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, October 30, 2022

Large stroke trial finds intensive blood pressure lowering after clot removal worsens recovery

This makes perfect sense, less blood pressure means less oxygen being delivered to the brain probably hastening the death of those neurons in the penumbra.  So we still have no blood pressure management protocol and it seems likely it will stay that way for a long time with NO STROKE LEADERSHIP.

Large stroke trial finds intensive blood pressure lowering after clot removal worsens recovery

Credit: CC0 Public Domain

A large stroke trial has shown that intensive blood pressure lowering after clot removal worsens recovery. The results of the trial, stopped early due to the significance of the findings, were presented in a late-breaking session at the World Stroke Congress and simultaneously published in The Lancet.

Professor Craig Anderson, Director of Global Brain Health at The George Institute for Global Health, said the rapid emergence of this effect suggested the more aggressive approach was compromising the return of blood flow to the affected area.

"Our study provides a strong indication that this increasingly common treatment strategy should now be avoided in ," he said.

Around 85 percent of strokes are ischemic strokes, caused by the loss of blood flow to an area of the brain due to a blockage in a blood vessel, leading to a loss of neurological function.

Endovascular thrombectomy is an increasingly used non-surgical treatment for ischemic stroke, in which microcatheters or thin tubes visible under X-rays are inserted into the blood clot to dissolve it.

"A potential downside of this now widely used and effective treatment is that the rapid return of blood supply to an area that has been deprived of oxygen for a while can cause known as ," said Professor Anderson.

"This has resulted in a shift in medical practice towards more intensive lowering of blood pressure after clot removal to try and minimize this damage, but without evidence to support the benefits versus potential harms."

To try and address the evidence gap, researchers recruited 816 adults with acute ischemic stroke who had elevated blood pressure after clot removal from 44 centers in China between July 2020 and March 2022. They had an average age of 67 and just over a third were female.

407 were assigned to more-intensive (target <120 mm Hg) and 409 to the less-intensive (target 140-180 mm Hg) systolic blood pressure control, with the target to be achieved within one hour of entering the study and sustained for 72 hours.

Researchers looked at how well the patients in both groups recovered according to a standard measure of disability, ranging from 0-1 for a good outcome without or with symptoms but no disability, scores of 2-5 indicating increasing levels of disability (and dependency), and a score of 6 being death.

Patients in the more-intensively treated group had significantly worse scores on the scale compared to those allocated to those treated less intensively.

Compared to the less-intensive group, they had more early brain tissue deterioration and major disability at 90 days but there were no significant differences in brain bleeds, mortality, or serious adverse events.

Patients who had their blood pressure more intensively controlled also rated their quality of life as significantly worse due to limitations on their physical abilities resulting from their stroke.

Prof. Anderson said that after scouring the medical literature the research team had been unable to find strong enough evidence to recommend the ideal target for blood pressure control after blood removal in patients with acute .

"While our study has now shown intensive control to a systolic target of less than 120 mm Hg to be harmful, the optimal level of control is yet to be defined," he said.

New initiative to improve post-acute stroke care across Montana, Nebraska and North Dakota

 There is that lazy word again; 'care'. NOT RECOVERY OR RESULTS!

Once again measuring the wrong thing; 'care'. 

There is no quality here if you don't measure the right things.

  1. tPA full recovery? Better than 12%?
  2. 30 day deaths? Better than competitors?
  3. rehab full recovery? Better than 10%?


“What's measured, improves.” So said management legend and author Peter F. Drucker 

The latest here:

New initiative to improve post-acute stroke care across Montana, Nebraska and North Dakota

The American Heart Association, the world's leading voluntary organization focused on heart and brain health for all, is launching a two-year initiative to expand and enhance post-acute stroke care across Montana, Nebraska and North Dakota, giving all patients the best chance at independent life after stroke.

Made possible with a $1.5 million grant from The Leona M. and Harry B. Helmsley Charitable Trust, this initiative will implement the newly developed American Heart Association Post-Acute Stroke Care Quality Standards program in rehabilitation facilities across the three states, where the Trust recently supported efforts under the American Heart Association Mission: Lifeline® Stroke initiative. Adoption of the program will maximize recovery of function lost during a stroke, reduce risk of secondary effects, and extend high quality guideline-directed care for all patients across their full stroke journey. The Helmsley Charitable Trust previously funded the development and piloting of the Post-Acute Stroke Care Quality Standards program.

