How To Pace Your Stroke Recovery Process

Notice they could find NOTHING USEFUL. Guidelines like this are full of crap.

How To Pace Your Stroke Recovery Process

(Newswire.net -- November 9, 2020) -- It is always smart and extremely integral to be well-informed about some, if not all, health complications, so that we don't tend to panic if, God forbid, a loved one happens to encounter them. If you're someone looking for the ultimate guide to stroke recovery, you've stumbled upon the right article, as it aims to lay out all the necessary information that you may grasp on your journey towards healing.

What is a stroke?

A stroke, also known as a brain injury, or if put in medical terms is called a cerebrovascular accident that causes damage to part of the brain as a result of a sudden blockage of arteries.

Recovery from Stroke:

Recovery from stroke is something that varies from individual to individual depending on some factors like age, overall health, etc. It may also vary depending upon the type of stroke the person has been affected with. So, there is no exact time frame calculated for complete recovery from the injury. While there is no span of time that is allocated to the recovery, the National Stroke Association claims that 10% of people affected are able to fully recover.(Did your doctor inform you of this appalling statistic?) 25% of people are seen to recover with slight impairment and 40% might experience dire disablements and need critical care.

Steps towards Recovery:

Stroke recovery begins as soon as the condition of the sufferer stabilizes and the disease is under control. The following steps have been formulated for you so that you may acquire knowledge and begin its implementation.

1.  DISCIPLINE YOURSELF

The first and foremost rule is to attain as much authentic information as you can, as it will aid in recovery. Make sure you have all the right advice and you are seeking help from proper medical practitioners. The following points are collected and summarized in order for you to educate yourself:

• Consult your doctor/nurse/therapist regularly and keep yourself updated on your current situation.(Why? They know nothing about recovery.)
  
• You may ask other stroke survivors about how they dealt with the trauma and what helped them recover.(They didn't recover.)
  
• The internet is a massive space that is filled with useful information. You may do your research and get answers to all the confusion in your head by just the touch of your finger.(You won't find a goddamn thing, I've been looking for a decade and never found anything useful. But then I'm looking for dead brain rehab and I don't think anyone is researching that.)
  
• You may consider learning what rehabilitation is required depending upon your condition.

2. STROKE REHABILITATION

The process will largely lie upon the segment of the body that is affected. Multiple steps contribute to the rehabilitation process, like:

i) Physical Activity:

In order to enhance your muscle strength and coordination, it is recommended to practice motor skill exercises and carry proper physical therapy sessions with the associated professional. Moreover, don’t only rely upon your therapy sessions only. You may consider taking a walk around with some help with you. Generally, try to be as physically active as you can. Regular physical activity should become a habit as it will contribute towards a healthy lifestyle. Choosing a healthy lifestyle is one of the most important factors that will eliminate the chances of you having to face a stroke again.

ii) Speech Therapy:

You may want to visit a speech therapist in order to attain fluent speech if you're having trouble understanding and producing speech. Taking regular speech therapy sessions will help you:

• Addressing problems related to oral/ motor functioning.
• If the survivor faces trouble swallowing, the associated therapist will introduce proper positioning techniques accompanied by special food techniques that contribute to your well being.
• Exercises and adaptations will be communicated with you in order to facilitate a return to normal living.

iii) Occupational Therapy:

If you're encountering trouble performing day-to-day activities it is possible that you may find a cure through occupational therapy. By proper occupational therapy you can:

• Relearn everyday valuable skills including grooming, using a computer and cooking, etc.
• It will help with the proper function of motor and sensory skills.

iv) Nutritional Therapy

If you are keen to heal, healthy dietary habits should not be compromised at all. A registered dietitian can help you in planning the diet you should be consuming. Moreover, we are providing you with general guidelines that will contribute to elevating your health. According to research people who are recovering should definitely be incorporating the beneficial foods for stroke recovery and following the steps listed below:

• Optimizing their body weight to a healthy range.
• Eating Variety of foods that are inclusive of all food groups and make sure that no food group is eliminated from the diet and ensure that you're consuming a nutrient-dense diet.
• Incorporate more fiber in your diet to regulate bowel movements and it will decrease the chances of you having to face a stroke again.

HOW TO INCORPORATE MORE FIBER IN YOUR DIET?

Consider whole grains your best friend! Don’t start your day without consuming whole-grain cereal or toast.

• Exchange fruit juices with consuming whole fruits.
• Try having beans with a green salad for lunch.
• Start making use of yogurt and cottage cheese.
• Cut down the sodium from your meals. Consuming a large amount of sodium has been seen to make blood pressure levels rise.

