Physical Activity in Midlife Not Linked to Cognitive Fitness in Later Years

To improve your cognitive functioning post-stroke your doctor should tell you the exact amount of physical activity needed. We need a fucking protocol, get your doctor to write up one rather than 10 million yearly stroke survivors  looking for the same damn thing.

Physical Activity in Midlife Not Linked to Cognitive Fitness in Later Years

Moving When Young May Strengthen the Adult Brain

Stroke Rehabilitation: Exercise Improves Cognitive Function

 

 

Feinstein Institute study finds robotic ankle rehabilitation helps post stroke recovery

More research will be needed to compare this latest one to the earlier 3 posts on anklebots. But that won't occur because we have NO fucking stroke leadership and NO fucking stroke strategy.
We need a damned protocol on what survivors can use this and what exercises they need to do to recover complete ankle function. That is the goal, damn it all. Get there! 
http://www.prnewswire.com/news-releases/feinstein-institute-study-finds-robotic-ankle-rehabilitation-helps-post-stroke-recovery-300499220.html

Stroke patients with high function walking speed had potential to return to normal after rehabilitation

---

News provided by

Feinstein Institute for Medical Research

11:46 ET

Share this article

---

MANHASSET, N.Y., Aug. 3, 2017 /PRNewswire-USNewswire/ -- A study published in NeuroRehabilitation by Feinstein Institute for Medical Research scientist Bruce T. Volpe, MD and Johanna L. Chang found that isolated ankle training with a robotic therapy device can improve walking speed and balance after a stroke, depending on the severity of the patient's initial impairment. Better understanding of severity-dependent recovery profiles after stroke will help medical professionals determine the best candidates for robotic rehabilitation. 

Strokes happen when a patient's brain does not receive sufficient blood supply due to a blockage or rupture of a blood vessel, which can result in impairment of motor or cognitive function. Patients typically participate in rehabilitation programs that focus on specific enhanced motor activity of their limbs under the direction of physical and occupational therapists.
Robotic devices are effective tools to aid in this recovery of, for example, wrist and arm movement. The devices have been less effective in encouraging recovery of walking speed (also known as gait). Dr. Volpe's study examines whether a robotic-assist device that uses interactive ankle movement in a seated position would improve a patient's walking speed and balance.
"Exercise is one of the main ways for patients who have had a stroke to regain movement," said Ms. Chang, who is the lead author of the study. "The use of robotic assisted-devices can enhance the therapy by increasing the intensity of the motor experience. This interactive robotic device moves the paralyzed arm or leg when the patient cannot and gets out of the way when the patient powers the movement.  In our study, the baseline or initial walking speed prior to therapy was an important factor in predicting the final walking speed."
Twenty-nine study participants with a foot drop and walking speed abnormalities after stroke were treated three times a week for six weeks with robot-assisted ankle training. The patients were separated into three groups: high function (walking speed greater than 3 feet per second), medium function (1 foot per second) and low function (less than 1 foot per second). During a session, patients were seated in front of a video monitor and the ankle robot was attached at the knee and foot. The patient viewed the video screen that had a cursor and used their legs and ankle to move the cursor to reach a particular target.
After 18 sessions, the high and medium function groups demonstrated significant improvements in walking speed, with the high functioning group achieving a speed that is considered normal for ambulating patients in the community (greater than 4 feet per second).  A further exciting result showed that in follow-up three months after the treatment finished, the high function group continued to improve (4.39 feet per second). The low functioning group demonstrated the greatest change in improved balance.
"Much like one medication is not effective for all patients with a certain condition, not all rehabilitation is beneficial to all," said Kevin J. Tracey, MD, president and CEO of the Feinstein Institute. "By understanding who can most benefit from robotic rehabilitation medical professionals can better tailor a program that will result in the highest benefit for patients."
About the Feinstein InstituteThe Feinstein Institute for Medical Research is the research arm of Northwell Health, the largest healthcare provider in New York. Home to 50 research laboratories and to clinical research throughout dozens of hospitals and outpatient facilities, the Feinstein includes 4,000  researchers and staff who are making breakthroughs in molecular medicine, genetics, oncology, brain research, mental health, autoimmunity, and bioelectronic medicine – a new field of science that has the potential to revolutionize medicine. For more information about how we empower imagination and pioneer discovery, visit FeinsteinInstitute.org
Contact: Heather E. Ball 
516-465-7917
hball@northwell.edu

SOURCE Feinstein Institute for Medical Research

Almost half of stroke survivors suffer fatigue, study reveals

Well shit, survivors could have told you that decades ago. And once again a description of a problem but no solutions. Damn it all, do something for survivors, solve their problems.
http://www.nottingham.ac.uk/news/pressreleases/2017/march/almost-half-of-stroke-survivors-suffer-fatigue-study-reveals.aspx

03 Mar 2017 16:11:23.077

PA35/17
Almost half of people who experience a stroke suffer from fatigue in the early days of their recovery, a landmark new study has found.
Although stroke survivors have reported fatigue as a problem, previous estimates of the numbers of people affected have varied greatly – from one-quarter to almost three-quarters of stroke survivors.
Now, for the first time, a more accurate picture of the problem is being published in the journal Clinical Rehabilitation, thanks to The Nottingham Fatigue after Stroke (NotFAST) study, led by experts at The University of Nottingham.

