Understanding stroke and spasticity: patient and caregiver experiences and quality-of-life impact

 We don't need 'awareness' you blithering idiots! 

Survivors WANT IT CURED! GET THERE!

You will want that cure when you are the 1 in 4 per WHO that has a stroke

Understanding stroke and spasticity: patient and caregiver experiences and quality-of-life impact

• 

  Monica Verduzco-Gutierrez ¹

• 

  Emilie Pain ²

• 

  Jonathan Bouchard ³

• 

  Amandeep Mann ^3*

• 1. UT Health San Antonio, San Antonio, TX, United States

• 2. Carenity, Online Patient Community, Paris, France

Abstract

Introduction: 

Poststroke spasticity (PSS) is a common sensorimotor disorder following a stroke, presenting in up to 38% of patients 1 year after first stroke. Owing to its heterogeneous and progressive presentation, PSS represents a significant challenge both in its effect on patients and in its clinical management. The objective of this US real-world survey was to assess the impact of self-reported PSS symptoms, gathering patient and caregiver perspectives on awareness of PSS and its treatments, the extent of shared decision-making, and the quality of life (QoL) impact of PSS.

Methods: 

This study was a noninterventional, cross-sectional, web-based survey of patients (or their caregivers) within 1 year of stroke resulting in hemiparesis. Participant demographics and survey responses were summarized using descriptive analyses. Subgroup analyses were performed between patients and caregivers and by sex, age group, and type of last stroke. A short version of the Stroke-Specific QoL (SS-QoL) scale was used to assess patient QoL.

Results: 

The study included 221 patients and 62 caregivers answering on behalf of patients. Almost all patients (98%) experienced PSS symptoms after their most recent stroke, with 59% experiencing ≥3 symptoms. Approximately half (56%) of patients who reported PSS symptoms were aware of drug treatments; of these, most (95%) had received ≥1 drug treatment. Among treated patients, 68% had been involved in the initial drug selection. Over half of patients reported difficulties carrying out daily activities, but caregivers were more likely to report difficulty showering or bathing unassisted (84%) compared with the patient group (58%); fatigue was reported by most patients (84%). The overall median (IQR) SS-QoL score was 2.5 (2.0–2.9) and was higher in the patient group (2.5; 2.1–2.9) than the caregiver-reported group (2.1; 1.8–2.8). Our real-world survey findings demonstrate a considerable impact of PSS on patient QoL, largely driven by fatigue and limitations in daily activities. Furthermore, subgroup analysis revealed significant differences between patient and caregiver perceptions of PSS symptoms and their impact.

Discussion: 

This study highlights the need for increased awareness of PSS among healthcare providers, patients, and caregivers to promote timely diagnosis and improve management with targeted, multidisciplinary interventions that enhance patient outcomes and support caregivers.

Plain language summary

After a stroke, some people experience a condition called poststroke spasticity (PSS) that causes muscle stiffness and uncontrolled spasms. Symptoms are not the same for everyone with PSS and may get worse over time. This survey-based study described how people with PSS and their caregivers were affected by PSS after a stroke. The survey included questions related to a person’s knowledge about the condition, access to treatments, and how PSS impacts their daily life. The researchers also looked at differences in people’s responses based on their age, sex, and the type of stroke they experienced, as well as whether the patient or their caregiver completed the survey. Nearly all of the people who took the survey experienced PSS symptoms after their most recent stroke, but only half of them were receiving drug treatment for their PSS symptoms. People most often reported being affected by fatigue and difficulty in doing daily activities, such as showering or bathing. Also, caregivers reported a greater impact on quality of life than patients themselves. This study emphasized the need for education about PSS to improve diagnosis, management, and support for patients and their caregivers.

Botulinum toxin type a within function-oriented management of post-stroke spasticity: a narrative review

 Survivors want SPASTICITY CURED not 'managed'. Or don't you fucking care about survivor requirements? Massive word salad here that SAYS NOITHING!

You're all fired!

