Congratulations to..

…Maree and Tamsin for gaining the two free places in the March 2018 Neuroplasticity course. There are still free places if you’d like to enrol. To find out more about all the courses I’m offering in 2018, go to the CPDLife® website.

Global Burden of Stroke

February 2018: Feigin et al (2016) Global burden of stroke and risk factors in 188 countries, during 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet Neurology, 15(9), 913–24 http://dx.doi.org/10.1016/ S1474-4422(16)30073-4

I thought I should start off this year talking about stroke prevention. As the old adage says: “Prevention is better than cure”, and this is certainly the case for stroke. Sure, I have digressed from stroke recovery in its purest sense, but actually, all those who have experienced stroke and/or transient ischemic attack or TIA, are at high risk of experiencing another stroke. Therefore, although risk and prevention are not ordinarily a component of the stroke recovery programs discourse, perhaps it should be, because, as Feigin et al found, “90.5% (95% UI 88.5-92.5) of the stroke burden was attributable to the modifiable risk factors analysed, including 74.2% (95% UI 70.7-76.7) due to behavioural factors (smoking, diet and low physical activity)”. If you think the blame lies mainly at the feet of those who appear to have unhealthy lifestyles, you may be surprised to read that these researchers found nearly 30% of all strokes are attributable to air pollution!

It’s important that all health professionals have an understanding of the factors that place some people at higher risk of stroke than others. The articles published by this research collaboration are, in my humble opinion, the most significant publications that those of us working in stroke, could be reading.  As with all Journal Club reviews, you’ll find the abstract and my Humble Opinion, under Journal Club 2018 and under the Global Burden of Disease option in the drop-down menu. This article is freely available from http://www.sciencedirect.com/science/article/pii/S1474442216300734

I’m excited about starting the year on such a significant article. I’m also looking forward to our journeying together in 2018, Isobel

Mindfulness After Stroke

We’re in December again, the festive season of Christmas is fast approaching for some of us, and 2018 will arrive in less than four weeks! The Christmas “message” is about joy and peace. Perhaps this is the craziest thing I have ever done, but this month, I found myself searching for a scholarly article using the search terms of “stroke”, “peace” and “joy”! I’m sure you won’t be surprised to find that my search was not hugely successful, if you’re just talking number of finds! However, it was successful in that it led me across a “small and rickety” bridge that took me to a place where I have now lots to think about, when it comes to spirituality, peace, joy and stroke! This article is such an interesting read. If you can’t read all of it, at least read pages 409-415. It is not publicly available, but don’t forget, you can always contact the author for a copy.

Do you and your family celebrate Christmas, and if so, I wonder what you’ll be doing? My family will be getting together for Christmas lunch at our house. With young children present, it will be noisy, chaotic, messy and exhausting; but oh, so much fun! I suspect joy will win out over peace, but eventually peace will come. On the turn of 2017 to 2018, I have three wishes for you:

  1. Some enjoyable, peaceful and relaxing time with those previous to you
  2. A rewarding and interesting year in 2018, no matter how challenging and/or blessed.
  3. All the very best in wherever your professional journey takes you.

For me, 2017 has been a busy year with the launch of the book, so here’s hoping 2018 is a little less busy. I’ll be taking a break over Christmas/New Year, so there will be no Journal Club in January. It will re-start in February.

A very special thank you to all my faithful blog followers. I look forward to continuing our “changing stroke” journey together in 2018.

Cognitive Rehabilitation

November 2017 Gamito et al (2017) Cognitive training on stroke patients via virtual reality-based serious games, Disability and Rehabilitation, 39(4), 385-388, DOI: 10.3109/09638288.2014.934925

I’m often asked: What interventions have proven efficacy to improve cognition outcomes after stroke? Or, put another way, if I need to do cognitive rehabilitation, what should I be doing? Good questions! There are many who claim to be doing cognitive rehabilitation, and they are keen to tell you what they do and why; however, there is very little research into what works and what doesn’t work. But fortunately, this is starting to change. This month’s journal article demonstrates that prescribing virtual reality-based serious games can improve attention and memory outcomes after stroke. If you’re interested in cognitive rehabilitation after stroke, this article is worth reading. For “humble opinion”, please go to Journal Club 2017 and select Cognitive Recovery from the drop down box. This article is not publicly available, but don’t forget that you can always email the corresponding author for a copy.

Stroke Clinical Guidelines

For this month’s journal club, I’ve chosen to feature the Australian Stroke Foundation’s Clinical Guidelines (2017) which were released in September. Clinical guidelines play a very important role in clinical practice and they are increasingly seen by the general public as what should and should not be doing as healthcare professionals.

When we have a question about clinical practice, rather than having to work through all the most recent evidence for ourselves, we can be thankful that an army of colleagues have already done this work for us. I disclose that I was involved in one of the sections relating to activities of daily living, but this does not result in any financial gains. Many countries have their own clinical guidelines, so keep in mind that the ones being featured here in the October Journal Club, are specific to the Australian context.

If you’re a health professional working with people directly affected by stroke, then you should be familiar with the clinical guidelines that are most relevant to your work place. For “humble opinion”, please go do this month’s Journal Club page.

Caregivers and Stroke

September 2017: Krieger et al. (2017) Developing a complex intervention program for informal caregivers of stroke survivors: The Caregivers’ Guide. Scandinavian Journal of Caring Sciences, 31(1), 146-156. DOI 10.1111/scs.12344

Yet again, I had the honour of presenting to therapists on stroke recovery; this time in Sydney. One of the questions we discussed at some length was the answer to the following question: “Whose stroke is it?” This is something I’ve been thinking a lot about in recent years. The processes of documenting stroke in health facilities clearly identifies the stroke as “belonging” to the facility, and yet, the actual stroke leaves the facility inside the head of the survivor. In fact, the long-term impact of stroke eventually falls almost entirely to the survivors and their families and carers. They are the people who carry the burden, who grieve the loss and who live with the stroke’s consequences and complications. As I say, “Whose stroke is it?”

I’ve selected this month’s journal article because these authors are reporting evidence about the impact of stroke on families and the benefits of well organised support framework for families and carers. You’ll find the article’s abstract and “Humble Opinion” in its usual place under this topic on the 2017 Journal Club page. This article is freely available at http://onlinelibrary.wiley.com/doi/10.1111/scs.12344/full

Changing Stroke book

It is my very great pleasure to let you know that my new book titled: Changing Stroke: Radical Rethink of Recovery, is now available!

The book costs AUD$45 and, for Australian customers, this includes GST. Please note, there are additional costs for packaging and postage which are dependent on where you live. To purchase it online, go to: http://www.cpdlife.com/changing-stroke-book/

I tried to write a book that wasn’t too long or too technical. I hope I’ve achieved this, and I hope you enjoy reading it. Regards, Isobel

“Changing Stroke is a must-read for clinicians who work with stroke survivors and who want to make a real difference. It is an essential read for clinicians passionate about optimising stroke recovery using evidence-based therapy, and doing so with empathy.”

Dr Heidi Janssen
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