Using large-scale sensor data to test factors predictive of perseverance in home movement rehabilitation: Early exercise frequency and schedule consistency

My conclusion is you don't understand ONE GODDAMN THING ABOUT SURVIVOR MOTIVATION, DO YOU? You create EXACT 100% recovery protocols and your survivor will be motivated to do the millions of reps needed because they are looking forward to 100% recovery. GET THERE!

There would be no need for useless research on perseverance!

 Using large-scale sensor data to test factors predictive of perseverance in home movement rehabilitation: Early exercise frequency and schedule consistency

IEEE Transactions on Neural Systems and Rehabilitation Engineering.

NARIC Accession Number: J94137. What's this?
Author(s): Kim, Sangjoon J., Swanson, Veronica A., Collier, George H., Rabinowitz, Amanda R., Zondervan, Daniel K., Reinkensmeyer, David J..
Publication Year: 2024.
Abstract: Study investigated whether weekly exercise frequency and schedule consistency (in terms of which days of the week exercises are performed) predict home exercise perseverance after stroke. Data were collected from 2,583 users of a sensor-based home rehabilitation system designed specifically for individuals with a stroke to motivate movement exercises at home. Researchers grouped users based on their early exercise frequency (defined across the initial 6 weeks of use) and calculated the evolution of habit score (defined as exercise frequency multiplied by exercise duration) across 6 months. Results showed that habit score decayed exponentially over time but with a slower decay constant for individuals with higher early frequency. Only the group with an early exercise frequency of 4 or more days per week had non-zero habit score at six months. Within each frequency group, dividing individuals into higher and lower consistency subgroups revealed that the higher consistency subgroups had significantly higher habit scores. These results are consistent with previous studies on habit formation in exercise and may help in designing effective home rehabilitation programs after stroke.
Descriptor Terms: BEHAVIOR, BODY MOVEMENT, COMPLIANCE, ELECTRONICS, EXERCISE, HOME BASED, MOBILITY, MOTOR SKILLS, STROKE.


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Citation: Kim, Sangjoon J., Swanson, Veronica A., Collier, George H., Rabinowitz, Amanda R., Zondervan, Daniel K., Reinkensmeyer, David J.. (2024.) Using large-scale sensor data to test factors predictive of perseverance in home movement rehabilitation: Early exercise frequency and schedule consistency. IEEE Transactions on Neural Systems and Rehabilitation Engineering. Retrieved 9/14/2024, from REHABDATA database.

Perseverance with technology-facilitated home-based upper limb practice after stroke: a systematic mixed studies review

 More blame the survivor for not recovering. What the fuck good does perserverance do when there are NO PROTOCOLS TO FOLLOW TO RECOVER? What is really needed is research on why the stroke medical world has no perserverance to actually solve stroke! With exact protocols including number of repetitions survivors would perservere even if it called for 10 million reps.  Solve the correct problem, lack of protocols. If you don't understand that, get the hell out of stroke.

Perseverance with technology-facilitated home-based upper limb practice after stroke: a systematic mixed studies review

• Bridee A. Neibling,
• Sarah M. Jackson,
• Kathryn S. Hayward &
• Ruth N. Barker 

Journal of NeuroEngineering and Rehabilitation volume 18, Article number: 43 (2021) Cite this article

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Abstract

Background

Technology is being increasingly investigated as an option to allow stroke survivors to exploit their full potential for recovery by facilitating home-based upper limb practice. This review seeks to explore the factors that influence perseverance with technology-facilitated home-based upper limb practice after stroke.

Methods

A systematic mixed studies review with sequential exploratory synthesis was undertaken. Studies investigating adult stroke survivors with upper limb disability undertaking technology-facilitated home-based upper limb practice administered ≥ 3 times/week over a period of ≥ 4 weeks were included. Qualitative outcomes were stroke survivors’ and family members’ perceptions of their experience utilising technology to facilitate home-based upper limb practice. Quantitative outcomes were adherence and dropouts, as surrogate measures of perseverance. The Mixed Methods Appraisal Tool was used to assess quality of included studies.

