Estimating the Number of Latent Ranks of the Fugl-Meyer Assessment Score for the Affected Upper Extremity After Stroke

 

 I consider the Fugl-Meyer Assessment completely and totally worthless. NOTHING in that testing gets you recovered!

Using Fugl-Meyer for anything in stroke is the height of stupidity, nothing objective in it, so nothing is repeatable. This is totally against your stroke medical 'professionals' who will defend it and ignore that it does nothing for recovery.

Fugl-Meyer (110 posts to March 2011)

Estimating the Number of Latent Ranks of the Fugl-Meyer Assessment Score for the Affected Upper Extremity After Stroke

Kensuke Hara • Yuta Tauchi • Keisuke Hanada • Takashi Takebayashi

Published: May 16, 2025

DOI: 10.7759/cureus.84210

Peer-Reviewed

Cite this article as: Hara K, Tauchi Y, Hanada K, et al. (May 16, 2025) Estimating the Number of Latent Ranks of the Fugl-Meyer Assessment Score for the Affected Upper Extremity After Stroke. Cureus 17(5): e84210. doi:10.7759/cureus.84210

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Abstract

Many clinical stroke rehabilitation studies have adopted the upper extremity motor section of the Fugl-Meyer Assessment (FMA-UE). In addition, some clinical studies use specific FMA-UE scores as inclusion criteria. However, it remains unclear whether it is appropriate to determine the criterion based on the total score of FMA-UE. This study aimed to determine a highly valid criterion using the latent rank theory (LRT) that can estimate the number of latent ranks of FMA-UE. This was a multicenter cross-sectional study; patients with stroke were recruited from 25 hospitals between March 2018 and April 2022. For all patients, FMA-UE results and participant information were collected. The collected FMA-UE data were divided into proximal and distal items and verified the dimensionality of the data. After that, the LRT was used to determine the latent ranks. Seven ranks were considered the most appropriate for proximal and distal items when estimating the number of latent ranks. These results suggest that FMA-UE has high construct validity. Furthermore, we recommend the novel interpretability of FMA-UE, which previous studies have yet to find. Although this cross-sectional study cannot directly guide stroke patients' recovery processes, it may be practical for optimizing the difficulty of stroke rehabilitation.

New device helping people recover from strokes at Allied Services

 Not new at all. I consider them incompetent for not having this years ago.

Wasn't the patient told about non-surgical options? Or is revenue generation of more importance than the patient?

vagus nerve (67 posts to July 2012)

 Earlobe Clip-On Attenuates POTS - Vagus Nerve Stimulation

Non-invasive VNS approach could enhance post-stroke recovery outcomes August 2023 The latest here:

10 Easy Ways to Stimulate Your Vagus Nerve to Reduce Stress from Debbie Hampton

The latest here:

New device helping people recover from strokes at Allied Services

Stroke survivor Trudy Coleman has recovered well with the assistance of a device implanted in her that stimulates her nerves.

The Kingston woman suffered a stroke while in her yard in October 2023, which affected her upper extremities.

During her rehabilitation at Allied Services in Wilkes-Barre Twp., she was introduced to the Vivistim system, a pacemaker-like device implanted in her chest that has helped her regain significant function.

The technology has led to a dramatic recovery for the 73-year-old who lives alone with her two dogs.

“She is so much more independent now and it’s exciting to see,” said Rebecca Carr, an occupational therapist and representative of Vivistim.

1 of 8

Trudy Coleman, left, a stroke patient utilizing Vivistim, delivers a painting to Becky Carr, a therapy development specialist at Vivistim, during a therapy session at Allied Services on Friday, May 16, 2025. (JASON ARDAN / STAFF PHOTOGRAPHER)

Carr and others from Vivistim visited Allied on Friday for one of Coleman’s therapy sessions as part of Stroke Awareness Month. The company claims the Vivistim system is a “first-of-its-kind breakthrough technology” approved by the Food and Drug Administration in 2021.

Coleman visits Allied several times a week and works to improve upper extremity function with an occupational therapist.  She performs simple tasks like picking up items by clasping her fingers or signing her name to checks. She also draws and paints, two of her passions.

“This would have been impossible a year ago,” said Coleman’s occupational therapist Lori Ackerman.

During therapy sessions, Ackerman clicks a device linked to the Vivistim system, which stimulates Coleman’s nerves. Initially, Coleman felt a “ping” with each click, but now she hardly feels anything at all.

Coleman also has a magnet she wears on a necklace that she swipes over the device when she is home and not in therapy to keep her nerves functioning.

The device has even allowed her to start driving again. Unfortunately, the device isn’t able to help with her speech.

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“I wish it would improve my speech. It’s a little slurred, but I can deal with that,” Coleman said. “I’m 85% better.”

Depression after stroke can seriously affect health for a decade, new research shows

 Post stroke depression is best prevented by EXACT 100% RECOVERY PROTOCOLS! Since the stroke medical world has completely failed at that task, they should all be fired for extreme incompetence and never allowed near anything medical again!

