Diagnosing brainstem stroke & change #ROSIER NOW! 12 tips & Sign/SHARE PETITION!

‘Brain stem strokes can be difficult to diagnose and complex’,  according to Dr. Richard Bernstein, assistant professor of neurology in the Stroke Program at  Northwestern University in Chicago.

In my experience Brain stem stroke from my own stroke and the countless people I have subsequently visited and corresponded with in my working with Fighting Strokes they are routinely misdiagnosed  in under 60 aged patients by frontline staff – paramedics & A&E or ER staff. They often misdiagnose:

 

1. A hemiplegic or complex or atypical migraine
2. Vertigo
3. Dizziness
4. Double vision
5. Slurred speech
6. Severe imbalance and
7. Decreased level of consciousness.
8. Drunk or on drugs like symptoms
9. Pinched nerve
10. Food poisoning
11. Eplipsy
12. Meningitis

This leads me onto thinking what stroke & TIA assessment tools are used by frontline staff and they use #ROSIER ie The Recognition or Stroke in The Emergency Room.  I have long believed that young people are slipping the ‘stroke net’ because of their age and the lifestyle assumptions of frontline staff. I think they rarely consider that a young persons’ symptoms early actually onset stroke. Instead they presume the symptoms are the result if drink, drugs or frequently some sort of migraine and overlook higher than normal blood pressure readings.

Here is pat of the current Rosier assessment tool it so I’m not lying!  Frontline staff specifically look for patients aged 60 and over for signs of stroke so there is a huge age bias! (Especially when we know that 1/4 of all strokes happen in under 60’s!)  THIS MUST BE CHANGED!

More young people than ever are reporting TIA and stroke, not just brainstem stroke!  They are of working-age and our medical system is failing them more than ever.  Here is our petition to sign.

 

Resources for Locked-in Syndrome

Running Free: Breaking out from Locked in syndrome Allatt/Stokes http://www.amazon.co.uk/Running-Free-Breaking-Locked-In-Syndrome-ebook/dp/B008G5LRZS

 

 

 

Locked In: A Young Woman’s Battle with Stroke. Mozersky, Judy. The Golden Dog Press, 1996. ISBN 0-919614-64-7.

The Diving Bell and the Butterfly. Bauby, Jean-Dominique. Random House Value Publishing, 1995. ISBN 0-517409-31-3.

 

Other information Sources:

Adapted from “Surviving a Brain Stem Stroke”, Stroke Connection January/February 2003 and http://www.strokeassociation.org/STROKEORG/AboutStroke/EffectsofStroke/Brain-Stem-Stroke_UCM_310771_Article.jsp#mainContent

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So what does the brainstem do? Well it controls all basic activities of the central nervous system: consciousness, blood pressure, and breathing. All the motor functions are controlled by it. It’s like our body’s control box.  Brain stem strokes can impair any or all of these functions. “These complications are often predictable and, with prompt recognition, can be treated,” Dr. Bernstein says. “If complications are dealt with quickly, there is a good chance of recovery.”

More severe brain stem strokes can cause Locked in Syndrome –http://cirrie.buffalo.edu/encyclopedia/en/article/303/ a condition in which survivors can move only their eyes.

“It is important that the public and healthcare professionals know all of the symptoms of a stroke and are aware that some brain stem strokes heave distinct symptom,” Dr. Bernstein says. “Patients need to receive treatment as soon as possible to promote the best recovery.”

Like all strokes, brain stem strokes produce a wide spectrum of deficits and recovery. Over time, these symptoms could result  in mild to moderate and short to long term difficulties.

Risk factors for brain stem stroke are the same as for strokes in other areas of the brain: high blood pressure, diabetes, heart disease, atrial fibrillation and smoking. Like strokes in other areas of the brain, brain stem strokes can be caused by a clot or a hemorrhage. There are also rare causes, like injury to an artery due to sudden head or neck movements. This was my actually the cause of my injury.

