Showing posts with label 'management'. Show all posts
Showing posts with label 'management'. Show all posts
Saturday, July 11, 2026
Wednesday, July 8, 2026
Post Stroke Management: Optimizing Care after the Acute Phase - Luke Bradbury, MD
There couldn't be more useless words in stroke than 'management' and 'care'! A hell of a lot of people in stroke need to be fired, starting with this MD!
Post Stroke Management: Optimizing Care after the Acute Phase - Luke Bradbury, MD
Intended Audience
This activity is designed for nurses, physicians (including EM, hospitalists, primary care, and neurology), neurosurgeons, and stroke coordinators.
Learning Objectives
As a result of participation in this educational activity, members of the healthcare team will be able to:
- Discuss guidelines and common pitfalls for post-stroke blood pressure management in the subacute and chronic phases of care
- Explain the various strategies for antiplatelet and anticoagulation treatment for different stroke subtypes
- Identify which patients are most appropriate to refer to cardiology for consideration of PFO closure
- Describe how the latest studies and guidelines inform the management of symptomatic and asymptomatic carotid artery stenosis
- NOTHING ON HOW TO GET SURVIVORS RECOVERED! Or don't you ever think what survivors want?
Monday, May 11, 2026
Post-stroke insomnia: multidimensional mechanisms, clinical heterogeneity, and toward mechanism-informed, objectively quantified management
The key word signifying failure in this is 'management' NOT CURE OR PREVENTION!
You didn't think that maybe survivors want it prevented! Oh, you did NO THINKING AT ALL!
- 32 to 41% insomnia in stroke survivors
(2 posts to December 2024)
Post-stroke insomnia: multidimensional mechanisms, clinical heterogeneity, and toward mechanism-informed, objectively quantified management
Abstract
Stroke survivors frequently experience sleep disturbance, among which post-stroke insomnia (PSI) is common yet often underrecognized across the post-stroke course. Although its clinical expression may vary over time, PSI is associated with reduced rehabilitation engagement, impaired quality of life, and potentially adverse long-term outcomes. Accumulating evidence suggests that PSI is not a unitary entity; rather, it reflects interacting neurobiological and psychosocial processes, including injury to sleep–wake regulatory networks, neurotransmitter and circadian disruption, neuroinflammation, hypothalamic–pituitary–adrenal (HPA) axis and autonomic hyperarousal, hemodynamic and neurovascular dysfunction, and comorbid conditions such as pain, nocturia, and sleep-disordered breathing. Despite growing interest, PSI management in clinical practice largely follows general insomnia strategies, and interpretation of treatment effects is constrained by heterogeneous intervention protocols, limited objective sleep assessment, and short follow-up.
Methods: This narrative review was informed by searches of PubMed, Web of Science, Google Scholar, and Chinese databases (CNKI and Wanfang) from inception to February 2026, complemented by reference screening. This review synthesizes key mechanistic domains and sources of heterogeneity in post-stroke insomnia (PSI) and discusses a pragmatic, mechanism-informed approach emphasizing objective sleep phenotyping and coordinated management of dominant drivers. We highlight controversies, current research gaps, and near-term opportunities to advance PSI care through standardized definitions, combined subjective–objective outcomes, and stratified interventions aligned with patient-level mechanisms.
Friday, May 8, 2026
The neuroplasticity-based model (NBM): an updated neurorehabilitation model that emphasizes evidence-informed strategies to induce neuroplastic changes
Nothing here will guarantee survivor recovery, right?
You haven't identified the EXACT signals between neurons that tell one neuron to drop their use and take on a neighboring neuron's use! That could then make neuroplasticity repeatable on demand. Until that occurs ALL OF THIS SUPPOSED NEUROPLASTICITY RESEARCH IS ALMOST COMPLETELY FUCKING USELESS!
