Use of the Knowledge-to-Action Framework to Increase Cardiovascular Activity Among Patients with Stroke, Spinal Cord Injury, or Traumatic Brain Injury in an in an Inpatient Rehabilitation Facility

Oh great, blame the patient for the lack of ability to engage in cardiovascular activity. You fuckers need to blame yourselves for not stopping the 5 causes of the neuronal cascade of death in the first week, allowing billions of neurons to die.

From reading this, this is all about blaming the patient. The first error they did was identifying the problem wrong. They assumed it was patient motivation, not lack of ability.  Then you need EXACT PROTOCOLS WITH NUMBER OF REPS. With that patients would easily do millions of reps to get to the desired result, 100% recovery.   

Use of the Knowledge-to-Action Framework to Increase Cardiovascular Activity Among Patients with Stroke, Spinal Cord Injury, or Traumatic Brain Injury in an Inpatient Rehabilitation Facility

Emily Evans, PT, DPT, PhD1,  Elizabeth Hansen, PT, DPT2, Caitriona Modoono, PT, DPT2and members of the Spaulding Rehabilitation Hospital Advancing Clinical Practice Group2: Deb Clooney, PT, DPT, Kristen Cook, PT, Christine Karlberg, PT,   Angela Link PT, DPT, Lisa Perkins PT, DPT, Kathryn QuagliaPT, DPT, Abigail Spaulding PT, DPT, Stacey Zalanowski, PT, DPT 1Brown University School of Public Health and Center on Health Services Training and Research, 2Spaulding Rehabilitation Hospital, Boston
Background 

• Patients with stroke1, spinal cord injury (SCI)2, and traumatic brain injury (TBI)3,4 are known to have impairments in cardiovascular health 

• Inpatient Rehabilitation provides an opportunity to start to address impairments in cardiovascular health while under professional supervision 

• Patients with stroke, SCI, and TBI do not appear to engage in cardiovascular activity at sufficient frequency or intensity to expect improvements while in inpatient rehabilitation5-9

The Post Ischaemic Stroke Cardiovascular Exercise Study: Protocol for a randomised controlled trial of fitness training for brain health

You'll have to ask your doctor for the results of this and if effective when the protocol will be instituted in the hospital. You do think that is part of your doctors' responsibility? That they keep up-to-date in their own field and institute such in their hospital?

The Post Ischaemic Stroke Cardiovascular Exercise Study: Protocol for a randomised controlled trial of fitness training for brain health

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Liam Johnson, Emilio Werden, Chris Shirbin, ...

First Published July 10, 2018 Research Article

https://doi.org/10.1177/2396987318785845

Article information

Abstract

Introduction

Compared to healthy individuals, stroke patients have five times the rate of dementia diagnosis within three years. Aerobic exercise may induce neuroprotective mechanisms that help to preserve, and even increase, brain volume and cognition. We seek to determine whether aerobic fitness training helps to protect brain volume and cognitive function after stroke compared to an active, non-aerobic control.

Methods

In this Phase IIb, single blind, randomised controlled trial, 100 ischaemic stroke participants, recruited at two months post-stroke, will be randomly allocated to either the intervention (aerobic and strength exercise) or active control (stretching and balance training). Participants will attend one-hour, individualised exercise sessions, three days-per-week for eight weeks. Assessments at two months (baseline), four months (post-intervention), and one year (follow-up) post-stroke will measure brain volume, cognition, mood, cardiorespiratory fitness, physical activity, blood pressure and blood biomarkers.
Study outcome: Our primary outcome measure is hippocampal volume at four months after stroke. We hypothesise that participants who undertake the prescribed intervention will have preserved hippocampal volume at four months compared to the control group. We also hypothesise that this group will have preserved total brain volume and cognition, better mood, fitness, and higher levels of physical activity, than those receiving stretching and balance training.

Discussion

The promise of exercise training to prevent, or slow, the accelerated rates of brain atrophy and cognitive decline experienced by stroke survivors needs to be tested. Post Ischaemic Stroke Cardiovascular Exercise Study has the potential, if proven efficacious, to identify a new treatment that could be readily translated to the clinic.

Cardio workouts?

I'm sure your doctor has told you you need more cardiovascular exercise. Don't do these shortcuts without your doctors prescription, it is way too dangerous

Study: Watching a musical equal to a half-hour cardio workout

Watching an intense hockey game could double your heart rate

 

1 Minute of All-Out Exercise May Have Benefits of 45 Minutes of Moderate Exertion

I'm sure your doctor and therapists don't even know how much light exertion doing stroke rehab is needed to get aerobic effects. Only once did I even get winded while in the hospital, that was on a stair stepper and was because I was pushing myself, not anything to do with my therapist or any goals he had for me. But I bet your doctor tells you you need to get more cardiovascularly fit to combat your stroke fatigue, which obviously did not work in my case.
http://well.blogs.nytimes.com/2016/04/27/1-minute-of-all-out-exercise-may-equal-45-minutes-of-moderate-exertion/?_r=0

PRO/CON: Prolonged intense exercise leads to heart damage

Where are our researchers on this topic? That great stroke association would have the database available to answer the question for brain health.
PRO/CON: Prolonged intense exercise leads to heart damage
One interesting comment is;
An increasing body of evidence points to increased arrhythmia incidence and a risk of
accelerated atherosclerosis in highly trained athletes.
Is this bad enough to offset the increased BDNF produced?

Antioxidants – too much of a good thing?

So I've got 8 more years get my resveratrol, so for now I can continue buying red grapes and drinking red wine.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=133096&CultureCode=en
In older men, a natural antioxidant compound found in red grapes and other plants – called resveratrol – blocks many of the cardiovascular benefits of exercise, according to research published today [22 July 2013] in The Journal of Physiology.
Resveratrol has received widespread attention as a possible anti-aging compound and is now widely available as a dietary supplement; much has been made of its role in explaining the cardiovascular health benefits of red wine, and other foods. But now, new research at The University of Copenhagen surprisingly suggests that eating a diet rich in antioxidants may actually counteract many of the health benefits of exercise, including reduced blood pressure and cholesterol.

Much more explanation at the link.