Posts Tagged recovery

[WEB SITE] Wearable tech aids stroke patients – BBC News

Scientists in the US are developing wearable sensors to speed up the recovery of stroke patients.

The sensors are able to send information to doctors continuously.

The team developing the system says it could allow therapists to more closely monitor the effectiveness of their care.

Details of the study were released at the recent annual meeting of the American Association for the Advancement of Science in Texas.

Lizzy McAninch had a stroke two years ago. She could not move or speak or swallow for several weeks.

Lizzy is testing out wearable sensors that might speed her recovery.

They look like small white sticking plasters, but they send information wirelessly to her medical team.

She is a doctor herself and can see how they could help her.


SHIRLEY RYAN ABILITYLAB They look like small sticking plasters

“This technology to put sensors on the body to assess which muscle groups work or not can really pinpoint the areas affected by the stroke and can target therapies to specifically improve those issues,” she told BBC News.

The sensors continue to send back readings even after she has finished her exercises. This means that her therapist Kristen Hohl, from the Shirley Ryan AbilityLab in Chicago, can monitor her progress at home.

“As a therapist, I think about what my patients are doing at home. Are they able to carry through the recommendations I’m giving them as a therapist to do more? Do we see that they are walking more or do we see them engaging in conversations?

“Those are the types of things that I can get feedback from the sensors where currently I have to rely on what they tell me they have done.”


 SHIRLEY RYAN ABILITYLAB  The team is gathering large amounts of data

The challenge for the scientists was to pack a lot of electronics on to a small flexible material and still make it comfortable for the patient to wear for a long time.

“It is almost mechanically imperceptible to the patient who is wearing the device,” according to John Rogers, of Northwestern University in Chicago, who developed the sensors.

“And you can embed all sorts of advanced sensor functionality, microprocessor computing capability, power supplies and WiFi into this very unusual platform, and that is the uniqueness of what we do.”

By the end of this year, the research team will have more information than ever before on stroke recovery. The scientists believe that their study could transform the way patients are treated in the future.

Lizzy and scientist



via Wearable tech aids stroke patients – BBC News


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[WEB SITE] 10 of the best apps for stroke recovery in 2018

Following a stroke, the body needs time to heal, and recovery time depends on the symptoms and severity of the stroke. We have identified the best apps to help stroke survivors with their recovery and rehabilitation.
older man looking at phone

Smartphone apps can assist with stroke recovery and rehabilitation.

More than 795,000 individuals in the United States have a stroke each year, and around 140,000 of these people die from stroke.

Ischemic strokes — wherein “blood flow to the brain is blocked” — account for roughly 87 percent of all strokes.

Stroke can cause significant injury to the brain that may result in many long-term problems.

For example, communication, concentration, memory, and executive function, as well as spatial awareness, are all cognitive functions that may be impacted by stroke.

Stroke can also trigger mental health issues such as anxiety and depression, as well as movement and coordination problems, paralysis, difficulties swallowing, visual impairment, and urinary incontinence and loss of bowel control.

The faster a person is treated after stroke, the more likely they are to recover from it. Surveys have shown that people who “arrived at the emergency room within 3 hours” of their first symptoms of stroke had “less disability” 3 months later than those who were treated later.

While some people recover quickly from stroke, others may need long-term support. Apps are available to help aid the stroke recovery process. They can help you or your loved one to track appointments and medications, provide language therapy, train the brain, and even lower some risk factors for future strokes.

Medical News Today have selected the top 10 apps to assist with stroke recovery.


Android: Free

iPhone: Free

Cozi logo

Cozi is a family organizer designed to keep track of multiple schedules. The app can help caregivers to manage their schedules and is ideal if the person recovering from a stroke has several caregivers.

Keep track of schedules with a shared color-coded calendar and set reminders for yourself or other family members so that medical appointments and medications are not missed.

Shopping and to-do lists can also be shared with everyone in the family to ensure that you have everything you need from the grocery store. All items added to lists are viewable instantly in real-time.


Android: Free

iPhone: Free

Medisafe logo

Medisafe is the must-have pill reminder that makes sure that you never miss a dose of your medication or mistakenly double up due to not tracking your medications ever again.

According to the app, mistakes with medicine use and dosage tracking result in 50 percent of individuals not taking medication as prescribed, 700,000 hospital visits, 125,000 deaths each year, and 44 in every 100 prescriptions not being collected from the pharmacy.

Whether you are taking one drug dose or multiple doses each day, it can be challenging to remember to take the right pill at the right time. Medisafe takes the stress out of having to remember if you or your loved one took their medications correctly.

Stop, Breathe & Think

Android: Free

iPhone: Free

Stop, Breathe & Think logo

Research has shown that increased activity in a brain region called the amygdala, which is involved in stress, is tied to a greater risk of stroke. Therefore, reducing stress while in recovery from stroke could reduce the risk of future strokes.

Stop, Breathe & Think is a meditation and mindfulness app that helps to decrease stress and anxiety. The app provides guided meditations, breathing exercises, and yoga and acupressure videos to help you check in with your emotions.

Stop, Breathe & Think says that taking a few minutes every day to feel calm is just as important as getting frequent exercise and will reduce stress and promote peace of mind.

7 Minute Workout Challenge

Android: $2.99

iPhone: $2.99

7 Minute Workout Challenge logo

Working out three to five times per week reduces the likelihood of recurrent stroke by fivefold, according to a study published in the journal Neurology.

If you are unsure of how to start an exercise routine after stroke, the 7 Minute Workout Challenge app could be the perfect app for you. The 7-minute workout is a research-backed exercise program that has become a hit internationally.

Scientists have put together 12 exercises to perform for 30 seconds each with a rest period of 10 seconds in-between. The exercise sequences are easy to do, require no equipment, and can be done anywhere.

