Deans' stroke musings: Cardiorespiratory strain during stroke rehabilitation: Are patients trained enough? A systematic review

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.

Monday, October 26, 2020

Cardiorespiratory strain during stroke rehabilitation: Are patients trained enough? A systematic review

Only once did I get my heart rate up, when I was racing against something on a biking machine. Otherwise my therapists were afraid to push me to breathlessness.

Cardiorespiratory strain during stroke rehabilitation: Are patients trained enough? A systematic review

Vicky Girard¹, Hubert Bellavance-Tremblay¹, Gabrielle Gaudet-Drouin¹, Geneviève Lessard², Myriam Dupont³, Marie-Andrée Gagnon², Armelle M Ngueleu², Stéphane Mandigout⁴, Charles Sebiyo Batcho⁵

Affiliations

PMID: 33080374
DOI: 10.1016/j.rehab.2020.09.007

Abstract

Background: Rehabilitation is a mandatory component of stroke management, aiming to recover functional capacity and independence.(WHY? Because you failed to stop the neuronal cascade of death in the first week? Place the blame for lack of recovery directly on your stroke doctors.) To that end, physical therapy sessions must involve adequate intensity in terms of cardiopulmonary stress to meet the physiological demands of independent living.

Objective: The aim of this systematic review was to determine the current level of cardiopulmonary strain during rehabilitation sessions in stroke patients.

Methods: Three electronic databases (PubMed, CINAHL and Embase.com) were searched to identify observational studies that documented cardiopulmonary strain during rehabilitation sessions in post-stroke patients (last search performed in February 2019). A manual cross-referencing search was also performed. To be included, articles needed to report data related to both cardiopulmonary strain (heart rate, oxygen consumption or energy expenditure) and active therapy time. The methodological quality of each study was assessed with the Evidence-Based Librarianship Critical Appraisal Tool. Data related to both cardiorespiratory strain and active therapy time were extracted from selected articles.

Results: Four of 43 full-text articles assessed for eligibility met the inclusion criteria. Results extracted from these articles suggested that the intensity of rehabilitation sessions was insufficient to induce a cardiopulmonary training effect in a post-stroke context as measured by metabolic stress. Patients were inactive from 21% to 80% of the therapy time. (This is for your therapists to solve.)The Evidence-Based Librarianship tool scores ranged from 65% (15/23) to 91% (21/23), which indicates questionable to good quality.

Conclusion: The current literature on cardiopulmonary solicitation during stroke rehabilitation sessions is poor in terms of both the number of studies available and their methodological quality. Summarized results tend to support previous claims that rehabilitation sessions offered to stroke patients are of suboptimal cardiopulmonary strain, which can interfere with their capacity to regain functional independence.

Keywords: VO2max; active time; cardiorespiratory fitness; heart rate; stroke rehabilitation.