Depression after stroke can seriously affect health for a decade, new research shows

People who experience depression following a stroke may face a higher risk of poor health and even death for up to a decade afterward, new research finds.

A study by researchers from King's College London has found that post-stroke depression (PSD) can have serious long-term effects on stroke survivors, lasting up to 10 years after the initial stroke. The findings emphasize a need for long-term mental health support in stroke rehabilitation.

Researchers tracked more than 2,500 stroke survivors using data from the South London Stroke Register, a population-based register recruiting stroke patients living within Lambeth and Southwark. They examined the participants' health for up to 10 years to understand the long-term consequences of depression for stroke survivors.

Published in The Lancet Regional Health—Europe, the study found that 36% of participants showed signs of depression three months after their stroke and survivors with PSD were nearly three times more likely to develop long-term physical disability compared to those without depression. They also faced a 30% higher risk of death in the decade following their stroke and were more likely to struggle with daily tasks and have a reduced quality of life.

Continued depression at one or five years after the stroke was associated with higher risks of death, more physical disability and lower quality of life. In contrast, survivors who recovered from PSD within the first year had a similar risk of death to those who never experienced depression.

Recovery during this period was also linked to a lower risk of another stroke, better functional outcomes, and improved quality of life. Although the timing of depression onset didn't appear to affect long-term health risks, recovering from depression was associated with better physical and mental well-being.

Mortality up to 10-years after stroke by depression status at 3-months. Credit: The Lancet Regional Health - Europe (2025). DOI: 10.1016/j.lanepe.2025.101324

Lu Liu, a Ph.D. student at King's College London and lead researcher on the study, said, "Post-stroke depression is linked to higher mortality and worse functional outcomes, but most previous studies have only followed patients for less than a year. Our study examined the long-term impact of depression after a stroke. These findings show how important it is to recognize and treat depression as part of stroke recovery."

Depression was identified using a questionnaire, and participants' ability to perform daily activities, their physical independence, and their overall quality of life, both physical and mental, were also assessed.

The South London Stroke Register has been collecting data since 1995, but follow-up typically ends after 10 years, as tracking patients beyond this point becomes increasingly difficult due to cognitive decline or communication challenges, which can affect the reliability of the data.

Professor Yanzhong Wang, Professor of Statistics in Population Health at King's College London and co-senior author of the study, added, "People often take depression seriously in the first few months after a stroke, but years later it can be overlooked. Just because the stroke happened five or six years ago doesn't mean the depression is any less serious.

"Our findings show that post-stroke depression remains a major risk factor long after the initial stroke and needs ongoing attention from clinicians."

Dr. Matthew O'Connell, Senior Lecturer in Health Services Research and Population Health Sciences at King's College London and co-senior author of the study, said, "The South London Stroke Register is unique in following stroke survivors for so many years after their stroke. Encouragingly, our data show those recovering from depression experience better outcomes in the longer term, suggesting effectively treating these symptoms could have broader-ranging health benefits."

Currently, post-stroke care primarily focuses on physical recovery, with depression often only screened in the early stages. The researchers hope their findings will encourage the inclusion of long-term mental health support in stroke rehabilitation programs. While more research is needed to develop effective treatments for PSD, these results underline the need for continued care that addresses both physical and mental health.

More information: Lu Liu et al, Long-term outcomes of depression up to 10-years after stroke in the South London Stroke Register: a population-based study, The Lancet Regional Health - Europe (2025). DOI: 10.1016/j.lanepe.2025.101324

Provided by King's College London

More Than Half of Mini-Stroke Patients Battle Long-Term Fatigue: Study Highlights

 

Post stroke fatigue has been known forever. YOUR DOCTOR NEEDS TO SOLVE THE FUCKING PROBLEM!

At least half of all stroke survivors experience fatigue Known since March 2017

Or is it 70%? Known since March 2015

Or is it 40%? Known since September 2017

The latest here: 

More Than Half of Mini-Stroke Patients Battle Long-Term Fatigue: Study Highlights

Predicting motor recovery of the upper limb after stroke rehabilitation: value of a clinical examination

 

 Do you not understand, prediction is completely useless for stroke survivors? It does nothing to get them recovered. There are a lot of mentors and senior researchers that need to be re-educated on the purpose of stroke research. The only goal in stroke is 100% recovery; not biomarkers, prediction, prognosis or other useless shit! I'd fire all of you for incompetence!

Predicting motor recovery of the upper limb after stroke rehabilitation: value of a clinical examination

2000, Physiotherapy Research International

Abstract

Background and Purpose. 

