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.

Monday, October 2, 2017

AHA: Meditation May Play a Role in Lowering CVD Risk

But we are too fucking lazy to make a protocol of it.
https://www.medpagetoday.com/Cardiology/Prevention/68193?

However, traditional medical therapy remains the gold standard

  • by Staff Writer, MedPage Today
  • This article is a collaboration between MedPage Today® and:
    Medpage Today
Mediation may benefit cardiovascular risk, but traditional care for risk factors such as high cholesterol and blood pressure remains the mainstay of preventing heart disease, according to a scientific statement from the American Heart Association (AHA).
A systematic review of approximately 400 studies found a possible, though not conclusive, benefit of meditation on cardiovascular risk reduction and suggested that it may be used as low-cost, low-risk adjunct to current guidelines, stated Glenn N. Levine, MD, of Baylor College of Medicine in Houston, and colleagues in the Journal of the American Heart Association.
However, the team stressed that this statement was intended solely to review what is currently known from the scientific evidence, not to make recommendations about whether or not meditation can lower heart disease risk. The current mainstay for primary and secondary prevention of CVD is still the American College of Cardiology/AHA guideline-directed interventions.
"Although studies of meditation suggest a possible benefit on cardiovascular risk, there hasn't been enough research to conclude it has a definite role," said Levine in a press release."Since education on how to meditate is widely available and meditation has little if any risk associated with it, interested people may want to use these techniques, in addition to established medical and lifestyle interventions, as a possible way to lower heart disease risk."
It's important that people understand that the benefits need to be better established and it should not substitute traditional medical care, he added.
Levine's group searched PubMed for studies on meditation and cardiovascular disease (CVD) risk reduction using search terms such as meditation, stress, blood pressure, hypertension, smoking, tobacco use, insulin resistance, metabolic syndrome, endothelial function, primary prevention, and secondary prevention.
While traditional meditation refers to mental practices that are designed to improve concentration, increase awareness, and familiarize a person with their own mind, a more contemporary definition focuses on attention, mindfulness, compassion, and mantra repetition. Common forms of sitting mediation included samatha, vipassana, zen, raja yoga, and transcendental.
Studies on combination mind-body practices, such as yoga and Tai Chi, were excluded since they have been established as ways to reduce heart disease risk.
The authors found that most studies showed some improvements in levels of perceived stress, mood, anxiety, depression, quality of sleep, or overall well-being, but few focused specifically on patients with CVD.
Levine's group noted that neurophysiological and neuroanatomical studies demonstrated that meditation can have long-standing effects on the brain, which may have beneficial effects on the physiological basal state and cardiovascular risk. Additionally, some randomized data suggested that mindful meditation can improve smoking cessation rates.
Two studies on short-term interventions yielded mortality reductions, but the authors said that the findings need to be reproduced in larger, multicenter studies before deeming meditation to be effective for primary prevention of CVD.
Similarly to primary prevention of CVD, there were limited and limited-quality data available for secondary prevention of CVD -- many of which had small sample sizes and limited follow-up.
The authors called for further research on meditation and cardiovascular risk, specifically randomized studies that are adequately powered to detect clinically meaningful benefit and free of inherent bias.
Levine and co-authors disclosed no relevant relationships with industry.
last updated

Childhood Disadvantage, Psychosocial Resiliency, and Later Life Functioning: Linking Early-Life Circumstances to Recovery From Mobility Limitation

More fucking 'blame the patient' for not recovering. This time all the way back to childhood and your mother. Fuck it all, blame your fucking doctor for not getting you 100% recovered.
http://journals.sagepub.com/doi/abs/10.1177/0898264317733861
First Published September 27, 2017 Research Article


Objective: There is limited knowledge about whether childhood disadvantage, defined as economic and health disadvantage, influences recovery from functional impairment.  
Method: Using data from the Health and Retirement Study (2008-2010), this research explores whether childhood disadvantage shapes recovery from mobility limitation. In addition, this research examines whether measures of psychosocial resiliency such as mastery, optimism, and religiosity moderate the relationship between childhood disadvantage and recovery.  
Results: Childhood disadvantage appeared to shape recovery from mobility limitation in later life. Greater number of chronic childhood conditions and low maternal education decreased the odds of recovery. Mastery was a robust predictor of recovery and also a moderator of childhood disadvantage (i.e., moving for financial reasons) and recovery.
Discussion: Findings suggest that mastery may be able to diminish the negative effects of financial hardship in childhood on recovery outcomes in later life.

The little known ways neurons communicate

From NeuroDojo
Are any of these still working post stroke? A simple question for your doctor. Details at link.

New function of MK2 in protecting cells from the cytotoxic effect of TNF

But is this other blocking of TNF better?

Developing drugs to reduce brain impairment after stroke -CAL-101 to block TNF December 2015.

