Use the labels in the right column to find what you want. Or you can go thru them one by one, there are only 34,278 posts. Searching is done in the search box in upper left corner. I blog on anything to do with stroke. DO NOT DO ANYTHING SUGGESTED HERE AS I AM NOT MEDICALLY TRAINED, YOUR DOCTOR IS, LISTEN TO THEM. BUT I BET THEY DON'T KNOW HOW TO GET YOU 100% RECOVERED. I DON'T EITHER BUT HAVE PLENTY OF QUESTIONS FOR YOUR DOCTOR TO ANSWER.
Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.
What this blog is for:
My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.
Showing posts with label objectives. Show all posts
Showing posts with label objectives. Show all posts
Friday, August 31, 2018
Is There Full or Proportional Somatosensory Recovery in the Upper Limb After Stroke? Investigating Behavioral Outcome and Neural Correlates
The objective of this research is completely wrong. It should be to create stroke protocols that recover Somatosensory functions. Hell, that was figured out in a Margaret
Yekutiel book about this from 2001, 'Sensory Re-Education of the Hand After Stroke'? And I bet 17 years later your stroke hospital is still incompetent, not having the book in the library or making sure every doctor and therapist has read it and applied the protocols to all stroke survivors.
First Published July 10, 2018
Research Article
Wednesday, January 31, 2018
ESO Announces Strategic Plan 2018-2020 - a total failure
What a pile of shit for objectives. NOTHING on solving all the problems in stroke, or creating a database of stroke protocols. It is not even for stroke survivors.
https://eso-stroke.org/eso/eso-announces-strategic-plan-2018-2020/
https://eso-stroke.org/eso/eso-announces-strategic-plan-2018-2020/
Strategic Plan Summary
Introduction
Across Europe, stroke accounts for over 1 million deaths each year. The risk of death due to stroke varies substantially between countries, and is more than three times higher in central and eastern Europe than in northern, southern and western Europe.
The vision of the European Stroke Organisation (ESO) is to serve as the voice of stroke in Europe, harmonising stroke management across the whole of Europe, and taking action to reduce the burden of stroke regionally and globally. (Nothing for helping survivors recover)
The society has developed rapidly in recent years, including:
- The launch and steady growth of the European Stroke Organisation Conference (ESOC) to over 4,000 participants
- Exceptional membership growth, from 700 to over 7,000 professionals represented in the society in the period 2014 – 2017
- Geographic expansion and outreach through ESO EAST (Enhancing and Accelerating Stroke Treatment)
- The launch of ESO’s own journal – European Stroke Journal (ESJ)
- Establishing the ESO Stroke Unit and Stroke Centre Certification programme
- Recognition by European institutions of ESO’s leadership in stroke science
In this context, in 2017, ESO leadership undertook a strategic planning exercise to maintain and further develop ESO, and to guide the investment of ESO resources over the next 3 years.
Key Objectives
The principal strategic objectives for ESO in the next 3 years are about ensuring sustainable success, including:
- Maintaining an exceptional level of quality output across ESO
- Continuing to attract the top talent in the field, whether as members, leaders or contributors to ESO projects
- Creating an organisational structure to encourage and facilitate further growth
- Providing reliable and consistently good services to members, customers and partners
- Further growth in individual membership, as well as via national societies and related associations.
Highlighted Projects
To support achieving its mission, ESO runs a wide range of projects in multiple areas, including:
Tuesday, August 2, 2016
Comeback Trail - Your Trial [sic], Your Way - National Stroke Association
Once again, a lazy awareness event rather than focusing their efforts on actually solving problems that survivors have due to their stroke. Damn the board of directors for not setting the proper goals and objectives for the stroke organization. Failure once again. You will always be on your own until these stroke organizations are run by survivors.
Dear dean,
Dear dean,
Last September, National Stroke
Association launched Comeback Trail - Your Trial, Your Way. This free, virtual event offered stroke
survivors and friends of the stroke community the opportunity to hit their
favorite sidewalk or walking trail in celebration of stroke survivorship and come
back strong journeys, all while raising awareness for the fifth leading cause
of death in the U.S.
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Nearly 1,000 people from 49 states (and even the United Kingdom!) came
together for our inaugural event. As we look forward to this fall, we need you
to help us double our number of virtual trailblazers and encourage you to share
your own come back strong story through a personal event fundraising page.
Mark
your calendar and join us on Sept. 10, 2016, for the second annual Comeback Trail—Your Trail, Your Way. It’s
easy to get started! Register for this free event
today and invite all of your friends and family to join
you in person, or from afar, as you walk around your neighborhood or along your
favorite trail, wherever that may be.