WONDERING HOW TO TRIM DOWN ON SODIUM?

Don’t you worry we have got you covered!

• Substitute your table salts with natural herbs.
• Minimize the use of packaged and canned foods
• Try eating freshly cooked foods in every meal.
• Removal of trans fats from your diet will provide the benefits that you're aiming for. Since the excessive use of trans fats is seen to be associated with higher cholesterol levels which lead to heart disease in worst-case scenarios it is best to discard them from everyday use.

SUBSTITUTES FOR TRANS FATS:

• Think smart and replace deep-fried foods with baked/grilled foods which will automatically provide healthier meals.
• Try understanding labels, and buy nonfat margarine instead of regular margarine.
• Exchange hydrogenated oil with vegetable oil.
• Make sure you're eating the right amount of fruits and vegetables in your diet.

We hope that we have eradicated all the chaos that you might have faced and the information provided works in your favor. Feel free to share this information so that it may benefit another person too. Remember that carrying out each step holds its own unique value. Each step mentioned is vital for the recovery from stroke and therefore should be carried out without any negligence. If all the steps and guidelines are followed religiously they will all show their own benefits and will aid in recovery. Make sure that you’re missing out on none and you read everything thoroughly.

Source: http://newswire.net/newsroom/blog-post/00125688-how-to-pace-your-stroke-recovery-process.htm

Clinical Data Reveals 6-month "Golden Rehabilitation Period"

Because of crap titles like this we don't get the research needed past that 6 month period to get 100% recovered. Making neuroplasticity and neurogenesis repeatable on demand are BHAG(Big Hairy Audacious Goals, but leaders tackle such goals.

Clinical Data Reveals 6-month "Golden Rehabilitation Period"

• The report on Clinical Performance and Quality of Rehabilitation for 2018-2019 released jointly by Consanas Rehabilitation and SIMC Rehabilitation Medicine Center reveals dramatic improvement in stroke patient survival rate with rehabilitation beginning within six months of onset. Stroke rehab should start as early as possible, but even if it starts later, it's not too late. 
• Studies show rehabilitation to be one of the most pivotal elements of stroke recovery, reducing functional disability, improving quality of life and lowering potential healthcare costs
• Professor Schoenle, Clinical Head of Consanas Rehabilitation, has studied and summarized key differences between Chinese and German neuro rehabilitation from four aspects: philosophy, patient management, innovative therapy methods and high-tech application.

SHANGHAI, June 4, 2020 /PRNewswire/ -- Strokes have become the leading cause of death among China's 1.4 billion population. Stroke patients also often suffer from harmful sequelae, such as hemiplegia, aphasia, cognitive dysfunction and a loss of ability to practice self-care, all of which can severely affect their quality of life. Rehabilitation is scientifically proven to be one of the most effective means to reduce the rate of disability among stroke patients.

Consanas Rehabilitation--a Boehringer Ingelheim brand, and SIMC Rehabilitation Medicine Center - supported by Consanas recently released a joint paper: "Report on Clinical Performance and Quality of Rehabilitation for 2018-2019". These findings in this report prove that the effect of functional rehabilitation can be greatly improved if the rehabilitation process starts early, within the six-month "golden" recovery period. But thereafter, improvements can still be achieved, only it takes longer. 

Earlier stroke rehabilitation, better functional recovery

Currently, 3.5 million stroke patients are diagnosed very year^[1], of which, up to 80% require support due to decreased ability to care for themselves independently^[2]. Effective rehabilitation can reduce functional disability in patients, improve their quality of life, accelerate the stroke recovery process, reduce potential healthcare costs and preserve social resources.

Timing is key to stroke recovery. Statistics show that eight to 12 weeks after stroke is the optimal recovery period for patients who suffer from physical dysfunction. If rehabilitation starts early, within six months after symptom onset, patient survival can improve up to 97%^[3].The "Healthy China 2030" plan discusses the importance of early diagnosis, early treatment and early rehabilitation.

In Germany, 365,000 German stroke survivors were re-employed through 2005, representing approximately 45% of all stroke patients who underwent rehabilitation services. As of 2020, this figure had grown to more than 417,000⁴.

