New AHA/ASA policy statement urges stroke rehab overhaul

 

WOW!  A policy statement; NOT A STRATEGY TO GET TO 100% RECOVERY! This is precisely why I consider the ASA a fucking failure of a stroke association! All these supposedly smart people and still not one useable brain cell amongst them!

You do have stroke in your name; it should mean you're trying to solve stroke to 100% recovery! But alas! That's obviously too fucking hard for you. Wait until you're the 1 in 4 per WHO that has a stroke and there is nothing for 100% recovery, that will become your problem. And every single fucking failure of a stroke association IS RUNNING AWAY! COWARDS! 

Send me personal hate mail on this: oc1dean@gmail.com. I'll print your complete statement with your name and my response in my blog. Or are you afraid to engage with my stroke-addled mind? No excuses are allowed! You're medically trained; it should be simple to precisely state EXACTLY WHY you haven't worked at all on 100% recovery with NO EXCUSES! Your definition of competence in stroke is obviously much lower than stroke survivors' definition of your competence! Swearing at me is allowed, I'll return the favor. Don't even attempt to use the excuse that brain research is hard.

Yeah, this is a repeat post but I'm trying to get through to the brain-dead ASA!  Not a single ASA president has contacted me; I can only assume they are afraid of me. My email address is directly above. 

New AHA/ASA policy statement urges stroke rehab overhaul

The University of Cincinnati's Joseph Broderick spoke with Medscape about a new American Heart Association/American Stroke Association policy statement warning that stroke survivors across the US face steep barriers to rehabilitation, including insurance denials, geographic “care deserts,” and high out-of-pocket costs. The statement was coauthored by UC's Oluwole Awosika, MD.

The writing group called for enacting measures to ensure full transparency in payer databases on the rehabilitation services patients with stroke receive and their outcomes, as well as the rate of denials for postacute stroke care. They additionally advocated for advancing research that reflects real-world stroke recovery challenges by prioritizing patient-centered studies and addressing caregiving needs, mental health and long-term outcomes such as quality of life, return to work and community reintegration.

Broderick told Medscape the statement is "very important and timely," noting the problem with postacute care does not lie with acute care hospitals where care is standardized, mesaured and recognized by certification programs. 

“The problem comes when the recommendation for inpatient rehab or skilled nursing facility is made to the insurance carrier and managed governmental programs. There is an incentive to not approve inpatient rehab and particularly long-term acute care — even when the patient meets the criteria,” said Broderick, professor in UC’s Department of Neurology and Rehabilitation Medicine in the College of Medicine, director of the UC Gardner Neuroscience Institute and a UC Health physician.

Another issue Broderick raised is insurers not approving, reviewing or interacting with postacute care plans for patients on weekends.

“So a key part of the health system for determining postacute care is not only delaying disposition but doesn’t function 2 days a week,” he said. “It would be like pilots in the airline industry not available to fly on the weekends and passengers piling up at the airport and surrounding hotels until Monday, when the pilots came back online and take them to their next destination."

Read the Medscape article.

Stronger policy, improved recovery: Closing gaps in stroke rehabilitation could improve lives

WOW!  A policy statement; NOT A STRATEGY TO GET TO 100% RECOVERY! This is precisely why I consider the ASA a fucking failure of a stroke association! All these supposedly smart people and still not one useable brain cell amongst them!

You do have stroke in your name; it should mean you're trying to solve stroke to 100% recovery! But alas! That's obviously too fucking hard for you. Wait until you're the 1 in 4 per WHO that has a stroke and there is nothing for 100% recovery, that will become your problem. And every single fucking failure of a stroke association IS RUNNING AWAY! COWARDS! 

Send me personal hate mail on this: oc1dean@gmail.com. I'll print your complete statement with your name and my response in my blog. Or are you afraid to engage with my stroke-addled mind? No excuses are allowed! You're medically trained; it should be simple to precisely state EXACTLY WHY you haven't worked at all on 100% recovery with NO EXCUSES! Your definition of competence in stroke is obviously much lower than stroke survivors' definition of your competence! Swearing at me is allowed, I'll return the favor. Don't even attempt to use the excuse that brain research is hard.

 Stronger policy, improved recovery: Closing gaps in stroke rehabilitation could improve lives

Stroke remains a leading cause of long-term disability in the United States, and while treatments have advanced, systems designed to support stroke survivors in recovery continue to fall short of the needs of patients. A new policy statement from the American Heart Association, a relentless force changing the future of health for everyone everywhere, highlights major gaps in U.S stroke rehabilitation and identifies needed improvements in public policies and performance measures to incentivize optimal patient care. The policy statement was published today in Stroke.

Stroke is currently one of the most expensive medical conditions covered by Medicare. The economic burden of stroke is expected to increase by more than five-fold between 2020 and 2050, from $67 billion to $423 billion, the largest absolute increase in costs among various types of cardiovascular disease.

Despite the growing cost burden of stroke, access to stroke rehabilitation care is often not determined by clinical need, with large gaps in care based on race, geography, insurance type and socioeconomic status. Some patients, including those in rural areas, face steep barriers to accessing post-acute rehabilitation services, widening the disability gap compared to stroke survivors in urban areas.