  The latest here:

New function of MK2 in protecting cells from the cytotoxic effect of TNF

29 September 2017 Ghent University
Identification of a novel cell death checkpoint in the TNF signalling pathway
The group of Prof. Mathieu Bertrand (VIB/UGent) reveals a new function of MK2 in protecting cells from the cytotoxic effect of TNF.
Tumor necrosis factor (TNF) is a proinflammatory cytokine that plays a very important role in orchestrating the immune response. Nevertheless, inappropriate signalling by TNF can also be detrimental and implicated in a variety of human inflammatory diseases, such as rheumatoid arthritis, inflammatory bowel disease and psoriasis. The pathogenic role of TNF in inflammatory conditions has long been thought to result from the ability of TNF to induce expression of a wide panel of proinflammatory mediators, but more recent studies have demonstrated that binding of TNF to its cognate receptor also promotes inflammation by inducing cell death, in the form of apoptosis and necrosis. Interfering with cell death induction therefore emerges as a promising therapeutic approach for the treatment of inflammatory conditions.
The research team of Prof. Bertrand (VIB/UGent), in the unit headed by Prof. Vandenabeele, is investigating the molecular mechanisms that protect the cells from death, and which are dysregulated in pathologic conditions. In the current issue of Nature Cell Biology, the group of Prof. Bertrand reveals the existence of a new cell death checkpoint in the TNF pathway. Dondelinger, Delanghe and colleagues show that MK2 protects the cells from death by inactivating the kinase RIPK1 through phosphorylation. Importantly, they show that this protective mechanism is affected in some inflammatory conditions and consequently results in cell death. This cell death can however be completely prevented by pharmacological inhibition of RIPK1.  Together with other studies, this work highlights the promising therapeutic potential of RIPK1 kinase inhibitor for the treatment of inflammatory diseases.
https://www.nature.com/ncb/journal/vaop/ncurrent/full/ncb3608.html

Conductive Education as a Method of Stroke Rehabilitation: A Single Blinded Randomised Controlled Feasibility Study

You'll have to ask your doctor and stroke hospital if they have any clue what this is and its' comparison to standard therapy
https://www.hindawi.com/journals/srt/2016/5391598/
Judith Bek,1 Melanie R. Brown,2 Jagjeet Jutley-Neilson,2,3 Nicholas C. C. Russell,4 Pia A. J. Huber,4 and Catherine M. Sackley4

1Faculty of Medical and Human Sciences, University of Manchester, Manchester M13 9PL, UK
2National Institute of Conductive Education, Birmingham B13 3RD, UK
3School of Social Sciences, Birmingham City University, Birmingham B4 7BD, UK
4Faculty of Life Sciences and Medicine, King’s College London, London SE1 1UL, UK

Received 14 January 2016; Accepted 29 May 2016

Academic Editor: Wai-Kwong Tang

Copyright © 2016 Judith Bek et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract

Background. Conductive Education for stroke survivors has shown promise but randomised evidence is unavailable. This study assessed the feasibility of a definitive randomised controlled trial to evaluate efficacy. Methods. Adult stroke survivors were recruited through local community notices. Those completing the baseline assessment were randomised using an online program and group allocation was independent. Intervention group participants received 10 weekly 1.5-hour sessions of Conductive Education at the National Institute of Conductive Education in Birmingham, UK. The control group participants attended two group meetings. The study evaluated the feasibility of recruitment procedures, delivery of the intervention, retention of participants, and appropriateness of outcome measures and data collection methods. Independent assessments included the Barthel Index, the Stroke Impact Scale, the Timed Up and Go test, and the Hospital Anxiety and Depression Scale. Results. Eighty-two patients were enrolled; 77 completed the baseline assessment (46 men, mean age 62.1 yrs.) and were randomised. 70 commenced the intervention () or an equivalent waiting period (). 32/37 completed the 10-week training and 32/33 the waiting period. There were no missing items from completed questionnaires and no adverse events. Discussion. Recruitment, intervention, and assessment methods worked well. Transport issues for intervention and assessment appointments require review. Conclusion. A definitive trial is feasible. This trial is registered with ISRCTN84064492.
1. Introduction

Rehabilitation provision for stroke survivors is typically limited to the first few months after stroke [1, 2]. However, improvements in mobility, activities of daily living, and quality of life have been reported following rehabilitation beyond this period [3–5]. The UK Department of Health’s National Stroke Strategy advised that support from stroke services should be available as required by patients and identified a need for the development of long-term community rehabilitation [6]. Similarly, the UK National Service Framework for Older People states that “rehabilitation should continue until it is clear that maximum recovery has been achieved” [7].

Conductive Education (CE) is an approach to rehabilitation that views stroke recovery as a learning process. CE was developed in Hungary in the 1940s as a specialised learning system for adults and children with neurological motor disorders [8]. Programmes are tailored to specific conditions, including stroke, Parkinson’s disease, multiple sclerosis, and cerebral palsy. CE aims to help stroke survivors at any stage of recovery to maintain or increase their range and control of movement, confidence, and coordination. It teaches strategies that participants can apply to their daily activities [9]. Functional tasks are broken down into a series of components, or a “task series,” which is designed to enable participants to develop an increased awareness of their own movement and to learn the basic rules of movement solutions. Movements are practised repeatedly and rhythmically with verbal reinforcement or “rhythmical intention” and the tasks are performed in a specific order. Both repeated practice [10] and rhythmic auditory cueing [11] have previously been shown to facilitate motor learning in neurological rehabilitation. To date, there have been no randomised trials of CE for stroke. However, three small studies with pre- and post-intervention assessments have shown promise, indicating benefits in terms of motor performance, activities of daily living, and quality of life [12–14]. Caregivers have reported improvements in the individuals they cared for, as well as a decrease in their own burden [15]. However, in the absence of a control group, the specific effects of CE are yet to be demonstrated.

Spastic cocontraction of triceps surae increases with the tension applied during swing phase of gait in chronic hemiparesis

In conclusion, I see absolutely nothing here that helps survivors get recovered. You try to decipher the results paragraph. 

Spastic cocontraction of triceps surae increases with the tension applied during swing phase of gait in chronic hemiparesis










Objective

The present study aimed to quantify the impact of the tension applied on triceps surae during the swing phase of gait on its cocontraction in chronic hemiparesis.