Happy
Trails,

Sr. Coordinator, Developmen
Tuesday, June 14, 2016
Altering the Rehabilitation Environment to Improve Stroke Survivor Activity (AREISSA): A Phase II Trial
All this seems like followup to enriched environment as talked about by Dr. Dale Corbett in 2011
Has your doctor done one fucking thing about enriched environment since 2011? Call the hospital president and ask what the goals and objectives are for stroke doctors. If there is nothing on staying current with research or updating stroke protocols you need to have a lot of people fired.
In a March 2015 report patients undertook a mean of 61 minutes (SD = 39) of activity per day.
Ask your doctor how much structured stroke rehab activity occurs on a daily basis. If not close to 12-14 hours ask why the hell not.
There should be hours upon hours of action observation videos to watch.
Meditation to do.
Tai chi or yoga to do.
Music listening.
Passive movement.
Lucid dreaming to continue stroke rehab during sleep.
Has your doctor thought about any of this stuff? Or was it just signing ET(Evaluate and Treat) prescriptions to the therapists thus washing their hands of any failures in recovery?
Altering the Rehabilitation Environment to Improve Stroke Survivor Activity (AREISSA): A Phase II Trial
Project team: A/Prof Neil Spratt, Prof Julie Bernhardt, Dr Heidi Janssen, Prof Louise Ada, Prof Michael Nilsson, A/Prof Michael Pollack and Prof Leonid Churilov
Design: Before-after non-randomised controlled trial
Current status: Recruitment ongoing
Site/s:. Bankstown Lidcombe, NSW; St Vincent’s Hospital Sacred Heart Rehabilitation Unit, NSW; Austin Health Royal Talbot, Mellor Unit, VIC, and Monash Health Kingston Centre, VIC
Background:
Despite higher levels of activity being associated with better stroke recovery, stroke patients on most rehabilitation units spend the majority of their day inactive and alone. In animal models, Environmental Enrichment (EE) involves organisation of the environment and provision of equipment to facilitate physical, cognitive and social activity. EE promotes rewiring of the brain after stroke and has been found to significantly enhance functional recovery. Preliminary work on the use of a human model of EE using individual (eg. iPods, & word puzzles) and communal (eg. access to interactive gaming, computer, books/newspapers & jigsaws) enrichment in a rehabilitation unit indicates it encourages stroke patients to be more active. Greater activity during rehabilitation has numerous benefits, the most important of which is achieving better functional recovery and subsequently, greater independence. Altering the Rehabilitation Environment to Improve Stroke Survivor Activity (AREISSA) is a Phase II Trial involving four rehabilitation units, 2 in NSW and 2 in VIC, which seeks to determine the safety, efficacy, feasibility and patient and staff acceptability of this model of EE during stroke rehabilitation. This and the other enrichment projects conducted alongside AREISSA, will be used to inform future larger trials required to determine the effect of EE on stroke survivor recovery and quality of life.
Aims:
To determine the clinical and operational feasibility and safety of Environmental Enrichment (EE)
Methods:
Behavioural mapping, in-depth interview, audit and survey
References:
- Janssen H, Bernhardt J, Collier JM, Sena ES, McElduff P, Attia J, Pollack M, Howells DW, Nilsson M, Calford MB, Spratt NJ (2010). An enriched environment improves sensorimotor function post-ischemic stroke. Neurorehabil Neural Repair. 24: 802-813.
- Janssen H, Ada L, Bernhardt J, McElduff P, Pollack M, Nilsson M, Spratt NJ (2014). An enriched environment increases activity in stroke patients undergoing rehabilitation in a mixed rehabilitation unit: a pilot non-randomized controlled trial. Disabil Rehabil. 36: 255-262.
- White J, Bartley E, Janssen H, Jordan LA and Spratt NJ (2015). Exploring stroke survivor experience of participation in an enriched environment: a qualitative study. Disabil Rehabil. 37(7): 593-600.
- White JH, Alborough K, Janssen H, Spratt N, Jordan L, Pollack M (2013). Exploring staff experience of an "enriched environment" within stroke rehabilitation: a qualitative sub-study. Disabil Rehabil. 36 (21): 1783-1789.
- Janssen H, Ada L, Bernhardt J, McElduff P, Pollack M, Nilsson M, Spratt NJ (2014). Physical, cognitive and social activity levels of stroke patients undergoing rehabilitation within a mixed rehabilitation unit. Clin Rehabil. 28: 91-101.