Results

Forty-two studies were included. Six studies were qualitative and of high quality; 28 studies were quantitative and eight were mixed methods studies, all moderate to low quality. A conceptual framework of perseverance with three stages was formed: (1) getting in the game; (2) sticking with it, and; (3) continuing or moving on. Conditions perceived to influence perseverance, and factors mediating these conditions were identified at each stage. Adherence with prescribed dose ranged from 13 to 140%. Participants were found to be less likely to adhere when prescribed sessions were more frequent (6–7 days/week) or of longer duration (≥ 12 weeks).

Conclusion

From the mixed methods findings, we propose a framework for perseverance with technology-facilitated home-based upper limb practice. The framework offers opportunities for clinicians and researchers to design strategies targeting factors that influence perseverance with practice, in both the clinical prescription of practice and technology design. To confirm the clinical utility of this framework, further research is required to explore perseverance and the factors influencing perseverance.

Registration: PROSPERO CRD42017072799—https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=72799

Introduction

Upper limb (UL) recovery after stroke is a long and often arduous journey. High doses of task-specific therapy have been suggested to enhance neuroplasticity, motor relearning and recovery [1, 2]. Yet, the specific dose and timing of UL practice required to maximise functional recovery remains unclear [3]. Stroke survivors in the inpatient setting have been observed to complete on average 18 min per day of UL therapy, which is considered insufficient for functional recovery [4]. In turn, up to 65% of stroke survivors have a non-functional UL six months after stroke [5]; extending their UL recovery journey beyond the inpatient rehabilitation phase and into the home.

Upper limb home exercise programs (HEP) are commonly provided to stroke survivors in an effort to increase practice and enhance recovery [6]. Dose and content of UL HEP are variable, ranging from a structured one-size-fits-all program, to an individualised program specific to the needs and goals of the stroke survivor [6]. Adherence to HEP after stroke has been attributed to family support, confidence in therapist knowledge and experience, and goal oriented practice with an accountability strategy [7,8,9]. Non-adherence with HEP after stroke has been attributed to fatigue, depression and diminished motivation, musculoskeletal issues, and lack of time due to competing commitments [8, 9]. Additionally, some stroke survivors have found that traditional HEP are not enjoyable, too difficult or insufficiently challenging, and thus of minimal functional benefit [8,9,10]. Evidently, practicing intensely in the home over a long period of time is challenging for stroke survivors. Therefore, options that enable stroke survivors to continue with home-based practice in the long term need to be considered.

Technology offers an increasing number of options to facilitate independent, intensive and task-specific UL practice in the home [11]. Upper limb rehabilitation technology typically allows stroke survivors to play motion-based games on an interactive platform that offers feedback on performance and results [11]. Practice is monitored and progressed either in person or online by a therapist [11]. Some technologies also provide mechanical assistance to make practice possible [11]. Unfortunately, adherence with technology-facilitated practice is variable, and has been reported to be lower than that of more traditional methods due to decreased task specificity and engagement with the technology [6]. Recommendations for technology design focus on engagement, including personalisation of games and sufficient variability and challenge, as well as user-friendliness and contextual applicability to the home environment [11]. To date however, within efficacy studies of technology-facilitated interventions, there has been limited exploration of how these design factors influence stroke survivors’ ability to persevere with practice.

Perseverance is a dynamic behaviour that has been defined as “persistence in doing something despite difficulty or delay in achieving success” [12] and is known to be influenced by multiple factors[13, 14]. Perseverance is thought to play a vital role in disciplines where significant amounts of practice over years are required to achieve expert skill [14,15,16]. Accordingly, perseverance is required by stroke survivors to recover UL skill through high dose practice, over a long period of time, to promote the neuroplasticity required for recovery [1, 2]. The added challenge for stroke survivors is that they must persevere in the presence of physical and cognitive impairments, and independently within their home environment. While technology offers a unique opportunity to enhance independent home-based UL practice, the factors that influence stroke survivors’ ability to persevere with technology-facilitated practice are yet to be explored in detail. Therefore, the question to be answered in this systematic mixed studies review was: What are the factors that influence perseverance with technology-facilitated home-based UL practice after stroke?