Botulinum toxin type a within function-oriented management of post-stroke spasticity: a narrative review

• 

  Baoling Su

• Y

  Yating Huang

• X

  Xiaotong Li

• K

  Kun Wang

• 

  Bing Bao ^*

• School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China

Abstract

Post-stroke spasticity (PSS) is a heterogeneous complication of stroke that affects motor recovery, care needs, pain, positioning, and participation in daily life. Current management frameworks commonly stratify patients by time since stroke, but disease duration alone does not capture differences in neural mechanisms, residual voluntary control, functional priorities, or response to intervention. This narrative review searched PubMed, the Cochrane Library, and Wanfang databases from inception to May 2026, prioritizing randomized controlled trials, prospective cohort studies, systematic reviews, real-world studies, Goal Attainment Scaling research, the Upper Limb International Spasticity cohort series, best-practice guidance, and clinical trials including BEST and InTENSE. We synthesize evidence that PSS heterogeneity can be understood across central and peripheral mechanisms, temporal trajectories, and active versus passive functional consequences. Available studies suggest that active and passive functional goals differ in baseline functional profiles, outcome assessment, treatment response, and intervention requirements. However, patients sharing a functional goal type may still differ in residual voluntary control, neural and non-neural contributors to movement restriction, pain, mobility, and care dependency. Botulinum toxin type A is well aligned with focal tone reduction and passive goals, including pain relief, hygiene, and limb positioning. It may also support contracture-prevention strategies when modifiable neural muscle overactivity remains, whereas active functional gains usually require preserved motor potential and integration with task-oriented training, rehabilitation, and adjunctive modalities. We propose that functional goal type should complement time-based staging as a decision dimension rather than serve as a complete clinical phenotype. This combined framework may better align patient selection, intervention matching, outcome assessment, and longitudinal treatment planning. Prospective goal-stratified studies and standardized assessment tools are needed to test its clinical utility.

A 30-day plank plan to build a stronger core

 What is your objective measurement of core strength? Oh, Your doctor doesn't have one, right?

PURE INCOMPETENCE! 
And surely without any measurement there is no exercise protocol to build one correctly either, right? 

Because my doctor was a complete failure at curing my hand spasticity; didn't even try, I can only do forearm ones and still not very good. Pictures and videos at link.

A 30-day plank plan to build a stronger core

Medically reviewed by Amy Kwan, PT

• Why this matters: The plank plan can improve core strength and posture, essential for overall fitness and health.
• What you can do: Start the 30-day plank plan to progressively strengthen your core.
• The payoff: Consistently practicing planks can increase your core stability, improve posture, and support long-term fitness.

Want to build your core endurance? This 30-day plan combines plank holds with moving variations, gradually increasing your time and rounds while including scheduled rest days.

What to Expect From This 30-Day Plank Plan

This 30-day plan gradually builds your core strength and endurance by increasing how long you hold a plank and introducing different plank variations. You’ll start with 30-second intervals and work your way up to one-minute holds, with some days combining multiple exercises into a single workout.

The plan includes scheduled rest days to give your muscles time to recover. You can also shorten intervals or modify exercises to match your fitness level. Focus on maintaining good form rather than holding a plank for longer than you comfortably can.

To track your progress, record how long you can hold a plank with good form on Day 1. After completing the plan, repeat the same plank variation to see whether your endurance has improved. Allow extra recovery time before retesting if needed.

30-Day Plank Plan Schedule

Days 1–6

• Day 1: Hold a plank for as long as you can maintain good form. Record your time.
• Day 2: Hold a plank for 30 seconds, then do rocking planks for 30 seconds.
• Day 3: Hold a plank for 30 seconds, then do plank hip dips for 30 seconds.
• Day 4: Hold a plank for 30 seconds, then do plank up-downs for 30 seconds.
• Day 5: Complete one circuit: plank, rocking planks, plank hip dips, and plank up-downs for 30 seconds each.
• Day 6: Rest.

Days 7–11

• Day 7: Hold a plank for 30 seconds, then do rocking planks for 30 seconds. Complete two rounds.
• Day 8: Hold a plank for 30 seconds, then do plank hip dips for 30 seconds. Complete two rounds.
• Day 9: Hold a plank for 30 seconds, then do plank up-downs for 30 seconds. Complete two rounds.
• Day 10: Complete two rounds of this circuit: plank, rocking planks, plank hip dips, and plank up-downs for 30 seconds each.
• Day 11: Rest.

