Deans' stroke musings: Comparing the effects of two spasticity management strategies on the long-term outcomes of individuals with bilateral spastic cerebral palsy: a multicentre cohort study protocol

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.

Wednesday, July 3, 2019

Comparing the effects of two spasticity management strategies on the long-term outcomes of individuals with bilateral spastic cerebral palsy: a multicentre cohort study protocol

Someplace in here our stroke leaders should be able to use this to help the 30% of survivors that have spasticity. But nothing will occur since our stroke leaders have their heads buried so far up their asses they can't see any way to use research that is out there might be able to solve any of the Problems in stroke.

Comparing the effects of two spasticity management strategies on the long-term outcomes of individuals with bilateral spastic cerebral palsy: a multicentre cohort study protocol

Meghan E Munger1,
Brian Po-Jung Chen1,2,
Bruce A MacWilliams3,4,
Mark L McMulkin5,
Michael H Schwartz1,2

Author affiliations

Abstract

Introduction Spasticity is one of the primary pathologies associated with cerebral palsy (CP), yet no definitive evidence exists to guide the appropriate level of spasticity management for an individual. Spasticity management strategies often differ by center. On one end of this strategy spectrum is a highly-interventional approach, characterized by treatments such as a selective dorsal rhizotomy (SDR), intrathecal baclofen pump (ITB), and anti-spasticity injections and medications. On the other end of the spectrum is a less interventional approach, involving minimal use of these treatments, and no SDR.

Methods and analysis A retrospectively-matched, multi-center study protocol is described that comprehensively compares the long-term outcomes of a highly-interventional versus a minimally-interventional spasticity management strategy. We will analyze two groups of adults with spastic bilateral CP (≥21 years). In one group are individuals who underwent an SDR between the ages of 4 and 10 years, along with ongoing spasticity management during childhood and adolescence. In the other group are individuals who received minimal spasticity management and did not undergo an SDR. Individuals with prolonged use of an intrathecal baclofen (ITB) pump will be excluded. The two groups will be matched for spasticity and other important clinical characteristics at baseline. This study design improves on many of the limitations found in the existing outcome literature.

Ethics and dissemination This study received necessary approval from the University of Minnesota and Western Institutional Review Boards. Results will be disseminated via peer-reviewed publications and conference presentations.

Trial registration number NCT03789786.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.