Only a few studies have been conducted to predict motor recovery of the arm after stroke. The aims of this study were to identify which clinical variables, assessed at different points in time, were predictive of motor recovery, and to construct useful regression equations. Method. One hundred consecutive stroke patients who had an obvious motor deficit of the upper limb were evaluated on entry to the study (two to five weeks post-stroke) and at two, six and 12 months after stroke. The Brunnström-Fugl-Meyer test was used as the outcome measure. Predictors included demographic data, overall disability, clinical neurological features, neuropsychological factors and secondary shoulder complications. Results. In multiple regression analyses, motor performance was invariably retained as the predictive factor with the highest R-square. Other significant predictive variables were overall disability, muscle tone, proprioception and hemi-inattention. Between 53% and 89% of the total amount of variance was accounted for in all selected models. The accuracy of prediction from clinical measurement in the acute phase diminished as the time span of measurement of outcome increased. Similarly, assessment of the variables at two and six months, rather than in the acute stage, resulted in a considerable improvement in the percentage variance explained at 12 months. The highest accuracy was obtained when predictions were made step-by-step in time. 

Conclusions. 

It is possible to predict motor recovery of the upper limb accurately through the use of a few clinical measures. Predictive equations are proposed, the use of which are practicable in both clinical practice and research.(Why the fuck do this? It won't get survivors recovered, will it? But it did get you published, so there's that; that doesn't help survivors, does it?)

FIGURE 1: Mean (SD) of the scores on the Brunnstrém—Fugel-Meyer test at baseline and at two, six and 12 months post-stroke. Figure 1 shows the means and standard deviations of the scores on the Brunnstr6m—Fugl-Meyer test at four measurement points. Mean initial score on the Brunnstrém-Fugl-Meyer test was 14 and increased to 33.8 at 12 months post-stroke. Figure 1 also demonstrates high standard deviations, which increase over time. Mean improvement on the Brunnstrém—Fugl-Meyer test between baseline and two months was 9.1 points. Between two and six months and six and 12 months post- stroke, the improvement was, respectively, 6.7 and 4.0. Prediction of motor recoveryTABLE 1: Significant correlation coefficients between predictor variables measured at baseline and motor recovery of the upper limb at two, six and 12 months post-stroke.* *Between predictor variables measured at two months and motor recovery of the upper limb at six and 12 months post-stroke and between predictor variables measured at six months and motor recovery of the upper limb at 12 months post-stroke. 

Predictive role of a combined model for futile recanalization in acute ischemic stroke: a retrospective cohort study

The correct objective would be to determine why futile recovery occurs after mechanical thrombectomy!  The goal of every stroke survivor is 100% recovery, they don't care about recanalization unless it leads directly to 100% recovery. Don't any of you know how to think?

Predictive role of a combined model for futile recanalization in acute ischemic stroke: a retrospective cohort study

Yangbin Zhou1†, Yitao Zhou1†, Huijie Yang2, Xiaoyan Wang2, Xiping Zhang2 and Ganying Huang1,2*

1School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China

2Department of Emergency, Afliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou, Zhejiang, China

Edited by

Linlin Zhang, Capital Medical University, China

Reviewed by

Abhi Pandhi, University of Tennessee Health Science Center (UTHSC), United States

Dan-Victor Giurgiutiu, Augusta University, United States

*Correspondence

Ganying Huang, ganying3304@163.com

†These authors have contributed equally to this work

Received 25 January 2025

Accepted 30 April 2025

Published 15 May 2025

Citation

Zhou Y, Zhou Y, Yang H, Wang X, Zhang X and Huang G (2025) Predictive role of a combined model for futile recanalization in acute ischemic stroke: a retrospective cohort study. Front. Neurol. 16:1566842. doi: 10.3389/fneur.2025.1566842

Objective: There is a lack of data regarding patients with acute ischemic stroke caused by large vessel occlusions (LVOs) undergoing mechanical thrombectomy (MT) and their predictors of futile recanalization (FR). We sought to investigate the predictors of FR in patients with AIS-LVO undergoing mechanical thrombectomy.

Method: A retrospective analysis was conducted on 229 acute AIS patients who received MT, after eliminating the 31 patients not meet the requirements. The patients were categorized into the FR group and the useful recanalization (UR) group. Multivariate logistic regression analysis was used to explore the factors that influence FR after mechanical thrombectomy. ROC curve was used to plot the ability to predict FR after MT, and then the combined model was constructed and evaluate the predictive ability of this model to FR.

Results: 198 patients who achieved successful recanalization were included in the analysis, of whom 124 experienced UR and 74 experienced FR. Patients with FR had higher Baseline NIHSS; they were more frequently on hypertension history and had longer door-to-puncture time (DPT) and door-to-recanalization time (DRT). Multivariable regression analysis showed that the hypertension history, Admission NIHSS, Admission DBP, Admission blood glucose, ischemic core, and DPT were associated with an increased probability of FR. The combined model was better than the models alone in predicting the risk of FR.

Conclusion: Admission blood pressure, admission NIHSS scores, admission DBP, ischemic core and DPT are independent risk factors for FR after MT in patients with AIS, and the combined model established by them has high predictive efficacy for FR risk after MT.