Across the U.S., approximately half of all stroke patients are discharged to in-patient rehabilitation, skilled nursing facilities, and long-term care facilities. Stroke is a leading cause of serious long-term disability and more than 11% suffer a second stroke within a year. Yet, post-acute care is often siloed from the rest of the health care system and inconsistent across care delivery settings.

Targeted, high-quality post-stroke rehabilitation interventions, customized to patient needs, can dramatically improve recovery of function lost during a stroke, but current gaps in the system of care can lead to high rates of hospital readmissions, variability in care coordination and sub-optimal outcomes for patients. This new initiative will help to ensure patients receive the most up-to-date science-informed care to improve recovery and reduce disability after experiencing a stroke."

Joel Stein, M.D., volunteer co-chair of the Association's standards writing committee and physiatrist-in-chief and chair of the Department of Rehabilitation and Regenerative Medicine at Columbia University Irving Medical Center in Irving, California

The new initiative seeks to establish post-acute care as a core component in the system of stroke care. Participating facilities will test the new standards to create benchmarks of success against which facilities nationwide will be able to assess their care.

This work expands on initiatives to strengthen the full spectrum of stroke care through the Association's Mission: Lifeline® Stroke program. Mission: Lifeline Stroke focuses on connecting all components of acute stroke care into a smoothly integrated system that reinforces the use of evidence-based guidelines to timely and effectively treat stroke patients. It brings together hospitals, emergency medical services and first responders, communications and regulatory agencies, state and local government, and payers to forge a proactive system of stroke care that saves and improves lives.

"In my experience as a first responder, I have witnessed firsthand the significant disparities in quality health care available close to home – disparities that demand attention," said Walter Panzirer, a trustee of the Helmsley Charitable Trust and former paramedic, firefighter and law enforcement officer. "Work like this initiative by the American Heart Association to expand access to care across rural communities is key to ensuring that where you live doesn't dictate the type of care you receive."

Since 2010, the Helmsley Charitable Trust's Rural Healthcare Program has committed more than $65 million to the American Heart Association's statewide Mission: Lifeline projects in the Upper Midwest.

IV thrombolysis may be safe in patients with ischemic stroke aged 90 years or older

What is your doctor doing to prevent this intracranial hemorrhage? NOTHING? Just hoping for the best? Then you don't have a functioning stroke doctor or hospital!

IV thrombolysis may be safe in patients with ischemic stroke aged 90 years or older 

The odds of 3-month symptomatic intracranial hemorrhage following IV thrombolysis for ischemic stroke among patients aged 90 years or older were not greater compared with younger patients, researchers reported.

“Higher probability of death and poor functional outcome during follow-up in the very elderly seems not to be related to IV thrombolysis (IVT) treatment. Very high age itself should not be a reason to withhold IVT,” Valerian L. Altersberger, MD, of the Stroke Centre and department of neurology at the University Hospital Basel and University of Basel, Switzerland, and colleagues wrote.

Heart Brain 2019 Adobe
The odds of 3-month symptomatic intracranial hemorrhage following IVT for ischemic stroke among patients aged 90 years or older were not greater vs. younger patients.
Source: Adobe Stock

Current IVT guidelines recommend IVT for patients with ischemic stroke who are > 80 years old. However, this recommendation is not based on evidence from any studies focusing on IVT in very elderly patients,” the researchers wrote.

The TRISP registry

Researchers used data from the Thrombolysis in Ischemic Stroke Patients (TRISP) registry to evaluate the 3-month safety of IVT in patients aged 90 years or older. Patients were compared with a younger cohort (< 90 years) for outcomes including intracranial hemorrhage, death and poor functional outcome at 3 months.

Poor functional outcome was defined as 3-month modified Rankin Scale score of 3 to 5 among patients with a before-stroke score of 2 or less, or a 3-month score of 4 to 5 in patients with before-stroke score of 3 or more.

Among 16,974 patients included in the analysis, 5.7% were aged 90 years or older.

