Optimizing Recovery: A Systematic Review of Ischemic Post-Stroke Rehabilitation and Its Impact on Quality of Life and Independence

Much more important would be CREATING EXACT RECOVERY PROTOCOLS! This review DID NOTHING USEFUL!

 Optimizing Recovery: A Systematic Review of Ischemic Post-Stroke Rehabilitation and Its Impact on Quality of Life and Independence

Rohematus Soleha3, Lono Wijayanti4, Umdatus Soleha5 1,2,3,4,5Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, Indonesia *Email Corespondent: yurikesepti1209@unusa.ac.id 

 Abstract 

 Background: 

Stroke is a leading cause of long-term disability and the second leading cause of mortality worldwide. In ischemic stroke survivors, recovery is often limited by age, comorbidities, cognitive impairment, and initial stroke severity. Mindfulness-based interventions have emerged as a potential complement to conventional rehabilitation by enhancing neuroplasticity, emotional regulation, and functional independence. Objective: To systematically review the effectiveness of mindfulness therapy as part of ischemic post-stroke rehabilitation in improving quality of life and independence. 

 Methods: 

A systematic review was conducted on studies published between 2020 and 2024 using PubMed, Scopus, and ScienceDirect. Search terms combined “Ischemic Stroke,” “Disability,” “Rehabilitation,” and “Mindfulness.” Eligible studies included ischemic post-stroke patients receiving mindfulness therapy with reported outcomes on quality of life or independence. 

 Results: 

Thirteen studies met the inclusion criteria: eleven randomized controlled trials, one quasi-experimental, and one pre-test post-test design. Mindfulness therapy, delivered individually, in groups, or via technology, consistently improved physical function, emotional well being, and daily living independence. Benefits included reduced anxiety, depression, and fatigue, along with improved cognitive function. Integration with standard rehabilitation produced greater gains in quality of life compared to conventional therapy alone. 

 Conclusion: 

Mindfulness-based rehabilitation offers promising benefits for ischemic stroke recovery, enhancing both motor and psychosocial outcomes. Incorporating structured mindfulness programs into multidisciplinary rehabilitation may optimize independence, improve quality of life, and reduce psychological distress. Future research should explore long-term effects, best delivery methods, and patient-tailored strategies.

Four Brain-Building Activities to Boost Attention and Focus After a Stroke

 Focus and attention after stroke are simple to accomplish. EXACT 100% RECOVERY PROTOCOLS and your survivor will be too busy getting rehabbed to do anything else! ARE YOU THAT BLITHERINGLY STUPID YOU CAN'T SEE THAT?

Four Brain-Building Activities to Boost Attention and Focus After a Stroke

Clinical Contributors to this story:

Monique Tremaine, Ph.D.

After a stroke, it can be hard to focus or pay attention. You may be easily distracted. Although these mental challenges are not unusual, there are ways to overcome them. 

Monique Tremaine, Ph.D., director of neuropsychology and the cognitive rehabilitation program at JFK Johnson Rehabilitation Institute,explains four ways to retrain your mind after a stroke.

How Strokes Affect Attention

During a stroke, a blood clot or hemorrhage can block oxygen from reaching your brain for some time. When your brain doesn’t have oxygen, its cells can die. The loss of brain cells can make thinking, focusing and remembering difficult.

“Strokes that occur on the right side of the brain tend to cause the most attention problems,” Dr. Tremaine says. “But, any type of stroke can cause problems with attention because strokes affect the overall workings of the brain.”

At-Home Strategies to Improve Focus and Attention After a Stroke

Some people who’ve had a stroke may benefit from an outpatient rehabilitation program. There, they can work with physical, occupational and speech therapists and neuropsychologists. But there are ways to promote stroke recovery at home on your own, too.

1. Practicing Mindfulness

Dr. Tremaine says mindfulness activities are a “tried and true” way to boost awareness. Mindfulness refers to focusing on the present.

You can find mindfulness tools everywhere, from apps to books to in-person or virtual classes. “We have a whole mindfulness module in our cognitive rehabilitation program that’s guided by a neuropsychologist,” Dr. Tremaine says. “Mindfulness can be a tricky concept for people to grasp at first.”

• To get started with mindfulness, try sitting somewhere without distractions. 
• See if you can focus only on the present. 
• If your mind wanders to the past or future, pause and regain your focus. 
• Try not to judge yourself for the distraction. 
• Keep practicing, and increase the amount of time you focus.
  
  

2. Meditating

A daily basic meditation and relaxation practice primes your brain to be more attentive and relaxed. This is especially helpful when you’re faced with challenging situations, Dr. Tremaine says.

“When you recognize you’re making mistakes and panic, daily meditation or relaxation practice will help you calm down those reactions, so you can better handle them in the moment,” says Dr. Tremaine.

