Repetitive transcranial magnetic stimulation in stroke rehabilitation: review of the current evidence and pitfalls

So still NO PROTOCOLS.  A great stroke association would ensure that protocols are created for all stroke research and would have a publicly available database of all protocols and research for survivor use. We need a bottom up approach where survivors direct their own therapy. The top down approach has been a failure forever, proven by current rehab that only gets you 100% recovered 10% of the time.  Our non-existent stroke leadership and strategy has totally failed survivors.  None of the following have been solved or is even being worked on. 

No one is even addressing all these problems;

Here is their list of problems to solve. 'WHY THE HELL WON'T THEY WORK ON THEM? 

1. 30% get spasticity NOTHING THAT WILL CURE IT.

2. At least half of all stroke survivors experience fatigue Or is it 70%?

Or is it 40%?

NOTHING THAT WILL CURE IT.

3. Over half of stroke patients have attention problems.

NOTHING THAT WILL CURE IT.

4.  The incidence of constipation was 48%.

NO PROTOCOLS THAT WILL CURE IT.

5. No EXACT stroke protocols that address any of your muscle limitations.

6. Poststroke depression(33% chance)

NO PROTOCOLS THAT WILL ADDRESS IT. 

7.  Poststroke anxiety(20% chance) NO PROTOCOLS THAT WILL ADDRESS IT. 

8. Posttraumatic stress disorder(23% chance)  NO PROTOCOLS THAT WILL ADDRESS IT.

  9.  12% tPA efficacy for full recovery NO ONE IS WORKING ON SOMETHING BETTER.

10.  10% seizures post stroke NO PROTOCOLS THAT WILL ADDRESS IT. 

11. 21% of patients had developed cachexia NO PROTOCOLS THAT WILL ADDRESS IT. 

 

12. You lost 5 cognitive years from your stroke  NO PROTOCOLS THAT WILL ADDRESS IT.

13.  33% dementia chance post-stroke from an Australian study?

       Or is it 17-66%?

       Or is it 20% chance in this research?

NO PROTOCOLS THAT WILL ADDRESS THIS

 

The latest useless shit here:

Repetitive transcranial magnetic stimulation in stroke rehabilitation: review of the current evidence and pitfalls

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Francesco Fisicaro, Giuseppe Lanza, Alfio Antonio Grasso, ...

First Published September 25, 2019 Review Article

https://doi.org/10.1177/1756286419878317

Article information

Abstract

Acute brain ischemia causes changes in several neural networks and related cortico-subcortical excitability, both in the affected area and in the apparently spared contralateral hemisphere. The modulation of these processes through modern techniques of noninvasive brain stimulation, namely repetitive transcranial magnetic stimulation (rTMS), has been proposed as a viable intervention that could promote post-stroke clinical recovery and functional independence. This review provides a comprehensive summary of the current evidence from the literature on the efficacy of rTMS applied to different clinical and rehabilitative aspects of stroke patients. A total of 32 meta-analyses published until July 2019 were selected, focusing on the effects on motor function, manual dexterity, walking and balance, spasticity, dysphagia, aphasia, unilateral neglect, depression, and cognitive function after a stroke. Only conventional rTMS protocols were considered in this review, and meta-analyses focusing on theta burst stimulation only were excluded. Overall, both HF-rTMS and LF-rTMS have been shown to be safe and well-tolerated. In addition, the current literature converges on the positive effect of rTMS in the rehabilitation of all clinical manifestations of stroke, except for spasticity and cognitive impairment, where definitive evidence of efficacy cannot be drawn. However, routine use of a specific paradigm of stimulation cannot be recommended yet due to a significant level of heterogeneity of the studies in terms of protocols to be set and outcome measures that have to be used. Future studies need to preliminarily evaluate the most promising protocols before going on to multicenter studies with large cohorts of patients in order to achieve a definitive translation into daily clinical practice.