 

Serotonin promotes perseverance

Because your doctor left you with lots of disabilities to correct via rehabilitation you will need tons of perseverance. Your doctor should be all over this and have a protocol for you on this in days.  I don't give a shit that this was in mice, either your doctor steps up to the plate and works with researchers to test this in humans or figures out what human doses should be. OR just sits on the shitter doing nothing.
http://magazine.ar.fchampalimaud.org/serotonin-promotes-perseverance/

It was thought that the neurotransmitter serotonin most likely acted by inhibiting behavior. Now, scientists at the Champalimaud Centre for the Unknown have shown that general idea to be wrong.

What happens when serotonin levels increase in human brain? How does this affect our behavior? This is a question that highly interests neuroscientists: serotonin has multiple functions in the brain and understanding what it actually does is a huge task. Not the least because serotonin is at the root of a whole class of antidepressant drugs, the most well-known of which being Prozac, that apparently work by increasing serotonin levels in the human brain.

Previous results suggested that increased serotonin levels make animals (including people) more willing to wait longer for a  reward to arrive – in other words, that it makes them more patient. This was compatible with the idea, accepted by many, that serotonin generally acts by inhibiting behavior, because in many cases patience requires postponing doing something.

But now this idea has been challenged by an international team, led by neuroscientists from the Champalimaud Centre for the Unknown, in Lisbon, Portugal. Their results have been published today in the journal Nature Communications.

The new study shows that serotonin promotes more than just passive waiting – more than simple patience. It enhances active persistence in a task, even in the face of uncertain reward.

Persistence means actively following through on a task, even if unpleasant, like completing your homework, whereas many forms of patience simply require sitting tight and doing nothing.

It so happens that the tasks used in the previous studies did not allow their authors to distinguish between patience and persistence. But in the new work, Eran Lottem, the first author of the paper, and his colleagues developed a task that is actually very similar to the natural situation animals face when foraging for food.

“We had some hints suggesting that the inhibitory effect of serotonin was not general. Some behaviors were unaffected by serotonin”, says Lottem. “But we had never seen an active behavior promoted by serotonin. This is, to my knowledge, the first time such a behavior has been observed when serotonin-producing neurons are activated.”

The task consisted in giving the mice the choice between two drinking sites placed at each end of a long rectangular box. At any given time, only one drinking site was ready to release water, so the mice had to roam back and forth between the two sides of the box to find the water, and to get it, they had to give a poke with their nose at the drinking site.

Sneakily, to mimic the unpredictability of real world situations, the experimenters arranged that even an active drinking site did not always deliver water, so they would have learn to tolerate some unsuccessful pokes. This provided the scientists with a way to measure the persistence of the animals: they could count the number of pokes they were willing to give in order to try to get water at a “dry” site (one that had ceased giving water).

Once the task was in place, the scientists used a technology known as optogenetics to stimulate the serotonin-producing neurons using pulses of laser light delivered by an implanted optic fiber to the animals’ brains.

“What we saw was that when those neurons were stimulated, the animals were willing to poke longer even when they were not getting water, says Lottem. Therefore, serotonin was not inhibiting their behavior because, in that case, the mice would have given up sooner.” In other words, he concludes, “the activation of serotonin neurons promotes active persistence rather than mere patience”.

Zachary Mainen, the lead author of this study, suggests that the results may ultimately help us to understand better how to treat depression, a disorder in which serotonin is implicated. “The difference between patience and persistence may sound subtle, but the implication is not: it could be the difference between quietly sitting in bed while the world goes by and jumping out of bed each day to greet it”.

Scientists Find the Secret to Thriving

How is your doctor making sure you thrive after your stroke? ANYTHING AT ALL? Or is s/he planning on YOU having the will, drive, persistence, perseverance and resilience to recover completely on your own? And then thrive?  My doctors had nothing to do with my thriving, they had nothing to do with my recovery past the tPA application.
http://neurosciencenews.com/thriving-feeling-good-7447/

