Deans' stroke musings: Electrical stimulation as a means for achieving recovery of function in stroke patients

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.

Sunday, May 24, 2020

Electrical stimulation as a means for achieving recovery of function in stroke patients

Ask your doctor if ANY PROTOCOLS have been created for this in the past 11 years. If we had a great stroke association we could easily look that up by checking out the publicly available database of all stroke research and rehab protocols. The gatekeeping of rehab knowledge by your doctor and therapists needs to be removed.

Electrical stimulation as a means for achieving recovery of function in stroke patients

2009, NeuroRehabilitation

Dejan B. Popovi´ ca,b,∗, Thomas Sinkjærc and Mirjana B. Popovi´ ca,b,d aDepartment of Health Science and Technology, Aalborg University, Denmark bFaculty of Electrical Engineering, University of Belgrade, Serbia cDanish National Research Foundation, Copenhagen, Denmark dInstitute for Multidisciplinary Research, Belgrade, Serbia

∗Address for correspondence: Prof. Dejan B. Popovic, Aalborg University, Department of Health Science and Technology, Fredrik BajersVej 7, D3, 9220 Aalborg, Denmark. Tel.: +45 99408726; Fax: +45 98154008; E-mail: dbp@hst.aau.dk.

Abstract.

This review presents technologies used in and assesses the main clinical outcomes of electrical therapies designed to speed up and increase functional recovery in stroke patients. The review describes methods which interface peripheral systems (e.g., cyclic neural stimulation, stimulation triggered by electrical activity of muscles, therapeutic functional electrical stimulation) and transcranial brain stimulation with surface and implantable electrodes. Our conclusion from reviewing these data is that integration of electrical therapy into exercise-active movement mediated by electrical activation of peripheral and central sensory-motor mechanisms enhances motor re-learning following damage to the central nervous system. Motor re-learning is considered here as a set of processes associated with practice or experience that leads to long-term changes in the capability for movement. An important suggestion is that therapeutic effects are likely to be much more effective when treatment is applied in the acute, rather than in the chronic, phase of stroke.
Keywords: Electrical stimulation, peripheral nerves, cortical stimulation, brain excitability, motor re-learning, stroke

1. Introduction

Stroke patients are often unable to functionally use upper and/or lower extremities on one side of their bodies. This impairment limits normal eating, drinking, walking, personal hygiene, and many other activities. Rehabilitation aims to enable stroke patients to regain hand/arm/leg function, as well as other vital functions, and to return to independent life-style in the easiest, simplest, and fastest way. Efﬁcacy of rehabilitation depends on the degree of initial severity of stroke and the initial treatment, as well as on the time interval from stroke to initiation of voluntary movement. Rehabilitation encompasses various techniques which are used to manipulate elements of the central and peripheral nervous system and includes neurodevelopmental techniques, proprioceptive neuromuscular facilitation, biofeedback, robot-assisted therapy, mirror therapy, constraint intensive movement therapy, and electrical stimulation [29]. Electrical nerve stimulation is a method for activation of sensorimotor mechanisms [88]. Electrical stimulation (ES) activates sensory-motor systems by delivering electrical charge in the form of bursts of electrical pulses(phasic activation). The characteristics of phasic activation are: frequency of pulses (f), pulse duration (T), and pulse amplitude (I); these are termed stimulation parameters. Recruitment of individual cells and summation of the effects of ES are directly related to stimulation parameters. Stimulation at low levels (low pulse amplitude, short pulse duration) activates afferent pathways, while strong stimulation activates both afferent and efferent pathways. Electrical stimulation can be directly applied to cortical tissues. In this case either direct DC stimulation is applied at low intensity over the skull, or tonic activation at low frequencies is accomplished by means of implantable systems. Finally, cortical tissue can be excited by electrical currents induced by means of repetitive transcranial magnetic stimulation.

More at link.