"Clinical guidelines from the American Heart Association and American Stroke Association recommend that discharge planning and rehabilitation decisions be based on a stroke survivor's functional needs," said Nneka L. Ifejika, MD, MPH, FAHA, American Heart Association and American Stroke Association volunteer, chair of the policy statement writing committee and chief scientific officer at Ochsner Health System in New Orleans, LA.

"However, research shows that non-clinical factors including the size and scope of a hospital network, a patient's insurance status and rehabilitation provider availability during the acute stroke hospitalization can limit access to appropriate care, resulting in poorer outcomes and higher long-term costs."

The policy statement outlines key measures to improve stroke care, including:

• Advance research that reflects real-world stroke recovery challenges by prioritizing patient-centered studies, addressing caregiving needs, mental health and long-term outcomes such as quality of life, return to work and community reintegration.
• Develop a national data infrastructure to track rehabilitation service utilization, costs (direct and indirect) and patient outcomes across diverse populations and care settings.
• Evaluate and compare rehabilitation models for their clinical effectiveness and cost-efficiency to determine what works best for stroke survivors.
• Study the impact of systemic factors—such as insurance coverage, geography, health systems and payment models—on rehabilitation quality and patient recovery to inform improvements in care delivery.
• Enhance care coordination and discharge planning by expanding staff training and addressing the unique needs of patients and their caregivers from varied social and economic backgrounds.

"The quality of one's recovery from stroke should not depend on their ZIP code, insurance status or the cultural competency of their health care providers when describing the importance of post-acute care," Ifejika said. "Every stroke survivor should be evaluated to receive high-quality, patient-centered rehabilitation, and should have equitable access if post-acute care is needed."

The American Heart Association is committed to advancing public policies at the federal and state levels that create optimal systems of care for stroke treatment, including rehabilitation and recovery.

The policy statement was prepared by the volunteer writing group on behalf of the American Heart Association Advocacy Coordinating Committee. American Heart Association policy statements position the Association on issues of public policy that will impact cardiovascular health and mortality, guide our advocacy work at all levels of government, allow us to support the important work of others, and inform policymakers, practitioners, health care professionals, researchers, the media and the public.

More information: Nneka L. Ifejika et al, Improving Access to Stroke Rehabilitation and Recovery: A Policy Statement From the American Heart Association/American Stroke Association, Stroke (2025). DOI: 10.1161/STR.0000000000000493

Journal information: Stroke 

Provided by American Heart Association 

Improving Access to Stroke Rehabilitation and Recovery: A Policy Statement From the American Heart Association/American Stroke Association

'Access' IS NOT WHAT SURVIVORS WANT; THEY WANT RECOVERY! This is precisely why I consider the ASA a fucking failure of a stroke association! All those Ph. D's. and still not one useable brain cell amongst them!

Send me personal hate mail on this: oc1dean@gmail.com. I'll print your complete statement with your name and my response in my blog. Or are you afraid to engage with my stroke-addled mind? No excuses are allowed! You're medically trained; it should be simple to precisely state EXACTLY WHY you haven't worked at all on 100% recovery with NO EXCUSES! Your definition of competence in stroke is obviously much lower than stroke survivors' definition of your competence! Swearing at me is allowed, I'll return the favor. Don't even attempt to use the excuse that brain research is hard.

  Improving Access to Stroke Rehabilitation and Recovery: A Policy Statement From the American Heart Association/American Stroke Association

n Nneka L. Ifejika, MD, MPH, FAHA, Chair; Oluwole O. Awosika, MD; Terrie Black, DNP, MBA, FAHA; Pamela W. Duncan, PhD, FAHA; Richard L. Harvey, MD, FAHA; Douglas I. Katz, MD; Teresa J. Kimberley, PT, PhD; Barbara Lutz, PhD, RN, CRRN, PHNA-BC, FAHA; Flannery O’Neil, BA, MPH; Joel Stein, MD, FAHA; Anil V. Yallapragada, MD; Mathew J. Reeves, BVSc, PhD, Vice Chair Downloaded from http://ahajournals.org by on August 2, 2025 

 ABSTRACT: 

Stroke rehabilitation is an integral component of comprehensive stroke care(NOT RECOVERY!). Inequities in access to stroke rehabilitation can further widen the disability gap and disproportionately affect underinsured patients, patients living in rural areas, and patients from underrepresented races and ethnicities. However, even insured patients face obstacles to receiving stroke rehabilitation. The prior authorization process, peer-to-peer reviews, and subsequent appeals to health care insurers for the provision of postacute rehabilitation increase length of the acute care(NOT RECOVERY!) stay, placing pressure on health systems to expedite the transition of care(NOT RECOVERY!), to the detriment of appropriate postacute rehabilitation placement. This policy statement focuses on (1) the provision of quality stroke rehabilitation to prevent complications, facilitate recovery, and limit disability, (2) the creation of evidence-based policies to improve equitable access, effectiveness, and efficiency of postacute care(NOT RECOVERY!), (3) the development and use of performance measures that are aligned with the American Heart Association/American Stroke Association Guidelines for Adult Stroke Rehabilitation and Recovery to incentivize optimal patient care(NOT RECOVERY!), and (4) identification of research priorities targeted to improve stroke rehabilitation access. This policy statement is a call for positive and sustained action.(Isn't stroke in your name, so YOU should be doing the action, instead of running away/) Stroke rehabilitation is the lifeline of hope for survivors, their caregivers, and their communities in the days, months, and years after stroke. It is imperative that governments and other funding agencies balance the support needed for acute stroke and stroke rehabilitation treatment, and that organizations, including the American Heart Association/American Stroke Association—an unrelenting advocate for improved brain health—advance the importance of stroke rehabilitation throughout the continuum of care(NOT RECOVERY!). Key Words: AHA Scientific Statements ◼ delivery of health care(NOT RECOVERY!) ◼ public policy ◼ quality of health care(NOT RECOVERY!) ◼ stroke ◼ stroke rehabilitation