If you’ve never meditated, try a simple body scan meditation. Follow these steps:

1. Find a quiet, comfortable space. You can listen to natural sounds, like nature or calming instrumental music.
2. Close your eyes and focus on the feeling of your breathing.
3. Next, try to focus on the feeling in each part of your body, starting with your toes and working your way up to your head.
4. If you get distracted or find yourself thinking about something other than the feelings in your body, gently refocus and forgive yourself for the lapse.
5. Once you’ve completed your body scan, slowly open your eyes and stand up.
   
   

3. Playing Games

Playing games, especially those that rely on memory and concentration, like card games, is a good way to enhance attention, Dr. Tremaine says. There are apps, too, such as Luminosity, with cognitive exercises that pinpoint areas that you need to work on and allow you to track your progress.

4. Continuing Current Hobbies

If physically able, drawing and cooking can be great activities that promote attention in stroke recovery. Stick to hobbies that can be done safely and that you had the skill to do before your stroke.

“Focus on doing things you enjoy, but adjust them to a level that makes sense for your new abilities.” If you love doing 1,500-piece jigsaw puzzles, scale it back to 100. If you love to tinker, start with small tabletop projects. Special tools to improve attention are great but not necessary,” she says. “It really is about individually tailoring and modifying things.”

Next Steps & Resources

• Meet our sources: Monique Tremaine, Ph.D.
• Make an appointment with a cognitive rehabilitation specialist near you or call 800-822-8905.
• Learn more about physical rehabilitation and physical therapy at Hackensack Meridian Health.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.

Comparing the Effectiveness of Mindfulness-based Stress Reduction Training and Powell’s Cognitive Rehabilitation on Improving the Quality of Life of Stroke Patients

Well, you missed the boat completely. 100% recovery protocols and the stroke survivors quality of life will return to the previous status. Not needing mindfulness training or separate cognitive rehabilitation.  GET THERE!

Comparing the Effectiveness of Mindfulness-based Stress Reduction Training and Powell’s Cognitive Rehabilitation on Improving the Quality of Life of Stroke Patients

authors:

Fatemeh Shojaei ¹ , Fatemeh Shahabizadeh ^{1 , *} , Seyed Mohammad Mousavi-Mirzaei ² , Mohammad Dehghani Firoozabadi ³ , Aliakbar Esmaeili ⁴

1 Department of Psychology, Birjand Branch, Islamic Azad University, Birjand, Iran

2 Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran

3 Department of Neurology, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran

4 Department of Psychiatry, School of Medicine, Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran

* Corresponding Author: Department of Psychology, Birjand Branch, Islamic Azad University, Birjand, Iran. Email: f_shahabizadeh@yahoo.com

---

Modern Care Journal: Vol.21, issue 3; e142817

published online: January 5, 2024

article type: Research Article

received: November 7, 2023

revised: December 6, 2023

accepted: December 12, 2023

DOI: https://doi.org/10.5812/mcj-142817

how to cite: Shojaei F, Shahabizadeh F, Mousavi-Mirzaei S M, Dehghani Firoozabadi M, Esmaeili A. Comparing the Effectiveness of Mindfulness-based Stress Reduction Training and Powell’s Cognitive Rehabilitation on Improving the Quality of Life of Stroke Patients. Mod Care J. 2024;21(3):e142817. https://doi.org/10.5812/mcj-142817.

Abstract

Background:

Stroke is a type of neurological disorder that can be attributed to a central vascular cause. Stroke can affect the patient’s performance in daily activities and quality of life (QoL). Research indicates a decrease in the quality of life in stroke patients due to cognitive and emotional damage.

Objectives:

The present study compared the effect of two group approaches, mindfulness training based on stress reduction and Powell’s cognitive rehabilitation, on improving the quality of life of stroke patients.

Methods:

This semi-experimental study used a pretest-posttest design with a control group and a follow-up period. The sample consisted of 36 eligible stroke patients selected in a targeted and simple random manner. The patients were divided into two intervention groups and one control group. The tools used were a demographic information questionnaire and a Stroke-specific QoL (SS-QOL) scale. Data were analyzed with SPSS software (version. 26). Chi-square, repeated measures analysis of variance, and Bonferroni statistical tests were applied at a significance level of P<0.05.

Results:

The majority of the sample were men, with 60%, 63.6%, and 75% in the cognitive rehabilitation, mindfulness, and control groups, respectively. There was no significant difference in gender distribution between the studied groups (P > 0.05). The mindfulness intervention had a higher effect on quality of life on average. Still, statistically, none of the interventions were effective in improving quality of life (P > 0.05), and there was no significant difference between the effect of mindfulness-based methods and cognitive rehabilitation on improving quality of life (P > 0.05).

Conclusions:

Mindfulness training increases behavioral responses related to attention as the basis of all cognitive activities. Also, mindfulness exercises improve cognitive skills and, by affecting the cognitive system, increase the capacity and ability of the information processing system and improve the quality of life.

The Effective Mind-Body Therapies For Anxiety

With this 20% chance your doctor better have protocols to treat your anxiety. Or is your doctor incompetent in this also with the lack of any protocols to get you 100% recovered?

