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, July 10, 2022

Gait in Cerebral Small Vessel Disease, Pre-Dementia and Dementia: A Systematic Review

 My gait is still impaired 16 years post stroke and will stay that way until I die. I have zero cognitive impairment.

Gait in Cerebral Small Vessel Disease, Pre-Dementia and Dementia: A Systematic Review

First Published July 7, 2022 Research Article 

Background:  

The interrelationships between gait, cerebral small vessel disease (CSVD), and cognitive impairments in aging are not well-understood – despite their common co-occurrence.

Objective:  

To systematically review studies of gait impairment in CSVD, pre-dementia, and dementia and to identify key gaps for future research and novel pathways toward intervention.

Methods:  

A PRISMA-guided search strategy was implemented in PubMed to identify relevant studies. Potential articles (n=263) published prior to December 1st, 2021 were screened by two reviewers. Studies with sample sizes >20 and including some adult over >65 years (n=202) were included.

Results: 

The key findings were that 1) adverse gait and cognitive outcomes were associated with several (rather than select) CSVD pathologies distributed across the brain, and 2) poor gait and CSVD pathologies were more strongly associated with dementia with a vascular, rather than an Alzheimer’s disease-related, cause.

Discussion: 

A better understanding of the interrelationships between gait performance in CSVD, pre-dementia and dementia requires studies examining a) comprehensive patterns in the clinical manifestations of CSVD, b) racially/ethnically diverse samples, c) samples followed for extended periods of time or across the adult lifespan, d) non-traditional CSVD neuroimaging markers (e.g., resting-state fMRI), and e) continuous (e.g., wearable sensors) and complex (e.g., dual-task) walking performance.

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