Material/patients and methods

Forty-one subjects with chronic hemiparesis (50 ± 15 years; time since lesion, 7 ± 7 years; mean ± SD) completed a kinematic gait analysis, barefoot at comfortable speed (10 opto-electronic cameras, 6 dynamometric force plates, 27 ± 13 cycles analyzed/subject), with electromyography of soleus (so) and gastrocnemius medialis (gm) on the paretic side. The Coefficients of Spastic Cocontraction, CSCso and CSCgm, were calculated over 3 periods of swing phase (T1, [0–33] %; T2, [34–66] %; T3, [67–100] %), by the ratio of the RMS of the electromyogram in the period of interest over the RMS of the electromyogram of the same muscle over 100 ms around the maximal agonist isometric activity (measured on standing position by a maximal effort against resistance). In addition, a coefficient of lengthening of triceps surae, CLts, was computed over each period in the sagittal plane, from the ankle/knee displacements recorded during the period of interest divided by the total range of ankle/knee movements measured across all gait cycles. CSCso, CSCgm and CLts were compared between the 3 periods (ANOVA, significant effect P < 0.05). Exploration of individual correlations were performed with all gait cycles of each patient, using univariate regression analysis with CLts as predictor and coefficients of spastic cocontraction (CSCso and CSCgm) as dependent variables.

Results

Between T2 et T3, CSCso increased by 233 ± 54% (mean ± SEM, P < 1E-5) and CSCgm by 67 ± 10% (P = 0.0017). CLts increased by 23 ± 7% in T2 (P = 0.009) and 52 ± 12% in T3 (P < 1E-5). CLts was positively correlated with CSCso in 63% of cases (n = 25, r = 0.63 ± 0.04, P < 0.1) and with CSCgm in 53% of cases (n = 21, r = 0.60 ± 0.04, P < 0.1).

Discussion – conclusion

In chronic hemiparesis, tension (lengthening) applied on triceps surae is associated with the increase of its spastic cocontraction during swing phase of gait at comfortable speed.

Structural changes in the muscle-tendon complex of triceps surae after a daily self-stretch program in chronic hemiparesis: A one-year randomized controlled trial

Useless,  NO clue what objective starting point for the research subjects was, or by what objective criteria you will know who can benefit from this.  Or what stretching entails. They never mentioned if the spasticity was removed.
http://www.sciencedirect.com/science/article/pii/S1877065717301549

Impairment from key lower limb antagonists vs. ambulation speed in chronic hemiparesis

My conclusion on this is that it is totally fucking useless, no way to get a stroke protocol out of this without objectively describing three motor mechanisms and how to get there from stroke survivor impairments.
http://www.sciencedirect.com/science/article/pii/S1877065717301409

ValentinaMardale1Catherine-MarieLoche1CarolineColas1CatherineHennegrave2Jean-MichelGracies1EmilieHutin1




Objective

In hemiparesis, three main motor mechanisms in lower limb produce ambulation impairment: paresis in agonists and contracture and overactivity in antagonists. The present study explores correlations between ambulation speed and indices of contracture, spasticity, and cocontraction in key ankle, knee and hip muscles in chronic hemiparesis.

Material/patients and methods

This retrospective study has included 132 subjects with chronic hemiparesis (mean ± SD, 50 ± 15 years, time since stroke, 8 ± 10 years). Inclusion criteria were: time since stroke > 6 months; completion, at the same visit, of the 10-meter ambulation test (AT10), barefoot without assistance at comfortable speed (CS) and fast speed (FS) and of the Five-Step Assessment (FSA), in three key muscles: triceps surae (TS), quadriceps (QD) and gluteus maximus (GM); no botulinum toxin injections in the 3 months prior to the visit. FSA was carried out on ankle dorsiflexion knee extended (against TS resistance), knee flexion hip extended (against QD resistance) and hip flexion knee flexed (against GM resistance) and measured passive range of motion at slow stretch (XV1), angle of catch at fast stretch (XV3) and active range of motion (XA). A multivariable regression analysis was performed with XV1, XV3, XA against each muscle as predictors and ambulation speeds (CS, FS) as dependent variables.

Results

Mean ambulation speeds were CS = 0.63 ± 0.28 m/s and FS = 0.84 ± 0.39 m/s. Both speeds were positively correlated with XA against TS (vs. CS, r = 0.50, P = 0.005; FS, r = 0.50, P = 0.006), QD (vs. CS, r = 0.62, P = 0.0001; FS, r = 0.56, P = 0.001) and GM (vs. CS, r = 0.68, P = 0.002; FS, r = 0.64, P = 0.013). XV1 and XV3 were not correlated with ambulation speeds.

Discussion – conclusion

After stroke, ambulation speed is correlated with active range of motion against triceps surae, quadriceps and gluteus maximus rather than corresponding passive ranges of motion or spasticity levels. These results may encourage therapists to primarily aim for improvement of individual active ranges of motion against key lower limb antagonists to enhance ambulation in chronic hemiparesis.

Size Doesn’t Matter: Cortical Stroke Lesion Volume is Not Associated with Upper Extremity Motor Impairment and Function in Mild, Chronic, Hemiparesis

My god, why the hell would volume have much to do with impairment of upper extremity? It is location, location, location. Waste of research dollars and time. 