Days 12–16

• Day 12: Hold a plank for 45 seconds, then do rocking planks for 45 seconds.
• Day 13: Hold a plank for 45 seconds, then do plank hip dips for 45 seconds.
• Day 14: Hold a plank for 45 seconds, then do plank up-downs for 45 seconds.
• Day 15: Complete one circuit: plank, rocking planks, plank hip dips, and plank up-downs for 45 seconds each.
• Day 16: Rest.

Days 17–21

• Day 17: Hold a plank for 45 seconds, then do rocking planks for 45 seconds. Complete two rounds.
• Day 18: Hold a plank for 45 seconds, then do plank hip dips for 45 seconds. Complete two rounds.
• Day 19: Hold a plank for 45 seconds, then do plank up-downs for 45 seconds. Complete two rounds.
• Day 20: Complete two rounds of this circuit: plank, rocking planks, plank hip dips, and plank up-downs for 45 seconds each.
• Day 21: Rest.

Days 22–26

• Day 22: Hold a plank for one minute, then do rocking planks for one minute.
• Day 23: Hold a plank for one minute, then do plank hip dips for one minute.
• Day 24: Hold a plank for one minute, then do plank up-downs for one minute.
• Day 25: Complete one circuit: plank, rocking planks, plank hip dips, and plank up-downs for one minute each.
• Day 26: Rest.

Days 27–30

• Day 27: Hold a plank for one minute, then do rocking planks for one minute. Complete two rounds.
• Day 28: Hold a plank for one minute, then do plank hip dips for one minute. Complete two rounds.
• Day 29: Hold a plank for one minute, then do plank up-downs for one minute. Complete two rounds.
• Day 30: Complete four one-minute plank holds, resting 60 seconds between holds. After your final hold, rest as needed, then do plank jacks for one minute.

Optional Day 31 progress check: Repeat your Day 1 plank using the same variation. Record how long you can hold it with good form and compare your times. If you still feel fatigued from Day 30, save this check for after you’ve recovered.

How to Use the Plank Schedule

• Plank choice: Choose a straight-arm or forearm plank and stick with it through the whole plan. For the moving exercises, repeat the movement for the listed time.
• Two-move workouts: Rest 10–30 seconds between exercises.
• Four-move circuits: Move from one exercise to the next without a planned break, but pause if you need to reset your form.
• Multiple rounds: Complete the full sequence once to finish one round. Rest 60 seconds before starting the next.
• Time targets: Shorten an interval or use an easier variation if you cannot maintain control. Keep breathing throughout each exercise.

How To Do the Plank Exercises

Straight-arm Plank

Credit: Rozalynn S. Frazier

The straight-arm plank gives you a foundation for this plan: supporting your body on your hands and toes while keeping your middle steady. You’ll also use this position to start plank up-downs.

How to do it:

1. Start on all fours with your wrists under your shoulders.
2. Step your feet back one at a time until your legs are extended.
3. Hold this position for the planned interval.
4. Lower your knees to the floor to finish.

Focus on: Keep your hips in line with your shoulders and heels.

Make it easier: Place your hands on a sturdy countertop instead of the floor.

Make it harder: Bring your feet closer together to narrow your base of support.

Forearm Plank

Credit: Rozalynn S. Frazier

The forearm plank is another option for the plan’s timed holds. It also sets you up for rocking planks, hip dips, and plank jacks.

1. Lie on your stomach with your forearms on the floor and elbows under your shoulders.
2. Tuck your toes under.
3. Lift your torso and hips off the floor.
4. Hold this position for the planned interval.
5. Lower your body to the floor with control.

Focus on: Keep your lower back from sagging as you hold.

Make it easier: Keep your knees on the floor, with your body aligned from your head to your knees.

Make it harder: Bring your feet closer together while keeping your hips steady.

Rocking Plank

Rocking planks add a small forward-and-back movement to your hold. The challenge is to keep your trunk steady as your weight shifts.

1. Start in a forearm plank with your elbows under your shoulders.
2. Shift your body forward a few inches over your toes.
3. Push back through your toes to move your body slightly behind the starting position.
4. Continue rocking forward and back for the planned interval.
5. Lower your knees to the floor to finish.

Focus on: Move your shoulders and hips together as one unit.

Make it easier: Use a smaller rocking motion.

Make it harder: Pause briefly at the forward position before rocking back.