As the leader and practitioner in introducing German rehabilitation model to China, Consanas and SIMC Rehabilitation Medicine Center - supported by Consanas has committed to helping patients recover with German wisdom. As covered in the report, the groups used multiple evaluation criteria to analyze clinical data from hospitalized stroke patients in the Rehabilitation Medicine Department [Stage C rehabilitation patients in Germany; patients that cannot move freely in daily life]. The rehabilitation analysis revealed that, based on the German Early Barthel Index (EBI) criteria, the average rate of improvement among patients hospitalized within six months after onset was 78.6%, and based on the Functional Independence Measure (FIM), the improvement rate of this patient group was 28%. Both improvements rates are significantly higher than that of stroke patients admitted after the six-month period.

"We hope that with the help of clinical data, more doctors, patients and family members will realize that the focus of stroke treatment should not just be survival, but also early and optimal functional recovery, improving quality of life, and effective re-engagement into society in order to help patients live a more meaningful life after their stroke," said Professor Paul Schoenle, a German professor specializing in neuro rehabilitation who serves as the head of Consanas Rehabilitation and was one of the initiators of the Report on Clinical Performance and Quality of Rehabilitation for 2018-2019. Professor Schoenle also stressed that treatment remains necessary after the six-month period following a stroke, as patients can still benefit from continued rehabilitation.

Unique qualities of Germany's neuro rehabilitation: From theory to conception to practice

The German neuro rehabilitation process--characterized by high standardization, high efficiency and high intensity--is recognized as a leading international standard due to the complete hierarchical rehabilitation approach, the collaboration of multi-disciplinary professional teams and the comprehensive rehab insurance system.

In March 2018, Consanas Rehabilitation and SIMC jointly established a Rehabilitation Medicine Center with the mission to follow the German-standard of rehabilitation treatment. With now more than two years of practical experience in China, Professor Schoenle has studied and summarized the key differences between Chinese and German neuro rehabilitation from four aspects: philosophy, patient management, innovative therapy methods and high-tech application.

1.      Difference in the rehabilitation philosophy

The first variance stems from the general perception of and approach to rehabilitation. Chinese patients generally prefer passive therapies, with many relying on their medical team and the established rehabilitation regimen as a means to recovery. Given the cultural influence of Confucianism, family members also believe it is their responsibility to help. However, rehabilitation differs from other medical disciplines in that throughout the rehabilitation process, the medical team plays nothing more than an auxiliary coach role, while patients are the primary promoters of their own recovery, they are subjects not objects of their rehab. The German rehabilitation approach advocates the active participation of patients, while the clinical team's charge is to prove guide patients in staying active, persistent and motivated for the duration of the treatment process. This happens through psychological counseling, emotional support, family education, group therapy and beyond.

2.      Difference in the patient management

The second distinction involves the rehabilitation management of patients. The German style of rehabilitation places a stronger emphasis on a complete process that is, creating a comprehensive communication and reporting system that involves the core team, the case manager, as well as simple and efficient data management platforms - RMS. Together, this system ensures consistency in clinical diagnoses and promotes a higher standard of care across the multi-disciplinary medical team. The medical team can develop a regimen and formulate consistent, phased rehabilitation goals based on a common and complete understanding of the patient. Additional patient incentives introduced throughout the program can help motivate the patients to remain active and compliant throughout treatment.

3.       Difference in innovative therapy methods

The medical team of SIMC Rehabilitation Medicine Center-supported by Consanas designs two innovate methods: group therapy and rehabilitation in personalized life scenarios. Group therapy refers to the simultaneous treatment of 3-5 patients with a similar functional status by a therapist. Participants are required to interact, assist each other, and compete, to improve their functional levels after training; rehabilitation in personalized life scenarios refers to the individualized treatment of patients according to their functional levels and personalized needs in real life scenarios. based on a patient's level of physical function. The programs are divided into three units—self-care, personal skills and social participation—and aim to help patients to live independently and gradually return to society.

"We merged the German-style of stroke rehabilitation with elements of Chinese culture and treatment, and over the last two years, this new method has proven quite effective," said Professor Schoenle. "Moving forward, we need to continue exploring and developing innovative new treatment methods to help more stroke patients follow effective rehabilitation programs, get access to rehabilitation earlier in their recovery journey, and return to their families and their normal lives as quickly and effectively as possible."

[1]Qian Weichong. Regulating Blood Lipids and Preventing Stroke [J]. Jiangsu Health Care: 2008(2):13-13.