Size Doesn’t Matter: Cortical Stroke Lesion Volume is Not Associated with Upper Extremity Motor Impairment and Function in Mild, Chronic, Hemiparesis


Stephen J. Page, Ph.D., M.S., M.O.T., OTR/L, F.A.H.A., Lynne Gauthier, Ph.D., and Susan White, Ph.D.

Abstract

Objective

To determine: (a) the relationship between lesion volume and upper extremity (UE) motor impairment using the UE section of the Fugl-Meyer (FM); and (b) the relationship between lesion volume and UE functional outcomes using the Arm Motor Ability Test (AMAT) Functional Ability (FA) and Time scales.

Design

Secondary, retrospective analysis of randomized controlled trial data

Setting

Not applicable

Participants

139 subjects with chronic stroke (83 males; mean age of all subjects = 56.7 ± 11.2 years; mean time since stroke onset = 59.6 ± 65.6 months; 90 subjects with right hemiparesis) and stable, active, distal UE movement.

Intervention

Data were collected related to subjects’ lesion volum and UE movement prior to their participation in a multicenter randomized controlled trial.

Main Outcome Measures

The FM and the AMAT.

Results

Neither age nor lesion volume was related to FM performance. The p-value for the regression coefficient of lesion volume was 0.045 in the AMAT FA model and 0.016 in the AMAT Time model. Lesion volume accounted for only an additional 1.7% (AMAT FA) to 3.1% (AMAT Time) of the variability in motor function, and was not clinically meaningful.

Conclusions

Data suggest no relationship between lesion volume and UE impairment, and a small, clinically insignificant relationship between lesion volume and UE motor function. Stroke affects metabolic changes in intact regions, and causes diffuse structural loss in anatomically remote regions from the infarction. These other factors may account for variance in motor outcomes following stroke.

Sleep, Sedentary Behavior, Physical Activity, and Functional Ability After Inpatient Stroke Rehabilitation

Image for article at link. The 74% sedentary time during the day is appalling.  Therapists are always complaining that survivors can't get enough repetitions during therapy to accomplish recovery. The answer is staring them in the face, create interventions that survivors can do by themselves during that sedentary time. Maybe music, action observation, virtual reality, passive movement?

Sleep, Sedentary Behavior, Physical Activity, and Functional Ability After Inpatient Stroke Rehabilitation


University of Alberta
Research Poster 293693
DOI: http://dx.doi.org/10.1016/j.apmr.2017.08.353

A Randomized Controlled Trial Investigating the Efficacy of Virtual Reality in Inpatient Stroke Rehabilitation

Image of article at link.  Protocol writeup needed which will not occur since we have NO stroke leadership.
University of British Columbia
Research Poster 304632

Waiting for perfect means not starting - Stroke rehab edition

This seems to be the stroke medical profession answer to why there are NO documented stroke rehab protocols anywhere in the world.  I got this reply from a neurologist from Sparrow hospital in Lansing MI when I asked for hyperacute therapies in the first week. 'There is no clinical research for any neuroprotective treatment in the first week'  What a crock of shit, at that point I had already had my 31 ideas on hyperacute therapy I'm going to insist my doctor give me during the first week. That just meant that that doctor and stroke practice is reading NO research and not even trying to extrapolate research findings to medical practice.

Waiting for SOMEONE ELSE TO SOLVE THE PROBLEM?

This post was inspired by this from Seth Godin:

"You're doing it wrong"

STROKE : rehabilitation helps to get out of aphasia

Still no concrete protocols with efficacy ratings to solve aphasia.
https://sivertimes.com/stroke-rehabilitation-helps-to-get-out-of-aphasia/71124
When the word refuses to release it. Among the people who have survived a cerebral vascular accident (STROKE), one-third suffers from aphasia. Without losing the ability to understand the language, these patients have difficulty putting words to express their thoughts or understand those of others. In order to help to recover this critical function, the care of speech and language are fully supported in the phase of rehabilitation.
If the link between STROKE and aphasia is so common, it is because of the damage to the brain observed in many patients. This is due to a hemorrhage or ischemia, the incident causes damage to certain areas. When they are involved in the practice of the language or its understanding, the consequences can be severe. Depending on the severity of the STROKE, patients may find themselves mute, or voice unintelligible words.
Patience
But the ability to speak is not lost. It is just damaged. However, ” the brain is plastic. It is able to reorganize itself to recover functions “, said Dr Pierre Decavel, neurologist to the university hospital of Besançon (Doubs). Where the interest of working on the functions that have been preserved.

The STROKE rehabilitation is above all a matter of patience. Several months to several years are necessary before a patient finds the correct level of language. In the best case, it can expect to recover 80 % of its level prior to the STROKE. Mireille Kerlan, speech-language pathologist at Vesoul (Haute-Saône), refers to ” little progress being made day-to-day “.

To accompany these (see report, above), Elizabeth Dutrieux has chosen to take the lead. Wife of a STROKE victim, she founded an association that offers singing sessions. An add-in that, it hopes, will help her husband to find the word.
In a register comparable, the association France AVC offers workshops and conferences to facilitate the rehabilitation of patients and to facilitate the task of caregivers.

Stroke survivor credits quick response

Hopefully this success doesn't stop that stroke hospital from solving all the other problems in stroke. Outliers like this are unusual.
http://www.dailyastorian.com/Local_News/20170929/stroke-survivor-credits-quick-response
Back on his couch two days later
By Edward StrattonThe Daily Astorian
Published on September 29, 2017 12:01AM
Last changed on September 29, 2017 10:11AM
Ronald Paapke, left, recounts the story of a stroke he suffered and the quick actions taken by his wife, Jane Leino, right, and emergency responders and doctors.
Colin Murphey/The Daily Astorian
Ronald Paapke, left, recounts the story of a stroke he suffered and the quick actions taken by his wife, Jane Leino, right, and emergency responders and doctors.