Plank Hip Dips

Hip dips introduce controlled rotation to the plan. You’ll practice moving your pelvis from side to side while supporting your upper body on your forearms.

1. Start in a forearm plank.
2. Rotate your pelvis to lower your right hip toward the floor.
3. Return to the center plank position.
4. Rotate your pelvis to lower your left hip toward the floor.
5. Continue alternating sides, returning to center between dips.

Focus on: Control each dip instead of dropping your hip toward the floor.

Make it easier: Reduce how far you lower your hips.

Make it harder: Pause just above the floor on each side without resting your hip.

Plank Up-Downs

Plank up-downs challenge you to keep your trunk steady while changing your arm support. They add upper-body work as you move between forearm and straight-arm planks.

1. Start in a straight-arm plank with your feet slightly wider than hip-width apart.
2. Lower onto your right forearm, followed by your left.
3. Plant your right palm beneath your shoulder.
4. Press up onto your right hand, then your left, returning to a straight-arm plank.
5. Repeat the sequence, switching which arm leads each time.

Focus on: Keep your hips from swaying side to side.

Make it easier: Perform the movement with your knees on the floor.

Make it harder: Bring your feet closer together while keeping your pelvis steady.

Plank Jacks

Plank jacks add a jumping movement to the final workout. Your goal is to keep your trunk steady while your feet move apart and together.

1. Start in a forearm plank with your feet close together.
2. Hop both feet out wider than hip-width apart.
3. Hop your feet back to the starting position.
4. Continue hopping out and in for the planned interval.
5. Lower your knees to the floor to finish.

Focus on: Keep your hips at a steady height as your feet move.

Related video: Start mat Pilates at home! Simple beginner moves for core strength (Natasa Boucher)

Make it easier: Step one foot out at a time, then step each foot back in.

Make it harder: Gradually increase your pace while keeping your landings controlled.

After the Plan

Keep using your favorite plank variations as part of your regular strength workouts. Choose a hold and a moving variation, using a duration you can complete with control. Progress by extending your time or trying a harder variation—one change at a time.

Read the original article on Health

These 5-Second Hand Exercises For Dementia Are Going Viral. Here's What A Neurologist Thinks.

 My incompetent everyone COMPLETELY FAILED at curing my spasticity and getting my left hand functioning again. Nothing here will help me. 

These 5-Second Hand Exercises For Dementia Are Going Viral. Here's What A Neurologist Thinks.

Social media is full of health hacks for better sleep, clear skin, a functioning gut, you name it. Lately, a tip for aging and cognitive function is gaining traction. 

Videos showing hand and finger exercises have racked up millions of views on TikTok and Instagram, with users suggesting these movements can help prevent dementia or Alzheimer’s disease.

The exercises include things like alternated clapping, tapping, arm circles and pointing your fingers in different directions. And although they might look easy enough, exasperated folks in the comments sections highlight that some of these motions are a lot harder than they appear. 

But does failing at intricate finger movements and hand coordination exercises mean you’re cognitively doomed? And can these exercises really ― as the captions claim ― prevent dementia or Alzheimer’s? HuffPost asked a neurologist to weigh in. 

“While there are a few studies showing that aspects of mild cognitive impairment might be improved with these types of hand exercises, I would put forward that there is nothing magical about these movements,” said neurologist Dr. Chris Winter.

Hand exercises are a way to practice motor skills, which can be beneficial for maintaining cognitive abilities as we age. But it might be a stretch to suggest that specific movements are going to remove your risk of developing dementia or Alzheimer’s disease. 

Winter explained that hand and finger coordination can be beneficial as part of a larger pattern of mental and physical activity, but it’s not the hand gestures themselves that matter ― it’s the engagement and concentration involved.

“Learning to play the piano or other activities that force concentration and the practice of improved hand/eye coordination are potentially just as useful,” Winter said. “I recommend that people stay active and engage in appropriately challenging activities. Learn a new language, pick up a guitar or a used set of drums, play pickleball. If you have the capacity to do these things, get off of TikTok and go do these things instead.”

Related video: Research reveals the habits scientifically proven to add a decade to your lifespan (Talking With Docs)

Brain function is less about hand gestures and more about movement and mental engagement that challenge your mind and body overall. 