[2]Zhang Tong (Author)--Chinese Journal of Rehabilitation Theory and Practice--Guidelines for Rehabilitation of Stroke in China (2011 Full Version)

[3]Shao Limin--Modern Practical Medicine--Effect Evaluation of Extended Nursing Service for Discharged Patients with Cerebral Infarction by Medical Care Combined with Health Education Intervention

[4] Prognos AG(2017) Die medizinische Rehabilitation Erwerbstätiger - Sicherung vonProduktivität und Wachstum, Available from: http://www.dbkg.de/downloads/pdf/die_medizinische_rehabilitation_erwerbstaetiger_sicherung_von_produktivitaet_und_wachstum.pdf [Accessed at 2 November 2017].

About Consanas Rehabilitation

Consanas Rehabilitation is a rehabilitation brand under Boehringer Ingelheim, a century-old German pharmaceutical enterprise. Consanas Rehabilitation is committed to bringing the sought-after German neuro rehabilitation concept and advanced rehabilitation model to countries and regions around the world that are in urgent need of effective stroke rehabilitation practices. In March 2018, Consanas Rehabilitation and SIMC jointly established a Rehabilitation Medicine Department with the founding principle and mission of delivering a world-class standard of German rehabilitation treatment.

SOURCE Boegringer Ingelheim

Usefulness of Goal Attainment Scaling in Intensive Stroke Rehabilitation During the Subacute Stage

Totally bad research right from the start. Therapist suggested goals;  the tyranny of low expectations in broad daylight. They all need to be fired. 

Usefulness of Goal Attainment Scaling in Intensive Stroke Rehabilitation During the Subacute Stage

Youngsu Jung, MD, Jaehoon Sim, MD, Joonhyun Park, MD, Jongmoon Kim, MD, MinYoung Kim, MD, PhD
Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University College of Medicine, Seongnam, Korea
Objective  

To investigate the usefulness of goal attainment scaling (GAS) in intensive stroke rehabilitation during the subacute stage. 

Methods  

Medical records of subacute post-stroke patients who had undergone intensive rehabilitation under hospitalization, before and after the application of GAS, were collected. GAS was conducted at the initial evaluation of each patient. Specific goals were suggested by physical and occupational therapists and were determined by the responsible physiatrist.(This is a fireable offense per Dean.) A 5-point scale was used for the GAS score after 4 weeks of rehabilitation according to the preset criteria of each goal. To evaluate the influence of GAS in rehabilitation practice, functional improvements were compared between two patient groups before (n=121) and after (n=141) GAS. To assess progress in GAS practice, the standard GAS score was calculated, and the changes were observed over a 3-year period. The standard GAS score converged to 50 points when the goal was achieved. The therapists who used GAS also completed a survey regarding its usefulness. Results  There were no statistical differences in the motor and cognitive outcomes of the patient groups before and after applying GAS scoring. Successive yearly changes in the standard GAS scores showed progressive convergence to 50 points, signaling that the patient’s goal-setting abilities improved. According to the survey, most therapists felt that GAS enhanced the quality of therapies (84.6%). Conclusion 
GAS improved goal-setting for the rehabilitation of subacute post-stroke patients and might have a positive effect on rehabilitation.(Yeah, it would show complete failure of all of your rehab interventions since the true goal of all survivors is 100% recovery. NOT THIS CRAP YOU SHOVE DOWN THEIR THROATS.)

Cognitive Test Given in Childhood May Predict Future Dementia

Useless piece of crap.  We need to know NOW what needs to be done to prevent dementia after our strokes. ARE YOU THAT FUCKING STUPID AND LAZY?

Your chances of getting dementia.

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.

2. Then this study came out and seems to have a range from 17-66%. December 2013.

3. A 20% chance in this research.   July 2013.

4. Dementia Risk Doubled in Patients Following Stroke September 2018 

5. Parkinson’s Disease May Have Link to Stroke March 2017

 

 

Cognitive Test Given in Childhood May Predict Future Dementia

Childhood thinking skills may influence cognitive performance later in life, according to a study published in Neurology.

The study also found that education level and socioeconomic status were also predictors of thinking and memory performance.

“Finding these predictors is important because if we can understand what influences an individual’s cognitive performance in later life, we can determine which aspects might be modifiable by education or lifestyle changes like exercise, diet, or sleep, which may in turn slow the development of cognitive decline,” said Jonathan M. Schott, MD, University College London, London, United Kingdom.

For the study, Kirsty Lu, PhD, University College London, and colleagues analysed 502 individuals born in the same week in 1946 who took cognitive tests when they were aged 8 years. Between ages 69 and 71 years, participants took thinking and memory tests again. One test, similar to a test they completed as children, involved looking at various arrangements of geometric shapes and identifying the missing piece from 5 options. Other tests evaluated skills like memory, attention, orientation, and language. Performance was characterised with respect to sex, childhood cognitive ability, education, and socioeconomic position.