“Dramatic recovery from a brain stem stroke is possible,” says Dr. Richard Harvey, director of stroke rehabilitation at the Rehabilitation Institute of Chicago. “Because brain stem strokes do not usually affect language ability, the patient is able to participate more fully in rehabilitation therapy. Most deficits are motor-related, not cognitive. Double vision and vertigo commonly resolve after several weeks of recovery in mild to moderate brain stem strokes.”

 

 

 

#Strokerecovery & technology tweetchat – Here’s what you said.

What an amazing tweetchat!

Our engagement with you doubled from last month, we all wrote 559 tweets, had 50 participants, received 726,202 impressions, with key influencers were @fightingstrokes, @stroketattler, @dailycaring & @sissstroke.  No wonder my fingers were on fire!  Thank you v much, it was fun and informative.  We were absolutely delighted to receive a tweet from the @natlstrokeassoc (see below)

 

So here’s what I gleaned from our #strokerecovery & technology tweetchat tonight but feel free to study the symplur #strokerecovery transcript if you like.

We asked you:

T1. What technology do you use/offer in #strokerecovery therapy?

You said:

• Electrical stimulation albeit it was offered tom slowly in the community at 11 months
• Scheduling apps to coordinate family visits
• Apps to help with aphasia and alarms to take medication
• Wii gaming technology for rehabilitation which also involved your children, though it doesn’t work for everyone.
• Blogging in itself helped keep the brain active and was used in #strokerecovery
• @natlstrokeassoc – ‘Wii, Constraint Therapy, Bioness, WalkAid, Mobile apps for aphasia, Myopro, sling supported treadmills.

T2. Is there some technology that you would use? Is it just about cost?

• The IREX system ie, uses immersive video gesture control technology to place patients into virtual sport or gaming environments http://www.gesturetekhealth.com/products-rehab-irex.php
• Transcranial electromagnetic stimulation for aphasia
• Electrical stimulation products
• We would use basic products which would be the basis for more complex based activities

T3. What the main barriers to treating stroke patients?

• A lack of knowledge of available products
• Costs/funding perhaps leasing arrangements is one solution?
• Lack of SALT therapist time.
• Mood, time, mood, depression, fatigue, therapy time, muscle tightening and available technology
• Insurance Companies not applying the ICF model. Ie, The ICF classification system focuses on human functioning and provides a unified, standard language and framework that captures how people with a health condition function in their daily life rather than focusing on their diagnosis or the presence or absence of disease.
• Huge lack of technology-based research for aphasia and cognition.
• Lack of evidence-based research for cognitive rehabilitation.
• We don’t share information enough with patients & families at home.
• Families are overworked with assisting with daily living activities. (Teasell)
• Families are crucial and there is again a lack of clinical evidence.
• Clinicians and academics must work better together. Things get lost in translation.
• Patient input is vital at every stage.

 

T4. Can we overcome those technological intervention barriers? Is it not just cost?  

• Yes cost and funding are issues, need lease agreements and insurance company education?
• Computer-based or web-based therapies to help aphasic patients.
• Overcome fatigue with early diagnosis, pharma drugs, psychological counselling CBT talking therapy, physical exercise.

 

I’m certainly going to find out more about the CogWatch product which helps with daily living activities. This is CogWatch is a European Commission funded research project whose aim is to enhance the rehabilitation of stroke patients, a third of whom will experience long term physiological and/or cognitive disabilities. A significant proportion of these patients can suffer from Apraxia or Action Disorganisation Syndrome (AADS) which, among other symptoms, is demonstrated by the impairment of cognitive abilities to carry out activities of daily living (ADL).

 

We failed on tweeting ideas based on finding out about evidence-based technology and I think we should share this in a tweetchat in the future.  I’m going to sign off and feed my hungry kids now but I’ll leave you with this poignant tweet I received that,

 

‘People want to feel ‘normal’ & to do things for themselves.’

