Too many rehab patients suffer harm, not help

And this is why everyone needs an advocate.

I ran across this article showing that while stroke rehabilitation services can provide a great deal of help, they can do harm as well. This is a great illustration that every stroke patient in a facility needs someone watching, and the facility personnel need to know that someone is watching.

So read how nearly 30% of rehab facility patients suffer care-related harm:

The Department of Health and Human Services' Office of Inspector General found that nearly 29% of Medicare beneficiaries admitted to inpatient rehab facilities experience an adverse event during their stay including healthcare-acquired infections, medication errors and pressure ulcers.

Not all stroke rehab facilities are equal: What's best for you?

Earlier this week, I posted an item about avoiding readmission to a hospital.

Now, here's a story about a facility that might help with that, too - in-patient facilities better for stroke rehab:

The report warned that as systems of care evolve in response to healthcare reform, "post-acute care and rehabilitation are often considered a costly area of care to be trimmed" with little recognition of their impact on patient outcomes.

"Stroke rehab is not considered very sexy, but it turns out that it can have a huge impact on quality of life and function," Winstein told MedPage Today.

The writing group noted that stroke rehabilitation services, as currently delivered in the U.S., are broad and "highly heterogeneous, varying in the type of care settings used; in the duration, intensity, and type of interventions delivered; and in the degree of involvement of specific medical, nursing and other rehabilitation specialists."

"The intensity of rehabilitation care varies widely, depending on the setting, with the most intensive rehabilitation care provided in (certified) inpatient rehabilitation facilities (IRFs), followed by skilled nursing facilities (SNFs), which provide 'subacute' rehabilitation," the group wrote.

As more stroke patients survive, more needs arise

Photo from the National
Library of Medicine

You've likely seen recent stories about how more people survive strokes. Generally, a good news story.

However, as this story illustrates, it also means that as more stroke patients live, more need rehab treatment:

More stroke patients now survive brain attacks that would have killed them a few years ago, and stroke has dropped from the fourth- to the fifth-leading cause of death in the U.S., the federal government said in late 2014.

With higher survival rates comes an increasing need for stroke rehabilitation programs for people like Cleveland, 41, who deal with varying disabilities.

In fact, stroke is one of the leading causes of disability.

Brain therapy might help stroke rehab

Stroke is the leading cause of permanent disability in the United States. So many people need physical, occupational and speech therapy to recover. I recently read about research that might lead to better tools to help stroke patients to recover.

This article describes how brain therapy helps rehabilitate stroke patients:

A new interventional therapy that uses a brain–computer interface appears to change brain activity in patients with stroke, new research has shown.

The therapy alters specific areas of the brain that correlate with both the affected and unaffected hands. The activation of these areas of the brain appears to correspond to executed and imagined tasks of the affected hand, and may represent neuroplastic recovery.

"Brain activity fed back to the patient is key for the therapy," explained Vivek Prabhakaran, MD, director of functional neuroimaging in radiology at the University of Wisconsin in Madison.

(Photo from the University of Wisconsin School of Medicine and Public Health) 

Brain stimulation might be viable post-stroke

Stroke recovery can be a challenge - many, many know that better than I - but it's good to see research on possible ways to improve that recovery.

A recent study discussed how brain stimulation is viable in post-stroke rehab:

Repeated noninvasive transcranial magnetic stimulation (nTMS) helped treat spasticity, motor symptoms, and post-stroke pain in a small population of stroke patients, researchers reported here.

Check out the link for the whole story, and keep in mind the research included a small number of people. Still, this bears watching.

(Image from the National Institutes of Health)

'He refreshes my soul'

The LORD is my shepherd, I lack nothing.
He makes me lie down in green pastures,
he leads me beside quiet waters,
he refreshes my soul.
He guides me along the right paths
for his name’s sake.

-Psalm 23:1-3

"Lack nothing," the Psalmist notes. Lack nothing.

Stroke survivors often have difficulty in walking - following the right paths. Visit any hospital or other rehabilitation facility and see.

But God's right paths are so more important - no physical ability required. With that guidance, we truly lack nothing of value. And, with following those paths, he refreshes your soul.

 

(Photo by Tomwsulcer, via Wikimedia Commons; text added for this blog)

Important to start rehab early

The research was set to compare the location of stroke-recovery rehabilitation - home or elsewhere.

The best part of the story saying at-home stroke rehab program as effective as outpatient training, though, had nothing to do with where, but with when. Experts recognized that that timing is really the important factor. It's important to get into rehab as soon as possible:

The learning platform did not matter nearly as much as the intervention’s timing, Pamela Duncan, Ph.D., reported at the International Stroke Conference. Patients who began to relearn walking 2 months after their stroke with the locomotor or home-based program progressed faster than did those randomized to the standard care of locomotor therapy beginning 6 months after their stroke.

"Patients recover faster and sustain recovery when the intervention is given early," she said.

Playing and working - at the same time

Wii games speed stroke rehab

In a first-of-its-kind study, 11 stroke victims with weakness in their arms could reach out and grab objects more easily and more quickly after two weeks of playing the active video games.

In contrast, 11 stroke patients who played card or block games for two weeks showed no change in arm strength afterward, says Gustavo Saposnik, MD, director of the Stroke Outcomes Research Unit at St. Michael’s Hospital in Toronto.

"For the first time, we've shown that the virtual reality gaming system is safe, feasible, and potentially effective at improving motor function after stroke," he tells WebMD.

Tai Chi: Not exactly my thing, but...

...For those who might have an interest in using it as a tool in stroke rehabilitation:

A recent study led by researchers at the University of Illinois shows that Tai Chi, a Chinese form of martial arts that consists of a series of coordinated movements of the head, trunk and limbs, and which does not need any equipment, is an effective form of stroke rehabilitation.

I'm more of a distance runner guy, but hey - this could be extremely helpful for some.

Rehab unit for stroke patients

In Columbia, Mo., good news for stroke patients and caregivers, from the Columbia Missourian:

Boone Hospital opens rehabilitation unit for stroke patients.

Rehabilitation - physical, speech and other manifestations - is a must for those recovering. Should be a valuable resource for mid-Missouri.