FDA clears MindMaze GO neurorehabilitation platform, easing access to continued outpatient therapy

Hopefully you have decent insurance, or your therapists have cobbled something together with Kinect. More likely you will have to figure this all out on your own because NO protocols seem to exist for stroke rehab. Guidelines exist, protocols don't. Guidelines don't have efficacy ratings.
https://sharpbrains.com/blog/2018/06/13/fda-clears-mindmaze-go-neurorehabilitation-platform-easing-access-to-continued-outpatient-therapy/

By: SharpBrains

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MindMaze Consolidates First-ever FDA Approval for Inpatient and Outpatient Neurorehabilitation Therapy (press release):

“MindMaze, a leader in braintech, has today announced that it has obtained FDA clearance to launch its portable neurorehabilitation product, MindMotion™ GO, in the United States. Together with MindMotion PRO (which received FDA clearance in 2017), MindMotion GO is the next offering in the company’s continuum of care, providing gamified neurorehabilitation therapy.

“Now that both MindMotion products have FDA clearance, MindMaze delivers a full spectrum of neuro-care solutions for both inpatient and outpatient recovery for patients in the United States,” said Tej Tadi, CEO and founder of MindMaze. “Our unique capability to safely and securely acquire data through our platform is essential for patient recovery and performance…”

The FDA approval for a series of neurorehabilitation devices that focus on both inpatient and outpatient care is unique…MindMotion GO differs from MindMotion PRO in both its technology and its intended use cases. MindMotion PRO is designed for patients with severe impairments and for early hospital care, allowing for therapeutic activities as early as four days after a neurological incident. MindMotion GO focuses on medium and light severity impairments and also provides continued therapy later in the recovery phase, primarily on an outpatient basis.

Neurological deficits are the leading cause of long-term disability in the United States. Each year nearly 800,000 Americans suffer a stroke, with direct annual costs estimated at $22.8 billion. A recent study estimated that direct and indirect costs associated with neurological diseases are an astounding $800 billion annually in the US.”

The new device:

Name: MindMotion GO

510(k) Premarket Notification:

• Device Classification Name: System, Optical Position/Movement Recording
• Classification Product: Code LXJ
• Date Received: 12/26/2017
• Decision Date: 05/17/2018
• Decision: Substantially Equivalent (SESE)
• Regulation Medical Specialty: Physical Medicine
• Regulation Description: Measuring exercise equipment

CDC: Outpatient rehab rates suboptimal for stroke survivors

Who gives a shit about participation rates? Survivors want to know about efficacy and results of stroke rehab. Maybe if results were better you would have higher participation. The goal is 100% recovery, start measuring that.  
https://medicalxpress.com/news/2018-05-cdc-outpatient-rehab-suboptimal-survivors.html

(HealthDay)—In 2015, 35.5 percent of adult stroke survivors used outpatient rehabilitation, up from 31.2 percent in 2013, according to research published in the May 25 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

Carma Ayala, Ph.D., from the CDC in Atlanta, and colleagues analyzed 2013 and 2015 data from the Behavioral Risk Factor Surveillance System to update estimates of participation in outpatient rehabilitation after hospital discharge for adult stroke survivors.

The researchers found that outpatient rehabilitation use was 31.2 percent overall in 20 states and the District of Columbia in 2013 and 35.5 percent in four states in 2015. There were disparities in rehabilitation use based on sex, race, Hispanic origin, and education level.

"Although estimates of stroke outpatient rehab referral might be high, participation in stroke outpatient rehab remains suboptimal," the authors write. "Barriers to participation in stroke outpatient rehab are evident, but focused attention on system-level interventions that ensure participation is needed, especially among populations with lower levels of participation."

Explore further: Many stroke survivors don't receive timely rehab

More information: Abstract/Full Text

Journal reference: Morbidity and Mortality Weekly Report

Association Between Early Outpatient Visits and Readmissions After Ischemic Stroke

This is so fucking simple to solve. You get all stroke survivors 100% recovered and these readmissions go away. Solve the correct problem.  Absolutely none of my doctor outpatient visits were worth anything at all, He knew nothing and suggested nothing.