In a subsample of 406 cognitively normal participants, associations were investigated between cognition and amyloid beta positivity, whole brain volumes, white matter hyperintensity volumes, and APOE E4.

Participants had positron emission tomography scans to see if they had amyloid beta plaques in the brain associated with Alzheimer’s disease. They also had detailed brain magnetic resonance imaging scans.

The researchers found that childhood thinking skills were associated with scores on the cognitive tests taken more than 60 years later, and there were independent effects of education and socioeconomic status. Women performed better than men in test of memory and thinking speed.

In addition, the researchers found that participants with amyloid beta plaques had lower scores on cognitive testing. However the presence of these plaques was not associated with sex, childhood cognitive skills, education, or socioeconomic status.

“Our study found that small differences in thinking and memory associated with amyloid plaques in the brain are detectable in older adults even at an age when those who are destined to develop dementia are still likely to be many years away from having symptoms,” concluded Dr. Schott. “It also found that childhood cognitive skills, education, and socioeconomic status all independently influence cognitive performance at age 70. Continued follow-up of these individuals, and future studies are needed to determine how to best use these findings to more accurately predict how a person’s thinking and memory will change as they age.”

Reference: https://doi.org/10.1212/WNL.0000000000008534

SOURCE: American Academy of Neurology

Outcomes of Thrombectomy in Transferred Patients With Ischemic Stroke in the Late Window

Useless crap. They don't even bother to tell us how many got fully recovered. And using the subjective Rankin scale for measuring anything is stroke in worthless.  Comparing failures and suggesting those outcomes are ok is not the way research should be done.

Utility-weighted modified Rankin Scale: Still too crude to be a truly patient-centric primary outcome measure?

The latest here:

Outcomes of Thrombectomy in Transferred Patients With Ischemic Stroke in the Late Window

A Subanalysis From the DEFUSE 3 Trial

Educational Objective
To determine whether patients with ischemic stroke with large-vessel occlusion in the anterior circulation who were transferred from outside facilities for endovascular thrombectomy have similar outcomes(So the comparison is to failure to fully recover?) in the late window compared with patients who were directly admitted to thrombectomy-capable hospitals.

1 Credit CME

JAMA Neurology

June 1, 2019

Original Investigation

Article Information and Disclosures

Amrou Sarraj, MD¹; Michael Mlynash, MD²; Sean I. Savitz, MD¹; et al Jeremy J. Heit, MD, PhD³; Maarten G. Lansberg, MD, PhD²; Michael P. Marks, MD³; Gregory W. Albers, MD² Author Affiliations Read article on JAMA Network

MOC/CME Information

Read Article Take Quiz

Key Points

Question  Do patients with ischemic stroke with large-vessel occlusion in the anterior circulation who were transferred from outside facilities and had penumbral imaging mismatch prior to endovascular thrombectomy have similar outcomes with thrombectomy in the late window as those who were directly admitted to thrombectomy-capable hospitals?
Findings  In this secondary analysis of a randomized clinical trial, transfer and direct patients had comparable rates of functional independence(How many got 100% recovered? THAT IS THE CORRECT ENDPOINT. Not the tyranny of low expectations you want us to accept.) and similar treatment effect with endovascular thrombectomy as well as similar symptomatic intracranial hemorrhage and mortality.
Meaning  Transferring patients for late-window thrombectomy may be associated with substantial clinical benefits and should be encouraged.