Social media strategy – Our top 15 tips #fightingstrokes

 

We’ve been very active on social media with our registered charity, Fighting Strokes – Fighting Strokes, @Fightingstrokes, Youtube and Instagram – which has resulted in raising awareness, engagement, followers and #strokerecovery interaction online.  So being the sharing type, I thought I’d  impart my knowledge of a health care social media ‘charity’ marketing.

1. Identified our audience:

Fighting Strokes is attempting to inspire, empower and influence all types of stroke survivors, their friends and family, clinicians, researchers and therapists. We have an interest in promoting stroke recovery issues which affect younger #strokesurvivors and acute brainstem stroke with locked in syndrome survivors. With so many voices banging the drum about #stroke prevention and our experience,  we instead choose to try to practically speak up about issues in stroke recovery.

 

2.  Identifies and set up the social media platforms

These included: Fighting Strokes, @Fightingstrokes, Youtube and Instagram

 

3. Then, we decided what we wanted to achieve in social media!

We wanted to raise awareness of the #stroke treatment and stroke self-management options and to grow our Twitter followers & Facebook likes by 15 per week.

 4. We agreed our budget

£0,000’s!

5. We decided how much TIME to commit to SM

We tried scheduling our tweets to reach more followers, to drive traffic to our blogs – Stroke Recovery Tips & Arockystrokerecovery – to reach new followers and make more efficient use of our time, but we couldn’t get on with Buffer (other ones include Tweroid, SocialOomph, Hootesuite, Tweetdeck).

6. Informative, informal content – are us!?

We decided that dynamic, informative and interactive content would distinguish us from other stroke charities. There would be a place for humour if appropriate also.

7. We look at what key opinion leaders in healthcare are doing

We look at other organisations we respect to see what they are doing well, not doing well and how they interact with their followers and established a hashtag on symplur.

8. Set up a Symplur Hastag

We established the #strokerecovery hashtag and use monthly tweetchats to grow our audience with @StrokeTattler. We plan to establish webinars later this year too.

9. Monitoring social media  

We use Tweetchat and symplur although Sumall is another type of monitoring app.

9. Google Analytics measures our activity

There are many ways to measure activity but we found Google Analytics as the best free software to use. Some measuring apps track the number of follower you attract, retain and what people are saying about our charity too. Other free sites include addictmatic, google alerts, hootsuite and howsociable

10. Mobile phone friendly

We plan to create a mobile friendly website and build an ‘opt-in’ subscriber list.

11. Headline: ‘What did Churchill and Thatcher have in common?’

We know people prefer to look at impactful pictures and short videos so we try to incorporate into our posts with links. We also try to use engaging headlines. eg

‘Clinical patient dignity is not equal to real patient dignity, trust me!‘

12. Shorten links

We try to shorten our links to make it easier to refer to on Instagram and to write more on Twitter. We use bitly.com.

13. Cross link with Instagram, linkedin and Facebook

It makes a lot of sense to use the same posts across different platforms using software like Hootsuite, Tweetdeck and Seesmic.

14. SM profiles

We try to maximise our word count in our profiles with specific description, hashtags, links and pictures. We always try to play with our profiles and update pictures reasonably regularly.

15. Real time posts

We only post in real time and have started trying to ‘pin’ tweets. Twitter  allows you to pin one tweet at the top of your timeline. You can use this to make sure your important messages are seen or if you want a specific tweet to get more retweets.

 

So, I hope my social media strategy summary is useful and helps you to drive followers, traffic, engagement and interaction to your non-profit organisation too!

 

NEW EBOOK!

I Am Still The Same -Self help stroke recovery tool

Internationally published author ‘Running Free’ (Amazon) .  Speaker –   Founder Fighting Strokes

Kate’s story in 2 minutes

5 years after my massive #stroke & still a rocky #strokerecovery for me!

Joan Armatrading’s lyrics from her best selling single, ‘The Weakness In Me’ summed up my high anxiety (which turned out to be my obsessive motivation in ICU and stroke rehabilitation) when she sang:

‘I need to see you, I need to hold you.’ Of course I am referring to our fabulous young children – India, Harvey and Woody.