Language Therapy 4-in-1

Android: $59.99

iPhone: $59.99

Language Therapy logo

After stroke, it is common to experience a condition called aphasia, which affects your ability to understand what people are saying, find the right words, and read and write. Aphasia is often a symptom of the brain damage caused by stroke.

Language Therapy 4-in-1 is a scientifically proven speech therapy app that aims to improve speaking, listening, reading, and writing in those with aphasia. Get started by giving their free version, Language Therapy Lite, a try today.

Research led by the University of Cambridge in the United Kingdom found that using the app for 20 minutes each day for 4 weeks showed improvements in all study participants with chronic aphasia.

Constant Therapy

Android: Free trial

iPhone: Free trial

Constant Therapy logo

Constant Therapy is a cognitive and speech therapy app designed for individuals who are recovering from stroke, brain injury, and aphasia. The app is free for 15 days and then offers users the chance to continue with a monthly or annual subscription.

With more than 65 task categories, 100,000 exercises, and 10 levels of difficulty, Constant Therapy can help to improve cognition, memory, speech, language, reading, and comprehension skills.

Constant Therapy was developed by scientists at Boston University in Massachusetts and is recommended by neurologists, speech language pathologists, and occupational therapists. Research published in the journal Frontiers in Human Neuroscience showed a significant improvement in standardized tests for stroke survivors after using Constant Therapy.

VocalEyes AI

iPhone: Free

VocalEyes logo

Stroke can sometimes cause damage to brain areas that receive, process, and interpret information sent from the eyes. This damage may result in losing part of your field of vision or causing double vision.

VocalEyes is computer vision for the visually impaired. The app uses machine learning to help people with vision problems identify objects in their everyday lives. Take a photo, and the app will tell you what the camera sees.

VocalEyes’s audio response describes scenes and environments, identifies objects, label logos, and brands, reads text, detects faces, classifies emotions, recognizes ages, and distinguishes currency denominations.


iPhone: Free

Glasses logo

Glasses is a digital magnifier and mirror that can help you to view fine print and objects with up to 12x magnification.

If your vision is impaired after stroke or you have simply forgotten your glasses, the app can zoom in on labels and nutritional information in a grocery store and menus in dark restaurants as well as help you see how much to pay on the bill after eating out.

Glasses is simple to use. Double tapping quickly zooms in or out by 6x, while swiping uses a slow and continuous zoom method. If you have shaky hands, you can tap and hold to freeze the image on screen.


Android: Free

iPhone: Free

Elevate logo

If you are experiencing cognitive function problems after stroke, brain-training apps provide a platform to exercise and improve the areas of the brain involved in concentration, memory, planning, reason, and problem-solving.

Elevate is a brain-training app that is designed to enhance speaking abilities, processing speed, focus, and memory. Elevate provides a personalized training program that adapts in difficulty over time to ensure you are always challenged.

Elevate features more than 40 games aimed at improving your skills, plus a workout calendar that tracks your streaks to keep you motivated. Users who train with Elevate at least three times each week have reported considerable gains in abilities and increased confidence.


Android: Free

iPhone: Free

Peak logo

The Peak app includes 40 unique brain-training games developed by neuroscientists to challenge and build your cognitive skills.

Peak features a personal brain trainer, known as Coach, who selects the perfect workouts for you at the correct time. Choose your training exercises from Coach’s recommendations to challenge yourself and stay motivated by tracking your progress with in-depth insights.

Free games challenge your attention, memory, problem-solving skills, mental agility, coordination, emotional control, language, and creativity. Upgrade to Pro for additional features.

via 10 of the best apps for stroke recovery in 2018

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[WEB SITE] VR could trick stroke victims’ brains toward recovery.

Could virtual reality help stroke survivors regain motor function?

That’s a question Sook-Lei Liew is looking to answer.

Liew, an assistant professor at the University of Southern California and an affiliate of the Stevens Neuroimaging and Informatics Institute at the Keck School of Medicine, was inspired by research from Mel Slater and Jeremy Bailenson on embodiment in VR. If someone’s given a child’s body in VR, for example, they might start exhibiting more childlike behavior.

She wondered if giving stroke survivors with motor impairments a virtual avatar that moves properly could help promote brain plasticity (or the ability to change) and recovery. Maybe it would eventually lead to them to moving an impaired limb again.


USC researcher Sook-Lei Liew and her partners are testing to see whether virtual reality could help with stroke rehab. Nate Jense

“So, kind of like tricking the brain through visual input,” said Liew, who is also director of the Neural Plasticity and Neurorehabilitation Laboratory. “There’s a lot of emerging evidence from neuroscience and psychology that was showing that you can really identify [with the avatar], and it changes your behavior based on the avatar you’re given in VR.”

Virtual reality is a computer-generated simulation of a 3D environment. Using a VR headset with lenses that feed images to the eyes, a person can be virtually transported to another location, or interact with a setting in a seemingly realistic way. It’s commonly been used in gaming, but it’s being tested in other environments, too — like rehab.

Implementing VR in health care and patient treatment isn’t new. It’s been used to help people overcome phobias and anxiety disorders. But the application is starting to take off now that the technology is more developed and commercially available. Some medical schools are looking to train students with virtual simulations, and it’s even helping midwives learn how to deliver babies.

Liew’s research team has been working on a study for about two years called REINVENT, an acronym for Rehabilitation Environment using the Integration of Neuromuscular-based Virtual Enhancements for Neural Training. The researchers also collaborated with the USC Institute for Creative Technologies to develop the prototype.

The process works by using a brain-computer interface, which takes a signal from the brain and uses it to control another device: a computer, a robot or, in REINVENT’s case, an avatar in VR.

Next, researchers read electrical signatures of brain activity from the surface of the scalp using electroencephalography, or EEG, for short. The team also uses electromyography, which studies the electrical activity of the muscles. That can tell them whether somebody’s moving or if they’re trying to move.

