Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Wednesday, February 22, 2012

Modulating the motor system by action observation: Implications for stroke rehabilitation

A good dissertation and they even tested this on chronic patients, so as a result therapy departments need to get videos of all kinds of movements for patients to study. This will lead to my looking for hand videos.
Video here: Finger Independence Exercise
and here:Finger Extension
And here:Advanced Finger Fitness Guide DVD Dance
And Here:Greg Irwin-Finger BalletDon't listen to me(I know nuthin) this needs to come from your therapists.

http://gradworks.umi.com/34/87/3487903.html
Abstract:
The first study used functional magnetic resonance imaging (fMRI) to measure activity in motor-related brain regions during action observation. 12 participants with chronic middle cerebral artery stroke and moderate to severe dominant right hand paresis, and 12 matched right-handed non-disabled participants observed precision reach to grasp actions (e.g. lift pencil ) made using the left and right hand. Observed actions were difficult or impossible for participants with stroke to perform using the paretic right hand, but easy to perform using the non-paretic left hand. All participants performed the actions using each hand to the best of their ability after the MRI. We find that non-disabled participants show bilateral, symmetric activation of cortical motor regions during left or right hand action observation. After stroke, a similar bilateral, symmetric activation of cortical motor regions is found during left hand action observation; yet during right (paretic) hand action observation, cortical motor activity is lateralized toward the left lesioned hemisphere. Overall, for non-disabled participants, left hand more than right hand action observation engaged cortical motor regions and more so in the right hemisphere; whereas for participants with stroke, right (paretic) hand more than left hand action observation engaged cortical motor regions, and more so in the left lesioned hemisphere. In addition, we find that activity in the motor system during action observation is related to motor capability to perform the observed actions, such that longer movement times using the paretic right hand, indicating great impairment, are associated with greater activity during right hand action observation in the inferior frontal gyrus of the left lesioned hemisphere. Results suggest that despite chronic non-use, cortical representations of the paretic limb in the damaged motor cortex are preserved and may be accessed by action observation in stroke rehabilitation.
The second fMRI study assessed how activity in the putative mirror neuron system and other cortical motor regions during action observation differs between participants with stroke and different lesion locations. 6 participants with stroke involving the internal capsule, and 6 participants with stroke broadly involving the cortex and internal capsule, observed reach to grasp actions made using the left and right hand. All patients had chronic middle cerebral artery stroke of the dominant left hemisphere and moderate to severe right hand paresis. Results indicate a consistent finding related to stroke that is independent of lesion information in this study: participants with stroke show strong cortical motor activity in the left lesioned hemisphere during right (paretic) hand action observation. Yet within the overall stroke group pattern, we find differences between lesion groups, indicating a specific effect of lesion on MNS activity after stroke, including: (1) stroke involving the cortex and internal capsule is associated with more widespread, bilateral activity than stroke limited to the internal capsule; (2) stroke involving the left ventral inferior frontal gyrus (IFG) is associated with greater activity in the left pars triangularis of the IFG; and (3) for stroke involving the internal capsule, less motor capability to perform the observed actions is related to greater activity in the left IFG; whereas for stroke involving the cortex and internal capsule, this relation is found in the premotor cortex. Findings from this study suggest plasticity in the putative mirror neuron system to support action observation and imitation after stroke.
The third study uses fMRI to evaluate whether action observation and execution share a common neural substrate after stroke affecting the motor system. 4 participants with chronic dominant left hemisphere stroke and moderate right hand paresis and 4 matched right-handed non-disabled participants took part in the study. During fMRI participants observed and performed a reach to grasp action (grasp tennis ball ) using their left hand and right hand to the best of their ability. For each single subject we assessed activity during action observation, execution, and overlap between conditions. We find that single subject MNS maps are variable in the healthy brain and after stroke. We discuss contributions to variability related to age and stroke. We attempt to interpret single subject MNS maps related to stroke and related to the potential for a given individual with stroke to benefit from rehabilitative methods that engage the MNS. We find that MNS maps provide information that may be relevant to clinical applications, or may be used to evaluate cortical motor activity before and after an intervention that engages the MNS and related to functional gains. (Abstract shortened by UMI.)
full dissertation here:
http://gradworks.umi.com/cgi-bin/redirect?url=http://gateway.proquest.com/openurl%3furl_ver=Z39.88-2004%26res_dat=xri:pqdiss%26rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation%26rft_dat=xri:pqdiss:3487903

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