I couldn’t speak, move, complain, reassure or even hug my beloved children – a basic right for any hands-on mother.  Thankfully, a remarkable and unexpected physical recovery started to happen in 2010 and beyond. In truth, my separation anxiety, my goals, my drive, my motivation and desire to prove the doubters wrong combined with an unshakable self-belief, got me here.

There have been many personal and professional *highs to punctuate the incredible emotional **lows, but perhaps more surprisingly, there have been far more rocky lows.

Will they ever get better? Well, its been 5 years now and depression (summed up by #Banksy below) and anxiety still rear their ugly heads (anxiety over travel, toilet proximity, doing things quickly, people not doing what they promised and letting me down, social exclusion etc) – so I’m not so confident.

A damaged brain is not like a broken arm that gets fixed in time. The biggest gift you can give a brain  injured human is PATIENCE and UNDERSTANDING.  However, that largely stopped when I left hospital in 2010.

Perhaps, the solution is to walk around with a bandage on my head?

So what about the next 5 years?:

The biggest battle I have is not pushing the Holy Grail of a full physical #strokerecovery (which is completely impossible, even if I were to be able to run 70 miles per week again, because I, Kate Allatt, will never be like I was) but controlling my emotional swings. Maintaining my mental health is my number one priority.

My second priority is to gain more influence in ‘stroke recovery patient advocacy’ and stroke policy, both nationally and globally. I want to influence brainstem stroke recovery, enhancing locked in syndrome progress outcomes, emotional, psychological and stroke rehabilitation research.

Thirdly, I plan to continue to stay physically fit so as to remain mentally fit and plan to start group mid week dog walks, to continue twice a week Pilates and widen my social networks.

Fourthly, I want to help get my daughter through her GCSE’s and my youngest son,Woody through his SATs and watch more of Harvey’s football matches – cold weather permitting!

I will never ever stop believing the power of  SELF-BELIEF!! 

* Highs – seeing my broken me, my husband and children mend themselves, my books, founding & running Fighting Strokes, making a difference to some incredible patients and families facing huge difficulties, launching a speaking career, securing (with considerable help) a £250,000 electrical stimulation research grant, invited to the Olympics Opening Ceremony, invited to Buckingham Palace, Cunard, UKSF Steering Group, etc.

Gosh a text book over-achiever – something any student psychologist would easily be able to attribute a cause to.

** Lows – the falls, the incontinence, the pain, the relentless pushing myself, the doubters, the sleeplessness, the anxiety and OCD, coping and supporting my shattered family as a lonely, broken mother and wife , emotional breakdown, PTSD, depression, losing loved-ones and friends, dealing with a lack of societal understanding, residual physical difficulties, social exclusion, slow physical movement, isolation (though I accept my social withdrawal exacerbated the isolation)  and self-esteem issues too, etc.

 

 

NEW EBOOK!

I Am Still The Same -Self help stroke recovery tool

Internationally published author ‘Running Free’ (Amazon) .  Speaker –   Founder Fighting Strokes

Get INVOLVED with the 1st #strokerecovery tweetchat!! @fightingstrokes @stroketattler

 

1. Have a think about what #strokerecovery means to you.
2. Then click on http://www.tweetchat.com
3. Enter the hashtag #strokerecovery and click GO
4. Click Authorise Tweetchat – after inputting your @Twitter handle & password
5. Then start by saying ‘Hi (at 4pm GMT on 13^th Jan) & tweet if you are a #stroke patient, carer, clinician, doctor, charity or researcher. But REMEMBER to always include the all-important hashtag #strokerecovery on all tweets!
6. We will try to respond to your questions or comments & hopefully our #strokerecovery community can not only be better informed but crucially influence #strokerecovery for others.
7. Towards the end of our hour long Tweetchat, we will call for your ideas on future #strokerecovery topics to discuss, share and influence.
8. We will also ask for any recommendations of key guest bloggers to invite at the end of our 1^st Tweetchat on 13^th January 2015 at 4pm GMT.
9. Finally, we will tell you when our next Tweetchat will be.
10. Enjoy we are so excited @FightingStrokes & @StrokeTattler !! (You can always follow us in the meantime?)