Those signals are then fed into a program on a laptop. The program has thresholds so that when specific signals in the brain or muscle activity that correspond to an attempt to move are detected, they drive the movement of a virtual arm. The resulting visual feedback through a VR headset could help strengthen neural pathways from the damaged motor cortex to the impaired arm or limb.

While the researchers could theoretically extend this process to a patient’s lower limbs, Liew said it can be dangerous for someone with a motor impairment in the lower extremities to try to move with VR, so seated studies are much safer.

The research group recently finished testing the prototype using an Oculus DK2 with 22 healthy older adults, who provided a sample of what the brain and muscle signals look like when they move. They’re now starting to test with stroke patients in a controlled lab setting, aiming to work with 10 in the short term and hundreds in the long term, in both clinical and home environments.

The team also found that giving people neurofeedback of the virtual arm moving in a VR headset was more effective than simply showing it on a screen.

“Their brain activity in the motor regions that we’re trying to target is higher, and they’re able to control the brain-computer interface a little bit better and faster,” Liew said. “It makes the case that there is an added benefit from doing this in virtual reality, which is one of the first things we wanted to know.”

An unclear future

Because VR is still a relatively new technology, there are many unanswered questions on the best ways to use it in the medical profession.

“For the most part, nobody knows how to make great VR experiences, for business or consumer,” Gartner analyst Brian Blau said. “Over time, those issues will get resolved. But for the medical industry, they have the extra added bonus of having even more types of physical behaviors that they have to either mimic or want to measure.”

And while the possibilities for VR in health care are exciting, Liew is careful not to get ahead of herself.

“We think that VR is a promising medium, but we’re moving ahead cautiously,” she said. “A lot of the work that we’re trying to do is to test assumptions, because there’s a lot of excitement about VR, but there’s not that much that’s scientifically known.”

Only time — and plenty of research — will tell.

Tech Enabled: CNET chronicles tech’s role in providing new kinds of accessibility.

The Smartest Stuff: Innovators are thinking up new ways to make you, and the things around you, smarter.

via VR could trick stroke victims’ brains toward –

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[BLOG POST] Signs Your Loved One is Recovering From Stroke – Saebo

A stroke—no matter how severe—can be devastating. Not only does it have the potential to cause damage physically and mentally, but the recovery process can be equally as difficult to navigate. With countless hurdles to overcome, monitoring progress during stroke recovery can be very frustrating, but there are certain things that you or a loved one can do to improve the experience and see results.  

Make and Keep Recovery Goals in Mind

The best thing that you or a loved one can do to set the pace for a healthy recovery is to be honest and open about any limitations or weaknesses that have surfaced as a result of a stroke attack. This transparency will make it clear what obstacles lie ahead and help you set firm, achievable goals.

Another way to remain inspired by this strategy is to personalize your goals as much as possible. For example, if a stroke survivor is trying to regain mobility in their legs, one of their goals may be to dance with a spouse to their favorite song. With the assistance of a personal touch, following through with a plan of action can offer an extra boost of support as opposed to generic goals lacking emotional incentives.

If you’re unsure of your status, or you need help formulating a plan, make sure to speak with a doctor or therapist that can set you on the right course.

Track and Assess Progress

Trying to get a handle on how you or a loved one is recovering after a stroke is perhaps one of the hardest things to do. This is because there are usually multiple problems that need immediate attention, rather than just one issue to focus on.

To combat this overwhelming feeling, make it a habit to track your progress both mentally and physically. Be sure to document your developments each day you work on a specific area no matter how small they may be. For physical categories like strength, range of motion, endurance, and decreasing spasticity, make sure to begin each session by writing down pre-workout numbers, and then noting the post-workout numbers so that comparisons can be made over time. The simple act of recording information will show concrete evidence of improvements or shortcomings, and this information can be further discussed with a doctor or therapist to ensure a pathway to success.

Keep Regular Therapy Appointments

Creating a routine and following it on your own can be a great choice for those who are easily self-motivated, but let’s face it, many of us can get unfocused or unmotivated. If you find yourself falling under the latter, then scheduling regular therapy appointments is the perfect way to guarantee continual regiments, as well as consistent support. Especially during the early stages of stroke recovery, having a solid team of trained healthcare professionals can assist in establishing a foundation so that individual recovery can then take place.

Exercise at Home Every Day

Ultimately, the benefits of a recovery program will only be experienced if a stroke survivor keeps up with it. Even though a routine is created by a therapist or doctor, the responsibility of executing it falls entirely on the patient, so making sure to stay active and consistent is essential for progress.

In addition to following a schedule, a stroke survivor must also take into consideration the importance of repetition as it applies to the exercises themselves. Since the main objective for stroke recovery is to restore the body’s abilities, it’s necessary to repeat exercises efficiently and for the correct amount of time. In the way that maintaining a healthy diet requires you to eat nutritious foods every day at multiple times, the body requires repetitive motions to keep up functionality and regain power.

Rehab is an Opportunity

Regardless of where you are in your recovery or where you think you should be, know that all pathways of rehabilitation are different and that there are no expectations to meet besides the ones you set for yourself.

After reading this article, if you happen to discover something that you can work on, that’s great! Healing yourself after a stroke doesn’t have to be experienced as a chore or burden to carry around; better yet, it should be embraced as an opportunity to learn about the body and what can be done to improve it.

If you or a loved one feels that they could benefit from a routine of setting goals and tracking progress, speak with a therapist or doctor to help get started. With patience and understanding, recovery is certainly within reach.

via Signs Your Loved One is Recovering From Stroke | Saebo

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[WEB SITE] 17 Ways To Help Stroke Survivors Recover Faster – Saebo

If you or a loved one has suffered from a stroke, there are many difficulties that can develop as a result. Primarily, these effects are physical, emotional, and cognitive.

