Biomarkers DO NOTHING TO GET SURVIVORS RECOVERED. You need to create rehab protocols. Are your mentors and senior researchers that clueless? You really don't understand stroke at all do you? Rehab is a complete failure, only 10% get fully recovered. You have to stop a lot of neurons dying in the first week from the 5 causes of the neuronal cascade of death in the first days.
I lost 5.4 billion neurons that first week. If I'd only lost 177 million neurons in the 90 minutes it took to get tPA I'd easily be recovered by now. They are not even focusing on the humongous elephant in the room(the neuronal cascade of death), just swatting mites on the gnats.
Upper-Limb Motor Intervention Elements That Drive Improvement in Biomarkers and Clinical Measures Post-Stroke: A Systematic Review in a Systems Paradigm
Abstract
Objective
To
use a systems paradigm to examine upper limb (UL) motor intervention
elements driving biomarker and clinical measure improvement after
stroke.
Methods
Databases
were searched up to March 2022. Eligibility screening was completed by 2
authors. Studies using biomarkers and clinical measures pre- and
post-upper limb intervention were included. Studies of adjunct
interventions (eg, brain stimulation) were excluded. Cochrane
Risk-of-Bias tools and Template for Intervention Description and
Replication were used to rate studies. Studies were synthesized using a
systems paradigm: intervention outcome was considered an emergent
property of the systemic interactions of 4 intervention elements
(demographics, type, quality, and dose) characterized by individual
dimensions.
Results
Sixty-four
studies (n = 1814 participants) containing 106 intervention groups (66
experimental; 40 control) were included. Combined biomarker and clinical
outcomes defined 3 scenarios: restitution, mixed, and unchanged. The
restitution scenario included more moderate-to-severely impaired
participants in earlier recovery phases (<6 months). Interventions
with graded difficulty were more frequently used in the restitution
scenario compared with the unchanged scenario. No difference in quality
or amount of therapy was identified when examining scenarios that
demonstrated restitution compared to those that did not (mixed and
unchanged).
Conclusions
A
systems paradigm may be one of many approaches to understand UL motor
restitution. This review found no single element consistently delivered
improvements in biomarkers and clinical measures in the examined
intervention groups. Complex patterns formed by multiple interacting
intervention elements were observed in participants with and without
restitution.
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