Objectively measured arm use in daily life improves during the first 6 months poststroke: A longitudinal observational cohort study

My objective analysis of my left arm use is that is is never used in any normal activities, 15 years later. Spasticity needs to be cured first because the hand will not open without force.  This research told us absolutely nothing of any use whatsever. I do use it when chainsawing but the right hand has to open the left hand to get it around the bar. This is needed because if kickback occurs it needs the left arm there to engage the brake.

 Objectively measured arm use in daily life improves during the first 6 months poststroke: A longitudinal observational cohort study

Journal of NeuroEngineering and Rehabilitation , Volume 18(51)

NARIC Accession Number: J86074.  What's this?
ISSN: 1743-0003.
Author(s): Regterschot, G. R. H. ; Bussmann, J. B. J. ; Fanchamps, Malou H. J. ; Meskers, Carel G. M. ; Ribbers, Gerard M. ; Selles, Ruud W..
Publication Year: 2021.
Number of Pages: 10.

Abstract: 

Study investigated the change in arm use during the first six months after stroke and compared arm-use changes between arm recovery clusters. Arm use was measured in 33 stroke patients during week 3, 12, and 26 poststroke with accelerometers on the wrists and the nonaffected leg. Outcomes were the amount of affected and nonaffected arm use during sitting and standing per day and per sit/stand hour, and the daily ratio between arms. Arm function was measured with the Fugl-Meyer Upper Extremity Scale to identify recovery clusters (poor/moderate/excellent). Generalized estimating equations compared arm use outcomes between time points and between recovery clusters. Affected arm use per day increased between week 3 and 12 (30 percent) and it increased per sit/stand hour between week 3–12 (31 percent) and between week 3 and 26 (48 percent). Nonaffected arm use per day decreased between week 3 and 12 (13 percent) and between week 3 and 26 (22 percent) and it decreased per sit/stand hour between week 3 and 26 (18 percent). The daily ratio increased between week 3 and 12 (43 percent) and between week 3 and 26 (95 percent). Changes in arm use did not differ significantly between recovery clusters. Affected arm use was higher in the excellent recovery cluster. Affected arm use and the ratio between arms increase during the first 26 weeks poststroke especially in patients with excellent arm recovery.
Descriptor Terms: BODY MOVEMENT, DAILY LIVING, LIMBS, MEASUREMENTS, STROKE.


Can this document be ordered through NARIC's document delivery service*?: Y.
Get this Document: https://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-021-00847-x.

Citation: Regterschot, G. R. H. , Bussmann, J. B. J. , Fanchamps, Malou H. J. , Meskers, Carel G. M. , Ribbers, Gerard M. , Selles, Ruud W.. (2021). Objectively measured arm use in daily life improves during the first 6 months poststroke: A longitudinal observational cohort study.  Journal of NeuroEngineering and Rehabilitation , 18(51) Retrieved 5/18/2021, from REHABDATA database.
 

Finally, morels

 In the 7 years I'm been looking for morels this is only the second year I found some. Was working on clearing a new trail, the chain came off my chainsaw and I sat down with it in my lap trying to get the chain in the bar grooves, making sure the chain engages the sprockets and then use that one hand to put the plastic housing on and screw the toggle down. Spent at least a half hour there failing at least a dozen times.  Finally looked out and saw a morel 6 feet away. Packed away the chainsaw in pieces, then walked around the area finally picking up 15 morels. Will head out there again tomorrow.

Tree removal

After coming back from Portugal this 10" log needed to be cut thru and moved. My battery powered chainsaw only lasts 4 minutes at a time, so in 5 days I visited it 10 times and still had to cut the last inch by hand. I haven't tried my gas powered chainsaw yet, maybe that vibration would be enough to kickstart my left arm/wrist/hand recovery. WHOM DO I GO TO TO ASK THAT QUESTION?

Mighty trophy tree hunter

A friend needed a branch cut down. Being the over confident idiot I am, I said sure I can do it. I'll bring my battery chainsaw and other pruning saws.A 12 foot extension ladder was propped up against the tree and my chainsaw handed to me, got a third of the way thru before the battery quit, it is a battery that no longer seems to hold a charge. It is quite challenging forcing a reluctant left hand open enough to grab the top bar of the chainsaw and still stay in place on the ladder. Finished cutting thru the branch, maybe 9 inches thick, with my 13 inch pruning saw. It fell wedging itself upright against the trunk three feet below the top of the ladder. Good thing it didn't swing out and fall all the way, it would have knocked the ladder down. Cut off one of the branches sticking in the ground and pulled it all the way down. Borrowed a neighbors plug in electric chainsaw and cut the limb into 16 inch pieces for firewood. Felt good to be useful once again. Dangerous as all get out but that is me. I had a summer job for 6 years as a steeplejack, the reason I got the job was because the previous employee died when he fell from the top of a steeple when he was trying to unrig the ropes.

Don't follow me, I'm stroke addled.

End result

End result

half the branches pile

Finally totally on the ground

The light post survived

Wedged three feet down from cutoff point

Most of the small branches removed, the two limbs on the ground and the base wedged against the trunk kept it upright 

Successful tree branch hunt

 

 

Trophy pose

Tree removal

Don't follow me.

2 large 14-18 inch trees fell across the paths. It is a 20-30 minute hike back to them through 3 mudholes. My 14 inch electric chainsaw only lasts for 4 minutes when cutting logs this size. I don't trust myself to use my 16 inch gas chainsaw. My Dad quite a few years ago when cutting down a butternut tree told me that chainsawing would be good therapy for my arm/hand. I can't see hospital lawyers approving any type of release form for survivors to participate in such therapy.
This tree needed to be cut in multiple pieces and took two weeks to accomplish.

