, we describe material culture as an approach to enable stroke survivors to clearly understand how the meaning they attach to [dis]ability has consequences for how they “got on” with their post-stroke lives. Third, we proceed with the study’s methodology; report on the project in which participants discussed the meanings they attach to assistive devices; and outline participants’ evaluations of the project. Finally, we discuss how considering [dis]ability as a discursive object in the situation might have enabled stroke survivors to participate.
 
Full paper at the link. Only 40 references so your doctor should know about all of them



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