Source: University of Portsmouth.
What it takes to thrive, rather than merely survive, could be as simple as feeling good about life and yourself and being good at something.
From a teenager studying for their exams to an employee succeeding at work, thriving can be seen at all ages and across all cultures.
Until now and despite plenty of theories, there has been no agreement on what makes a person thrive or on how people can try and ensure they do.
Dr Daniel Brown, a sport and exercise scientist at the University of Portsmouth, has pulled together all the research on what makes people thrive, from studies of babies and teenagers, to studies of artists, sportspeople, employees and the elderly, and has come up with the first definitive catch-all.
He said: “Thriving is a word most people would be glad to hear themselves described as, but which science hasn’t really managed to consistently classify and describe until now.
“It appears to come down to an individual experiencing a sense of development, of getting better at something, and succeeding at mastering something.
“In the simplest terms, what underpins it is feeling good about life and yourself and being good at something.”
The study outlines the ‘shopping list’ underlying Dr Brown’s simple definition. To thrive doesn’t need all the components, but suggests a combination of some from each of the two following lists may help –
A: Is:

• optimistic,
• spiritual or religious,
• motivated,
• proactive,
• someone who enjoys learning,
• flexible,
• adaptable,
• socially competent,
• believes in self/has self-esteem.

B: Has:

• opportunity,
• employer/family/other support,
• challenges and difficulties are at manageable level,
• environment is calm,
• is given a high degree of autonomy,
• is trusted as competent.

Research has established that though thriving is similar to resilience, prospering or growth, it stands alone.
Thriving has been examined at various stages of human life and has at times been described as vitality, learning, mental toughness, focus, or combinations of these and other qualities. It has also been examined in various contexts, including in the military, in health and in child development.
“Since the end of the 20th century, there has been a quest in science to better understand human fulfilment and thriving, there’s been a shift towards wanting to understand how humans can function as highly as possible,” said Dr Brown.

Thriving has been examined at various stages of human life and has at times been described as vitality, learning, mental toughness, focus, or combinations of these and other qualities. It has also been examined in various contexts, including in the military, in health and in child development. NeuroscienceNews.com image is in the public domain.

“Part of the reason for a lack of consensus is the research so far has been narrowly focused. Some have studied what makes babies thrive, others have examined what makes some employees thrive and others not, and so on. By setting out a clear definition, I hope this helps set a course for future research.”
Dr Brown’s research makes six recommendations for future research, including the need for close examination of what enables thriving, and whether thriving has any lasting or cumulative effect on individuals.
He carried out the research as part of his PhD studies at the University of Bath. His primary supervisor, Dr Rachel Arnold, an expert in the psychology of performance excellence, is a co-author of the paper.

About this neuroscience research article

Source: Kate Daniell – University of Portsmouth
Image Source: NeuroscienceNews.com image is in the public domain.
Original Research: Full open access research for “Human Thriving” by Daniel J. Brown, Rachel Arnold, David Fletcher, and Martyn Standage in European Psychologist. Published online September 7 2017 doi:10.1027/1016-9040/a000294

GRIT Study Recruitment Notice - How much do survivors of Stroke and their caregivers have?

A friends spouse is running this. I scored at 3.417, so-so in the grit category. To me this is a combination of persistence, resilience, perseverance.

We are currently recruiting participants for a study entitled GRIT: How much do survivors of Stroke and their caregivers have? GRIT is defined as perseverance and passion for long-term goals. The goal of this study is to learn about the grit experiences of patients who have survived stroke and the grit experiences of their caregivers. The results of this study may help us better understand how GRIT contributes to the recovery and community reintegration process. We also wonder how GRIT among caregivers influences successful community reintegration.

The study consists of 2 phases – an online survey and an optional interview. In the first phase, participants will be asked to complete a single online survey. We anticipate that the total time commitment of this survey to be approximately 20 - 30 minutes. Phase 2 is optional. It consists of an interview about grit experiences with reaching goals after having a stroke. The interview is expected to last between 45-60 minutes.

Expedited status has been received for this study (#0012-2017) from the Briar Cliff University Institutional Review Board. Completion of the survey in all or in part will be interpreted as consent to participate in the study. Respondents will be anonymous to the researchers for phase one. Demographic data will be analyzed and disseminated in aggregate. For phase 2 interviews, participants may choose a pseudonym for a name.

