Stroke Recovery & Rehab

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October 2019: Bernhardt, Borshmann, Kwakkel et al (2019) Setting the scene for the second stroke recovery and rehabilitation roundtable. International Journal of Stroke, 4(5), 450-456, DOI ttps://doi.org/10.1177/1747493019851287

It’s hugely, hugely encouraging to hear about the work of international collaboratives like this one. I’ve been involved in one of the sub-groups and again, this is also hugely encouraging and energising. After all, why not approach stroke recovery from an international perspective; taking what is done best in one country and applying it in another, and learning lessons from the less effective practices and models of care? When it comes to improving outcomes for those directly affected by stroke, an international “team” approach should be underpinning the clinical practices of every local team. To stay up-to-date on what is happening at an international level, this is the team to follow.

As the authors rightly state, this team includes those who are working with people recovering from stroke right through to researchers like Andrew Clarkson, who are investigating animal models of stroke. This broader perspective and collective provides a richer source of what is, and is not, the very best practice that we can deliver to those directly affected. It also provides the broadest platform on which future research and change can occur. If you have a professional and/or personal interest in stroke recovery and rehabilitation, I commend the work and output of this group to you. If we liken stroke recovery to a ship sailing international waters, this group acts as the rudder mechanisms directing and plotting its course.

This article is freely available. Although it is not reporting original research, it is nevertheless an important publication for those with an interest in stroke recovery.

Neuroplasticity, Stroke Recovery & Learning

August 2019: Carey et al (2019) Finding the intersection of neuroplasticity, stroke recovery, and learning: Scope and contributions to stroke rehabilitation. Neural Plasticity, Article ID 5232374, https://doi.org/10.1155/2019/5232374

My congratulations to Leeanne and her colleagues on this incredible piece of research. The fact that an initial search identified just over 400,000 publications gives you some idea of just how much work was involved in this investigation. The temptation to stop right there must have been very strong indeed. Not only is this research innovative in its research question and methods, it is intriguing in its findings. As the title indicates, the investigators set out to find the intersection between neuroplasticity, stroke recovery and learning, and what they found is portrayed in Figure 3. Interestingly, the findings don’t quite intersect, which may say more about where research is up to, in the evolution of this evidence; because, the connectivity between these three issues is in no doubt at all. That “cognition was the major theme identified”, does not come as any surprise. Other identified themes like “task-based….and activity-based learning” and “experience-dependent learning” provides the therapeutic perspective. This watershed evidence is a “must read” for all those involved in recovery after stroke, I’d suggest. This article is freely available. As always, this is just my “humble opinion”.

PS: To make my blog less complicated, as of this month, I’m only going to post. I’ll leave it to others to comments if they want to.

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.