Keywords

futile recanalization; acute ischemic stroke; ROC curve; mechanical thrombectomy; AIS-LVO

Introduction

As the second-leading cause of death disease, Stroke is a widespread neurological condition and the primary cause of disability worldwide (1). Also, it resulted in approximately 6 million annual fatalities. Ischemic stroke accounts for 71% of all strokes worldwide and 81.9% in China. The proportion of acute ischemic stroke (AIS) caused by large vessel occlusions (LVOs) in Chia was 20% (2). Acute ischemic stroke (AIS) is a sudden neurologic dysfunction caused by focal brain ischemia which is accompanied by imaging evidence of acute infarction (3). AIS occur caused by focal cerebral hypoperfusion, particularly from embolism and atherosclerotic disease. At present, the main effective treatment method for early reperfusion in acute ischemic stroke is intravenous rt-PA thrombolysis (4–6). For AIS-LVOs, the vascular revascularization rate of intravenous thrombolysis is low (13% ~ 18%) and the therapeutic effect is not good (7). The successful recanalization rate of MT has achieved 41–88%, which was much higher than that yielded by traditional therapies, including intravenous thrombolysis (8). Partial randomized clinical trials (RCTs) (9–14) have proven benefits on functional outcomes of endovascular thrombectomy (EVT) compared with intravenous thrombolysis. The functional outcomes of AIS patients with proximal anterior circulation LVO were improved by MT, particularly in those with good collateral circulation (6, 15). Preceding randomized controlled trials (10–12, 14, 16, 17) have consistently demonstrated that, among patients receiving standard care, MT markedly enhances successful reperfusion.

The modified Thrombolysis in Cerebral Infarction (mTICI) score can evaluate the degree of recanalization, which is considered a powerful predictor of good functional prognosis (18, 19). However, FR are not always associated with successful or complete reperfusion. Previous studies have revealed that more than 50% of patients suffer from futile recanalization (FR), which is defined as an adverse functional outcome at 90 days despite successful recanalization (mTICI = 2b-3) (18, 20). FR was linked to age, admission NIHSS, comorbidities, Alberta Stroke Program Early CT Score (ASPECTS), as well as time from symptom onset to recanalization (21, 22). Furthermore, studies have demonstrated that a high mRS score prior to stroke onset, coexisting dyslipidemia, and atrial fibrillation were identified as predictors of FR (23).

Therefore, it is of paramount importance to better understand the therapeutic effect of patients after MT and determine the factors that may help predict the occurrence of FR in patients. Predictive models for the occurrence of FR following MT surgery in patients are relatively scarce. Such models are necessary to accurately convey potential risks and benefits to the patients themselves or the proxies, and facilitate patient-oriented informed decision-making. The advent of reliable prediction models is capable of adapting to the continuously escalating healthcare demands and costs in China.

We conducted an observational retrospective study aiming to explore the predictors of futile recanalization in patients with LVO undergoing MT. Therefore, this study aims to utilize the National Stroke Center Construction Management Information System (NSCCMI) registry to clarify the predictive ability of admission blood pressure, baseline NIHSS scores, admission DBP, ischemic core and DPT for the risk of FR after MT in patients with AIS.

Methods

Study design and participants

The cohort was comprised of patients enrolled in the NSCCMI registry (National Stroke Center Construction Management Information System), a cohort study registering AIS patients in China which includes a hospital-based follow-up study. We enrolled 229 AIS-LVO patients from Hangzhou First People’s Hospital who were treated with mechanical thrombectomy between March 2022 and February 2024. The sample size met the principle of 10 Events Per Variable (EPV) (24). Inclusion criteria were 198 patients who achieved successful recanalization were included in the analysis, of whom 124 (62.63%) experienced UR and 74 (37.37%) experienced FR. The sample size met the principle of 10 Events Per Variable (EPV). All participating subcenters were obligated to recruit consecutive patients, and all patients or their legal representatives supplied informed consent. All patients used computed tomography and/or magnetic resonance imaging to diagnose AIS. According to TOAST criteria (25), AIS can be divided into four subtypes: (1) large-artery atherosclerosis (LAA), (2) cardioembolism (CE), (3) small-artery occlusion, (SAO), (4) stroke of other determined etiology, and (5) stroke of undetermined etiology (25). Categories 4 to 5 were defined as “other causes” in this study. This study included patients with subtypes according to TOAST criteria. All patients were followed for 3 months after AIS onset.

The present study enrolled patients with AIS-LVO undergoing MT between March 2022 and February 2024. Patients met the following inclusion criteria: (1) Age 18–90 years; (2) meet the diagnostic criteria for AIS (26); (3) patients treated with MT; (4) mTICI of 2b-3 after MT (27); (5) without rheumatoid immune disorders, severe hepatic or renal disorders, hematological disorders, or malignant tumors; (6) without any systemic infections that occurred at the time of specimen collection or 2 weeks before stroke onset; (7) finish 90-day follow-up.