Abstract

Importance  Although thrombectomy benefit was maintained in transfer patients with ischemic stroke in early-window trials, overall functional independence rates were lower in thrombectomy and medical management–only groups.
Objective  To evaluate whether the imaging-based selection criteria used in the Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3 (DEFUSE 3) trial would lead to comparable outcome rates and treatment benefits in transfer vs direct-admission patients.
Design, Setting, and Participants  Subgroup analysis of DEFUSE 3, a prospective, randomized, multicenter, blinded–end point trial. Patients were enrolled between May 2016 and May 2017 and were followed up for 90 days. The trial comprised 38 stroke centers in the United States and 182 patients with stroke with a large-vessel anterior circulation occlusion and initial infarct volume of less than 70 mL, mismatch ratio of at least 1.8, and mismatch volume of at least 15 mL, treated within 6 to 16 hours from last known well. Patients were stratified based on whether they presented directly to the study site or were transferred from a primary center. Data were analyzed between July 2018 and October 2018.
Interventions or Exposures  Endovascular thrombectomy plus standard medical therapy vs standard medical therapy alone.
Main Outcomes and Measures  The primary outcome was the distribution of 90-day modified Rankin Scale scores.
Results  Of the 296 patients who consented, 182 patients were randomized (66% were transfer patients and 34% directly presented to a study site). Median age was 71 years (interquartile range [IQR], 60-79 years) vs 70 years (IQR, 59-80 years); 69 transfer patients were women (57%) and 23 of the direct group were women (37%). Transfer patients had longer median times from last known well to study site arrival (9.43 vs 9 hours) and more favorable collateral profiles (based on hypoperfusion intensity ratio): median for transfer, 0.35 (IQR, 0.18-0.47) vs 0.42 (IQR, 0.25-0.56) for direct (P = .05). The primary outcome (90-day modified Rankin Scale score shift) did not differ in the direct vs transfer groups (direct OR, 2.9; 95% CI, 1.2-7.2; P = .01; transfer OR, 2.6; 95% CI, 1.3-4.8; P = .009). The overall functional independence rate (90-day modified Rankin Scale score 0-2) in the thrombectomy group did not differ (direct 44% vs transfer 45%) nor did the treatment effect (direct OR, 2.0; 95% CI, 0.9-4.4 vs transfer OR, 3.1; 95% CI, 1.6-6.1). Thrombectomy reperfusion rates, mortality, and symptomatic intracranial hemorrhage rates did not differ.
Conclusions and Relevance  In late-window patients selected by penumbral mismatch criteria, both the favorable outcome rate and treatment effect did not decline in transfer patients. These results have health care implications indicating transferring potential candidates for late-window thrombectomy is associated with substantial clinical benefits and should be encouraged.
Trial Registration  ClinicalTrials.gov identifier: NCT02586415

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How To Breathe To Boost Your Brain Power

But are these others already vetted and used by your doctor?

Science Explains Why Deep Breathing Calms You Down May 2017 

Creation of nitric oxide via Breath of Fire  February 2014 

Meta-analysis of effects of voluntary slow breathing exercises for control of heart rate and blood pressure in patients with cardiovascular diseases  April 2017 

Breathing is not just for oxygen; it’s now linked to brain function and behavior. 

December 2016

The Breathing Technique That Helps Fight Major Depression  December 2016

 

 

Oh God, more right brain/left brain crap. Nostrils don't connect to the brain, they connect to the lungs. Sounds as silly as a friend who stated that the nostril you are breathing with decides the sex of your child. Which person, the man or woman? What about conflicting breathing?

How To Breathe To Boost Your Brain Power

by Catherine Carrigan | Apr 18, 2016 | Blog | 0 comments

You can increase your brain power by taking advantage of a very specific breathing technique called alternate nostril breathing.
Just as you have a dominant hand that you use most commonly, you also have a dominant brain hemisphere.
Your right brain is generally considered your gestalt hemisphere. If you are right brain dominant, you generally learn by understanding the big picture first.
Your left brain is your logic hemisphere. If you are left brain dominant, you learn details first and proceed in a linear, logical fashion.
Under stress, most people’s non-dominant brain hemisphere is 75 to 85 percent shut down.
So if you are gestalt dominant, under stress you would have trouble thinking logically, adding and subtracting and understanding details.
If you are logic dominant, under stress you would lose the big picture, context and relevance.
The more you can access your entire brain more of the time, the more you can remain in the flow of life, accessing your full intelligence. You can think faster, feel more relaxed and see the big picture and the details at the same time.
Brain integration work is so important that the first 10 years I studied healing work, my main focus was learning everything I could about how to heal the brain naturally.
One of the simplest ways to turn on both sides of your brain is with alternate nostril breathing, also known as nadi shodan pranayama.
Here’s how you do this breathing technique:

1. Sit comfortably on a chair or yoga bolster. When you sit properly, there’s a natural curve of 30 to 35 degrees in your lumbar spine. Your spine can lengthen. Your lungs can expand. You pull your shoulders back. Your chest opens and the crown of your head extends upwards.
2. If your sinus passages are blocked, I recommend you blow your nose before you begin.
3. Bring the thumb together with the first two fingers of your left hand.
4. Fold the pointer finger and middle finger of your right hand.
5. Place your right hand in front of your nose.
6. Inhale. After you inhale, place your right thumb on the corner of your right nostril.
7. Exhale. After you exhale, place your right finger on the corner of your left nostril. Pressing into the corners of your nostrils stimulates the pituitary gland in your brain, which in turn calms your adrenal glands and balancing your thyroid gland.
8. Release your thumb off the right nostril. Exhale through your right nostril.
9. Inhale through your right nostril. Close your right nostril.
10. Release your ring finger off the left nostril. Exhale through your left nostril.
11. Continue alternate nostril breathing. Stay relaxed and don’t force the breath. When you are complete, finish by exhaling out of your right nostril.