Association Between Early Outpatient Visits and Readmissions After Ischemic Stroke 

Samuel W. Terman, Mathew J. Reeves, Lesli E. Skolarus, James F. Burke

Circulation: Cardiovascular Quality and Outcomes. 2018;11:e004024

Originally published April 13, 2018

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Abstract

Background: Reducing hospital readmission is an important goal to optimize poststroke care and reduce costs. Early outpatient follow-up may represent one important strategy to reduce readmissions. We examined the association between time to first outpatient contact and readmission to inform postdischarge transitions.

Methods and Results: We performed a retrospective cohort study of all Medicare fee-for-service patients discharged home after an acute ischemic stroke in 2012 identified by the InternationalClassification of Diseases, Ninth Revision, Clinical Modification codes. Our primary predictor variable was whether patients had a primary care or neurology visit within 30 days of discharge. Our primary outcome variable was all-cause 30-day hospital readmission. We used separate multivariable Cox models with primary care and neurology visits specified as time-dependent covariates, adjusted for numerous patient- and systems-level factors. The cohort included 78 345 patients. Sixty-one percent and 16% of patients, respectively, had a primary care and neurology visit within 30 days of discharge. Visits occurred a median (interquartile range) 7 (4–13) and 15 (5–22) days after discharge for primary care and neurology, respectively. Thirty-day readmission occurred in 9.4% of patients. Readmissions occurred a median 14 (interquartile range, 7–21) days after discharge. Patients who had a primary care visit within 30 days of discharge had a slightly lower adjusted hazard of readmission than those who did not (hazard ratio, 0.98; 95% confidence interval, 0.97–0.98). The association was nearly identical for 30-day neurology visits (hazard ratio, 0.98; 95% confidence interval, 0.97–0.98).

Conclusions: Thirty-day outpatient follow-up was associated with a small reduction in hospital readmission among elderly patients with stroke discharged home. Further work should assess how outpatient care may be improved to further reduce readmissions.

Developing a System for Post-Stroke Rehabilitation: An Exergames Approach

But I bet your stroke department already has a prescribed recovery plan for out-patients. HEP - Hand em Photocopies.

Developing a System for Post-Stroke Rehabilitation: An Exergames Approach

• Arsénio Reis
• , Jorge Lains
• , Hugo Paredes 
• , Vitor Filipe
• , Catarina Abrantes
• , Fernando Ferreira
• , Romeu Mendes
• , Paula Amorim
• , João Barroso

$29.95 / €24.95 / £19.95 *

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Abstract

Stroke episodes are a major health issue worldwide for which most patients require an initial period of special rehabilitation and functional treatment, involving medical doctors and specialized therapists, followed by ambulatory physiotherapy exercise. In this second period most do not fulfil the prescribed recovery plan, resulting in setbacks in their recovery. This paper reports on the design of a methodology to develop a system to support the ambulatory rehabilitation therapy, providing constant feedback to the clinicians, by means of an information system platform, and maintaining the patient motivation by using an exergames approach to design and deliver the therapy exercises to the patient. Whatever the hell exergames is.

Amana Healthcare announces launch of first specialized neurorehabilitation outpatient program in the United Arab Emirates