MT was selected for patients meeting the following criteria: (1) confirmed AIS, and bleeding or other pathological brain diseases ruled out by CT; (2) LVO confirmed by CTA or digital subtraction angiography; (3) MT treatment can be initiated between 6 and 16 h of stroke onset (28); (4) obtaining informed consent from family members. Exclusion criteria: (1) confirmed intracranial hemorrhage or intracranial tumor on admission; (2) inability to take care of oneself; (3) previous psychiatric disorders that would interfere with neurologic evaluation; (4) Other serious, advanced, or terminal illness (investigator judgment) or life expectancy is less than 6 months; (5) Any other condition that, in the investigator’s judgment, precludes an endovascular procedure or poses a considerable risk to the subject in the event that an endovascular procedure is performed; (6) incomplete baseline data.

More at link.

Cardiovascular risk factors modulate the effect of brain imaging-derived phenotypes on ischemic stroke risk

Ask your competent? doctor what this means.

 Cardiovascular risk factors modulate the effect of brain imaging-derived phenotypes on ischemic stroke risk

Short title: CRF Affect IS Risk

Yuan-yuan Liang1, Meng-jie Li1,5, Dong-rui Ma1, Meng-nan Guo1, Xiao-yan Hao1,5,

Shuang-jie Li1, Chun-yan Zuo1, Chen-wei Hao1, Zhi-yun Wang1, Yan-mei Feng1,

Chenyuan Mao1, Chan zhang1, Bo Song1,2,3,4, Yuming Xu1,2,3,4, Changhe Shi, MD,

PhD1,2,3,4

1 Department of Neurology, The First Affiliated Hospital of Zhengzhou University,

Zhengzhou University, Zhengzhou, 450000, Henan, China.

2 NHC Key Laboratory of Prevention and treatment of Cerebrovascular Diseases, The

First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou,

450000, Henan, China.

3 Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of

Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, Henan, China.

4 Institute of Neuroscience, Zhengzhou University, Zhengzhou, 450000, Henan, China.

5 Academy of Medical Sciences of Zhengzhou University, Zhengzhou, 450000, Henan,

China.

Abstract

Studies have shown that cardiovascular risk factors are closely related to the occurrence

of stroke, especially ischemic stroke, as they can lead to changes in brain structure and

function. However, the role of cardiovascular risk factors - induced changes in brain

structure and function in the development of ischemic stroke has not been studied. The

aim of this study is thus to explore the causal association among cardiovascular risk

factors, brain phenotypes and ischemic stroke by assessing mendelian randomization.

We used univariate mendelian randomization to sequentially investigate the causal

effects of the 12 most common cardiovascular risk factors on brain structure and 3,935

brain imaging-derived phenotypes in the development of ischemic stroke. We also

examined the mediating effect of brain structure on blood pressure - induced ischemic

stroke using a multivariable mendelian randomization test. We tested the reliability of

our results using the Steiger test, heterogeneity test, horizontal pleiotropy test and leave-

one-out method.

We found that 8 of the 12 examined cardiovascular risk factors were associated with

538 brain imaging-derived phenotypes, and 9 of the 12 cardiovascular risk factors were

associated with IS. The main cardiovascular risk factors associated with brain imaging-

derived phenotypes and ischemic stroke was blood pressure (systolic and diastolic),

which can affect the occurrence of ischemic stroke through 6 types of brain imaging-

Page 4 of 34

Increased sedentary behavior is associated with neurodegeneration and worse cognition in older adults over a 7-year period despite high levels of physical activity

Sedentary time wouldn't exist if you had 100% RECOVERY PROTOCOLS! If you can't figure that out; GET THE HELL OUT OF STROKE!

 Increased sedentary behavior is associated with neurodegeneration and worse cognition in older adults over a 7-year period despite high levels of physical activity

Marissa A. Gogniat1,2,3 Omair A. Khan4,5 Judy Li1 Chorong Park6

W. Hudson Robb1 Panpan Zhang1,4 Yunyi Sun1,4 Elizabeth E. Moore1,7

Michelle L. Houston1,8 Kimberly R. Pechman1 Niranjana Shashikumar1

L. Taylor Davis1,2,9 Dandan Liu1,4 Bennett A. Landman1,2,9,10,11 Keith R. Cole1,12

Corey J. Bolton1,13 Katherine A. Gifford1,2,14 Timothy J. Hohman1 Kelsie Full1,15

Angela L. Jefferson1,2,16

1 Vanderbilt Memory and Alzheimer’s Center, Nashville, Tennessee, USA

2 Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA

3 Department of Neurology, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

4 Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA

5 Vanderbilt Brain Institute, Vanderbilt University, Medical Research Building III, Nashville, Tennessee, USA

6 College of Nursing, Seoul National University, Jongno District, Seoul, South Korea

7 Department of Neurology, Brigham and Women’s Hospital, Boston, Massachusetts, USA

8 Center for Biomedical Ethics and Society, Section of Surgical Sciences, Vanderbilt University Medical, Nashville, Tennessee, USA

9 Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA

10 Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, Tennessee, USA

11 Department of Biomedical Engineering, Vanderbilt University Center, Nashville, Tennessee, USA

12 Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA

13 Division of Geriatrics, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA

14 Department of Anatomy and Neurobiology, Boston University, Boston, Massachusetts, USA

15 Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA

16 Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA

Correspondence

Angela L. Jefferson, Vanderbilt Memory and

Alzheimer’s Center, 3319 West End Avenue,

8th Floor, Nashville, TN 37203, USA.