Winter also emphasized that TikTok viewers shouldn’t mistake their inability to do some of these hand exercises as a red flag for cognitive decline. If you have trouble alternating pointing your thumbs and pinkies, that doesn’t mean you’re “already developing dementia,” as some commenters fear. 

“I think there are a variety of reasons why one could not do these gestures ― or rub their stomach while patting their head,” he said. “While someone with significant dementia is probably not likely to be able to do these activities, the fact that someone struggles with coordination does not indicate dementia or progression in this direction. Ability to pat your hands together is not a diagnostic test for cognitive decline.”

So while those quick coordination challenges might be fun or stimulating, experts say, your best bet for brain health still lies in the basics: regular exercise, quality sleep, a balanced diet and staying mentally and socially active. And what exercise and mental stimulation mean can vary based on individuals’ abilities. 

Health: The U.S. Is Experiencing 'National Trauma' — And It Explains Why So Many Of Us Feel Miserable

“If you only have the capacity to practice hand gestures, then that’s OK too,” Winter said. 

But just remember that the real “hack” for keeping your brain sharp isn’t a social media exercise ― it’s a holistic approach to living a healthy, mindful and engaged life. 

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Read the original on HuffPost

Ultrasound Imaging Comparison of Crural Fascia Thickness and Muscle Stiffness in Stroke Patients with Spasticity

 Based on this, what will your competent? doctor do to cure spasticity? 

Nothing like usual? PURE INCOMPETENCE THEN! 

A fireable offence for the past two years!

Ultrasound Imaging Comparison of Crural Fascia Thickness and Muscle Stiffness in Stroke Patients with Spasticity

                                 by

Jongwon Choi

^1,2,

Yerim Do

³ and

Haneul Lee

^2,4,*

¹

Fascia Research Institute, Myofascial Release Korea, Seoul 06136, Republic of Korea

²

Department of Physical Therapy, The Graduate School, Gachon University, Incheon 21936, Republic of Korea

³

Department and Research Institute of Rehabilitation Medicine, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea

⁴

Department of Physical Therapy, College of Medical Science, Gachon University, Incheon 21936, Republic of Korea

^*

Author to whom correspondence should be addressed.

Diagnostics 2024, 14(22), 2606; https://doi.org/10.3390/diagnostics14222606

Submission received: 13 October 2024 / Revised: 14 November 2024 / Accepted: 17 November 2024 / Published: 20 November 2024

(This article belongs to the Special Issue Advances in Ultrasound Imaging for Musculoskeletal Diseases)

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Versions Notes

Abstract

Background/Objective: 

Spasticity following stroke causes structural changes in the muscles and fascia, affecting the mobility and functional recovery of patients. Understanding these structural changes is critical to optimizing the rehabilitation strategies for patients. Therefore, in this study, we aimed to investigate the differences in crural and epimysial fascia thickness and muscle stiffness in the affected and unaffected lower limbs of chronic stroke patients with spasticity. 

Methods: 

A total of 88 patients with chronic stroke (mean age: 62.7 ± 10.2 years) were included in this study. Ankle range of motion, crural fascial thickness, and muscle stiffness in affected and unaffected lower limbs were assessed using ultrasound. Results: For the affected lower limbs, 59 patients (67.1%) exhibited a modified Ashworth scale score of 2, whereas 29 patients (32.9%) exhibited a score of 3. Ankle range of motion, fascia thickness, and muscle stiffness were also measured. The range of motion in ankle dorsiflexion and plantar flexion was significantly reduced on the affected side (p < 0.05). Crural fascia thickness was significantly greater in all regions of the affected side (anterior: 0.96 ± 0.14 vs. 0.72 ± 0.08 mm [p < 0.001]; lateral: 1.01 ± 0.14 vs. 0.75 ± 0.14 mm [p < 0.001]), and the epimysial fascia of the tibialis anterior muscle was similarly greater in the affected side (0.46 ± 0.07 vs. 0.34 ± 0.03 mm [p < 0.001]). However, no significant differences in muscle stiffness were observed between the affected and unaffected sides (p > 0.05). 

Conclusions: 

Overall, these findings revealed significant fascial thickening with only minimal changes in muscle stiffness on the affected side, highlighting the importance of controlling fascial changes for post-stroke spasticity management.