The neuroplasticity-based model (NBM): an updated neurorehabilitation model that emphasizes evidence-informed strategies to induce neuroplastic changes
Sarah dos Anjos Mary H. Bowman Alexandra Evancho Brian King show all Received 21 Feb 2025 Accepted 15 Apr 2026 Published online: 03 May 2026 Cite this article https://doi.org/10.1080/09638288.2026.2662103Purpose
Since its inception, neurorehabilitation principles guiding patient/client assessment and management have evolved alongside scientific discoveries. Historically, three models have shaped neurorehabilitation assessment and intervention: muscle-reeducation, neurotherapeutic facilitation, and contemporary task-oriented approaches, grounded in reflex, hierarchical, and systems theories of motor control and recovery. In recent decades, neuroplasticity research has challenged established principles of neurorehabilitation, supporting a shift toward an updated model. The purpose of this paper is to describe the implications of neuroplasticity research for neurorehabilitation and propose a new model that integrates emerging theories of adaptive neuroplasticity promotion in rehabilitation.Methods
This special interest paper explores the current understanding of neuroplasticity and the implications of these findings for management(NOT RECOVERY!) of neurologic movement dysfunction. Based on the current literature, we propose and describe a fourth neurorehabilitation model, the Neuroplasticity-Based Model (NBM), that may better guide clinical assessment and management.Results
The NBM’s five therapeutic aims include optimal intervention delivery, experiences designed to focus attention, intentional experiences to induce physiological stress, health promotion strategies, and behavioral change support. These aims are tailored to individual factors to create client-centered interventions that promote adaptive neuroplasticity.Conclusion
The NBM offers a comprehensive framework for integrating emerging neuroplasticity discoveries into neurorehabilitation practice.IMPLICATIONS FOR REHABILITATION
Current neurorehabilitation models require updating to integrate recent neuroplasticity research into the recovery process. The Neuroplasticity-Based Model (NBM) proposes four core therapeutic aims applied according to individual factors to induce neuroplastic changes during rehabilitation. Rehabilitation professionals are encouraged to systematically design motor training that includes a “just-right challenge”(So, NOTHING EXACT! or repeatable) to assure cognitive effort while also promoting success to motivate further efforts. During therapy, clinicians should apply interventions that prioritize one function at a time, promoting specificity and optimizing neuroplastic changes related to that function.Monday, May 4, 2026
Muscle energy techniques for post-stroke spasticity: mechanisms and clinical applications
You still incompetently haven't cured spasticity! Survivors want it CURED; not 'managed'! I'd fire you all for not understanding survivor requirements! Comeuppance is going to be a bitch when you are the 1 in 4 per WHO that has a stroke? Then you just might want 100% recovery. Better start that research NOW!
Muscle energy techniques for post-stroke spasticity: mechanisms and clinical applications
Abstract
Spasticity is a common and disabling complication after stroke, often leading to progressive joint stiffness, restricted movement, and reduced functional independence. Current management strategies for post-stroke spasticity (PSS) are limited by inconsistent efficacy and a lack of standardized protocols. Muscle energy techniques (MET) have emerged as a promising non-invasive approach, though their mechanisms and clinical value in PSS remain poorly understood. This review summarizes available evidence on MET for PSS based on systematic searches of PubMed, Web of Science, CNKI, and WanFang up to November 2025. MET may alleviate PSS through two main routes, namely inhibiting spinal and cortical motor neuron excitability and modulating pain pathways, though the evidence for these mechanisms remains limited and comes mainly from experimental studies. Key clinical studies indicate that MET can reduce(NOT GOOD ENOUGH! It's not a cure, is it?) muscle tone, improve range of motion, and enhance(NOT GOOD ENOUGH! It's not a cure, is it?)functional outcomes, with particularly notable effects on upper limb spasticity. However, heterogeneity in treatment protocols and a shortage of high-quality trials limit the strength of current conclusions. We further discussed critical limitations, including the reliance on active patient participation, which may preclude its use in persons with stroke with significant cognitive or motor deficits. Future directions include standardizing treatment protocols and integrating MET with emerging technologies such as biofeedback and brain-computer interfaces. This review offers a mechanistic and clinical framework to support the evidence-based integration of MET into PSS rehabilitation.
Monday, April 20, 2026
Advances in the diagnosis and management of post-stroke limb spasticity: a narrative review
Where is the CURE SPASTICITY RESEARCH?
'Management' is NOT what survivors want! They want it CURED! Are you that stupid that you believe in the idiotic opinion of the infamous Dr. William M. Landau thinks spasticity is not worth treating!
Do you believe in the do nothingism of Dr. William M. Landau on spasticity?
His statement from here:
Spasticity After Stroke: Why Bother? Aug. 2004
Wonder if he will be singing the same tune after he becomes the 1 in 4 per WHO that has a stroke, will he be satisfied with not getting recovered?
The latest here:
Advances in the diagnosis and management of post-stroke limb spasticity: a narrative review
Abstract
Objective:
This review aims to provide a comprehensive overview of the current understanding and clinical management of post-stroke limb spasticity.