Email: angela.jefferson@vumc.org

Statistical Analysis conducted by Omair A.

Khan, MAS, Yunyi Sun, MA, Panpan Zhang,

PhD and Dandan Liu, PhD, Department of

Abstract

INTRODUCTION: Sedentary behavior may be a modifiable risk factor for Alzheimer’s

disease (AD). We examined how sedentary behavior relates to longitudinal brain

structure and cognitive changes in older adults.

METHODS: Vanderbilt Memory and Aging Project participants (n = 404) completed

actigraphy (7 days), neuropsychological assessment, and 3T brain MRI over a 7-year

period. Cross-sectional and longitudinal linear regressions examined sedentary time

in relation to brain structure and cognition. Models were repeated testing for effect

modification by apolipoprotein E (APOE) ε4 status.

RESULTS: In cross-sectional models, greater sedentary time related to a smaller AD-

neuroimaging signature (β = -0.0001, p = 0.01) and worse episodic memory (β = -0.001,

p = 0.003). Associations differed by APOE-ε4 status. In longitudinal models, greater

sedentary time related to faster hippocampal volume reductions (β = -0.1, p = 0.008)

and declines in naming (β = -0.001, p = 0.03) and processing speed (β = -0.003, p = 0.02;

β = 0.01, p = 0.01).

DISCUSSION: Results support the importance of reducing sedentary time, particularly

among aging adults at genetic risk for AD

FACTORS AFFECTING QUALITY OF LIFE IN PATIENTS SUFFERING FROM CVA (STROKE) WITH HEMIPARESIS

100% recovery is the quality of life survivors want! THAT'S NON-NEGOTIABLE! That is the only goal in stroke; 100% RECOVERY! GET THERE! The tyranny of low expectations raises its' ugly head once again! You'll need to scream at your therapists and doctors to get you protocols that deliver 100% recovery. Embarrass them about their incompetence in not doing that.

 FACTORS AFFECTING QUALITY OF LIFE IN PATIENTS SUFFERING FROM CVA (STROKE) WITH HEMIPARESIS

Ravi Prakash Degala*1, Naga Subrahmanyam Satupati2, N. Ramya3, D. Ainwesly4,

B. Jaya Madhuri5 and V. Pravallika6

1,2Associate Professor, Department of Pharmacy Practice, Koringa College of Pharmacy,

Korangi, Kakinada, Andhra Pradesh, India.

3Associate Professor, Department of Pharmaceutical Analysis, Koringa College of Pharmacy,

Korangi, Kakinada, Andhra Pradesh, India.

4,5,6Pharm D Scholar, Department of Pharmacy Practice, Koringa College of Pharmacy,

Korangi, Kakinada, Andhra Pradesh, India.

ABSTRACT

Background: 

Cerebrovascular accident (CVA), commonly known as stroke, is a leading cause of long-term disability worldwide. Hemiparesis, a frequent post-stroke complication, significantly impairs functional independence and may adversely affect the overall quality of life (QoL) of patients. Understanding the multifactorial determinants of QoL in this population is crucial for effective rehabilitation and care

planning. 

Objective: 

To identify and analyze the key factors influencing the quality of life in patients with post-stroke hemiparesis.(Totally wrong objective! Should be ' Deliver protocols that result in 100% recovery'!)

Methods: 

A cross-sectional observational study was conducted involving stroke survivors diagnosed with hemiparesis. Data were collected using validated tools, including the Stroke-Specific Quality

of Life (SS-QOL) scale. Factors such as demographic variables, severity of hemiparesis, level of functional independence (measured by the Barthel Index), presence of comorbidities, depression, and social support were analyzed for their correlation with QoL outcomes.

Results: The study revealed that lower levels of functional independence, presence of

depression, limited social support, and severe motor impairment were significantly associated

with reduced QoL scores (p < 0.05). Age, gender, and duration since stroke onset also

showed variable effects on different QoL domains. 

Conclusion: 

Quality of life in patients with stroke-induced hemiparesis is influenced by a combination of physical, psychological, and social factors. Targeted interventions addressing mental health, social support systems,

and functional rehabilitation are essential to enhance QoL in this vulnerable group.

Sensing of Surface Texture using Smart Glove for Post Stroke Rehabilitation

 

Margaret Yekutiel wrote a whole book about this in 2001, 'Sensory Re-Education of the Hand After Stroke'.