 

The Time Zones:

 

 

Make sense?

Thanks @kateallatt

 

NEW EBOOK!

I Am Still The Same -Self help stroke recovery tool

Internationally published author ‘Running Free’ (Amazon) .  Speaker –   Founder Fighting Strokes

New! #strokerecovery tweetchats! Listen, learn, share & improve

Stroke is global healthcare problem. In developed countries, it is the third or fourth most common cause of death.  However as 80% or more people now survive the initial stroke, the largest effect of stroke is through the long-term residual difficulties, daily living activity limitations and reduced social participation/interactivity.  Stroke is the main cause of adult disability.  Physical and emotional  impairments from stroke affect the whole family, not just the person with stroke.

Most stroke survivors and their families want get on with the rest of their lives after stroke —in other words their goal is #strokerecovery. This doesn’t not mean the stroke survivor or family will fully recover like they were pre-stroke. Rather, our #strokerecovery tweetchat aims to practically advise, help and inspire people to make progress in the daily living activities, socially and professionally.   This includes motor, communicative, cognitive and emotional recovery. In other words, it is possible for  stroke survivors and their families can live satisfying lives with impairments.

What is #strokerecovery ?

#strokerecovery is a vibrant community of people interested in exploring stroke recovery in for themselves and in stroke recovery. Sharing, learning & improving from each other.

Our first chat is held on 13th January 2015 at 4pm London time.

Why #strokerecovery ?

Fighting Strokes is a global patient advocate charity which was founded primarily to help inspire and support anyone affected by stroke. We try to help people make progress improvement both physically and emotionally. We also have a special interest in inspiring families and patients affected by brainstem stroke and diagnosed with locked in syndrome to improve.  See here Fighting Strokes.

Who takes part in #strokerecovery ?

Anyone and everyone delivering and receiving health care who is interested in open conversation to help improve quality, access, value and effectiveness of stroke recovery. This includes: patients, caregivers, patient advocates, healthcare professionals, not-for-profit health organisations, educators, heath content providers, health institutions, health administrators, health systems and networks, government and health policy makers.

Join us.

How to take part in #strokerecovery tweet chats.

1. Get a Twitter account!!
2. Go to twubs.com or tweetchat.com.
3. Enter the #strokerecovery in the box that says “Enter a hashtag” and press Enter.
4. Sign in to participate in the chat. (note the hashtag #strokerecovery will automatically be added to your tweets.
5. Review this week’s topics.
6. Be online at 4 pm London time on the 13th of each month.
7. Chat!

Our next tweet chat will discuss:

T2: What the strengths are in our current #strokerecovery systems?

T3: What are the weaknesses in the current #strokerecovery systems?

T4: What should we concentrate on in the initial Tweetchats? 

Tweet Chat Etiquette

1. At the beginning of the Tweetchat or when you join, briefly introduce yourself.
2. Please use #strokerecovery in your tweet.
3. The Tweetchat will be for active for 1 hour, but you can add to the Tweetchat transcript by including #strokerecovery in your posts between chats.
4. The moderator will introduce the questions. Please respond to the current questions.
5. You can respond and add to others posts by replying or favouring.
6. Be kind to others and have fun.
7. Suggest future tweet chats if you like ?

 

 

 

2014 in review of my Arockystrokerecovery blog

The WordPress.com stats helper monkeys prepared a 2014 annual report for this blog.

Here’s an excerpt:

The concert hall at the Sydney Opera House holds 2,700 people. This blog was viewed about 30,000 times in 2014. If it were a concert at Sydney Opera House, it would take about 11 sold-out performances for that many people to see it.

Click here to see the complete report.

12 reasons why meeting The Queen was NOT my highlight in 2014! My review Kate Allatt

This year has been an unprecedented year even by my standards! (though the law of averages meant that I was due a good year both professionally and personally.)