Alternate nostril breathing is part of a longer breath work routine I put together for you for FREE called Eight Minutes to Inner Peace. 
If you are practicing alternate nostril breathing as part of this longer routine, you can practice it for as short of a time as one minute.
If you practice this breathing technique separately, I would recommend you continue for at least two minutes or until you feel significantly calmer.
How does alternate nostril breathing affect your brain?

1. Your right nostril connects to the left side of your brain.
2. Your left nostril connects to the right side of your brain.
3. When you are healthy, you will notice that your nostril dominance naturally alternates. Persistent closure of one side or the other is a sign that you are becoming ill.
4. By opening both the right and left channels, you will activate both hemispheres of your brain, allowing you to access your full intelligence.

I recommend alternate nostril breathing as a natural healing remedy for students studying for tests, for anyone who wants to calm anxiety or stop a panic attack without drugs and to experience inner peace anytime, anywhere.
Writers and artists can use this technique when they feel stuck because the creative process requires us to use both sides of our brains – the right side for inspiration and the left side for detailed execution.
What is healing?
Healing happens when you learn how to breathe and access the full power of your brain.

Neuromechanical Differences Between Successful and Failed Sit-to-Stand Movements and Response to Rehabilitation Early After Stroke

Useless, nothing on what to do to get better at sit-to-stand, just measuring crap. 

Neuromechanical Differences Between Successful and Failed Sit-to-Stand Movements and Response to Rehabilitation Early After Stroke 

Andy Kerr, PhD, Allan Clark, PhD, Valerie M. Pomeroy, PhD

First Published May 3, 2019 Research Article

https://doi.org/10.1177/1545968319846119

Article information

Abstract

Background. Recovery of the sit-to-stand (StS) movement early after stroke could be improved by targeting physical therapy at the underlying movement deficits in those people likely to respond.(Like what you fucking lazy bastards? Are we supposed to read your minds?) 

Aim. To compare the movement characteristics of successful and failed StS movements in people early after stroke and identify which characteristics change in people recovering their ability to perform this movement independently following rehabilitation.  
Methods. Muscle activity and kinematic (including center of mass, CoM) data were recorded from 91 participants (mean 35 days after stroke) performing the StS movement before (baseline), immediately after (outcome), and 3 months after (follow-up) rehabilitation. Three subgroups (never-able [n = 19], always-able [n = 51], and able-after-baseline [n = 21]) were compared at baseline with the able-after-baseline subgroup compared before and after rehabilitation.  
Results. The subgroups differed at baseline for quadriceps onset time (P = .009) and forward body position when quadriceps peaked (P = .038). Following rehabilitation, the able-after-baseline subgroup increased their forward position (P < .001), decreased the time difference between bilateral quadriceps peaks (P < .001) and between quadriceps and hamstrings peaks on the nonhemiplegic side (P = .007). An improved performance in the always-able subgroup was associated with a number of baseline factors, including forward positioning (P = .002) and time difference between peak activity of bilateral quadriceps (P = .001).  
Conclusions. This neuromechanical study of StS before and after rehabilitation in a sample of people early after stroke identified the importance of temporal coupling between forward trunk movement and quadriceps and hamstrings’ activity. These findings advance the science of stroke rehabilitation by providing evidence-based therapy targets to promote recovery of the StS movement.

Keywords stroke rehabilitation, physical therapy, sit-to-stand, kinematics, EMG, therapy targets

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Sleep as a model to understand neuroplasticity and recovery after stroke: Observational, perturbational and interventional approaches

Useless piece of crap. Nothing here will help survivors recover. You should all be fired. 

Sleep as a model to understand neuroplasticity and recovery after stroke: Observational, perturbational and interventional approaches

Mensen A¹, Pigorini A², Facchin L³, Schöne C³, D'Ambrosio S², Jendoubi J³, Jaramillo V⁴, Chiffi K³, Eberhard-Moscicka AK³, Sarasso S², Adamantidis A³, Müri RM³, Huber R⁴, Massimini M², Bassetti C³.