Oregon Health & Science University
Doctors at Oregon Health & Science University removed a blood clot from Ronald Paapke’s carotid artery.

Ronald Paapke sat down on the couch in his Lewis and Clark home one evening this month to watch the news on TV when a massive stroke left the entire left side of his body paralyzed.
Within two days, Paapke, 54, was back on his couch, after a quick response by all involved, a surgery at Oregon Health & Science University and a recovery one of his doctors called miraculous.
After a day of running around, Paapke came home and sat down to watch the news just before 5 p.m. on Sept. 19.
“As soon as I hit my chair, I felt like a weird sensation on the left side, mainly in my leg,” he said.
Paapke tried but couldn’t move his leg. He tried to get up off the couch and crashed to the floor before calling for his wife, Jane Leino.
“He was fighting me, because he wasn’t thinking quite right,” she said. “He wanted me to help him up. I tried one time, two times. I said, ‘Ron, I would like you to lay down on the floor so I can look at you and see what’s going on.’”
Leino, who had worked at a hospital in Alaska, asked Paapke to smile and lift his arm or leg. By then, she knew he was having a stroke and called 911.
Within five minutes, responders with the Lewis and Clark Fire District arrived and stabilized Paapke until Medix took over. Within an hour of the stroke, Paapke was at Columbia Memorial Hospital.
At 5:30 p.m., Dr. Stewart Weber, a vascular neurologist at OHSU, received an alert on his pager from Columbia Memorial, where a doctor determined Paapke was having a sizable stroke. He connected via the hospital’s telemedicine program and examined Paapke. A brain scan showed a blood clot running 12 centimeters up Paapke’s carotid artery from his neck to his brain.
“We decided that he would probably benefit the most from getting clot-busting medication,” Weber said.
Paapke was given a shot of tPA, or tissue plasminogen activator, used to dissolve blood clots. Only about 5 percent of stroke patients receive the drug, which needs to be administered within three hours. But the clot wasn’t dissolved by the medication, making Paapke a good candidate for a newer treatment at OHSU known as a mechanical thrombectomy.
Paapke was flown to Portland by Life Flight Network and by 7:30 p.m. was being stretchered into OHSU’s emergency department.

Plaque from smoking
Dr. Hormozd Bozorgchami, an interventional neuroradiologist at OHSU, inserted a catheter into an artery in Paapke’s groin, threading it through his aorta and into the carotid artery.
“It was filled with plaque from smoking,” Bozorgchami said of Paapke’s artery. The doctor inserted a stent mesh used to reinforce weak vessels.
Within a half-hour, Bozorgchami pulled out the stent, and with it the blood clot, a long, snaking mass of coagulated blood cells. It was the largest blood clot he had pulled out in six years at OHSU, Bozorgchami said.
“Within a minute after we got it out, he could start moving his left arm, which was totally paralyzed, and give us a thumbs up,” Weber said. “It was pretty miraculous, almost an immediate recovery.”

Prayers
Paapke’s friends and family prayed for him the entire time he was gone, Leino said.
“I’m just praying that it continues to be as great as it’s come out so far, because his life and my life could have been completely different, if everything didn’t work as smoothly.”
With about a month to go before his next checkup, Paapke’s goal is to quit smoking and lose about 5 pounds. Since being released from the hospital, he has been going around thanking the responders with Lewis and Clark, Medix, Life Flight, Columbia Memorial and OHSU whose response he said was textbook.
“I’d like to thank everyone involved,” he said. “It was a great team effort.”

Mental Training Enhances Cognitive Function and BDNF More Than Either Physical or Combined Training in Elderly Women With MCI: A Small-Scale Study

Your doctor should be able to IMMEDIATELY take this and create a cognitive protocol for all stroke survivors.  You need BDNF for better stroke recovery. What the hell is your doctor doing to improve your BDNF levels? ANYTHING AT ALL?
115 posts on BDNF for your doctors edification.

Low Circulating Acute Brain-Derived Neurotrophic Factor Levels Are Associated With Poor Long-Term Functional Outcome After Ischemic Stroke


Mental Training Enhances Cognitive Function and BDNF More Than Either Physical or Combined Training in Elderly Women With MCI: A Small-Scale Study 


First Published September 25, 2017 Research Article




The effects of mental, physical, and combination of these two trainings were investigated on cognitive performance, serum level of brain derived neurotrophic factor (BDNF), and irisin in women diagnosed with mild cognitive impairment (MCI).

Forty-four participants were randomized into 4 groups: physical training (PH; 8 weeks’ aerobic training, n = 11), mental training (ME; special computer gaming, n = 11), combined (PH + ME; n = 13), and control group (CO; n = 9).

Analysis of variance with Tukey post hoc test revealed a significant increase in working memory (P = .012) and BDNF (P = .24) in the ME compared with the CO group. Also the ME group in comparison with the PH group demonstrated better working memory (P = .014) and processing speed (P = .024).

Positive effect of mental training on the cognitive parameters, parallel with BDNF elevation, suggests that mental training is a more useful, safe, and persistent strategy to attenuate the progression of MCI probably via BDNF elevation, but the effect size is relatively small elevation.