So I’ve chosen my top 12 moments of the year to share with you both from my charity – Fighting Strokes – point of view & from Kate Allatt – the motivational & educational speaker/writer/blogger/consultant.

So here we go..

12.  Fighting Strokes lost a trustee but gained three new trustees who are all utterly fabulous and specialists in their own areas!  Joanna Fletcher-Smith – a specialist occupational therapist researcher at the prestigious Nottingham University.  Kate Scott-Nelson a trained and highly experienced accountant who is employed by Ernst & Young. Finally, we are also delighted to welcome to our team consultant physician in stroke and geriatric medicine, Sarah Blayney.

 

 

11.  Fighting Strokes has been invited to become a member of the prestigious UKSF Steering Committee which guides and influences stroke policy.  We have already raised our profile and respect amongst stroke clinicians, researchers and doctors and personally visited over 18 patients affected by stroke in the UK. This is what Fighting Strokes stands for.

 

 

 

10.  We increased our ‘likes’, followers, reach, engagement & interactivity on all forms of social media we use – Facebook, Twitter, Instagram, Vine, our new Youtube channel & more blog hits to this blog – arockystrokerecovery.com.  We are regularly endorsed for our social media posting activities.  We are also a guest blogger for three other sites and extended our recruitment of social media administrators to share the load/interactivity and inspiration globally.

 

 

9.  We found and sourced  a documentary film Director to explore the ‘myths of locked in syndrome’  and we have been filming for 6 months now.  The Diving Bell & Butterfly film and book only represents one side of this awful illness and prognosis – some people actually recover significantly more movement than initially expected and make more progress.  I’ve always believed these stories need to be told too in the interests of both balance and inspiration and real, not false, hope.

 

 

8.  We secured important  collaborations with Devices 4 Dignity & others and delivered a variety of speeches to preceptorships, nurses and professionals on a variety of subjects including – continence, compassion & dignity, inclusivity, assistive devices and improving patient care in  the NHS.

 

 

7.   I finished writing and then launched my 3rd ebook – I Am Still The Same –  in November 2014. It designed to be a self-help stroke recovery tool. It took 2.5 years to research and write. I hope it practically helps anyone affected by stroke. We tried our best! (Be gentle!)

Kate Allatt (internationally published author of ‘Running Free’ ) and Cheryl Galsworthy have written this practical book which aims to be a self-management tool for anyone affected by stroke or acquired brain injury.

We hope I Am Still The Same will equip survivors with hands-on information to help them manage their own recoveries, both physically and emotionally, after ‘the bomb has exploded.’

What may surprise you is that I Am Still The Same is not just a book about Locked-in Syndrome recovery although the subject is covered.

I Am Still The Same alludes to the fact that the person inside often thinks and feels the same yet their life and others’ attitudes towards them, are now very different.

This book also covers subjects such as coping with cognition and mobility issues, assistive technology, aphasia, childhood stroke and parenting after stroke, the  emotional fallout and other taboos.

Hopefully, sufferers will be able to proactively self-manage their own progress improvement but also benefit from better understanding and empathy from others.

We proudly give a ‘voice’ to other stroke survivors who otherwise are often unheard. The book includes an abridged version of Kate’s own stroke recovery journey.

 

 

6.  Fighting Strokes is absolutely DELIGHTED to announce the new national feasibility study which we hope will help all types of stroke survivors struggling with upper limb disabilities. I always believed that my own recovery was aided by the experimental electrical stimulation that I received applied quite soon on my arms/wrists in rehab.  My experience was also corroborated by other stroke survivors who used electrical stimulation  frequently, repetitively and intensively too themselves privately. They say it has helped to either reduce pain or contractures or gave them positive neuroplasticity or brain re-wiring effects. The feasibility study grant application, that was so impressively formally written by Joanna Fletcher-Smith was approved to the tune of £250,000 by the RfPB!  Perhaps my legacy?  Can you believe the whole idea started from a cheeky Tweet to Joanna! I loved social media before this Tweet, but now I like it even more!