Below, we provide tips on how to overcome these common post-stroke conditions. Keep in mind that dealing with the aftermath of a stroke can be frustrating, but with patience and consistent effort, considerable progress can be made.



Tip 1. Recognize Symptoms of Stroke

One of the most important ways to successfully recover from stroke, is by taking preventative measures such as knowing and recognizing the symptoms of a stroke because immediate treatment can be life saving and greatly affects the chances for a full recovery. Unfortunately the chances of a second stroke occurring increases in stroke survivors. According to The National Stroke Association, about 25% of stroke survivors will experience a second stroke. Within the first 5 years after the first stroke, risk of a second stroke is about 40% higher. Fortunately it is estimated that of all secondary strokes, about 80% of them are preventable with lifestyle changes and medical intervention. Read more about recognizing the symptoms of stroke in men and in women to better prepare you to act FAST.


Tip 2. Walking Again and Foot Drop

Foot drop is the difficulty or inability to lift the front part of the foot because of fatigue or damage affecting the muscles and nerves that aid in its movement. To combat this, using a brace or Ankle-foot Orthoses (AFO) has proven to be a major aid in rehabilitation. These devices prevent the front of the foot from dipping down and disrupting walking movements.

Leg exercises described in this supplementary post after experiencing a stroke are crucial for recovery. While each patient should have a custom exercise routine, personalized for you, there are several exercises that should be included in most every stroke survivor’s regimen. These low-impact strength and stretching leg exercises for stroke recovery are a good complement to use in conjunction with the Saebo MyoTrac Infiniti biofeedback system.

Richard Sealy, director of The Rehab Practice, a private neuro-therapy rehabilitation program in the United Kingdom, regularly works with individuals, families, and caregivers to establish custom exercise routines to aid in recovery from long-term neurological problems, like the damage caused by stroke. While he acknowledges that each patient should have a custom exercise routine specific and personal to their struggles, he recommends a series of exercises for anyone working to strengthen their legs and improve range of motion during stroke recovery.

Rehabilitation of the legs and feet can occur at a faster rate with a combination of the aforementioned exercises and orthopedic aids such as the SaeboStep.The SaeboStep is a unique foot drop brace worn on the outside of the shoe that assists with lifting the toes when walking. It is made to eliminate cumbersome, unreliable splints and braces placed within the shoe.


Tip 3. Dealing with Curled Toes

Often referred to as “curled toes” or “claw toe,” this symptom is caused by a miscommunication between the brain and muscles within the foot. This misfiring of signals causes an issue with controlling muscular movements, leading to over-contracting of the toes and spasticity, a condition where there is a miscommunication between the brain and the muscles in the toes, causing them to over contract.

The best way to regain strength and movement while dealing with this condition is to create a routine with a variety of exercises—toe taps, floor grips, finger squeezes, and toe-extensor strengthening. With effort and repetition, these workouts can make a huge difference in recovery.


Tip 4. Lack of Arm Function

One of the most common deficiencies following a stroke is the impairment of the arm and hand. This typically results in decreased strength, coordination, and range of motion. Those affected are often unable to support their own arms in order to perform rehabilitation exercises. When this occurs it is crucial that you include additional arm support during rehabilitation to avoid the arms becoming weaker due to learned non-use.

Learned non-use occurs when a stroke survivor prefers to use their strong arm because it is easier to move. This tendency makes it even more difficult for a stroke survivor to recover, because challenging the weakened arm with these exercises plays a crucial role in regaining arm function. Often physical therapists and occupational therapists use a technique known as Constraint-Induced Movement Therapy (or CIMT) to challenge a weakened shoulder and make further exercises and drills possible. Mobile arm supports such as the SaeboMAS and SaeboMAS mini help support the weight of the arm, allowing the user to do a much wider range of exercises. For more information about the SaeboMAS and how it can aid in stroke recovery click here.

As with rehabilitating any part of the body with reduced function after a stroke, it is important to consistently repeat the exercises and stretches to strengthen the brain-muscle connections. It is also important to stay positive and try to have fun with your rehab. Here are 35 fun rehab activities for stroke patients to help keep you motivated.


Tip 5. Hand Paralysis

Paralysis is the inability of a muscle to move voluntarily. The National Stroke Association sites as many as 9 out of 10 stroke survivors have some degree of paralysis following a stroke. Rehabilitation and therapy can help to regain voluntary movement, even several years after the stroke takes place.

The primary symptoms of hand paralysis are spasticity (stiff muscles), weakness, and lack of coordination. Fortunately, there are several methods of treatment in addition to therapy to help manage and recover from spasticity. Additional treatments include medications to relax muscles, botox injections (relaxes muscles temporarily), stretching exercises, anti-spasticity orthotics, and functional orthoses. Surgery is another option in the most severe cases.

The least invasive and most permanent treatment for hand paralysis is therapy to rehabilitate the connection between your brain and muscles using neuroplasticity. To make these exercises even more effective and to increase your rate of recovery, it is important to repeat your hand exercises often. By performing exercises repeatedly, you are strengthening that brain-muscle connection.


Tip 6. Difficulty Speaking and Communicating

Another common side effect of stroke is aphasia, which is the inability to speak or understand speech. This is one of the most frustrating side effects for survivors to deal with. It’s estimated that 25 to 40 percent of people who suffer from a stroke develop aphasia, though this condition is not limited to stroke survivors. Aphasia occurs when there is damage to the brain, specifically the left side that deals with language. There are two primary forms of aphasia: receptive aphasia and expressive aphasia. Receptive aphasia is when the individual has trouble understanding what is being said to them. Expressive aphasia is when the individual is having difficulty expressing what they want to say.