Those aged 90 years or older were more often women, were more likely to have a before-stroke modified Rankin Scale score of 3 or more, and had higher NIH Stroke Scale score, BP, glucose and creatinine levels at hospital admission for stroke compared with the younger group.

Researchers reported that the likelihood of intracranial hemorrhage at 3 months was not significantly greater between the older and younger groups (older, 5.7%; younger, 4.4%; adjusted OR = 1.14; 95% CI, 0.83-1.57). However, the odds of death (aOR = 3.77; 95% CI, 3.14-4.53) and poor functional outcome at 3 months (aOR = 2.63; 95% CI, 2.13-3.25) were greater among patients aged 90 years or older compared with younger patients.

After adjustment for confounders, the probability of functional improvement after 24 hours did not differ among patients aged 90 years or older compared with younger patients (aOR = 0.85; 95% CI, 0.7-1.04), according to the study.

Plateau after 79 years

In a post hoc analysis in which patients were stratified by age, researchers observed the rate of symptomatic intracranial hemorrhage increased with every 10 years until patients were aged 70 to 79 years, after which point the rate of symptomatic intracranial hemorrhage remained stable.

“As expected, patients 90 years had more severe strokes, more often relevant prestroke disability and were more likely to have cardiovascular risk factors compared with patients < 90 years,” the researchers wrote. “Consequently, patients 90 years died more often during follow-up and had poorer functional outcomes even after adjustment for potential confounders.

“[A]lthough widely accepted risk factors for symptomatic intracranial hemorrhage were more frequent in the very elderly ... the probability of symptomatic intracranial hemorrhage after IVT did not differ significantly between patients 90 and < 90 years in our study. However, when analyzing the age-dependent probability for symptomatic intracranial hemorrhage by decade, the probability increased up to 70 to 79 years and plateaued for higher age, which might reflect a ceiling effect of symptomatic intracranial hemorrhage after the age of 70 in our cohort.

Prolonged Cardiac Monitoring and Stroke Recurrence

 So you wrote this up as a protocol and distributed it to all stroke hospitals in the world? Where can I find that protocol?  Just writing this stuff in a journal does nothing to get it into the correct hands that will implement it.

Prolonged Cardiac Monitoring and Stroke Recurrence

A Meta-analysis

Georgios Tsivgoulis, Sokratis Triantafyllou, Lina Palaiodimou, Brian Mac Grory, Spyridon Deftereos, Martin Köhrmann, Polychronis Dilaveris, Brittany Ricci, Konstantinos Tsioufis, Shawna Cutting, Gkikas Magiorkinis, Christos Krogias, Peter D. Schellinger, Efthymios Dardiotis, Ana Rodriguez-Campello, Elisa Cuadrado-Godia, Diana Aguiar de Sousa, Mukul Sharma, David J. Gladstone, Tommaso Sanna, Rolf Wachter, Karen L. Furie, Andrei V. Alexandrov, Shadi Yaghi, Aristeidis H. Katsanos

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Abstract

Background and Objectives Prolonged poststroke cardiac rhythm monitoring (PCM) reveals a substantial proportion of patients with ischemic stroke (IS) with atrial fibrillation (AF) not detected by conventional rhythm monitoring strategies. We evaluated the association between PCM and the institution of stroke preventive strategies and stroke recurrence.

Methods We searched MEDLINE and SCOPUS databases to identify studies reporting stroke recurrence rates in patients with history of recent IS or TIA receiving PCM compared with patients receiving conventional cardiac rhythm monitoring. Pairwise meta-analyses were performed under the random effects model. To explore for differences between the monitoring strategies, we combined direct and indirect evidence for any given pair of monitoring devices assessed within a randomized controlled trial (RCT).

Results We included 8 studies (5 RCTs, 3 observational; 2,994 patients). Patients receiving PCM after their index event had a higher rate of AF detection and anticoagulant initiation in RCTs (risk ratio [RR] 3.91, 95% CI 2.54–6.03; RR 2.16, 95% CI 1.66–2.80, respectively) and observational studies (RR 2.06, 95% CI 1.57–2.70; RR 2.01, 95% CI 1.43–2.83, respectively). PCM was associated with a lower risk of recurrent stroke during follow-up in observational studies (RR 0.29, 95% CI 0.15–0.59), but not in RCTs (RR 0.72, 95% CI 0.49–1.07). In indirect analyses of RCTs, the likelihood of AF detection and anticoagulation initiation was higher for implantable loop recorders compared with Holter monitors and external loop recorders.