 

 

 

5.  I have secured some phenomenal paid speaking gigs this year which have enabled me to carry on doing my voluntary work with Fighting Strokes – Cunard & BNP Paribas to name a couple – along with appointing a new speaker agent Diana, from  DBA Speakers.

 

 

4.  After months of wrangling we managed to get the dramatisation Rights back for ‘Running Free’ and have recently made some significant progress with an American Emmy award winning TV producer. Watch this space???

3.  I wrote the content for a stroke recovery app … but now I need to secure funding and a key collaborator – could it just be Imperial College London?

 

 

2.  I was also invited on my 44th birthday (and completely coincidentally) to go to a Buckingham Palace Garden Party to honour my charity work with my best friend Al. (Mark was supposed to be away in Dubai in case you were wondering!)

 

 

1.  My family. We have had a traumatic three and a half years but calmness has restored, well for now at least!

Long may it last?  Happy Christmas and a merry new 2015!

 

 

 

 

By @KateAllatt 

NEW EBOOK!

I Am Still The Same -Self help stroke recovery tool

Internationally published author ‘Running Free’ (Amazon) .  Speaker –   Founder Fighting Strokes

Things you must know about arm & hand stroke rehabilitation treatments. #strokerehabilitation #fightingstrokes

stroke rehabilitation interventions

Anyone interested in this was a very useful chapter from Dr Robert Teasell so I’m sharing it.

More stuff on https://m.facebook.com/fightingstrokes?_rdr or https://www.youtube.com/user/fightingstrokes

 

 

Abstract Upper extremity complications are common following stroke and may be seriously debilitating. Regaining mobility in the upper extremities is often more difficult than in lower extremities, which can seriously impact the progress of rehabilitation. A large body of research exists around upper extremity complications but debate continues regarding the timing of treatmentand adequate prognostic factors.This review provides current information regarding upper extremity interventions. Topics include robotic devices for movement therapy, virtual reality technology, spasticity treatment, EMG/biofeedback, transcutaneous electrical nerve stimulation, functional electric stimulation, and hand edema treatment. Neurodevelopmental upper extremity therapy techniques are reviewed along with repetitive/task-specific training, sensorimotor interventions, hand splinting and constraint induced movement therapy.

 

But here are some things you should know:

Initial degree of motor impairment is the best predictor of motor recovery following a stroke. Functional recovery goals are appropriate for those patients who are expected to achieve a greater amount of motor recovery in the arm and hand. Compensatory treatment goals should be pursued if there is an expected outcome of poor motor recovery.

 Attempts to regain function in the affected upper extremity should be limited to those individuals already showing signs of some recovery.

 Neurodevelopment techniques are not superior to other therapeutic approaches in treatment of the hemiparetic upper extremity.

 It is uncertain whether enhanced therapy results in improved short-term upper extremity functioning.

 It is uncertain whether repetitive task specific training techniques improve upper extremity function.

 It is uncertain whether sensorimotor training results in improved upper extremity function.

 It is uncertain whether mental practice results in improved motor and ADL functioning after stroke.

 Hand splinting does not improve motor function or reduce contractures in the upper extremity.

 Constraint-induced movement therapy is a beneficial treatment approach for those stroke patients with some active wrist and hand movement.

 Sensorimotor training with robotic devices improves functional and motor outcomes of the shoulder and elbow; however, it does not improve functional and motor outcomes of the wrist and hand.

 There is preliminary evidence that virtual reality therapy may improve motor outcomes post stroke.

 Hand splints do not reduce spasticity nor prevent contracture.

 Botulinum Toxin decreases spasticity and increases range of motion; however, these improvements do not necessarily result in better upper extremity function.

 Botulinum Toxin in combination with electrical stimulation improves tone in the upper extremity.

 More research is needed to determine the effectiveness of Nerve Blocks for spasticity.

 Physical Therapy may not be effective for reducing spasticity in the upper extremity.