Sunday, October 1, 2017

Stroke patients benefit from at-home therapy video game trial

Who fucking cares? Until you tell me OBJECTIVELY who can use this and exactly the effort it requires. So shut the fuck up until you answer those questions.  I've written  61 posts on video games, why SPECIFICALLY  is this one better?
https://medicalxpress.com/news/2017-09-patients-benefit-at-home-therapy-video.html

Constraint-induced movement therapy— a therapeutic approach developed by University of Alabama at Birmingham researcher Ed Taub, Ph.D., to rehabilitate movement after stroke— is being translated to a video game version called Recovery Rapids through an ongoing clinical trial.
CI therapy allows patients to learn to improve movement of the weaker parts of their bodies. By encouraging regular movement in the injured body part and constraining the functioning counterpart, the patient's brain rewires itself to regain some level of limb function.
These therapies have proved to significantly improve the quality of movement and the amount of use of the more-affected arm or leg for common daily living activities in most patients who have been treated.
"We know from several randomized controlled trials that patients with stroke, like the individuals who will participate in this trial, obtain large improvements in the use of their stroke affected arm in everyday life after CI therapy when it is delivered face-to-face in the clinic," said Gitendra Uswatte, Ph.D., professor in the College of Arts and Sciences' Department of Psychology and associate director of the CI Therapy Research Group and Taub Therapy Clinic. "Patients who did not use that arm to carry out activities like eating, combing your hair, and picking up a telephone begin to do so after in-clinic CI therapy."
The therapy allows patients to receive treatment from home, while still benefiting from the innovative constraint-induced movement therapy techniques and therapist interaction.
"Given the lower cost and increase in access to treatment made possible by the virtual reality version of CI therapy, the virtual reality version will represent an advance for patients even if the treatment gains are only two-thirds to half as large as for the in-clinic version of CI therapy," Uswatte said.
Recovery Rapids can be played on a home video system that is supplied by the study. The game contains tasks that were derived from activities that are used in standard CI therapy and automatically progresses with the player increasing in difficulty as the patient improves.
Patients virtually kayak down a river using the game system and perform tasks that will force them to exercise their affected body part, avoiding use of the opposite limb completely. While playing the game, patients encounter tasks such as paddling, reaching for fruit on trees, avoiding rocks, fishing and picking up trash floating in the water.
The game is also customizable to the patient's needs. For example, if a patient has more trouble with hand activities, the game can be customized to present more hand tasks.

Patients in the study wear activity trackers on their wrists that monitor the movement of the arms, and provides real-time feedback on how much they are using their affected arms vs. non-affected arms.
Improvements on the video game translate into improvements on everyday tasks. By having rehabilitation at their fingertips, stroke patients can drive their own recovery.
Jeremy Reynolds participated in the trial after suffering a stroke and undertaking traditional CI Therapy at UAB.
"I had a stroke in January of 2015 and I lost a lot of the use of my right arm, well mainly my right hand," Reynolds said. "I had been through physical and occupational therapy, and was looking for another way to get the use of my hand better than it was."
Reynolds says CI Therapy worked for him.
"CI therapy really forces you to use your 'bad' hand, so in your daily life you start to use the affected hand more, whether it being opening your car door, carrying a bag or really anything," Reynolds said.
He knew he wanted to try the video game version after learning about it from his mother, who saw a flier with information on the trial.
"The video game makes therapy a little easier, and more fun," Reynolds said. "It's definitely more convenient as well, and I believe it works."
Stroke patients who are interested in participating in the trial are encouraged to contact (205) 934-9768.
Eligible patients are those who are more than six months after a stroke, can partially open and close the hand(this leaves out me), and have some movement of the wrist, elbow and shoulder. Eligible will be randomized to traditional CI therapy, home-based gaming CI therapy, or standard physical . Treatment will be at no cost to the patient.
Provided by: University of Alabama at Birmingham search and more info

The Simple Depression Treatment That Works In 24 Hours

With a 33% chance of depression after stroke, is your doctor ANY GOOD AT ALL in how to prevent(NOT TREAT!)? Either short term or long term? Taking antidepressants helps stroke recovery even if not depressed. Remember, I'm not medically trained so I know nothing and should never be followed even to asking your doctor these questions.

Common antidepressant can help stroke patients improve movement and coordination Sept. 2015 

 

Antidepressants may help people recover from stroke even if they are not depressed Jan. 2013 

The latest here:

 The Simple Depression Treatment That Works In 24 Hours

30 years worth of research reveals that 50% of people benefit from this simple treatment.
Sleep deprivation can rapidly reduce the symptoms of depression, 30 years of research suggests.
Around half of people with depression who are sleep deprived under controlled, inpatient conditions feel better quickly.
Many see improvements in just 24 hours, in comparison to the weeks it can take for antidepressants to start working.
‘Wake therapy’, as it is sometimes called, involves staying awake all night and the next day.
Around 50% of people find their depression improves — until they sleep again.
There is evidence that staying awake for half the night, instead of the whole night, can be effective.
The problem, however, is that the therapy is not a long-term solution.
People typically feel depressed again after one full night’s sleep.
Sometimes taking a nap is enough for the depression to return.
However, the technique can help bridge the gap until antidepressants start working.
Wake therapy is sometimes referred to as a ‘response inducer’ or accelerator.
In other words, it is used when the patient needs a very quick release.
The conclusions come from a new review of 66 studies carried out over 36 years.
Dr Philip Gehrman, a study author, said:
“More than 30 years since the discovery of the antidepressant effects of sleep deprivation, we still do not have an effective grasp on precisely how effective the treatment is and how to achieve the best clinical results.
Our analysis precisely reports how effective sleep deprivation is and in which populations it should be administered.”
They found that around half of people who were depressed responded to sleep deprivation.
It didn’t matter whether or not they were taking medication, what age or gender they were, or even the method of sleep deprivation used.
Dr Elaine Boland, the study’s first author, said:
“These studies in our analysis show that sleep deprivation is effective for many populations.
Regardless of how the response was quantified, how the sleep deprivation was delivered, or the type of depression the subject was experiencing, we found a nearly equivalent response rate.”