If you are interested in participating in this study, please complete the survey at the following link:

https://newqtrial2015az1.az1.qualtrics.com/jfe/form/SV_3wJPj73Y68fnt5z

If you have any questions or concerns, please feel free to contact me. I can be reached at:

Sue Klappa PT, PhD

Professor

Briar Cliff University

4280 Sergeant Road, suite 100

Sioux City, IA 51106

Office: 712-279-5560

Email: Susan.klappa@briarcliff.edu

Cold temperatures perceived in a photo increase cognitive control

Your doctor should be using this to maximize the long-term best interests of the individual. Looking at the incredibly long and unknown path to 100% recovery you need lots of cognitive control, persistence, perseverance and resilience.
https://medicalxpress.com/news/2017-04-cold-temperatures-photo-cognitive.html

Ben-Gurion University of the Negev (BGU) researchers have demonstrated that the perception of cold temperatures elicits greater cognitive control, even from a photo.

"Metaphorical phrases like 'coldly calculating,' 'heated response,' and 'cool-headed' actually have some scientific validity, which we demonstrate in our study," says lead researcher Dr. Idit Shalev of the BGU Department of Education. Dr. Shalev conducted the research with Prof. Nachshon Meiran of the BGU Department of Psychology and their Ph.D. student, Eliran Halali, now of the Department of Psychology at Bar-Ilan University.
"Previous research focused on the actual effect of temperature on the psychological phenomenon known as 'cognitive control,'" says Dr. Shalev. "But this is the first time we were able to measure the effects of perceived temperature." The study, "Keep it Cool: Temperature Priming Effect on Cognitive Control," was published in Psychological Research.
Cognitive control is the ability to deliberately inhibit responses or make choices that maximize the long-term best interests of the individual. For example, when a person is very hungry and sees a sandwich but does not eat it, he is exhibiting cognitive control.
The researchers conducted two experiments for the study. In the first, 87 students performed an "anti-saccade task," which requires looking in the opposite direction an object is moving and measures cognitive control. In the second experiment, 28 students were shown images of winter scenery, a temperature-neutral concrete street and a sunny landscape, and told to picture themselves in those settings.
"The result indicated that those viewing the cold landscape did better and that even without a physical trigger, cognitive control can be activated through conceptual processes alone," says Dr. Shalev.
The researchers state there is a possible explanation for the relation of temperature and cognitive control with social proximity. "While signals of warmth induce a relaxed attitude, cool signals trigger alertness and a possible need for greater cognitive control."

Explore further: Benefits of cognitive training in dementia patients unclear

More information: Eliran Halali et al, Keep it cool: temperature priming effect on cognitive control, Psychological Research (2016). DOI: 10.1007/s00426-016-0753-6

Journal reference: Psychological Research
Provided by: American Associates, Ben-Gurion University of the Negev

Read more at: https://medicalxpress.com/news/2017-04-cold-temperatures-photo-cognitive.html#jCp

 Ben-Gurion University of the Negev (BGU) researchers have demonstrated that the perception of cold temperatures elicits greater cognitive control, even from a photo.

"Metaphorical phrases like 'coldly calculating,' 'heated response,' and 'cool-headed' actually have some scientific validity, which we demonstrate in our study," says lead researcher Dr. Idit Shalev of the BGU Department of Education. Dr. Shalev conducted the research with Prof. Nachshon Meiran of the BGU Department of Psychology and their Ph.D. student, Eliran Halali, now of the Department of Psychology at Bar-Ilan University.

"Previous research focused on the actual effect of temperature on the psychological phenomenon known as 'cognitive control,'" says Dr. Shalev. "But this is the first time we were able to measure the effects of perceived temperature." The study, "Keep it Cool: Temperature Priming Effect on Cognitive Control," was published in Psychological Research.

Cognitive control is the ability to deliberately inhibit responses or make choices that maximize the long-term best interests of the individual. For example, when a person is very hungry and sees a sandwich but does not eat it, he is exhibiting cognitive control.

The researchers conducted two experiments for the study. In the first, 87 students performed an "anti-saccade task," which requires looking in the opposite direction an object is moving and measures cognitive control. In the second experiment, 28 students were shown images of winter scenery, a temperature-neutral concrete street and a sunny landscape, and told to picture themselves in those settings.

"The result indicated that those viewing the cold landscape did better and that even without a physical trigger, cognitive control can be activated through conceptual processes alone," says Dr. Shalev.