Discussion PCM after an IS or TIA can lead to higher rates of AF detection and anticoagulant initiation. There is no solid RCT evidence supporting that PCM may be associated with lower stroke recurrence risk.

Glossary

AF=
atrial fibrillation;
AHA=
American Heart Association;
ASA=
American Stroke Association;
ESC=
European Society of Cardiology;
ESUS=
embolic stroke of undetermined source;
ICH=
intracranial hemorrhage;
ILR=
implantable loop recorder;
IS=
ischemic stroke;
NMA=
network meta-analysis;
PCM=
poststroke cardiac rhythm monitoring;
RCT=
randomized controlled trial;
RR=
risk ratio;
SUCRA=
surface under the cumulative ranking

Effect of the Shanghai Stroke Service System (4S) on the quality of stroke care and outcomes: A prospective quality improvement project

Once again measuring the wrong thing; 'care'. 

There is no quality here if you don't measure the right things.

  1. tPA full recovery? Better than 12%?
  2. 30 day deaths? Better than competitors?
  3. rehab full recovery? Better than 10%?


“What's measured, improves.” So said management legend and author Peter F. Drucker 

The latest here:

Effect of the Shanghai Stroke Service System (4S) on the quality of stroke care and outcomes: A prospective quality improvement project

Abstract

Background:

In China, disparities in the quality of stroke care still exist and implementing quality improvement is still a challenge.

Aim:

The aim of the study was to determine whether the intervention by Shanghai Stroke Service System (4S) has helped improve adherence to stroke care guidelines and patient outcome.

Methods:

The 4S is a regional stroke network with real-time data extraction among its 61 stroke centers in Shanghai. A total of 11 key performance indicators (KPIs) were evaluated. The primary outcomes were a composite measure and an all-or-none measure of adherence to 11 KPIs. The secondary outcomes were length of hospital stay and in-hospital mortality.

Results:

The study enrolled 92,395 patients (mean age 69.0 ± 12.5 years, 65.2% men) with acute ischemic stroke hospitalized within 7 days of onset in Shanghai from January 2015 to December 2020. More patients received guideline recommended care between 2018 and 2020 than those between 2015 and 2017 (composite measure 87.1% vs 83.6%; absolute difference 2.9%, 95% confidence interval (CI) = [2.7%, 3.2%], p < 0.001; all-or-none measure 49.2% vs 44.8% patients; absolute difference 3.5%, 95% CI = [2.7%, 4.2%], p < 0.001). Further analysis of individual KPIs showed an absolute increase in six KPIs ranging from 3.4% to 8.9% (p < 0.001 for all comparisons). Compared with 2015–2017, hospital length of stay was shorter (10.95 vs 11.90 days; absolute difference –1.08, 95% CI = [–1.18, –0.99], p < 0.001), and in-hospital mortality was significantly reduced (risk ratio (RR) = 0.88, 95% CI = [0.79, 0.98], p = 0.01) in 2018–2020.

Conclusion:

The 4S intervention was associated with increased adherence to the stroke care guidelines, which further translated to improved clinical outcomes.

Trial registration:

ClinicalTrials.gov identifier: NCT02735226.

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A framework for clinical utilization of robotic exoskeletons in rehabilitation

You mention limited guidance on the use of these but don't actually solve the problem.

1. What is the objective diagnosis that would indicate use of each one of these. 

2. What is the EXACT PROTOCOL for their use?

3. What is the expected result from following that protocol?

A framework for clinical utilization of robotic exoskeletons in rehabilitation

Abstract

Exoskeletons are externally worn motorized devices that assist with sit-to-stand and walking in individuals with motor and functional impairments. The Food & Drug Administration (FDA) has approved several of these technologies for clinical use however, there is limited evidence to guide optimal utilization in every day clinical practice. With the diversity of technologies & equipment available, it presents a challenge for clinicians to decide which device to use, when to initiate, how to implement these technologies with different patient presentations, and when to wean off the devices. Thus, we present a clinical utilization framework specific to exoskeletons with four aims.