Sunday, January 31, 2016
Stroke Research: Current Advances and Future Hopes
Have your doctor submit their research to this journal, Journal of International Medical Research (JIMR. No research, then call up the hospital president and ask what the hell the objectives are for the stroke department head to stay employed. Because the status quo is totally unacceptable. I'm not ok with how poorly I and most other survivors are recovering. Don't let them get away with the lazy excuse, 'All strokes are different, all stroke recoveries are different'. Anyone who says that needs to be keel hauled.
http://info.sagepub.co.uk/q/1mah0DkFC080p1pu8gc1/wv
Submitting your manuscript to the journal is free, and all submissions will be fully peer-reviewed as rapidly as possible. If your manuscript is accepted then you will be asked to pay the page charge, which currently stands at the rate of £325 (+VAT where applicable) per printed journal page, assuming no colour figures (colour figures are subject to an additional fee).
For advice on submitting your manuscript, visit the Manuscript Submission Guidelines for more information. Please don't hesitate to get in touch with any questions you may have regarding this Special Issue.
Kind Regards,
Professor Malcolm H. Lader, OBE, LLB, DSc, PhD, MD, FRCPsych, FMed Sci Editor, Journal of International Medical Research
http://info.sagepub.co.uk/q/1mah0DkFC080p1pu8gc1/wv
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Submit to this Special Issue today
Potential topics for the Special Issue could include, but are not limited to:- Stroke prevention and health promotion
- Current advances in the medical management of stroke
- Risk factors for stroke
- Stroke complications
- Motor rehabilitation after stroke
- Cognitive rehabilitation
- Gait rehabilitation
- Balance rehabilitation
Submitting your manuscript to the journal is free, and all submissions will be fully peer-reviewed as rapidly as possible. If your manuscript is accepted then you will be asked to pay the page charge, which currently stands at the rate of £325 (+VAT where applicable) per printed journal page, assuming no colour figures (colour figures are subject to an additional fee).
For advice on submitting your manuscript, visit the Manuscript Submission Guidelines for more information. Please don't hesitate to get in touch with any questions you may have regarding this Special Issue.
Kind Regards,
Professor Malcolm H. Lader, OBE, LLB, DSc, PhD, MD, FRCPsych, FMed Sci Editor, Journal of International Medical Research
Wednesday, March 4, 2015
Stroke breakthrough: Oestrogen the key, say researchers
What is your doctor doing to start up a clinical trial with this? Does your doctor not have any goals and objectives to improve stroke rehab through research? If not, call your hospital president and ask why they are so incompetent that they don't set useable goals for their doctors to help their patients.
Stroke breakthrough: Oestrogen the key, say researchers
Australian scientists have discovered a drug that may have the potential to reduce, and even stop, the effects of stroke.
Trials on mice show the drug, which mimics some actions of oestrogen, protects females against stroke, while worsening the condition in males.
But, on the other hand, blocking an oestrogen receptor in males could alleviate the symptoms of stroke if administered within four hours, Monash University researchers said.
About 50,000 Australians suffer strokes each year. Aside from a clot-busting drug, there are limited treatments. About one-third of people who have a stroke die from it, another third recover fully and one-third survive but remain dependent on care.
While hundreds of clinical trials have failed to find new treatments, researchers at the Monash school of biomedical sciences have found that the recently discovered oestrogen receptor that occurs in both men and women plays a role in the severity of a stroke.
During the trials in mice, they found by blocking this oestrogen receptor in males they could alleviate the symptoms of stroke, while triggering the receptor with a drug in older females protected them from harmful effects of stroke.
Lead researcher Chris Sobey said targeting the receptor GPER in younger females had no effect, suggesting they already had enough oestrogen naturally present in their bodies. He said the findings, published in the journal Stroke this week, could lead to sex-specific treatments for stroke - Australia's second biggest killer after coronary heart disease and a leading cause of disability.
''We don't really understand the mechanisms yet but it's a very profound sex difference, so it could mean that when a male comes into emergency with a stroke, he could be given the receptor blocker and when a woman comes in, she could be given an activator of the receptor,'' he said. ''Based on our experiments, we predict both will be beneficial.''
Associate Professor Sobey said the findings might help to explain why strokes were more common in men up until the age of 75 because women had naturally higher levels of oestrogen - the primary female sex hormone - up until menopause. After 75, the rate of stroke was similar in men and women but after 85, women tended to experience strokes more than men.
Associate Professor Sobey said his team planned more animal trials to better understand the mechanisms and refine dosing in the hope of human trials in coming years.