Send your doctor immediately after that specialized outpatient neurorehabilitation service to see how they created that for each patient. It has to be better than anything you are currently getting from your doctor. If this doesn't occur call the president and demand to know when they are going to get competent stroke rehab specialists.
https://www.zawya.com/story/Amana_Healthcare_announces_launch_of_first_specialized_neurorehabilitation_outpatient_program_in_the_United_Arab_Emirates-ZAWYA20150819074639/
Pain management, spasticity management, stroke prevention and therapy services treated in Amana Healthcare's new outpatient program United Arab Emirates - Amana Healthcare, a specialized provider of long-term acute care, post-acute rehabilitation and home transition and respite care services in the United Arab Emirates, announced today the commencement of outpatient services in both its Abu Dhabi and Al Ain long-term medical and rehabilitation hospitals.
Launching outpatient services in long-term medical and rehabilitation facilities distinguishes Amana Healthcare as the first of its kind in the UAE to provide a specialized outpatient neurorehabilitation service for patients recovering from strokes, head injuries or other neurological conditions.
Specialized outpatient services support individuals who need both acute and chronic pain management, spasticity management due to neurological impairments, primary and secondary stroke prevention, and outpatient therapy services. Each segment offers treatment programs specific to the condition or injury of each patient including medical interventions, exercise programs, and educational therapies.

A western trained rehabilitation team consisting of consultant rehabilitation physicians, occupational therapists, physiotherapists, speech and language therapists, and specialist nurses is dedicated to working with individuals in Amana Healthcare's neurorehabilitation outpatient service. Consultant Rehabilitation Physicians assess each patient and develop a tailored rehabilitation program specific to the needs of each individual. "The objective of our outpatient service is to treat and assist patients in regaining their sense of independence with an expert rehabilitation team serving as a support system," said Magi Livadaris, VP for Clinical Operations at Amana Healthcare. "Creating tailor made treatments for each patient helps us track their performance and improvement thoroughly, resulting in an overall more effective recovery process."

The various treatments provided in Amana Healthcare's outpatient services include: - Pain Management: A specialized service for patients recovering from orthopedic or neurological injuries or arthritis that involve both medical treatment and specialized rehabilitation programs.
- Spasticity Management: A team of consultant rehabilitation physicians, nurses, and therapists design treatment programs, including hydrotherapy, to promote and maximize function and use of limbs in patients with cerebral palsy or spasticity-causing disorders.
- Primary and Secondary Stroke Prevention: A team of specialist rehabilitation experts provide a specialized outpatient protocol for patients recovering from a stroke, which is one of the UAE's leading causes of disability.
- Outpatient Therapy Services: A team of specialist therapists assess and treat patients requiring intervention for complex neurological or medical conditions.
"Everything we do at Amana Healthcare, including the launch of our outpatient service, is in line with our mission of using innovative care models characterized by strong cultural and religious adaptation, an emphasis on evidence-based medicine and a commitment to international standards of care," continued Magi Livadaris. "Helping a patient of any age regain their individuality after suffering an illness or trauma of any kind is our key focus."

Factors Affecting the Ability of the Stroke Survivor to Drive Their Own Recovery outside of Therapy during Inpatient Stroke Rehabilitation

This solution is possibly the worst idea yet. It's very very simple, you stop the neuronal cascade of death resulting in much less disability.
Survivors don't know what to do to recover because doctors/therapists have no clue on how to get survivors to 100% recovery. Solve that problem first and then maybe you can dump the problem into the survivors lap.
Then you also don't have to worry about all the inactivity while in the hospital. Everyone here is solving the wrong problem. The medical stroke world has to attract the stupidest people in the world. Just so they can feel comfortable around all us stroke-addled persons.

Factors Affecting the Ability of the Stroke Survivor to Drive Their Own Recovery outside of Therapy during Inpatient Stroke Rehabilitation

Outpatient Therapy Could be Limited After March 31 - US Medicare

Another sky is falling press release from the National Stroke Association. If you want to solve the real problem of disability after stroke you stop the neuronal cascade of death. But that would require some intelligent people to expend some brainpower and we can't bother to hurt their widdle neurons.
Stupidity prevails once again.
And because they haven't figured out that stroke needs to get to the tipping point, these press releases will continue forever. You solve the REAL problem, not just tiptoe around it. 
http://www.stroke.org/site/MessageViewer?pw_id=2002&dlv_id=33081&em_id=24141.0