When communicating with someone with receptive aphasia, try not to use long complex sentences. When communicating with someone with expressive aphasia, it is important to be patient and remember that the person’s intelligence has not been affected by the stroke, just their ability to speak.

For those with aphasia, the most important thing you can do to improve your communication is to take a deep breath and try to relax. If you can remain relaxed and focus on what you are trying to say you will have much greater success. It is easy to get flustered or feel self conscious, but you shouldn’t. Create tools that you can use to make communication easier such as a book of words, pictures, phrases, or symbols that can help you get your message across. If you are going out and know you will not be around friends or family, it may also be helpful to carry a card or piece of paper that indicates that you have aphasia and explains what it is, just in case you find yourself needing to explain your condition.

Once these tools are set in place, seeking the help of a speech-language pathologist (SLP) can greatly increase one’s ability to regain normal speech behavior. SLPs can assist in rehabilitating all types of physical speech behavior and offer support and proper guidance for you or a loved one. Read more about aphasia and recovery here.


Tip 7: Coping with PTSD After Stroke

Following a stroke, it is fairly common for a survivor to experience PTSD, or Post-Traumatic Stress Disorder. This condition is usually associated with combat veterans and sexual-assault survivors; however, according to a study published in the journal PLoS One, almost a quarter of stroke survivors experience some form of PTSD.

Common symptoms of PTSD include the victim experiencing the traumatic event over and over in their head or in the form of nightmares. This replaying of the event is typically accompanied by the individual’s unyielding anxiety and feelings of self doubt or misplaced guilt over their condition. Some experience a state of hyperarousal or feelings of being overly alert.

The two main treatments for PTSD include medications such as antidepressants, anti-anxiety medications or psychotherapy. If you are experiencing PTSD, it is important that you communicate how you feel with your doctor, family, and friends, as a strong support system can help you find the relief from psychological pain that you deserve.


Tip 8: Understanding Fatigue

Feeling tired is a normal part of life for everyone, but for stroke survivor, fatigue is a very common symptom that can be frustrating to deal with. About 40 to 70 percent of stroke survivors experience fatigue, which can make recovering feel even more difficult. Post-stroke fatigue is draining both physically and emotionally/mentally, and rest may not be the only solution.

It is important to discuss the fatigue with a doctor so they can rule out potential medical causes or determine if fatigue might stem from current medications. By speaking with the proper medical professionals and taking time to squeeze in a nap or rest as often as possible—and by maintaining a positive mindset—you can help yourself or a loved one combat the constant drowsiness of fatigue and work on returning to pre-stroke energy levels. The key thing to realize is that some level of post-stroke fatigue is normal and that survivors need to be proactive about treating and working around it.


Tip 9: Counteract Learned Non-Use

If the limbs weakened after stroke are not consistently exercised over time, muscles have the potential to atrophy—waste away due to cell degeneration. This often occurs when the person tries to compensate for their weak limb by using their stronger limb more often. Daily attempts to move the affected limbs are necessary to maintain and improve functionality.One method is the use of Constraint-Induced Movement Therapy (CIMT). CIMT is a form of therapy that prevents the unaffected limbs from moving while trying to exercise the affected ones.


Tip 10: Reduce Inflammation and Stress

Inflammation in the body can cause other issues to arise, which is why it’s important to stay stress free whenever possible. When stress does begin to take hold, a hormone called cortisol floods the body, causing pH levels to become imbalanced with acidity. High acidity levels—after an extended period of time—can kill good bacteria in the body while giving rise to bad bacteria, ultimately weakening the immune system.

With that in mind, a natural probiotic like yogurt is a great way to boost good bacteria in the body. Supplemental drinks can also improve the immune system significantly. In addition to pH balance, adopting stress management exercises such as yoga, deep breathing, tai chi, qi gong, and meditation, can limit one’s cortisol levels, promoting overall health.


Tip 11: Coping with Emotional Effects

Experiencing a stroke is not only a major hardship to overcome physically; it can also take a huge toll on a survivor’s emotions in many ways.

If the area of your brain that controls personality or emotion is affected, you may be susceptible to changes in your emotional response or everyday behavior. Strokes may also cause emotional distress due to the suddenness of their occurrence. As with any traumatic life experience, it may take time for you or your loved one to accept and adapt to the emotional trauma of having experienced a stroke.

Some common emotional changes strokes may cause are PseudoBulbar Affect, depression, and anxiety. Thankfully, there are several methods for treating the emotional changes associated with a stroke, with the first step being to discuss how you or your loved one is feeling with a doctor. Treatment may consist of one, or a combination, of the following: one-on-one counseling, group counseling, medication, diet, and exercise. The most effective treatment is different for everyone, so it is important to discuss and explore which combination works best for your or your loved one.


PseudoBulbar Affect

Sometimes referred to as “reflex crying,” “emotional lability,” or “labile mood,” PseudoBulbar Affect (PBA) is a symptom of damage to the area of the brain that controls expression of emotions, and it is one of the most frequently reported post-stroke behaviors. Characteristics of the disorder include rapid changes in mood, such as suddenly bursting into tears and stopping just as suddenly or even beginning to laugh at inappropriate times.



Survivors have a one in four chance of developing serious depression as a side effect of stroke. If you are feeling sad, hopeless, or helpless after having suffered a stroke, you may be experiencing this. Other symptoms of depression may include irritability or changes to your eating and sleeping habits. Talk to your doctor if you are experiencing any of these symptoms, as it may be necessary to treat with prescription antidepressants or therapy to avoid it becoming a road block to your recovery.