''There are basically no treatments for stroke at the moment,'' he said. ''All we really have is a clot busting drug that can only be given within 4½ hours of a stroke and even then you require a scan before that to make sure it's not a bleed, because if it is the drug will make it worse. So any new finding with the potential for therapy in the clinic is of great interest.''
Trials on mice show the drug, which mimics some actions of oestrogen, protects females against stroke, while worsening the condition in males.
But, on the other hand, blocking an oestrogen receptor in males could alleviate the symptoms of stroke if administered within four hours, Monash University researchers said.
About 50,000 Australians suffer strokes each year. Aside from a clot-busting drug, there are limited treatments. About one-third of people who have a stroke die from it, another third recover fully and one-third survive but remain dependent on care.
While hundreds of clinical trials have failed to find new treatments, researchers at the Monash school of biomedical sciences have found that the recently discovered oestrogen receptor that occurs in both men and women plays a role in the severity of a stroke.
During the trials in mice, they found by blocking this oestrogen receptor in males they could alleviate the symptoms of stroke, while triggering the receptor with a drug in older females protected them from harmful effects of stroke.
Lead researcher Chris Sobey said targeting the receptor GPER in younger females had no effect, suggesting they already had enough oestrogen naturally present in their bodies. He said the findings, published in the journal Stroke this week, could lead to sex-specific treatments for stroke - Australia's second biggest killer after coronary heart disease and a leading cause of disability.
''We don't really understand the mechanisms yet but it's a very profound sex difference, so it could mean that when a male comes into emergency with a stroke, he could be given the receptor blocker and when a woman comes in, she could be given an activator of the receptor,'' he said. ''Based on our experiments, we predict both will be beneficial.''
Associate Professor Sobey said the findings might help to explain why strokes were more common in men up until the age of 75 because women had naturally higher levels of oestrogen - the primary female sex hormone - up until menopause. After 75, the rate of stroke was similar in men and women but after 85, women tended to experience strokes more than men.
Associate Professor Sobey said his team planned more animal trials to better understand the mechanisms and refine dosing in the hope of human trials in coming years.
''There are basically no treatments for stroke at the moment,'' he said. ''All we really have is a clot busting drug that can only be given within 4½ hours of a stroke and even then you require a scan before that to make sure it's not a bleed, because if it is the drug will make it worse. So any new finding with the potential for therapy in the clinic is of great interest.''
Researchers propose novel new treatment of stroke and other neurological diseases - Thymosin beta-4
What is your doctor doing to start up a clinical trial with this? Does your doctor not have any goals and objectives to improve stroke rehab through research? If not, call your hospital president and ask why they are so incompetent that they don't set useable goals for their doctors to help their patients.
Researchers propose novel new treatment of stroke and other neurological diseases - Thymosin beta-4
Medicine should reconsider how it treats stroke and other neurological disorders, focusing on the intrinsic abilities of the brain and nervous system to heal themselves rather than the "modest" benefits of clot-busting drugs and other neuroprotective treatments.
The co-authors argue that pharmacologically enhancing the brain's own restorative abilities could benefit not only stroke patients, but those suffering other neurological damage or disease including traumatic brain injury (TBI), multiple sclerosis (MS) and peripheral neuropathy - nerve damage that afflicts the elderly, chemotherapy patients and especially diabetics.
Central to their proposal is a new pharmacological agent developed by Dr. Chopp and his colleagues, a synthetic version of a peptide that occurs naturally in humans and other mammals called Thymosin beta-4.
"Pioneering animal studies at Henry Ford have shown Thymosin beta-4 is highly effective for the treatment of neurological diseases in part by increasing the formation of protective myelin around nerve fibers in the central and peripheral nervous systems," says Dr. Chopp.
In their editorial, the authors first detail the limited effectiveness of current standard drug therapy, using tissue plasminogen activator (tPA), more commonly known as a "clot buster," to treat neurological disease.
Offering stroke as an example, they cite research showing that only about 5 percent of patients receive tPA, and of those only about 30 percent show significant improvements.
Similar conditions exist for nerve injury after TBI, MS and peripheral neuropathy, the authors write, and for those patients "there is a paucity of therapeutic options."
Among tPA's limitations is that it must be administered within a very short time after stroke to prevent "cascades" of irreversible cell damage.
In contrast, "restorative therapies" such as dosing with Thymosin beta-4 "may be applied well after the onset of injury or the onset of clinical symptoms for degenerative diseases" including stroke and others.
Says Dr. Chopp: "Rather than focusing on destroying clots or other lesions leading to nerve damage, restorative therapies are designed to 'remodel' or rebuild the nervous system by stimulating self-healing processes that already exist in the brain, spinal cord and the peripheral nerves connected to them."