The researchers state there is a possible explanation for the relation of temperature and cognitive control with social proximity. "While signals of warmth induce a relaxed attitude, cool signals trigger alertness and a possible need for greater cognitive control."

Explore further: Benefits of cognitive training in dementia patients unclear

More information: Eliran Halali et al, Keep it cool: temperature priming effect on cognitive control, Psychological Research (2016). DOI: 10.1007/s00426-016-0753-6

Journal reference: Psychological Research search and more info website

Provided by: American Associates, Ben-Gurion University of the Negev search and more info website

Ben-Gurion University of the Negev (BGU) researchers have demonstrated that the perception of cold temperatures elicits greater cognitive control, even from a photo.

"Metaphorical phrases like 'coldly calculating,' 'heated response,' and 'cool-headed' actually have some scientific validity, which we demonstrate in our study," says lead researcher Dr. Idit Shalev of the BGU Department of Education. Dr. Shalev conducted the research with Prof. Nachshon Meiran of the BGU Department of Psychology and their Ph.D. student, Eliran Halali, now of the Department of Psychology at Bar-Ilan University.
"Previous research focused on the actual effect of temperature on the psychological phenomenon known as 'cognitive control,'" says Dr. Shalev. "But this is the first time we were able to measure the effects of perceived temperature." The study, "Keep it Cool: Temperature Priming Effect on Cognitive Control," was published in Psychological Research.
Cognitive control is the ability to deliberately inhibit responses or make choices that maximize the long-term best interests of the individual. For example, when a person is very hungry and sees a sandwich but does not eat it, he is exhibiting cognitive control.
The researchers conducted two experiments for the study. In the first, 87 students performed an "anti-saccade task," which requires looking in the opposite direction an object is moving and measures cognitive control. In the second experiment, 28 students were shown images of winter scenery, a temperature-neutral concrete street and a sunny landscape, and told to picture themselves in those settings.
"The result indicated that those viewing the cold landscape did better and that even without a physical trigger, cognitive control can be activated through conceptual processes alone," says Dr. Shalev.
The researchers state there is a possible explanation for the relation of temperature and cognitive control with social proximity. "While signals of warmth induce a relaxed attitude, cool signals trigger alertness and a possible need for greater cognitive control."

Explore further: Benefits of cognitive training in dementia patients unclear

More information: Eliran Halali et al, Keep it cool: temperature priming effect on cognitive control, Psychological Research (2016). DOI: 10.1007/s00426-016-0753-6

Journal reference: Psychological Research
Provided by: American Associates, Ben-Gurion University of the Negev

Read more at: https://medicalxpress.com/news/2017-04-cold-temperatures-photo-cognitive.html#jCp

Back on Track: After a traumatic brain injury, Matthew Ponder wanted to run competitively again. He achieved that and so much more, says his mother, Tamika

A great example of resilience, perseverance and never quitting. Does your doctor give you positive examples of recovery or the Debbie Downer version?
http://journals.lww.com/neurologynow/Fulltext/2016/12060/Back_on_Track__After_a_traumatic_brain_injury,.15.aspx

The Most Reassuring Thing You Can Say To Someone Experiencing Fear And Anxiety

Is your doctor using this to diffuse your fear and anxiety about not recovering because they have no stroke protocols to get you 100% recovered?

The Most Reassuring Thing You Can Say To Someone Experiencing Fear And Anxiety

Persevere, and the fear will dissolve.

This Raisin Test Can Predict an Infant’s Academic Future - What about stroke recovery?

If we had anyone in stroke leadership doing long term planning this would be researched to see if passing the test would mean better recoveries because they have patience, persistence and perseverance. But we don't have that, so go fuck off and die is the implicit message we get from stroke leadership.
This Raisin Test Can Predict an Infant’s Academic Future

Former Farmington man bikes across the nation after stroke

Thanks to Barb for pointing this out. I however would bike across Canada if that idea were to stick in my craw. 

Former Farmington man bikes across the nation after stroke

From May to September 2012, he traveled 4,400 miles from Neah Bay, Wash., to Key West, Fla., eight years after suffering a stroke that left him struggling to speak or write.
The trip began as a personal challenge. The mission: complete a solo bike ride cutting a diagonal across the nation from north-west to south-east while sleeping in a one person tent along the way.

More at link.