SaeboStim Micro

If the glove is required then I could never use it unless I have two other people cranking my fingers open. But then that much spasticity would probably mean it had never been tested on persons like myself . Companies can decline to figure out how to treat the wicked problems. A great stroke association would tackle those difficult problems rather than running away. 

SaeboStim Micro 

Saebo, Inc., is a leading global provider of innovative rehabilitation products for stroke survivors and other neurologically impaired individuals. Headquartered in Charlotte, NC, the company was founded in 2001 by two occupational therapists specializing in stroke rehabilitation. As the leading cause of long-term disability in the U.S., stroke affects over 700,000 Americans every year, leaving many with crippling side affects including the loss of hand function. Saebos pioneering treatment protocols are based on new research documenting the brains remarkable ability to re-program itself following injury.

The companys neurological orthotic devices, including the ground-breaking SaeboFlex and SaeboReach, allow patients with very little residual arm and hand function to immediately begin performing task-oriented, grasp and release activities, thereby forging new pathways in the brain. Named Most Valuable Product in 2008 by Therapy Times, the Saebo Program is now offered as a treatment option at over 2,000 clinics and hospitals nationwide, including 22 of the Top 25 Rehabilitation Hospitals as ranked by U.S. News & World Report. The Saebo orthoses are also eligible for reimbursement by Medicare and most commercial insurers. With a network of over 6,000 trained clinicians spanning four continents, Saebo is committed to helping stroke survivors around the globe achieve a new level of independence.

Visit us at: http://www.saebo.com/saebostim-micro/

People often delay seeking stroke treatment, study says

So the solution is to blame the victim, rather than figuring out how to address the problem of tPA only being usable for a short time. Goddammit, you are running away from the problem. Leaders solve problems, they don't hide from them. Confront these lazy assholes. 100% recovery is the goal, regardless of when the patient comes in. That is non-negotiable. That means you need to solve the neuronal cascade of death, neuroplasticity and neurogenesis. Better get cracking. 

People often delay seeking stroke treatment, study says

While a public campaign in England has raised stroke awareness, researchers at one hospital say it is not good enough.
Despite a campaign to inform the public of stroke symptoms, as well as raise awareness of strokes overall, researchers in England say most still have limited knowledge.
Nearly two-thirds of people in a study conducted by researchers at the John Radcliffe Hospital in Oxford waited to seek treatment for a stroke, delaying care for an adverse health even that requires immediate attention to minimize its long-term effects.
Doctors and researchers have long acknowledged that every minute a stroke patient does not receive treatment -- among the most effective are clot-busting drugs which have become standard in the last several years -- lowers the doctors' ability to limit damage from the stroke, and lessens the potential for full recovery.
The Stroke Association started a campaign in 2009 in England to raise awareness of strokes in the hope people would sooner recognize whether they were having one and seek treatment.
While the National Stroke Strategy had some success, researchers say the acronym FAST, which stands for "Face Arm Speech Time" -- the order of things affected by a stroke -- may not have conveyed the most important part of the message.
"FASTER -- Face, Arm, Speech, Time, Eyes, React -- may be a better acronym for the public campaign," Dr. Ashok Handa, an assistant professor of surgery at the University of Oxford and lead author of the new study, said in a press release.
For the study, published in the British Journal of Surgery, researchers analyzed 150 patients who presented with a confirmed minor stroke between June and October 2014, analyzing the progression of their symptoms and when they sought treatment.
Nearly all the patients -- 92 percent -- delayed going to the doctor and 58.7 percent did not think they were having a stroke.
Of the patients, 34 percent had a history of stroke and 23.3 percent had undergone some type of "index" event, or basic health event that can indicate a stroke. Of the patients, 30 percent experienced a reduction or loss of vision, and none attributed the symptom to a cerebrovascular health event.
With about a third of patients unaware of the National Stroke Strategy, the researchers recommend a more rigorous, more effective public campaign to help patients recognize stroke symptoms and seek treatment with greater speed.
"Two-thirds of patients were not aware they were having a stroke, one-third were unaware of the FAST campaign and nearly one-third presented with eye symptoms," researchers write in the study. "Inclusion of eye symptoms and reaffirmation of the need to react might avoid unnecessary delays in the presentation of patients."