Methods:
Literature searches were conducted in PubMed and CNKI databases for articles published between January 2000 and June 2025, using keywords related to post-stroke spasticity, assessment, and interventions (botulinum toxin, rehabilitation, neuromodulation, surgery). The search was restricted to English-language articles addressing post-stroke limb spasticity. After screening, 68 studies were included and categorized by research theme.
Results:
Several interventions were identified as effective in alleviating post-stroke limb spasticity. Specifically, botulinum toxin injection has emerged as the primary choice for managing focal spasticity. Neuromodulation methods, including transcranial magnetic stimulation, transcranial direct current stimulation, spinal cord stimulation, and vagus nerve stimulation, demonstrated significant therapeutic potential.(NOT GOOD ENOUGH! WHERE THE FUCK IS THE CURE?)
Conclusion:
Neuromodulation techniques exert their effects by adjusting corticospinal tract excitability and promoting neural plasticity. However, additional randomized controlled trials are necessary to optimize stimulation settings and confirm their long-term effectiveness.
More at link.
Wednesday, March 18, 2026
UMBRELLA: Using AI to improve stroke care from SAFE(Stroke Alliance for Europe)
A complete fucking failure! 'Care' NOT RECOVERY!
Really hope your comeuppance is incredibly difficult when you become the 1 in 4 per WHO that has a stroke! Not recovering 100% is going to be a real bitch since you DID NOTHING when you could have! Until 100%recovery research is out there, artificial intelligence isn't going to do much good. Wrong goal: the only goal in stroke is 100% recovery! GET THERE!
UMBRELLA: Using AI to improve stroke care
On Brain Awareness Week’s third day we are focusing on UMBRELLA, a European research project that uses artificial intelligence (AI) and digital tools to improve how strokes are diagnosed, treated and managed(Survivors want recovery; NOT managing their compensation! Don't you people HAVE ANY BRAINS AT ALL?).
A stroke occurs when blood flow to the brain is blocked or a blood vessel bursts. Quick treatment is vital, but recovery can be long and complex and many survivors remain at risk of another stroke.
UMBRELLA aims to support doctors by using AI to help them make faster and more personalised decisions, while keeping patient information safe and private.
The project follows a careful process: health data is securely collected, organised and analysed inside hospitals. Personal details are removed, and strict privacy rules are followed. The AI is then trained to recognise patterns and tested to make sure it works safely and truly helps patient care.
Led by Vall d’Hebron Research Institute and Siemens Healthineers, and supported by the EU’s Innovative Health Initiative, the project brings together hospitals, researchers, patient organisations and companies from across Europe.
“Stroke survivors live with many long-term challenges. Better tools to support them are urgently needed. UMBRELLA is an exciting step toward more personalised and effective stroke care, with the potential to make a real difference for patients and families across Europe,” said Arlene Wilkie, Director General of SAFE.
By improving diagnosis, treatment and prevention, UMBRELLA aims to transform stroke care(NOT RECOVERY!) and improve the quality of lives(This should be return them to their previous lives!) of thousands of people.
To learn more about the project:
Visit the Umbrella website https://umbrella-ihi.eu
Or contact research@safestroke.eu
This project is supported by the Innovative Health Initiative Joint Undertaking (IHI JU) under grant agreement No 101172825. The JU receives support from the European Union’s Horizon Europe research and innovation programme and COCIR, EFPIA, Europa Bío, MedTech Europe and Vaccines Europe.
Summary of the best evidence for frailty management in patients with ischemic stroke during the rehabilitation period
'Management' NOT PROTOCOLS that prevent frailty; so completely fucking useless! Your mentors and senior researchers are hopelessly useless!
Summary of the best evidence for frailty management in patients with ischemic stroke during the rehabilitation period
Xiaokang Wang &Zhe ZhangCite this article https://doi.org/10.1080/00207454.2026.2643316 Citations
Background
To retrieve and summarize the best evidence for frailty management in patients with ischemic stroke during the rehabilitation period, providing reference for clinical practice.
Methods
The system searches for literature on stroke frailty management in domestic and foreign databases and guideline websites, with a search period from the establishment of the database to November 2024. Two researchers independently evaluated the quality of the literature and organized and summarized the evidence. Results
A total of 22 articles were included, 4 guidelines, 1 expert consensus, 7 systematic reviews, 1 evidence summary, 1 quasi-experimental study, and 8 randomized controlled trials. Finally, 31 pieces of evidence were summarized from six aspects: frailty assessment, team building, exercise intervention, nutritional support, psychosocial support, and health education.