"It is therefore time to reconsider how we think about treating neural injury and disease," the authors contend.
Tuesday, February 3, 2015
Clopidogrel plus aspirin versus aspirin alone for preventing early neurological deterioration in patients with acute ischemic stroke
Is this enough to have your stroke department head create a stroke protocol? Ask that department head how many protocols they have created/updated? What is their goal per year? We shouldn't have to setup goals and objectives for our stroke staff but look where it has gotten us in the past twenty years when we haven't done this. How many stroke protocols has your stroke staff setup in the past 20 years? NONE I bet? That would be a fireable offense under my watch.
Clopidogrel plus aspirin versus aspirin alone for preventing early neurological deterioration in patients with acute ischemic stroke
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Department
of Neurology, General Hospital of Shen-Yang Military Region, 83 Wen Hua
Road, Shen He District, Shen Yang 110840, PR China
1These authors have contributed equally to the manuscript.
Received: July 4, 2013; Accepted: May 25, 2014; Published Online: July 31, 2014
Abstract
Recent studies have suggested that combination antiplatelet therapy may be superior to monotherapy in the treatment of acute stroke. However, additional prospective studies are needed to confirm this finding. The present trial compared the efficacy and safety of clopidogrel plus aspirin versus aspirin alone in the treatment of non-cardioembolic ischemic stroke within 72 hours of onset. Six hundred and ninety patients aged ⩾40 years with minor stroke or transient ischemic attack (TIA) were identified for enrollment. Experienced physicians determined baseline National Institutes of Health Stroke Scale scores at the time of admission. All patients were randomly allocated (1:1) to receive aspirin alone (300 mg/day) or clopidogrel (300 mg for the first day, 75 mg/day thereafter) plus aspirin (100 mg/day). The main endpoints were neurological deterioration, recurrent stroke, and development of stroke in patients with TIA within 14 days of admission. After 43 patients were excluded, 321 patients in the dual therapy group and 326 patients in the monotherapy group completed the treatment. Baseline characteristics were similar between groups. During the 2 week period, stroke deterioration occurred in nine patients in the dual therapy group and 19 patients in the monotherapy group. Stroke occurred after TIA in one patient in the dual therapy group and three patients in the monotherapy group. Similar numbers of adverse events occurred in both groups. This study showed that early dual antiplatelet treatment reduced early neurological deterioration in patients with acute ischemic stroke, compared with antiplatelet monotherapy. These results imply that dual antiplatelet therapy is superior to monotherapy in the early treatment of acute ischemic stroke.Wednesday, August 13, 2014
Molecular control of brain plasticity and repair
How is your doctor enabling this post-stroke? 5 years is plenty of time to create a stroke protocol for this. Has your hospital created goals and objectives for neurologists to create stroke protocols within 6 months of research being released? Is your board of directors enforcing adherence to results oriented goals? Does your hospital have any stroke related goals at all? 30 day deaths improved every year? Following Get With the Guidelines or Joint Commission certification are not valid because they are not results oriented.
http://www.ncbi.nlm.nih.gov/pubmed/19660677
http://www.ncbi.nlm.nih.gov/pubmed/19660677
Abstract
Recovery
of function after damage to the CNS is limited due to the absence of
axon regeneration and relatively low levels of plasticity. Plasticity in
the CNS can be reactivated in the adult CNS by treatment with
chondroitinase ABC, which removes glycosaminoglycan (GAG) chains from
chondroitin sulfate proteoglycans (CSPGs). Plasticity in the adult CNS
is restricted by perineuronal nets (PNNs) around many neuronal cell
bodies and dendrites, which appear at the closure of critical periods
and contain several inhibitory CSPGs. Formation of these structures and
the turning off of plasticity is triggered by impulse activity in
neurons. Expression of a link protein by neurons is the event that
triggers the formation of PNNs. Treatment with chondroitinase removes
PNNs and other inhibitory influences in the damaged spinal cord and
promotes sprouting of new connections. However, promoting plasticity by
itself does not necessarily bring back useful behavior; this only
happens when useful connections are stabilized and inappropriate
connections removed, driven by behavior. Thus after rodent spinal cord
injury, combining a daily rehabilitation treatment for skilled paw
function with chondroitinase produces much greater recovery than either
treatment alone. The rehabilitation must be specific for the behavior
that is to be enhanced because non-specific rehabilitation improves
locomotor behavior but not skilled paw function. Plasticity-enhancing
treatments may therefore open up a window of opportunity for successful
rehabilitation.
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