 

 

Frequent sauna bathing keeps blood pressure in check

Do you really think your hospital is ever going to put in a sauna?
This earlier report:

Frequent sauna bathing protects men against dementia  Dec. 2016 

and this:

Finns Find Steaming Hot Way to Fight Alzheimer's Disease

Frequent sauna bathing keeps blood pressure in check

29 September 2017 University of Eastern Finland
Frequent sauna bathing reduces the risk of elevated blood pressure, according to an extensive follow-up population-based study carried out at the University of Eastern Finland. The risk of developing elevated blood pressure was nearly 50% lower among men who had a sauna 4–7 times a week compared to men who had a sauna only once a week. These findings were published recently in the American Journal of Hypertension.
The same researchers have previously shown that frequent sauna bathing reduces the risk of sudden cardiac death, and cardiovascular and all-cause mortality. Elevated blood pressure is documented to be one of the most important risk factors of cardiovascular diseases. According to the research group, underlying protective mechanisms may include the beneficial effects of regular sauna bathing on blood pressure.
The Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) involved 1,621 middle-aged men living in the eastern part of Finland. Study participants without elevated blood pressure of over 140/90 mmHg or with diagnosed hypertension at the study baseline were included in this long-term follow-up study. Based on their sauna bathing habits, men were divided into three sauna frequency groups: those taking a sauna once a week, 2–3 times a week, or 4–7 times a week. During an average follow-up of 22 years, 15.5% of the men developed clinically defined hypertension. The risk of hypertension was 24% decreased among men with a sauna frequency of 2–3 times a week, and 46% lowered among men who had a sauna 4–7 times a week.
Sauna bathing may decrease systemic blood pressure through different biological mechanisms. During sauna bathing, the body temperature may rise up to 2 °C degrees, causing vessels vasodilation. Regular sauna bathing improves endothelial function, i.e. the function of the inside layer of blood vessels, which has beneficial effects on systemic blood pressure. Sweating, in turn, removes fluid from the body, which is a contributing factor to decreased blood pressure levels.  Additionally, sauna bathing may also lower systemic blood pressure due to overall relaxation of the body and mind.
A recent analysis of the same study also revealed that those taking a sauna frequently have a lower risk of pulmonary diseases.

Abstract WP95: Splenectomy Protects Aged Mice From Cerebral Injury in the Experimental Stroke Model

What the hell made you think that spleen removal would help in stroke? You thought there was any chance in hell that this could be tried in humans? Was this problem considered?

Splenectomy Does Not Improve Long-Term Outcome After Stroke  Jan. 2017

Abstract WP95: Splenectomy Protects Aged Mice From Cerebral Injury in the Experimental Stroke Model 



Anjali Chauhan, Meaghan Roy-O’Reilly, Abdullah Mamun, Nia Harris, Javiera Bravo-Alegria, Louise McCullough

Abstract

Introduction: Aging is a non-modifiable risk factor for stroke. Although aged animals tend to have smaller infarcts they have worse functional recovery after stroke, suggesting difference in mechanisms between young and aged. Splenectomy reduces infarct in animal models, but how the spleen contributes to brain injury in aged mice has not been as well studied.
Hypothesis: We hypothesized that peripheral inflammation increases over the lifespan. We predicted that the detrimental effects of the spleen would be reversed by splenectomy in aged mice.
Methods: Young and aged male mice were splenectomized (n= 8-9), 2 weeks prior to induction of 1 hour of middle cerebral artery occlusion. Ninety-six hours after reperfusion, behavioral and infarct area was assessed. In a separate cohort, peripheral and central immune cells were quantified by flow cytometry.
Results: After stroke, there was 13.3, 17.7, 25.9 and 5.88% mortality in spleen intact young, splenecyomized young, spleen intact aged and splenctomized aged mice respectively. Splenectomy led to improved behavioral deficits in aged mice as seen by lower neurological deficits scores,(1.63 ± 0.26 Vs 2.57 ± 0.20) and reduction in number of right turns in the corner test. There was significant reduction in infarct size in the splenectomized aged mice (p<0.05) as compared to spleen-intact mice. Splenectomy in aged mice lead to reduction in the frequency of CD3CD44+ T cells. Additionally, there was significant decrease in TNF-α, IL-6, IL-4, IL-12MIP-1b and RANTES levels in the aged splenectomized aged mice as compared to spleen-intact aged mice (p<0.05). In the brain, the frequency of CD45hiCD11b+ cells was reduced in the splenectomized MCAo aged as compared to spleen-intact stroke mice (p<0.05).
Conclusions: Splenectomy reduced the peripheral activation of T cells in the aged mice. Also less peripheral leukocyte infiltration was observed, which mirrored improved functional recovery and reduced infarct damage in splenectomized aged mice. Hence, this study provides new information regarding age specific peripheral immune responses and interaction with the brain after experimental stroke highlighting a need for the incorporation of aged mice in the basic stroke research. Funding: 16POST27490032

Major breakthrough as doctors REVERSE symptoms of a stroke: Patients to walk, talk and live a normal life after stem cell treatment - up to 3 YEARS later

I'm not sure that this is anything other than placebo. No proof that the stem cells either survived or triggered massive neurogenesis and neuroplasticity.  Did they inform their patients of these possible side effects?

