Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 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:

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's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Monday, October 2, 2017

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.

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