Along with medication and therapy, a lot of research shows that a few simple lifestyle changes help relieve the symptoms of depression. If you or a loved one is having a difficult time coping with the emotional repercussions of a stroke, here are tips on how to implement positivity and resilience:

  • Attend a support group. Talking about your struggles with people in the same situation makes you feel less lonely and can offer helpful insight or different approaches to dealing with difficulties.
  • Eat healthy food. A good diet is important for your general health and your recovery from stroke and can also improve your mental health.
  • Remain socially active. Although you may not be able to do as much as you used to, it’s crucial to stay in touch with family and friends and take part in social activities.
  • Be as independent as possible. Humans need to feel independent and competent. Stroke recovery may require the help of caregivers, but if there are things that you can safely do by yourself, insist on it.
  • Exercise regularly. Physical activity, especially a low-impact one like walking, is proven to boost mental health and will also contribute to your recovery.



Tip 12: Set Recovery Goals with Your Therapist

Setting specific and meaningful goals can help keep one focused and motivated once they are achieved, and these goals can range from simple tasks to long-term accomplishments. By establishing a list consisting of difficulties and goals, overcoming obstacles can be put within reach.

When setting these goals, working with a therapist, doctor, or close friend can be a good way to find encouragement, as well as assistance in creating a list that places goals into an appropriate timeframe. Overall, a therapist will be familiar with your case, understanding the issues and complications, and will be able to offer sound advice in all aspects of recovery.


Tip 13: Stay Motivated

Since apathy is common during stroke recovery, staying motivated can be a challenge. Combining one’s interests with a solid rehabilitation regimen can effectively eradicate feelings of lethargy and depression. The best thing to do is to focus on a reason for recovery and to associate it with your plan of action. This can be done by implementing sentimental items into daily routines, thus giving you personal and motivational support at all times. For example, if one of your routines is to write a list of things to do for the day, try writing it on the back of a special photo. That way, as you’re checking things off, you’ll have a little reminder to keep you motivated.


Tip 14: Watch Out For The Recovery Plateau Stage

The recovery plateau stage refers to the point at which a stroke survivor begins to see a slow down or stop in the progression in their recovery. Some of the most significant improvements often occur in the subacute phase, which is usually the first three to six months after the stroke  (though there is anecdotal evidence of people making significant stroke recovery progress outside of that zone.)

Seeing improvement in the early days of a survivor’s recovery can make it a lot easier for them to stay motivated and continue working hard in therapy. Research shows that further recovery is still very possible after the plateau stage though, which is why it is so important to have a strong support system to encourage you to continue with therapy and working on recovery.


Tip 15: Working After Stroke

Since the brain is a major organ affected when it comes to strokes, chances are that some of its functions may have trouble performing like they did before. After a stroke, learning new things, or even just recalling information can be a challenge, and working through thoughts may suddenly be difficult.

After rehabilitation, many stroke survivors do find themselves able to return to work, but preparing for this transition can come with a lot of questions. Are you physically going to be able to perform your job? Will your disability benefits lapse? What do you need to communicate with your employer? These can be tough questions, but they do have answers. Some may not ever be able to go back to the same work, but for others, just a little assistance is needed.

When you are ready to return to work, it is important to know your rights and what your employer is, and is not, legally required to provide to employees with disabilities. Keep in mind that if you are unable to perform the essential functions of your job even with reasonable accommodation, your employer is not obligated to offer you a different position or create a new role for you. They might be willing to anyway, but it is not a requirement.


Tip 16: Understand and Combat Memory Loss

Not only is it common for stroke survivors to experience, but memory loss can affect a wide range of people through multiple factors. Age, physical trauma, and emotional stress have the potential to cause memory decline, but rebuilding memory’s strength is highly possible and can be fun.

Specifically, incorporating technology into daily rehabilitation exercises is a great way to show quick improvements. There are numerous apps for smartphones and tablets that use different techniques to significantly improve memory, and they have the ability to set reminders, schedule appointments, and oversee other illnesses.


Tip 17: Be Aware of Vascular Dementia

A common problem among stroke survivors, this symptom disrupts cognitive functions, which can make it challenging for one to sort out information.

Due to the damage of blood vessels from a stroke, blood pressure, cholesterol, and blood sugar must be maintained at healthy levels to ensure good blood flow throughout the body. If you are diabetic, it is crucial that you are paying careful attention to your blood sugar and insulin levels. Studies have shown that by managing these three components, vascular dementia can be decreased or prevented.

Helping Stroke Survivors Help Themselves

The process of stroke recovery is long and full of ups, downs, twists, and turns. It takes hard work and dedication to regain mental and physical function after a stroke. The information and tips above will help you to identify and overcome the many challenges that come with recovery.

To read our answers to the most common stroke recovery questions, click here. And remember, at the end of the day, there are dozens of approaches you can take to improve the speed of stroke recovery.

All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the Saebo website is solely at your own risk.

via 17 Ways To Help Stroke Survivors Recover Faster | Saebo

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[ARTICLE] The Relationship between Poststroke Depression and Upper Limb Recovery in Patients Admitted to a Rehabilitation Unit – Full Text PDF


Objective: We sought to determine the relationship between poststroke depression and upper limb recovery in a cohort of patients admitted to a rehabilitation center in Singapore.

Method: We conducted a secondary analysis of an interventional study of 105 patients with a stroke. Depression was diagnosed using the Centre for Epidemiological Studies Depression Scale (CES-D) and this was correlated with the following measures: Fugl-Meyer Assessment of Upper Limb (FMA), Action Research Am Test (ARAT), Stroke Impact Scale – Upper Limb Items (SIS) and Functional Independence Measure-Selfcare (FIM-Selfcare) at 3, 7 and 15 weeks after admission to rehabilitation.

Results: Poststroke depression was present in 20% of patients on admission to rehabilitation. It was negatively correlated to SIS and FIM-Selfcare at 7 weeks and to FMA, ARAT, SIS and FIM-Selfcare at 15 weeks after rehabilitation admission. Depression on rehabilitation admission did not influence upper limb recovery at 3 weeks, 7 weeks, and 15 weeks after admission to rehabilitation.