Tumors caused by pluripotent stem cells can be tackled with radiation, say Stanford researchers

 

Donor-derived brain tumor following neural stem cell transplantation in an ataxia telangiectasia patient.

 

He went abroad for stem cell treatment. Now he’s a cautionary tale. Stroke patient Jim Gass

 

“Off-the-charts dangerous”: Sham stem cell trial at Florida clinic blinds three women

 

Stem cell propagation fuels cancer risk in different organs 


http://www.dailymail.co.uk/health/article-3622589/Major-breakthrough-doctors-REVERSE-symptoms-stroke-Patients-walk-talk-live-normal-life-stem-cell-treatment-3-YEARS-later.html

Doctors have reversed the symptoms of stroke in a major medical breakthrough using stem cell treatment, a Stanford University study has shown
Doctors have reversed the symptoms of stroke in a major medical breakthrough using stem cell treatment, a Stanford University study has shown
Doctors have reversed the symptoms of stroke in a major medical breakthrough.
Patients regained the ability to walk, speak and have a normal family life, thanks to a procedure requiring only local anaesthetic and a single night in hospital.
Remarkably, the stem cell treatment was shown to work even three years after someone had suffered a stroke - meaning that millions of people could potentially benefit from the treatment.
Eighteen patients underwent the procedure in an initial trial - with stunning results.
Despite the long gap between stroke and treatment, all 18 patients in the pilot showed increasing improvement for the 12 months they were tracked after the operation.
Nearly half showed ‘clinically meaningful’ results - which meant the procedure had a significant impact on their lifestyle.
One patient who relied on a wheelchair, unable to properly use her legs, has since taken up jogging.
Another woman, who could barely get to her feet before the operation, has since walked down the aisle and is now expecting a baby with her new husband.
And another, completely paralysed apart from the use of her left thumb, has regained the ability to walk.
The treatment, carried out by scientists at Stanford University in California, is thought to be so effective because it triggers the rapid regeneration of brain circuits damaged during a stroke.
There are 1.2million stroke survivors in Britain - many who have never recovered their independence.
More than 150,000 people have a stroke in England every year, with patients suffering paralysis, speech problems and personality changes.
Experts last night stressed that we are several years away from the treatment being rolled out to all stroke patients - because far more testing is needed before the procedure is proven to be completely effective.
The experiment was only set up to establish that the treatment was safe - which it did - but 18 patients are not enough to show that it will work on all people.
But the team has already started on work to replicate their results on a larger scale, and if that is successful the technique has great potential to revolutionise life for stroke patients.
The researchers, whose work was published last night in the Stroke medical journal, tested the treatment on 11 women and seven men, aged 33 to 75.
Each was given stem cells between six months and three years after they suffered a chronic stroke.
Although stem cell treatments have been shown to work for stroke patients in other small trials in the past, most have been given within days of suffering a stroke.
But the new study suggests that the treatment might work for a much longer window - significantly expanding the number of people who might benefit.
Study leader Professor Gary Steinberg said: ‘Patients improved by several standard measures, and their improvement was not only statistically significant, but clinically meaningful.
‘Their ability to move around has recovered visibly. That’s unprecedented. At six months out from a stroke, you don’t expect to see any further recovery.’
The participants remained conscious under local anaesthesia, while a small hole was drilled through their skulls and stem cells injected into the damaged area of their brain.

WOMAN CONFINED TO A WHEELCHAIR AFTER SUFFERING A STROKE AT 31, WALKS DOWN THE AISLE AND IS EXPECTING A BABY WITH HER HUSBAND

Twelve months ago Sonia Coontz proudly strode down the aisle to marry her fiancé Peter.
Just a few months earlier, such a feat would have been unthinkable.
Because Mrs Coontz had been consigned to a wheelchair, the victim of a vicious stroke that had struck when she was just 31.
She survived the stroke, but was left profoundly disabled.
Sonia Coontz suffered a stroke when she was just 31 years old. It left her confined to a wheelchair, unable to walk and profoundly disabled. Mrs Coontz pictured with her husband Peter
Sonia Coontz suffered a stroke when she was just 31 years old. It left her confined to a wheelchair, unable to walk and profoundly disabled. Mrs Coontz pictured with her husband Peter
‘It was very bad,’ Mrs Coontz, now aged 36, said last night, speaking from her home in California.
‘I could not speak well, my left leg did not work very well so I had to use a wheelchair. My right arm was almost dead and my shoulder hurt so badly.’
Two years ago, Mrs Coontz was one of 18 patients to undergo a radical new procedure at Stanford Medical School.
Under local anaesthetic, she received stem cell injections directly into her brain, designed to regenerate the neural circuits left damaged by her stroke.
‘After the surgery instantly all that pain had gone from my shoulder,’ she said. ‘I could move my arm all the way back for the first time.
‘And from that day on I never sat in a wheelchair again.’
Mrs Coontz had been putting off her marriage, too embarrassed at her inability to walk to put herself through the spectacle of a wedding.
‘Last June I was able to walk down the aisle,’ she said. ‘I would not have been able to do that before.
‘And now I’m pregnant - we are expecting a boy in September.
‘Every day I get better. I still have some recovering to do, but I feel terrific.’