These aims are to assist with clinical decision making of when exoskeleton use is clinically indicated, identification of which device is most appropriate based on patient deficits and device characteristics, providing guidance on dosage parameters within a plan of care and guidance for reflection following utilization. This framework streamlines how clinicians can approach implementation through the synthesis of published evidence with appropriate clinical assessment & device selection to reflection for success and understanding of these innovative & complex technologies.

Background

The evolution towards evidenced based practice in physical therapy has progressed over the past 25 years, however many barriers to effective translation to clinical practice persist [1]. One critical barrier is when a novel intervention or technology is introduced, there is a paucity of evidence and processes to guide clinicians on how it can be integrated into their everyday clinical practice.

In the current manuscript, we will discuss the clinical use of robotic exoskeletons, which have come into commercial availability since 2011. In the context of this manuscript, exoskeletons are defined as externally worn devices that assist with sit-to-stand and gait training in individuals with motor and functional impairments. They have tremendous potential to assist in the delivery of rehabilitative care through improved efficiency, decreased cost with ability to achieve a high stepping dosage and intensity, and decreased therapist-burden and risk of injury compared to other gait training strategies [2, 3]. The field of robotic technologies is rapidly evolving, with a projected growth of 26% over the next 5 years [4]. Exoskeletons currently approved for clinical use by the US FDA include RewalkTM, Ekso™, Indego™, Hybrid Assistive Limb (HAL) TM for medical use (lower limb type), Rewalk Restore™, B-Temia Keeogo + ™ and Honda Walking Assist Device (WAD)TM.(5, 6) Table 1 describes the FDA-approved device features including level of assistance, resistance modulation, joint control, type of feedback, and stepping actuation. Exoskeletons currently are not considered standard of care in rehabilitation, however patients often seek facilities offering these advanced technologies. Given the emerging evidence of clinical utility, patient interest, and anticipated growth of the field, it is critically important clinicians can effectively evaluate and implement the use of these devices.

Table 1 Comparison of FDA Approved Exoskeleton Devices. Summary of current devices in marketplace with difference in joints controlled, location and type of support provided, resistance or assistance capabilities, method of stepping actuation, and minimum walking function required

B LE = bilateral lower extremity device, U LE = unilateral lower extremity device, FP = fully powered; device provides majority of power at joints and user needs little to no volitional strength to utilize; PA = partially assistive; device provides customized partial assistance to augment deficits to improve gait.

Depending on the rehabilitation facility, clinicians may have access to only one of these devices while others may have multiple options. Regardless of the device availability, practitioners must systematically assess the technology’s features related to their patient’s impairments and functional level to determine if utilization is indicated. Table2 describes the outcomes from randomized control trials to date that have focused on use of FDA approved devices compared to conventional care.

Table 2 Clinical outcomes for trials including diagnoses approved by FDA. Summary of objective outcome measures pre to post intervention from clinical trials investigating FDA approved diagnoses

Specifically, this manuscript focuses on diagnoses approved for use by the FDA. Studies which have investigated the sub-acute and chronic stroke populations included persons with single or unilateral stroke, with a majority including individuals greater than 55 years of age [7,8,9,10,11, 14, 15]. In the incomplete spinal cord injury (SCI) population, most investigations are single group interventional studies or pilot randomized trials. These studies mostly focus on inclusion of participants with incomplete (AIS C or D) injuries with upper motor neuron signs and sufficient upper extremity strength to use an assistive device. Studies focusing on participants with cervical level injuries, AIS A and B injury classification, and lower motor neuron injuries are limited and with varying sample sizes of 9–52 subjects [12, 13]. It should be noted, the aim in many of these studies was to obtain FDA approval with a primary focus on establishing safety with one primary efficacy outcome. Thus in many cases, the true functionality and clinical effectiveness of these devices has not been investigated. Furthermore, these studies also do not focus on dosing, progression strategies, or rehabilitation principles critical to therapeutic intervention [16,17,18].