Click here for full story

The study, funded by the Stroke Association, is the first to specifically exclude patients with depression, which is strongly linked to fatigue, and which may have influenced the outcome of previous studies that included people with depressive symptoms.
Avril Drummond, Professor of Healthcare Research and Director of Research in the University’s School of Health Sciences, led the study.
She said: “Fatigue is not feeling tired; the terms are not the same. Fatigue is an overwhelming feeling of exhaustion which doesn’t improve with sleep or rest and which isn’t related to activity.
“Fatigue is a major problem for stroke survivors and effects all aspects of their lives. It can be a key factor in reducing participation in rehabilitation after stroke, and this can have a real impact on recovery. People simply do not reach their fullest potential.”
The study recruited patients within four weeks of experiencing a stroke from four UK inpatient stroke services at Nottingham University Hospitals, University Hospitals of Leicester, University College London Hospitals and Salford Royal Hospitals over an 18- month period. The study excluded patients with dysphasia, dementia and depressive symptoms.
The participants were assessed for: self-reported fatigue; mobility and activities of daily living; sleep; mood and emotional factors; and cognitive abilities.
The patients were followed up between four and six weeks after their stroke and the study found that 43 per cent of participants reported experiencing fatigue – for a large proportion of them (62 per cent) this was a new, post-stroke symptom.
Professor Drummond added: “We have followed up the patients over the longer term and will publish the results of their progress at six months after their stroke in due course.
“It is incredibly important that clinicians become more aware of fatigue as it has a huge impact on rehabilitation and quality of life.”
Dr Dale Webb, Director of Research and Information at the Stroke Association, said: “We are delighted to have supported this research, and hope that it will help lift the veil on what is one of the most distressing, poorly understood, and inadequately managed conditions caused by stroke. There is so much more that needs to be done, but this research is a significant step towards getting these stroke survivors the support they so desperately need.”

Clarkson University Study on Walking Ability Shows Path to Treatment for Stroke Survivors

Damn it all , still no protocol listed so other survivors and therapists could reuse it. If you can walk for six minutes you are already at a high functioning level. This research told me nothing new. 

Clarkson University Study on Walking Ability Shows Path to Treatment for Stroke Survivors

Stroke is the leading cause of disability in older adults in the United States, but research by Clarkson University Associate Professor of Physical Therapy George Fulk and his colleagues is pointing the way to recovery for people who are relearning how to walk.
Using data collected over a number of years from two other large clinical trials, the Potsdam, N.Y. researcher and his team were able to create and analyze one large database. Their results show a six-minute walk test is the strongest predictor of walking activity in the home and community for stroke survivors. That information, in turn, helps map the most effective steps for physical rehabilitation and independence.
“One of my main focuses in research and my passion in physical therapy is to better understand how physical therapy interventions help people with stroke to relearn to walk again, so we need to better understand how to measure walking activity," says Fulk. "We can't follow patients around all day, so we measure how they walk in the clinic to try to understand out how they will function in the community and at home. A lot of times clinic and at-home experiences don't match, though."
For example, some people perform better in a clinic because it's a closed safe environment with not as many obstacles to walking. Sometimes, patients could be afraid of falling or they may not have the social support to get out, he notes. Then again, some people may not seem to be as likely to succeed but they just do it.
Step activity monitors turned out to be the answer to the puzzle of how much and how well stroke survivors were walking. Among the factors they measured, researchers found that walking endurance with the six-minute walk test was the strongest individual predictor of community walking activity.
The study matches Fulk's belief that a person's walking endurance, motor function, and balance are essential for walking activity after a stroke, so rehabilitation interventions should focus on these areas to improve a stroke survivor’s ability to walk once they leave the hospital or clinic.
“The more we can learn, the more we can help them have a better recovery,” Fulk says.
He and his Clarkson University colleague, Assistant Professor of Mathematics Ying He, and Assistant Professor of Rehabilitation Sciences Pierce Boyne and Associate Professor of Rehabilitation Sciences Kari Dunning, both of the University of Cincinnati, published their results online in the journal Stroke on Jan. 5.
Clarkson University educates the leaders of the global economy. One in five alumni already leads as an owner, CEO, VP or equivalent senior executive of a company. With its main campus located in Potsdam, New York, and additional graduate program and research facilities in the Capital Region and Beacon, N.Y., Clarkson is a nationally recognized research university with signature areas of academic excellence and research directed toward the world's pressing issues. Through more than 50 rigorous programs of study in engineering, business, arts, education, sciences and the health professions, the entire learning-living community spans boundaries across disciplines, nations and cultures to build powers of observation, challenge the status quo and connect discovery and innovation with enterprise.
Photo caption: Above, Clarkson University doctor of physical therapy students work with patients with stroke. Research by Associate Professor of Physical Therapy George Fulk and his colleagues is pointing the way to recovery for people who are relearning how to walk.

Damn, damn, damn, damn

Mom whispered to me over the phone that my dad has been diagnosed with Alzheimers.  From that I assume that Dad has not been told of the diagnosis. I'm traveling there next week to see what needs to be done. Once I go thru my hundreds of posts on dementia/Alzheimers I'll come up with a protocol on it for him. Damn it all, not only do I have to tackle stroke pretty much alone, I'm going to have to become the world's expert in dementia/Alzheimers also. I'm not sure I have enough brains and stamina to handle both at the same time, along with working full time and traveling to NY on almost a weekly basis. My wine group met this weekend in Saugatuck, MI and it was a good thing that  my bedroom was 30 feet down the hallway with walls along the way.