Conclusions
The best evidence summary for frailty management in stroke patients is comprehensive, and medical staff should combine clinical application evidence to effectively improve patient frailty.
Tuesday, March 3, 2026
New Webinar: Understanding Post-Stroke Fatigue
'Understanding' DOES NOTHING TO PREVENT FATIGUE! Survivors want it prevented, you blithering idiots, not 'understood'! My god, the absolute stupidity in stroke is out of this world!
Here's how long you have been incompetent in not getting fatigue solved!
- post stroke fatigue
(57 posts to January 2018)
At
least half of all stroke survivors experience fatigue Known since March 2017
Or is it 70%? Known since March 2015
Or is it 40%? Known since September 2017
The latest here:
New Webinar: Understanding Post-Stroke Fatigue
A large number of stroke survivors live with post-stroke fatigue, a challenging and often misunderstood effect of stroke that can impact daily life in many ways. Unlike ordinary tiredness, this kind of fatigue doesn’t simply disappear after rest. It happens because the brain is working harder to reroute messages and compensate for injured areas, using up energy much faster than before. For many people, it can feel unpredictable, frustrating and, at times, overwhelming — especially because it’s invisible to others. To help shine a light on this important topic, we’re hosting our first webinar of 2026, bringing together a panel of four stroke survivors who will share their personal experiences of living with fatigue. They’ll talk openly about what can trigger it, how it affects their lives, and the practical ways they manage it day to day(Survivors don't want it 'managed'! They want it CURED! Can't you get that thru your thick skulls?
You've had over a decade to work on that, what the hell have you accomplished?). As there are currently no specific medications or treatments for post-stroke fatigue, learning self-management strategies — and hearing what works for others — can be incredibly valuable.
Date: Wednesday 25 March
Time: 11:30am
Where: Online via Zoom
This supportive, informative session is free to attend and open to all. If fatigue is part of your stroke journey, or you want to better understand someone who lives with it, we’d love you to join us.Why attend? This session is a chance to hear real voices, real stories and real strategies. You’ll gain insight into how different fatigue can feel from person to person, and why finding your own approach is so important. Whether you’re a stroke survivor, family member, carer or professional, the discussion will offer understanding, reassurance and practical ideas.The webinar features four inspiring speakers who each bring unique perspectives: Lynne Cameron ;– Had her first stroke 7½ years ago while gardening and experienced another last year. Fatigue has remained one of her biggest ongoing hurdles.
Andy Wilson – Had a stroke aged 46 while wild camping after completing a half marathon and cycle ride. He later retired from the Police Force and is finishing a PhD, learning to adapt to fatigue along the way.
Karl Davis – Experienced two strokes at 39 caused by a PFO and was medically retired from his role as a Traffic Police Officer. He now volunteers extensively but still lives with significant fatigue years later.
Maggie Doar – Had a major brain haemorrhage in 2020 requiring emergency surgery and months in hospital. She has since explored fatigue management strategies and believes understanding your own limits is key. As always, you’re invited to submit questions before the webinar and during the live session. We’ll answer as many as possible, making sure the discussion reflects what matters most to our community.
Wednesday, February 18, 2026
Special Episode: The 2026 AHA/ASA Guideline for Early Management of Acute Ischemic Stroke
I'm not wasting my time listening to 'management' crapola!
REALLY! Useless guidelines; NOT PROTOCOLS! The comeuppance for you is going to be hell when you are the 1 in 4 per WHO that has a stroke? Then you just might want 100% recovery and guidelines DO NOT GUARANTEE THAT!
Special Episode: The 2026 AHA/ASA Guideline for Early Management of Acute Ischemic Stroke
Kelly King
Mind Moments®, a podcast from NeurologyLive®, brings you an exclusive interview with Shyam Prabhakaran, MD, MS. [LISTEN TIME: 15 minutes]Shyam Prabhakaran, MD, MS
A special episode of the NeurologyLive®
The Mind Moments podcast features exclusive interviews with leaders in the field discussing the latest research and disease management strategies across the breadth of neurology, including epilepsy, multiple sclerosis (MS), Parkinson disease, dementia, sleep disorders, and more.
In this special episode, "The 2026 AHA/ASA Guideline for Early Management of Acute Ischemic Stroke," Shyam Prabhakaran, MD, MS, the James Nelson and Anna Louise Raymond Professor of Neurology and chair of the Department of Neurology at the
Subscribe to:
Posts (Atom)