Deans' stroke musings: An update on predicting motor recovery after stroke

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.

Friday, May 21, 2021

An update on predicting motor recovery after stroke

What the fuck good does prediction of non-recovery do? Do you tell your patients you have nothing that will get them 100% recovered? Or will you be like my doctor and know nothing and tell nothing about stroke?

An update on predicting motor recovery after stroke

W.D.Byblow^b^c¹ S.H.Ward^c

^a: Clinical Neuroscience Laboratory, Department of Medicine, University of Auckland, Private Bag, 92019 Auckland, New Zealand

^b: Centre for Brain Research, University of Auckland, Private Bag, 92019 Auckland, New Zealand

^c: Movement Neuroscience Laboratory, Department of Sport and Exercise Science, University of Auckland, Private Bag, 92019 Auckland, New Zealand

Received 9 August 2014, Accepted 9 August 2014, Available online 27 August 2014.

https://doi.org/10.1016/j.rehab.2014.08.006Get rights and content

Under a Creative Commons license

open access

Abstract

Being able to predict an individual's potential for recovery of motor function after stroke may facilitate the use of more effective targeted rehabilitation strategies, and management of patient expectations and goals. This review summarises developments since 2010 of approaches based on clinical, neurophysiological and neuroimaging measures for predicting individual patients’ potential for upper limb recovery. Clinical assessments alone have low prognostic accuracy. Transcranial magnetic stimulation can be used to assess the functional integrity of the corticomotor pathway, and has some predictive value but is not superior when used in isolation due to its low negative predictive value. Neuroimaging measures can be used to assess the structural integrity of descending white matter tracts. Recent studies indicate that the integrity of corticospinal and alternate motor tracts in both hemispheres may be useful predictors of motor recovery after stroke. The PREP algorithm is currently the only sequential algorithm that combines clinical, neurophysiological and neuroimaging measures at the sub-acute stage to predict the potential for subsequent recovery of upper limb function. Future research could determine if a similar algorithmic approach may be useful for predicting the recovery of gait after stroke.