Moving stroke rehabilitation research evidence into clinical practice: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable

If it takes years or decades you are doing it all wrong. You should be contacting the boards of directors and if the president doesn't implement in a decent time have them fired. This is simple Management 101. Absolutely nothing here tells me this stuff will produce results. All I see is service delivery, assessment, guidelines; so you aren't even addressing getting survivors recovered you blithering idiots.

Moving stroke rehabilitation research evidence into clinical practice: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable 

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Janice J Eng, Marie-Louise Bird, Erin Godecke, ...

First Published September 30, 2019 Research Article

https://doi.org/10.1177/1747493019873597

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Abstract

Moving research evidence to practice can take years, if not decades, which denies stroke patients and families from receiving the best care. We present the results of an international consensus process prioritizing what research evidence to implement into stroke rehabilitation practice to have maximal impact. An international 10-member Knowledge Translation Working Group collaborated over a six-month period via videoconferences and a two-day face-to-face meeting. The process was informed from surveys received from 112 consumers/family members and 502 health care providers in over 28 countries, as well as from an international advisory of 20 representatives from 13 countries. From this consensus process, five of the nine identified priorities relate to service delivery (interdisciplinary care, screening and assessment, clinical practice guidelines, intensity, family support) and are generally feasible to implement or improve upon today. Readily available website resources are identified to help health care providers harness the necessary means to implement existing knowledge and solutions to improve service delivery. The remaining four priorities relate to system issues (access to services, transitions in care) and resources (equipment/technology, staffing) and are acknowledged to be more difficult to implement. We recommend that health care providers, managers, and organizations determine whether the priorities we identified are gaps in their local practice, and if so, consider implementation solutions to address them to improve the quality of lives of people living with stroke.

Keywords Knowledge translation, implementation, stroke, rehabilitation, recovery, consensus

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Whole-brain magnetic resonance imaging of plaque burden and lenticulostriate arteries in patients with different types of stroke

But what do you do with the results of this research? How will it be used to benefit stroke survivors?

Whole-brain magnetic resonance imaging of plaque burden and lenticulostriate arteries in patients with different types of stroke

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Fang Wu, Qian Zhang, Kai Dong, ...

First Published February 26, 2019 Research Article

https://doi.org/10.1177/1756286419833295

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Abstract

Background:

Large-vessel atherosclerotic disease is an important pathogenesis of deep-perforator infarction (DPI). However, altered vessel walls of intracranial large arteries and distribution of small arteries in DPI are unclear because of the limited resolution of current imaging techniques. In this study the intracranial plaque burden and lenticulostriate artery (LSA) distribution in patients with recent DPI and non-DPI using whole-brain vessel-wall imaging (WB-VWI) were investigated.

Methods:

A total of 44 patients with recent DPI (23 patients) or non-DPI (21 patients) due to intracranial atherosclerotic disease were prospectively enrolled. WB-VWI was performed in all the patients using a three-dimensional T1-weighted vessel-wall magnetic resonance technique. Hemispheres with DPI and non-DPI were considered as the DPI group and non-DPI group, respectively. Hemispheres without a history of stroke were the control group. The intracranial plaque burden was compared between the DPI and non-DPI groups. The number and length of visualized LSA branches among DPI, non-DPI, and control groups were also evaluated.

Results:

A total of 77 hemispheres were analyzed (23 in the DPI group, 21 in the non-DPI group, and 33 in the control group). Plaque burden was lower (p = 0.047) in the DPI group (82.0 ± 45.9 mm³) compared with the non-DPI group (130.9 ± 90.3 mm³). There was a significant reduction (p = 0.002) in length of visualized LSA branches in the DPI group (74.1 ± 21.7 mm) compared with the control group (104.6 ± 33.3 mm).

Conclusions:

WB-VWI enables the combination of vessel-wall and LSA imaging in one image setting, which can provide information about plaque burden and LSA distribution.

Antioxidant Reduces Risk for 2nd Stroke, Heart Attack

Now YOU just need to find the protocol for this and train your doctor in its use.  Not the other way around. Has your doctor EVER  put ANY clinical research into practice? This is one of the few things I got from the NSA that was worth it.

Antioxidant Reduces Risk for 2nd Stroke, Heart Attack

Posted by Lynn Bronikowski Sep 27 2018

 

Healthcare professionals have long known that in the months after a heart attack or stroke, patients are more likely to have another attack or stroke.
Now a study published in the Journal of the American College of Cardiology explains what happens inside blood vessels to increase stroke and heart attack risk—and suggests a new way to treat it.
Researchers found that heart attacks in mice caused inflammatory cells and platelets to more easily stick to the inner lining of arteries throughout the body—particularly where there was already plaque, according to the study’s writeup. As a result, these sticky cells and platelets caused plaque to become unstable and contribute to blood clots that led to another stroke or heart attack.
But the study found treating mice that had experienced a stroke or heart attack with the powerful antioxidant apocynin cut plaque buildup in half and lowered inflammation to pre-attack levels.
"Knowing that newer forms of antioxidants such as apocynin can lower the risk of a second heart attack or stroke gives us a new treatment to explore and could one day help reduce heart attacks and strokes," said the study’s author, Jonathan R. Lindner, M.D., a professor of cardiovascular medicine at the OHSU School of Medicine.
Lindner penned the research paper with colleagues from OHSU, Scripps Research Institute and Bloodworks NW.
The researchers discovered the sticky cells and platelets by using unique forms of ultrasound imaging they developed to view molecules on the lining of blood vessels.
This research could help explain why the recent Canakinumab Anti-inflammatory Thrombosis Outcomes Study, also known as the CANTOS clinical trial, found an anti-inflammatory drug already approved to treat juvenile arthritis also reduced the risk of a second heart attack in trial participants by 15 percent.
Lindner and his colleagues are further studying how the relative stickiness of remote arteries affects the risks for additional heart attacks and strokes and are also evaluating new therapies beyond antioxidants.
The study was supported by the National Institutes of Health and the Swiss National Science Foundation.

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