Author information

Erratum in

• Corrigendum to: "Sleep as a model to understand neuroplasticity and recovery after stroke: Observational, perturbational and interventional approaches" [Journal of Neuroscience Methods Volume 313, 1 February 2019, Pages 37-43]. [J Neurosci Methods. 2019]

Abstract

Our own experiences with disturbances to sleep demonstrate its crucial role in the recovery of cognitive functions. This importance is likely enhanced in the recovery from stroke; both in terms of its physiology and cognitive abilities. Decades of experimental research have highlighted which aspects and mechanisms of sleep are likely to underlie these forms of recovery. Conversely, damage to certain areas of the brain, as well as the indirect effects of stroke, may disrupt sleep. However, only limited research has been conducted which seeks to directly explore this bidirectional link between both the macro and micro-architecture of sleep and stroke. Here we describe a series of semi-independent approaches that aim to establish this link through observational, perturbational, and interventional experiments. Our primary aim is to describe the methodology for future clinical and translational research needed(So you want someone else to do the actual hard work of solving this? Too hard for you? Not your job?) to delineate competing accounts of the current data. At the observational level we suggest the use of high-density EEG recording, combined analysis of macro and micro-architecture of sleep, detailed analysis of the stroke lesion, and sensitive measures of functional recovery. The perturbational approach attempts to find the causal links between sleep and stroke. We promote the use of transcranial magnetic stimulation combined with EEG to examine the cortical dynamics of the peri-infarct stroke area. Translational research should take this a step further using optogenetic techniques targeting more specific cell populations. The interventional approach focuses on how the same clinical and translational perturbational techniques can be adapted to influence long-term recovery of function.

Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

KEYWORDS:

Brain damage; EEG; Functional recovery; Sleep; Slow waves; Stroke; Translational

PMID:

30571989

DOI:

10.1016/j.jneumeth.2018.12.011

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Synergistic Benefits of Combined Aerobic and Cognitive Training on Fluid Intelligence and the Role of IGF-1 in Chronic Stroke

With no protocols written on this, this is totally useless. We need to fire the mentors and senior researchers that allowed such crap. 

Synergistic Benefits of Combined Aerobic and Cognitive Training on Fluid Intelligence and the Role of IGF-1 in Chronic Stroke

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Michelle Ploughman, PhD, Gail A. Eskes, PhD, Liam P. Kelly, MSc, ...

First Published February 28, 2019 Research Article

https://doi.org/10.1177/1545968319832605

Article information

Abstract

Background. Paired exercise and cognitive training have the potential to enhance cognition by “priming” the brain and upregulating neurotrophins.  
Methods. Two-site randomized controlled trial. Fifty-two patients >6 months poststroke with concerns about cognitive impairment trained 50 to 70 minutes, 3× week for 10 weeks with 12-week follow-up. Participants were randomized to 1 of 2 physical interventions: Aerobic (>60% VO_2peak using <10% body weight–supported treadmill) or Activity (range of movement and functional tasks). Exercise was paired with 1 of 2 cognitive interventions (computerized dual working memory training [COG] or control computer games [Games]). The primary outcome for the 4 groups (Aerobic + COG, Aerobic + Games, Activity + COG, and Activity + Games) was fluid intelligence measured using Raven’s Progressive Matrices Test administered at baseline, posttraining, and 3-month follow-up. Serum neurotrophins collected at one site (N = 30) included brain-derived neurotrophic factor (BDNF) at rest (BDNF_resting) and after a graded exercise test (BDNF_response) and insulin-like growth factor–1 at the same timepoints (IGF-1_rest, IGF-1_response).  
Results. At follow-up, fluid intelligence scores significantly improved compared to baseline in the Aerobic + COG and Activity + COG groups; however, only the Aerobic + COG group was significantly different (+47.8%) from control (Activity + Games −8.5%). Greater IGF-1_response at baseline predicted 40% of the variance in cognitive improvement. There was no effect of the interventions on BDNF_resting or BDNF_response; nor was BDNF predictive of the outcome. Conclusions. Aerobic exercise combined with cognitive training improved fluid intelligence by almost 50% in patients >6 months poststroke. Participants with more robust improvements in cognition were able to upregulate higher levels of serum IGF-1 suggesting that this neurotrophin may be involved in behaviorally induced plasticity.

Keywords rehabilitation, fluid intelligence, brain-derived neurotrophic factor, insulin-like growth factor–1, neuroplasticity, cognition

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