Of course, your competent? doctor put together somatosensory protocols from this earlier research a long time ago, right? Oh no, you DON'T have a functioning stroke doctor, do you? Too bad, it's your problem to solve since your stroke hospital board of directors is fucking incompetent in running their hospital! 24 years of incompetence! WOW, that's got to be a record for staying incompetent!

Sensing of Surface Texture using Smart Glove for Post Stroke Rehabilitation

PDF

S Priya; P Sherin Heera; Rj Hemalatha

All Authors

---

Abstract

Document Sections

• I.
  INTRODUCTION
• II.
  PROPOSED SYSTEM
• III.
  METHODOLOGY
• IV
  RESULTS AND DISCUSSION
• V.
  CONCLUSION

Authors

Figures

References

Keywords

Abstract:

Post-stroke patients need to be rehabilitated in order to gain partly or fully some of the motor facilities that seem to have ceased to function effectively. According to the research, post-stroke deficits in the human ability to palpate and comprehend surface features is the major difficulty a stroke survivor may experience; often they cause harm or accidentally destroy objects due to an incorrect manner of holding them. This research offers a new strategy with the aid of wearable haptic interface in the form of a smart glove that employs an ESP32 microcontroller and force sensors to identify surface texture. Using pattern recognition, we can effectively distinguish between a rough and a smooth surface to adapt to the pressure required to hold any object. This innovation apart from improving safety also gives the patient feedback in the process of rehabilitation. The use of machine learning in particular proves to be more preferable when it comes to texture recognition preventing shortcomings observed in other senor-based approaches.

Published in: 2025 5th International Conference on Trends in Material Science and Inventive Materials (ICTMIM)

Date of Conference: 07-09 April 2025

Date Added to IEEE Xplore: 12 May 2025

ISBN Information:

DOI: 10.1109/ICTMIM65579.2025.10988294

Conference Location: Kanyakumari, India 

Exploring perspectives on the management of patients with complex care needs in stroke rehabilitation An interpretive description study

 

This is the whole problem in stroke enumerated in one word; 'care'; NOT RECOVERY!

YOU have to get involved and change this failure mindset of 'care' to 100% RECOVERY! Survivors want RECOVERY, NOT 'CARE'!

I see nothing here that states going for 100% recovery! You need to create EXACT PROTOCOLS FOR THAT!

ASK SURVIVORS WHAT THEY WANT, THEY'LL NEVER RESPOND 'CARE'! This tyranny of low expectations has to be completely rooted out of any stroke conversation! I wouldn't go there because of such incompetency as not having 100% recovery protocols!

RECOVERY IS THE ONLY GOAL IN STROKE! GET THERE!

Exploring perspectives on the management of patients with complex care needs in stroke rehabilitation

Indar, Alyssa; Nelson, Michelle; Berta, Whitney; Mylopoulos, Maria

Author Information

Health Care Management Review ():10.1097/HMR.0000000000000440, May 9, 2025. | DOI: 10.1097/HMR.0000000000000440

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Abstract

Background 

Exploring the “wicked” problem of improving care(NOT RECOVERY!) for patients with complex care(NOT RECOVERY!) needs could benefit a large swath of health system stakeholders given the breadth and depth of this issue. Patients with complex health and social needs often require customized care(NOT RECOVERY!) that deviates from expected care(NOT RECOVERY!) trajectories. At Canadian Stroke Distinction sites, clinicians provide care(NOT RECOVERY!) for a high proportion of patients with complex needs while adhering to best practice recommendations.

Methods 

We conducted an interpretive description study, which explored the perspectives of 16 stroke rehabilitation clinicians, four organizational key informants, and two health system key informants. We collected data via 45- to 60-minute virtual interviews and engaged in a hybrid inductive–deductive approach to analysis.

Results 

We constructed three main themes: (a) recognizing complexity is routine work for clinicians, (b) clinicians use workarounds to manage complexity, and (c) clinicians perceived and worked to bridge a difference between organizational processes and the realities of patient care(NOT RECOVERY!). When comparing clinician and key informant perspectives, we noted differences regarding their perceptions of the prevalence and nature of patient complexity. We developed the concept of “work-as-expected” as an intermediary to bridge the gap between the “work-as-imagined” and “work-as-done” framework.

Conclusion 

We describe the strategies used by expert clinicians to continually manage care(NOT RECOVERY!) for a high proportion of patients with complex care(NOT RECOVERY!) needs. Although expert clinicians have developed effective workarounds, they experience significant moral distress when these strategies are unable to compensate for health system limitations.

Practice Implications 

A better understanding of how clinicians manage the needs of patients with complex care(NOT RECOVERY!) needs could support policymakers and organizational leaders to consider macro- and meso-level strategies to support the adaptive practices of clinicians.

