Deans' stroke musings: Longer time before acute rehabilitation therapy worsens disability after intracerebral hemorrhage

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.

Saturday, July 18, 2020

Longer time before acute rehabilitation therapy worsens disability after intracerebral hemorrhage

This is so fucking easy to explain, the hemorrhage cascade of death is occurring and immediate rehab forestalls that cascade. Whereas in ischemic strokes the

neuronal cascade of death seems to go on killing neurons regardless of initiation of rehab.

Longer time before acute rehabilitation therapy worsens disability after intracerebral hemorrhage

Archives of Physical Medicine and Rehabilitation , Volume 101(5) , Pgs. 870-876.

NARIC Accession Number: J83796. What's this?
ISSN: 0003-9993.
Author(s): Capo-Lugo, Carmen E. ; Askew, Robert L. ; Muldoon, Kathryn ; Maas, Matthew ; Liotta, Eric ; Prabhakaran, Shyam ; Naidech, Andrew.
Project Number: 90SF0010.
Publication Year: 2020.
Number of Pages: 7.

Abstract:

Study investigated the relationship between time to initiation of acute rehabilitation therapy during hospitalization and disability after intracerebral hemorrhage (ICH), and identified clinical and patient characteristics that best predict time to initiation of acute rehabilitation therapy. Data were obtained from 203 adults with ICH consecutively admitted to a certified comprehensive stroke center. Disability was assessed with the modified Rankin Scale (mRS), with poor outcome defined as mRS score = 4-6 (dependence or worse). Time to initiation of acute rehabilitation therapy was defined as the number of days between hospital admission and the first consult by any rehabilitation therapy specialist (e.g., physical therapy, occupational therapy, speech therapy). The median number of days from hospital admission to initiation of acute rehabilitation therapy was 3 (range=2-7). Multivariable logistic regression models indicated that each additional day between admission and initiation of acute rehabilitation therapy was associated with increased odds of poor outcome at 30 days (adjusted odds ratio [OR]=1.151) and at 90 days (adjusted OR=1.107) for patients with ICH. A multivariable linear regression model used to identify the predictors of time to initiation of rehabilitation therapy identified heavy drinking (>5 drinks per day), premorbid mRS<4, presence of pulmonary embolism, and longer length of stay in the intensive care unit as independent predictors of later initiation of acute rehabilitation therapy. Findings suggest that longer time to initiation of acute rehabilitation therapy after ICH may have persistent effects on post stroke disability. Delays in acute rehabilitation therapy consults should be minimized and may improve outcomes after ICH.
Descriptor Terms: ACUTE CARE, CLIENT CHARACTERISTICS, FUNCTIONAL STATUS, HEALTH CARE, MEDICAL ASPECTS, PREDICTION, REHABILITATION SERVICES, SERVICE DELIVERY, STROKE.

Can this document be ordered through NARIC's document delivery service*?: Y.

Citation: Capo-Lugo, Carmen E. , Askew, Robert L. , Muldoon, Kathryn , Maas, Matthew , Liotta, Eric , Prabhakaran, Shyam , Naidech, Andrew. (2020). Longer time before acute rehabilitation therapy worsens disability after intracerebral hemorrhage. Archives of Physical Medicine and Rehabilitation , 101(5), Pgs. 870-876. Retrieved 7/18/2020, from REHABDATA database.