Conclusion: Given the negative impact of depression on upper limb impairment, function and performance of selfcare, routine screening of depression should be considered in subacute stroke patients, especially in those with poorer upper limb function.

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[Editorial] Motor Priming for Motor Recovery: Neural Mechanisms and Clinical Perspectives – Neurology

Editorial on the Research Topic

Motor Priming for Motor Recovery: Neural Mechanisms and Clinical Perspectives

The Oxford dictionary defines the term priming as “a substance that prepares something for use or action.” In this special issue, we define motor priming as a technique, experience, or activity targeting the motor cortex resulting in subsequent changes in motor behavior. Inadequate functional recovery after neural damage is a persisting burden for many, and this insufficiency highlights the need for new neurorehabilitation paradigms that facilitate the capacity of the brain to learn and recover. The concept of motor priming has gained importance in the last decade. Numerous motor priming paradigms have emerged to demonstrate success to improve functional recovery after injury. Some of the successful priming paradigms that have shown to alter motor behavior and are easily implementable in clinical practice include non-invasive brain stimulation, movement priming, motor imagery, and sensory priming. The full clinical impact of these priming paradigms has not yet been realized due to limited evidence regarding neural mechanisms, safety and effectiveness, dosage, individualization of parameters, identification of the appropriate therapies that need to be provided in combination with the priming technique, and the vital time window to maximize the effectiveness of priming. In this special issue, four manuscripts address critical questions that will enhance our understanding of motor priming paradigms and attempt to bridge the gap between neurophysiology and clinical implementation.

In their study, “Non-Invasive Brain Stimulation to Enhance Upper Limb Motor Practice Poststroke: A Model for Selection of Cortical Site,” Harris-Love and Harrington elegantly address the extremely important issue of individualizing brain stimulation for upper limb stroke recovery. Many brain stimulation techniques show high interindividual variability and low reliability as the “one-size-for-all” does not fit the vast heterogeneity in recovery observed in stroke survivors. In this article, the authors propose a novel framework that personalizes the application of non-invasive brain stimulation based on understanding of the structural anatomy, neural connectivity, and task attributes. They further provide experimental support for this idea with data from severely impaired stroke survivors that validate the proposed framework.

The issue of heterogeneity poststroke is also addressed by Lefebvre and Liew in “Anatomical Parameters of tDCS to modulate the motor system after stroke: A review.” These authors discuss the variability in research using tDCS for the poststroke population. According to the authors, the most likely sources of variability include the heterogeneity of poststroke populations and the experimental paradigms. Individually based variability of results could be related to various factors including: (1) molecular factors such as baseline measures of GABA, levels of dopamine receptor activity, and propensity of brain-derived neurotropic factor expression; (2) time poststroke, (3) lesion location; (4) type of stroke; and (5) level of poststroke motor impairment. Variability related to experimental paradigms include the timing of the stimulation (pre- or post-training), the experimental task, and whether the protocol emphasizes motor performance (a temporary change in motor ability) or motor learning based (more permanent change in motor ability). Finally, the numerous possibilities of electrode placement, neural targets, and the different setups (monocephalic versus bi-hemispheric) add further complexity. For future work with the poststroke population, the authors suggest that tDCS experimental paradigms explore individualized neural targets determined by neuronavigation.

In another exciting study in this issue, Estes et al. tackle the timely topic of spinal reflex excitability modulated by motor priming in individuals with spinal cord injury. The authors choose to test four non-pharmacological interventions: stretching, continuous passive motion, transcranial direct current stimulation, and transcutaneous spinal cord stimulation to reduce spasticity. Three out of four techniques were associated with reduction in spasticity immediately after treatment, to an extent comparable to pharmacological approaches. These priming approaches provide a low-cost and low-risk alternative to anti-spasticity medications.

In another clinical study in individuals with spinal cord injury, Gomes-Osman et al. examined effects of two different approaches to priming. Participants were randomized to either peripheral nerve stimulation (PNS) plus functional task practice, PNS alone, or conventional exercise therapy. The findings were unexpected. There was no change in somatosensory function or power grip strength in any of the groups. Interestingly, all of the interventions produced changes in precision grip of the weaker hand following training. However, only PNS plus functional task practice improved precision grip in both hands. The authors found that baseline corticospinal excitability were significantly correlated to changes in precision grip strength of the weaker hand. The lack of change in grip strength in any of the groups was surprising. Previous evidence suggests, however, that the corticomotor system is more strongly activated during precision grip as compared to power grip, and the authors suggest that interventions targeting the corticomotor system (i.e., various priming methods) may more strongly effect precision grip.

Overall, this special issue brings together an array of original research articles and reviews that further enhance our understanding of motor priming for motor recovery with an emphasis on neural mechanisms and clinical implementation. We hope that the studies presented encourage future studies on motor priming paradigms to optimize the potential for functional recovery in the neurologically disadvantaged population, and further our understanding of neuroplasticity after injury.

Author Contributions

SM and MS have made a substantial, direct, and intellectual contribution to the work and approved it for publication.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


SM is supported by funding from the National Institutes of Health (R01HD075777).

Source: Frontiers | Editorial: Motor Priming for Motor Recovery: Neural Mechanisms and Clinical Perspectives | Neurology

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[Abstract] Motor Recovery Beginning 23 Years After Ischemic Stroke


It is widely believed that most stroke recovery occurs within 6 months, with little benefit of physiotherapy or other modalities beyond a year. We report a remarkable case of stroke recovery beginning 23 years after a severe stroke due to embolization from the innominate artery and subclavian artery, resulting from compression of the right subclavian artery by a cervical rib. The patient had a large right fronto-parietal infarction with severe left hemiparesis, and a totally non-functional spastic left hand. He experienced some recovery of hand function that began 23 years after the stroke, a year after he took up regular swimming. As a result, intensive physiotherapy was initiated, with repetetive large muscle movement and a spring-loaded mechanical orthosis that provides resistance to finger flexors and supports finger extensors. Within two years he could pick up coins with the previously useless left hand. Functional MRI studies document widespread distribution of the recovery in both hemispheres. This case provides impetus not only to more intensive and prolonged physiotherapy, but also to treatment with emerging modalities such as stem cell therapy, exosome and micro-RNA therapies.