Approximately 20% of stroke patients experience clinically significant levels of anxiety at some point after stroke

The Effective Mind-Body Therapies For Anxiety

Anxiety affects around one-third of adolescents in the US.

Biofeedback, mindfulness, yoga and hypnosis all provide promising mind-body approaches to treating anxiety, new research finds.
The standard treatments for anxiety are cognitive-behavioural therapy and/or medication.

→ Enjoying these psych studies? Support PsyBlog for just $4 per month (includes ad-free experience and more articles).

However, these treatments can be difficult to obtain, expensive and, in the case of medication, involving significant side-effects.
Mind-body approaches, though, are often cheaper, accessible and usually with no side-effects.
The researchers identified studies on adolescents that supported the use of:

• Mindfulness involves increasing self-awareness and using breathing techniques. Studies show it can benefit anxiety.
• Yoga is effective in reducing anxiety.
• Hypnosis involves relaxation and imagery techniques, which can be effective.
• Biofeedback helps control anxiety by increasing self-awareness through showing people their own physiological stress response.

Yoga in particular has seen a massive rise in popularity in recent years, the study’s authors write:

“Low in cost, easy to implement, and accessible to individuals of all physical fitness levels, yoga has become an increasingly popular anxiety management tool.”

Anxiety affects around one-third of adolescents in the US.

Almost one-in-ten adolescents experience anxiety severe enough to disrupt their lives.
The study’s authors write:

“Whereas anxiety and fear are typical reactions to the academic, social, and developmental challenges common during the adolescent years, clinical or pathological anxiety is excessive, persistent, and disruptive.”

Most adolescents do not receive any treatment.
Ms Fulweiler and Dr John write:

“A growing body of evidence supports the implementation of mind-body therapy as a low-risk and cost-effective strategy in the management of anxious teenagers.
[…] Mind-body therapies encompass self-regulation and positive thinking…to help promote self-control, physical health, and emotional well-being.”

The study was published in the journal The Nurse Practitioner (Fulweiler & John, 2018).

Mindfulness Can Improve Heart Health

I bet there is nothing that will get your stroke hospital to implement mindfulness training. 20 years of incompetency already; How long are YOU going to let that last? You can't do it on your own, that would be practicing medicine without a license.
http://blog.cardiometabolichealth.org/2018/02/27/mindfulness-can-improve-heart-health/?

What’s good for the mind also tends to be good for the heart, and the mind-calming practice of meditation may play a role in reducing your risk of heart disease, according to a scientific statement published in the September Journal of the American Heart Association.

Experts reviewed dozens of studies published over the past two decades, and found that meditation may improve a host of factors linked with heart disease — making it worth including in an overall program for ongoing heart care. “Not only can meditation improve how your heart functions, but a regular practice can enhance your outlook on life and motivate you to maintain many heart-healthy behaviors, like following a proper diet, getting adequate sleep, and keeping up regular exercise,” says Dr. John Denninger, director of research at the Harvard-affiliated Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital.

Meditation involves sitting comfortably with closed eyes and focusing on breathing, a mental image, or repetition of a single positive word or phrase. The goal is to keep the mind focused on the present: away from stressful or distracting thoughts. As your mind becomes calm, so too does your body.

A meditation practice supports your heart in many ways, from changing how you cope with stress to lowering high blood pressure. Research has found that meditation can positively affect a measure of heart health known as heart rate variability (HRV). HRV reflects how quickly your heart makes small changes in the time interval between each heartbeat. A high HRV is a sign of healthier heart. A 2013 study found that low HRV is associated with a 32% to 45% increased risk of heart attack or stroke among people without cardiovascular disease.

With regular meditation, you may be able to raise your HRV. A 2013 study found that people who did five minutes of meditation daily for 10 days had a better HRV compared with those who didn’t meditate. A number of high-quality studies also show that meditation can modestly lower blood pressure, according to a 2013 American Heart Association scientific statement published in Hypertension. One analysis pooled results from nine studies and found that, on average, meditation lowered systolic blood pressure (the top number in a reading) by 4.7 milligrams of mercury (mm Hg) and diastolic blood pressure (the bottom number) by 3.2 mm Hg.

As with any new endeavor, it takes time to learn meditation and build confidence in your ability. Dr. Denninger recommends that you begin small and give yourself space to progress at your own speed. For example, devote just five minutes a few days per week to meditation, and then gradually increase the time and frequency until you can do it daily for up to 20 minutes. “Doing some meditation, no matter how brief, is always better than nothing,” says Dr. Denninger.

Set up a schedule to help establish a routine. Try to meditate at the same time each day, says Dr. Denninger. If you have trouble sticking to a set time, plan to do your meditation after a regular activity like brushing your teeth. “If you miss a day or two, don’t feel you have lost any progress and have to start over,” says Dr. Denninger. “Simply pick up where you left off and keep going.”

Some people find that learning and practicing meditation with a group is helpful, so you could inquire about meditation classes at yoga studios and community centers, or even follow meditation exercises online. Meditation can be yet another way to improve heart health and at the same time help ease your mind.