Adding more uncertainty to application of the available literature, the clinical practice guideline (CPG) for improving walking function in chronic neurological diagnoses, recommended against utilizing robotic interventions [17]. Ten of the eleven studies referenced were not the FDA approved devices focused on in this current manuscript, and eight of the studies focused on treadmill-based robots, specifically the Lokomat [17] These conclusions should be taken with caution, given the substantial differences in functionality and physical demand between the treadmill-based robots and the overground exoskeletons of current focus. Thus, understanding the current literature along with synthesis of knowledge from clinical experience regularly utilizing exoskeletons in practice was critical in developing this framework.

In this four-step framework, we focus specifically on clinical application, rather than exoskeleton use for personal mobility. As authors, we are in a unique position to propose a comprehensive framework to assist in this systematic evaluation due to having extensive experience utilizing a wide array of these exoskeletons during the research and development phase, FDA clinical trials, as well as extensive use in everyday clinical practice [2, 11, 14, 19, 20].

Framework

Fig. 1
figure 1

4-step clinical exoskeleton framework. Framework structures clinical decision making surrounding appropriate patient identification, leveraging suitable technology to match patient needs, implementing into a plan of care and clinical reflection to guide further use

Step 1: Clinical indications for exoskeleton use

Clinicians performing evaluations may identify a patient is suitable for exoskeleton utilization at the beginning of an episode of care, or when challenges arise during gait training within a conventional plan of care. Often a patient’s clinical presentation does not match the exact inclusion/exclusion criteria described in the published literature. This should not preclude a clinician from considering incorporation of exoskeleton technology in the plan of care. Inclusion criteria can serve as a baseline for understanding which patient populations and presentations have been investigated to date. Because technology and software development often outpace scientific research, frequently the device investigated is an older version with fewer features or modes than what is available currently.

Saturday, October 29, 2022

World Stroke Organization Tackle Gaps in Access to Quality Stroke Care

Look how fucking worthless the WSO is. Working on 'CARE' NOT RECOVERY OR RESULTS! They need to be destroyed and run by survivors for survivors.  I forwarded this to Anita, we'll see if she responds.

World Stroke Organization Tackle Gaps in Access to Quality Stroke Care

GENEVA, Switzerland, Oct. 28, 2022 /PRNewswire/ -- On World Stroke Day (29th Oct), the World Stroke Organization has announced the launch of a new program that aims to drive access to quality acute stroke care and save lives around the world.

The WSO Stroke Certification initiative is a strategic response to the results of a WHO-WSO survey which found that less than half (49%) of countries could provide comprehensive evidence-based acute stroke care. The survey also identified a huge gap in provision of care between high- and low- and middle-income countries. While 91% of high-income countries were able to provide access to specialist stroke unit care, the number was just 8% in low-income countries. 

Two of the fundamental markers of quality acute stroke care are the provision of thrombolysis (the removal of blood clots using intravenous medication) and thrombectomy (the removal of blood clots by keyhole surgery). Research published by WSO found global rates of access to these treatments stand at 46% and 30% respectively.

'One in four of us will have a stroke in our lifetime, yet the majority of people globally lack access to effective treatment and stroke center care. On top of this, a lack of effective global prevention strategies has led us to a place where stroke is the second leading cause of death and the third leading cause of disability worldwide, with a soaring human and economic cost,' said WSO President Professor Marc Fisher. Incoming WSO President and leading Brazilian neurologist, Professor Sheila Martins added: 'We have the knowledge and tools that could save millions of lives and hundreds of millions of dollars. Delivering quality stroke care is not just the right thing to do, it's the smart thing to do.'

WSO's Global Stroke Guidelines and Action Plan aim to help institutions and governments implement evidence-based criteria and standards for care developed by WSO. Initially targeting hospitals in middle-income countries, the program will be launched on Nov 1st with the primary aim of growing the global network of accredited stroke care providers.

Stroke is a leading cause of death and disability worldwide. On World Stroke Day the public, health care professionals, stroke survivors, politicians and industry leaders will come together to raise awareness of stroke symptoms and the importance of timely treatment.  

The public can follow the campaign on social media using #Precioustime and help raise awareness by sharing a clock selfie or participating in the strokespotter.org online game challenge.