EMG/Biofeedback therapy is not superior to other forms of treatment in the treatment of the hemiparetic upper extremity.

 Intermittent pneumatic compression is not an effective treatment for hand edema.

 It is uncertain whether Transcutaneous Electrical Nerve Stimulation improves outcomes post-stroke

 Functional Electrical Stimulation therapy improves hemiparetic upper extremity function.

 Antidepressant drugs may improve short-term motor performance.

By @KateAllatt 

NEW EBOOK!

I Am Still The Same -Self help stroke recovery tool

Internationally published author ‘Running Free’ (Amazon) .  Speaker –   Founder Fighting Strokes

How to improve patient care in the NHS? @kateallatt

Clinical patient dignity is not equal to real patient dignity, trust me!

 

We talk about patient dignity and compassion all the time but aren’t they simply fashionable new buzz words?

 

In the back of my mind I’m thinking that the phrase ‘patient or person-centred’ feels like a term we often use but don’t actually fully embrace.

 

Being patient-centred is‘where the rules and procedures of the health care fit the person, rather than making the person fit the rules and procedures of the health service’ according to The Royal College of Nursing.

 

We also talk about treating ‘the whole patient’. The phrase sounds nice doesn’t it? So does that mean we treat the whole patient by understanding that patients’ former life, interests, motivations, family AND FRIEND dynamics, before they got ill? If it is then great but this was often not the case with me or other patients..

 

Wouldn’t this help improve patient outcomes, facilitate patients’ earlier discharge home and reduce overall treatment costs?

 

Most patients I engage with via social media through the charity I founded – Fighting Strokes – think these are simply convenient, empty words or slogans.

 

I will always be forever grateful for the knowledge, professionalism, diligence and timeliness of my own brainstem stroke with locked-in treatment action plan.  This started on 7th February 2010 almost immediately after I collapsed at home and continued in the ambulance, ICU and then on in rehab.  I completely understand that the NHS is being squeezed from every angle and at a time when patient treatment expectations are also going through the roof!

 

Without the immediate treatment response I received to my illness, I wouldn’t have been able to return home to be a mother to my three, dependent children and a wife to my husband.

 

But I also wouldn’t have become the VOICE that I am for other stroke survivors globally either.  I like to think I’m a true patient advocate.

 

Stroke recovery, acute locked in syndrome improvement and raising awareness of the physical and emotional post-stroke issues, once ‘the bomb has exploded’,  is my calling, it’s simply not a choice for me.  I received amazing life-saving treatment and I have a second chance of life which I have grabbed with both hands, for as long as I am around!

 

So when we talk of compassion and patient dignity I have one simple rule to help the caring/life-saving profession – TREAT PEOPLE LIKE YOU WOULD WANT TO BE TREATED. Simple!

For example, when a paralysed woman (who is heavily menstruating) is the wrapped up in the standard issue-white-NHS towel after a shower, I suggest that every effort should be made to preserve her dignity and quickly dress her and replace a new incontinence pad. Trust me, it would have helped me manage my anxiety levels enormously.

 

Similarly, don’t ALWAYS send a student nurse to attend a locked-in patient when the patient needs their soiled ‘nappy’ changing as it generally takes four times longer to do, (and with considerably more wipes.) Just because the patient can’t complain, more often than not a qualified nurse should do this task.

 

Finally, when doctors or nurses say they will do something for a patient, but then don’t/can’t, explain this to the individual immediately. Try not to leave the patient waiting.

They will usually respect your honesty and understand that you have had an unforeseen event to attend to ahead of their promised treatment procedure. The patient is also likely to trust you more.

 

It’s not rocket science!

As I stress, please TREAT PEOPLE LIKE YOU WOULD WANT TO BE TREATED (or you would treat your Gran!)

 

 

 

By @KateAllatt 

NEW EBOOK!

I Am Still The Same -Self help stroke recovery tool

Internationally published author ‘Running Free’ (Amazon) .  Speaker –   Founder Fighting Strokes