Direct oral anticoagulants increase bleeding risk after intracerebral hemorrhage in patients with atrial fibrillation

 Hope your stroke medical 'professionals' read AND IMPLEMENT RESEARCH!

Direct oral anticoagulants increase bleeding risk after intracerebral hemorrhage in patients with atrial fibrillation

1. Ischemic stroke occurred less often in patients with atrial fibrillation on DOACs compared to those on placebo.

2. Patients in the DOAC group reported an increased risk of intracerebral hemorrhage.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Patients with atrial fibrillation are often prescribed direct oral anticoagulants (DOACs) to reduce the risks of thromboembolism and stroke. However, the safety and efficacy of restarting anticoagulation after spontaneous intracerebral hemorrhage (ICH) remains uncertain. This randomized controlled trial aimed to determine whether DOACs could reduce the risk of ischemic stroke without significantly increasing the risk of recurrent ICH in this high-risk population. The primary outcome was first occurrence of ischemic stroke, while key secondary outcome was recurrence of ICH. According to study results, DOACs significantly lowered the risk of ischemic stroke compared to no anticoagulation; however, they were also associated with a higher risk of recurrent ICH. Although this study was well done, it was limited by a small sample size, which may affect the generalizability of its findings.

Click to read the study in The Lancet

Relevant Reading: Early versus Later Anticoagulation for Stroke with Atrial Fibrillation

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2 Minute Medicine Rewind April 21, 2025

In-depth [randomized controlled trial]: Between May 31, 2019, and Nov 30, 2023, 327 patients were assessed for eligibility across 75 hospitals in 6 European countries. Included were patients ≥ 18 years with spontaneous ICH, a clinical diagnosis of atrial fibrillation, and a modified Rankin Scale score ≤ 4. Altogether, 319 patients (158 in DOAC group and 161 in no anticoagulant group) were included in the final analysis. The primary outcome of ischemic stroke occurred significantly less often in the DOAC group (hazard ratio [HR] 0.05, 95% confidence interval [CI] 0.01-0.36, log-rank p<0.0001). The secondary outcome of recurrent ICH occurred more frequently in the DOAC group (event rate 5.00 per 100 patient-years in DOAC vs. 0.82 per 100 patient-years in placebo). Findings from this study suggest that while DOACs reduce the risk of ischemic stroke in patients with atrial fibrillation, they increase bleeding.

Image: PD

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Prediction of the functional outcome of intensive inpatient rehabilitation after stroke using machine learning methods

 Do you not understand, prognosis is completely useless for stroke survivors? It does nothing to get them recovered. There are a lot of mentors and senior researchers that need to be re-educated on the purpose of stroke research. The only goal in stroke is 100% recovery; not biomarkers, prediction, prognosis or other useless shit! I'd fire all of you for incompetence!

Prediction of the functional outcome of intensive inpatient rehabilitation after stroke using machine learning methods

• Silvia Campagnini,
• Alessandro Sodero,
• Marco Baccini,
• Bahia Hakiki,
• Antonello Grippo,
• Claudio Macchi,
• Andrea Mannini &
• Francesca Cecchi 

Scientific Reports volume 15, Article number: 16083 (2025) Cite this article

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Abstract

An accurate and reliable functional prognosis is vital to stroke patients addressing rehabilitation, to their families, and healthcare providers(NO ITS NOT! PROGNOSIS DOES NOTHING FOR RECOVERY! ARE YOU THAT BLITHERINGLY STUPID?). This study aimed at developing and validating externally patient-wise prognostic models of the global functional outcome at discharge from intensive inpatient post-acute rehabilitation after stroke, based on a standardized comprehensive multidimensional assessment performed at admission to rehabilitation. Patients addressing intensive inpatient rehabilitation pathways within 30 days from stroke were prospectively enrolled in two consecutive multisite studies. Demographics, description of the event, clinical/functional, and psycho-social data were collected. The outcome of interest was disability in basic daily living activities at discharge, measured by the modified Barthel Index (mBI). Machine learning-based prognostic models were developed, internally cross-validated, and externally validated. Interpretability techniques were applied for the analysis of predictors. 385 patients were considered, 220 (165) for training (external test) sets. A 50.9% (55.8%) of women, 79.5% (80.0%) of ischemic, and a median [interquartile range- IQR] age of 80.0[15.0] (79.0[17.0]) were registered. The Support Vector Machine obtained the best validation performances and a median absolute error [IQR] on discharge mBI estimation of 11.5[15.0] and 9.2[13.0] points on the internal and external testing, respectively. The baseline variables providing the main contributions to the predictions were mBI, motor upper-limb score, age, and cognitive screening score. We achieved a solution to support the formulation of a functional prognosis at intensive rehabilitation admission. The interpretability analysis confirms the relevance of easily collected motor and cognitive dataat admission and of the patient’s age.

Trial registration: Prospectively registered on ClinicalTrials.gov (registration numbers RIPS NCT03866057, STRATEGY NCT05389878).