Notes to Editors

I. The World Stroke Organization is the only global body solely focused on stroke. With around 3000 individual and 100 society members, spanning every global region, we represent over 55,000 stroke specialists in clinical research and support services. WSO is in official relations with WHO and has UN consultative status.
II. The WSO Stroke Certification program builds on the WSO-SIEVC Certification program in Latin America and the Caribbean https://www.world-stroke.org/news-and-blog/news/wso-siecv-certification-of-stroke-centers-in-latin-america-and-caribbean
III. State of stroke services across the globe https://journals.sagepub.com/doi/abs/10.1177/17474930211019568 
IV. WSO Global Stoke Factsheet https://www.world-stroke.org/publications-and-resources/resources/global-stroke-fact-sheet 
V. World Stroke Day website www.worldstrokecampaign.org

Contacts:

Anita Wiseman,
Campaign & Partnerships Manager, WSO
campaign@world-stroke.org
+447940029444

Determination and rehab promote stroke survivor's message: never give up!

 

Or would you rather get this opposite information? I have given up on consistent stroke rehab because it's pretty much useless until somebody solves spasticity. I don't need to beat my head against the wall when life is out there to live and useless rehab doesn't get me anywhere better.


Wharton's No. 1 professor Adam Grant: 'Never give up is bad advice.'

 

Why "Never Give Up" Is Bad Advice - Heleo

 

Why "Never Give Up" is a Bad Motto - The Berkeley Science Review

 

3 reasons why "Never Give Up" is really bad advice - The Chief

 

15 Reasons "Never Give Up" Is Terrible Advice | TheTalko

 

When "Never Give Up" is Bad Advice - The Meaning Movement

The latest here:

Determination and rehab promote stroke survivor's message: never give up!

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The victim of three strokes in a matter of 14 months has turned his back on his wheelchair and taken his place among walkers in a Kawana business hub’s Walk for Daniel.

Garry Reynolds attributed his recovery to his ‘never give up’ attitude, the support of his family and the great work of several rehabilitation and support services, including Comlink on the Sunshine Coast.

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“I was bedridden to start with and the therapist asked me, ‘Alright, mate, what is your vision?’ and I said, ‘I’d like to walk out of here and be part of mainstream life again and not a passenger’,” Garry explained.

“And I’d like to ballroom dance again, because I had a stroke on a ballroom dance floor’.

“So, we set that goal, they had me working out at the gym, five hours a day, the whole bit.”

Comlink volunteer Jenny Humphrey with her pup Geordie, and stroke survivor Garry Reynolds. Picture: Richard Bruinsma.

Garry was living in Canberra at the time of his strokes and was so determined to bounce back that, when he moved to Caloundra earlier this year, he left his wheelchair behind.

Through the work of rehabilitation staff initially at the University of Canberra and these days at the Sunshine Coast University Hospital, Garry has recovered strongly and is now living independently. Comlink Australia provides him with in-home care and support.

He even had a dancer-turned-therapist who used his love of ballroom dancing to influence some exercises.

“She was so keen and she was so creative with the exercises – she would come up with routines and would make all the exercises really fun,” Garry said.

“And they would let me choose the music in the gym, and turn the volume up, so I got really spoiled.”

He was invited by Comlink to join the mini Walk for Daniel hosted by Comlink and the Vitality Village health hub near SCUH.

Garry Reynolds takes part in the mini Walk for Daniel around 
Lake Birtinya. Picture: Richard Bruinsma.

Teneale Rush, of Comlink Sunshine Coast, said Garry showed just what can be achieved in life if you combine the right attitude with the right professional support.

“He struggled deeply with feeling like a burden to his family members as he was living with his daughter and her husband … he requested that they allow him six months to prove he could live independently with the help of Comlink Australia,” she explained.

“Fourteen months later he is now fully mobile, highly socially active … he is a wonderful gentleman.”

Garry was a teacher and public servant and wrote six books during in his working life; he has used writing as therapy and is now writing some of the life stories of friends and acquaintances.

He still has another goal to tick off his to-do list – a return to ballroom dancing.

But for now, he’s happy with his progress and to share his positive story.

“Things could look bad … (but) if you look hard enough, there’s always a win-win result.”

For information about Comlink Australia visit comlinkaustralia.com.au