The very right limbs of this were cut by hand

The 5 foot middle section is rolled off the trail in the middle of the picture almost out of sight

The before picture

The next tree was even larger, I sometimes walked back here three times a day since I only managed 1 inch in depth for each battery charge. I had manged to get maybe halfway through when I walked out there one morning and heard a chainsaw running. It seems a neighbor uses that trail to dump grass clippings and leaves and needed to get thru. The six pieces he cut it into would have taken me all summer. Today I got thru a 7 inch tree in three cuttings, it had been dead quite a long time.

The before

The aftermath

Tree clearing on trails

Finally got my electric chainsaw working. I have to clear some major trees yet. I don't trust my ability to use my gas chainsaw and a friend has threatened to steal the gas one. Both of these are a 20 minute walk to get to. I get to see turkeys way back here.

Only about 12 inches in diameter

The major trunk is 18 inches in diameter, I will work on the smaller upper half.

New rehab items from storage locker

Over Christmas I was back in Minnesota and picked up more stuff. Three sleeping bags, enough to allow me to go winter camping again as long as someone I trust can zip me up and out again. My backpack and a couple of Duluth Packs. My camping stove, Svea 123, the greatest stove I've owned. Now all I need is a tent.  My 16 inch gas powered chainsaw, trail clearing here I come. Several friends have said they would do interventions if I attempted to use that. Well I don't even listen to my own voice telling me not to do stuff.

Can Brain Imaging Detect Risk Takers?

I think I have recovered relatively well because I am willing to take risks on the exercise I do and the situations I put myself into. With no challenges you will likely not recover very well. Magic Johnson did not become a great basketball player by practicing layups, he practiced the hard stuff precisely because it was hard. You are going to have to push your therapists to actively give you therapy that is very difficult. My best example of risk taking is considering and using a chainsaw for therapy, a lesser one is walking in the dark with no flashlight or walking on ice or bar stool rehab.
Your doctor should be telling you that stroke rehab will be the hardest thing you ever will have done.
http://brainblogger.com/2014/10/18/can-brain-imaging-detect-risk-takers/

Brain Structure May Predict Risky Behavior

Don't you think your doctor should know how much of a risk-taker you are? They really should know if you are willing to do bar stool rehab or chainsaw rehab  or bike rehab or canoe rehab

Brain Structure May Predict Risky Behavior

Safety last

Don't follow my ideas. Three weeks ago I fell on my left butt twice while trying to move a couple of long branches off the trails. Last night I finally saw the results, a 1x4 inch bruise on the upper butt and a 8x10 inch purple and green bruise from the butt down the left rear of the thigh. No selfies will be provided. This is pushing boundaries way beyond what Scott has in his blog post 'Safety First'.
But I'm good, I didn't cut off an arm with the chainsaw.

And my balance was good enough not to land on the 6-8 inch logs lying on the ground.
This pretty much matches my Epic failure at bike stroke therapy.

Trail clearing rehab

My battery powered chainsaw is a problem. When cutting thru thicker wood the chain loosens up and comes off the bar after 5 minutes. I thought 4 weeks ago that I had just 2 trees to clear. 2 weeks ago a storm came through and I had another 4 trees to clear. This afternoon I finally got through one of the problem trees and got to walk the back loop. Another 4 more trees to clear yet. As long as the snow holds off for a couple more weekends I can get this accomplished and xc ski the trails this winter. In carrying the branches off the trails I managed to heavily fall on my left butt twice, luckily not into brambles or rose bushes.  I'm walking with a heavy limp tonight because of that and using vitamin I.  I am using gumshoe boots to walk the trails now. An excellent stroke rehab  boot because it has  no ankle support. 2 hours of walking is great for my ankle muscles and balance.

Clearing trails

After about a dozen trips into the woods with my chainsaw I got the tree limbs cleared. Only pinched and bound the bar up about 6 times, they were interesting times to free it up, the 14 inch pruning saw did the job with lots of swearing.  The chain loosened up and fell off the bar numerous times. The worst one was when I took it back to the apartment and ended up taking the bar off totally, getting it back on one-handed while tightening the bolt was problematic. That led to the next problem, I went out the next day to try to finish up the last two logs and found out that I had put the chain on in the wrong direction. It burnished the log instead of cutting it.
I'm now in the process of clearing  the tall grass and weeds with this.

I probably have 6 weeks before the snow comes.
All this is giving me lots of exercise

Chainsaw stroke rehab - really

I got my battery powered 10 inch chainsaw and walked the trails until I got to the 8 limbed tree across the trail, cut thru 5 of the 8 6-8 inch limbs yesterday. Its only 5.5 lbs so it never feels out of control. My gas one had a 16 inch bar and weighed 18-20 lbs, that one had power and would be dangerous  to use right now. It only lasted about 20 minutes. On the walk out I brushed my arm on stinging nettle, too bad it was on my good arm, the bad arm could have used the extra burning sensation. Today I went out again and got thru 2 more limbs before running out of power. I got the bar stuck trying to get thru a 10 inch limb on the ground. Finally got it freed by leveraging one of the branches on top of my shoulder.
Went out again this afternoon after the 90 minute recharge, got the big tree fully cleared for skiing. Cleared 3 more small trees lying across the trail. Two more 8-10 inch trees to cut sections out of, then I can walk the far loop again to see what needs doing out there
This is all in preparation to be able to cross-country ski the trails.

Don't do this!!! Its stupid.


I'm not sure where  I found this graphic but it was used in my Dangerous Stroke Rehab presentation. And Chainsawing was not even the most dangerous, walking is.