Source: ARTICLES | Journal of Neurophysiology

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[ARTICLE] Standardized measurement of sensorimotor recovery in stroke trials: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable – Full Text 

Finding, testing and demonstrating efficacy of new treatments for stroke recovery is a multifaceted challenge. We believe that to advance the field, neurorehabilitation trials need a conceptually rigorous starting framework. An essential first step is to agree on definitions of sensorimotor recovery and on measures consistent with these definitions. Such standardization would allow pooling of participant data across studies and institutions aiding meta-analyses of completed trials, more detailed exploration of recovery profiles of our patients and the generation of new hypotheses. Here, we present the results of a consensus meeting about measurement standards and patient characteristics that we suggest should be collected in all future stroke recovery trials. Recommendations are made considering time post stroke and are aligned with the international classification of functioning and disability. A strong case is made for addition of kinematic and kinetic movement quantification. Further work is being undertaken by our group to form consensus on clinical predictors and pre-stroke clinical data that should be collected, as well as recommendations for additional outcome measurement tools. To improve stroke recovery trials, we urge the research community to consider adopting our recommendations in their trial design.

Lack of a standardized approach to measurement in stroke recovery research hampers our ability to advance understanding of recovery mechanisms, devise better treatments and consolidate knowledge from a body of research using meta-analyses.1 As examples, examination of a recent Cochrane Overview of interventions to improve upper limb function after stroke identified 208 unique assessment tools from 243 trials2; another review found more than 100 measures of activities of daily living (ADLs).3 Furthermore, in most motor rehabilitation trials, measures are taken at arbitrary time points relative to stroke onset, e.g. time of admission to, or discharge from, rehabilitation rather than at standard time points aligned with underlying recovery processes.4

We must challenge the common assumption that most sensorimotor therapies are universally applicable and will achieve the same benefit for all people with stroke. The magnitude of change and likelihood of achieving clinically meaningful improvement in response to specific therapies will depend on age, stroke severity, and other factors including pre-existing comorbid conditions (e.g. diabetes, cognitive impairment, depression)5 and pre-stroke lifestyle factors (e.g. social engagement, exercise).6 The respective contributions of these factors have yet to be fully understood. Going forward, we need to identify the determinants that may help predict responders and non-responders to interventions.

The measurement working group of the Stroke Recovery and Rehabilitation Roundtable (SRRR)7 was established to develop recommendations for standardized assessment time points and measures to be included in all adult trials of sensorimotor recovery after stroke. Given the current lack of standards for data collection and heterogeneous reports in stroke recovery trials, our expert group also considered pre-stroke clinical, demographic and stroke-related data that should be collected to improve clinical prediction of recovery and characterization of patient cohorts.

The decision to focus on sensorimotor recovery reflects the volume of existing trials in this area, the range of outcomes currently in use across these trials, and the gap in current research that known international initiatives has not addressed (e.g. Core Outcome Measures in Effectiveness Trials Initiative (COMET), National Institute of Neurological Disorders and Stroke Common Data Elements (NINDS CDE), The International Consortium for Health Outcomes Measurement (ICHOM),8 Improving Research Outcome Measurement in Aphasia (ROMA)9 and Standardization of Measures in Arm Rehabilitation Trials after Stroke (SMART), Supplementary Table 1). Acknowledging that clinical measures cannot distinguish between true neurological repair (behavioral restitution) and use of compensatory strategies,10 a second objective was to consider whether we could recommend specific kinetic and/or kinematic outcomes that reflect quality of motor performance in order to better understand the neurophysiological changes that occur when patients improve.11,12 Our overall objective of the roundtable was to provide recommendations that, if applied, could improve the methodology of rehabilitation and recovery trials, help build our understanding of the trajectory of stroke recovery and aid discovery of new and more targeted treatments.

Continue —>  Standardized measurement of sensorimotor recovery in stroke trials: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation RoundtableInternational Journal of Stroke – Gert Kwakkel, Natasha A Lannin, Karen Borschmann, Coralie English, Myzoon Ali, Leonid Churilov, Gustavo Saposnik, Carolee Winstein, Erwin EH van Wegen, Steven L Wolf, John W Krakauer, Julie Bernhardt, 2017

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[Abstract] Motor Recovery Beginning 23 Years After Ischemic Stroke – Journal of Neurophysiology


It is widely believed that most stroke recovery occurs within 6 months, with little benefit of physiotherapy or other modalities beyond a year. We report a remarkable case of stroke recovery beginning 23 years after a severe stroke due to embolization from the innominate artery and subclavian artery, resulting from compression of the right subclavian artery by a cervical rib. The patient had a large right fronto-parietal infarction with severe left hemiparesis, and a totally non-functional spastic left hand. He experienced some recovery of hand function that began 23 years after the stroke, a year after he took up regular swimming. As a result, intensive physiotherapy was initiated, with repetetive large muscle movement and a spring-loaded mechanical orthosis that provides resistance to finger flexors and supports finger extensors. Within two years he could pick up coins with the previously useless left hand. Functional MRI studies document widespread distribution of the recovery in both hemispheres. This case provides impetus not only to more intensive and prolonged physiotherapy, but also to treatment with emerging modalities such as stem cell therapy, exosome and micro-RNA therapies.


Source: ARTICLES | Journal of Neurophysiology

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