Stroke Rehabilitation: Which is the Main Functional Outcome to Reach?

 You're THAT FUCKING STUPID that you don't know that the only goal in stroke is 100% recovery? Don't you dare bring up your tyranny of low expectations to justify your COMPLETE INCOMPETENCE IN STROKE!

You may have 500 publications between you four but obviously you haven't talked about what survivors want without dumbing down their goals.

Oops, I'm not playing by the polite rules of Dale Carnegie,  'How to Win Friends and Influence People'. 

Telling your supposedly smart stroke medical 'professionals' they know nothing about stroke is a no-no even if it is true. 

Politeness will never solve anything in stroke. Yes, I'm a bomb thrower and proud of it. Someday a stroke 'leader' will try to ream me out for making them look bad by being truthful, I look forward to that day.

Stroke Rehabilitation: Which is the Main Functional Outcome to Reach?

Loredana Cavalli*, Andrea Guazzini, Bruno Rossi and Carmelo Chisari

University of Florence, Italy

Abstract

Background: 

Stroke rehabilitation targets range from treatment of spasticity to pain reduction, gait speed gain, or

autonomy amelioration. A correct evaluation of individual residual capabilities is essential to select the most appropriate rehabilitative programme; furthermore the observation of rehabilitative outcomes can provide information about gait training effects and possible compensation mechanisms.

Aim: To investigate the main outcome to reach in stroke rehabilitation.

Methods: 

We examined retrospectively a heterogeneous sample of 119 subjects recovered for the treatment of stroke outcomes. Functional parameters were assessed before and after rehabilitative treatment, such as upper limbs motility impairment, lower limb sensitiveness, muscle trophism or tone, necessity of auxilium, Berg and Fugl-Meyer scale.

Results: 

A consistent improvement of standing equilibrium was reported, regardless of gender, stroke nature,

hemiparetic side, type of rehabilitation performed, botulin toxin use and initial conditions, with an average increase of Berg and Fugl-Meyer scales score of 14% and 21%, respectively. The variation of equilibrium and motility across treatment resulted directly proportional and negatively correlated to lower limbs sensitivity impairment. On the contrary, initial equilibrium resulted inversely correlated with the variation of motility and vice versa. Interestingly, older subjectsm seem to better increase equilibrium and sensitivity as measured by Fugl-Meyer scale.

Conclusion: 

In stroke subjects any type of rehabilitation leads to a consistent improvement of standing balance.

While proportional to motility and sensitivity increase, this result is inversely correlated to initial motility score, suggesting that an appropriate evaluation of the stroke patient’s functional parameters at admission contributes to select the main rehabilitation targets and the best therapeutic strategy.