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DIASCHISIS AND IMPLICATIONS OF REHABILITATION IN THE POST-Stroke PATIENT

It is a fundamentally important argument for those who are facing the issue of stroke. We have already treated the topic of diaschisis in a generic way in another article, but I felt the need to expand the information also taking into consideration the new scientific contributions on the subject. Objectives of the article: 1. To show that the initial condition of the patient after suffering a stroke does not correspond to the reality of the injury. 2. A great part of the patient’s recovery, in the first months, is the result of the regression of the diaschisis. 3. To understand the reason why it is erroneously said that after the first six months of a stroke there is no recovery. 4. To explain the mechanisms through which it would be possible to accelerate the recovery while respecting diaschisis. MOST SERIOUS CONDITION OF REALITY After a CVA (Cerebrovascular Accident) we put ourselves in a condition that does not correspond exactly to the magnitude of the damage suffered. The effects that we will experience in the coming weeks after cerebral ischemia or cerebral hemorrhage seem notably more devastating from reality than from the brain injury, for a series of reasons that we will develop in more detail. Perilesional edema As we know, an ischemia or a cerebral hemorrhage entails suffering to the brain tissue, causing an injury and then cell...

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VANESSA WANTED TO TIE HER FATHER’S “GOOD” ARM

Vanessa asked me if it would be a good idea to tie her father’s “good” arm. Clearly, tying the healthy arm of a hemiplegic patient is not a wise decision for a number of reasons that we will discuss together below. For now it is useful to say that the idea conceived by Vanessa in rehabilitation is called CIMT (Constraint Induced Movement Therapy), that is, movement therapy induced by constriction, which is carried out precisely as she had thought it, it is literally immobilizing the healthy arm of the hemiplegic patient to constrain him to move his plegic limb. This rehabilitation procedure for hemiplegic patients is in boga in the United States, where it is promoted as an innovation; In Anglo-Saxon countries this type of muscular and motivational physiotherapy is also very popular. In fact, the intuition of stimulating movement of the hemiplegic limb by immobilizing the healthy one, had already been thought by an Italian doctor a few decades ago. Let’s go back to Vanessa’s question: Is it correct to immobilize the healthy limb of a patient with hemiparesis to stimulate him to move the limb on the side affected by hemiplegia? Let’s reason with the CIMT It would undoubtedly be magnificent if it was that simple: Rehabilitation clinics would be made up only by corridors to force stroke patients to walk, and therapists would just use ropes...

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Facebook Groups; Strength cores

Social networks are a social structure that group people from all around the world. The use of these tools is practically infinite due to their wide functional diversity, and the tendency to use them has increased recently because of the emergence of new applications that seek to capture people’s attention by activities, tastes or needs. Now, according to statistical data, Facebook social network has about 2.7 billion active users per month. Something interesting has been happening for some time now through “Facebook Groups”, people who have suffered certain diseases that affect their life quality, in search of having a space of hope with people who have lived the same circumstances, choose to group themselves by pathologies, in order to feel that they not are alone and to look for information that can help them. When a person is sick he or she feels that nobody understands them, because only they are the ones who feel the difficulties in their body, they feel that the world is falling apart and that nobody sees it like that, causing them much anguish and desolation. But the virtue of the right use of technology in favor of health is that, through these groups, people with the same medical diagnosis can give rise to a company site, where they can tell their experiences, their doubts, their fears or provide advice to other members, sharing...

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IS IT POSSIBLE TO RECOVER FROM A LEFT OR RIGHT HEMIPLEJIA FROM HOME?

Every year 15 million people in the world suffer a Cerebrovascular Accident (CVA). Faced with this reality, and the technological possibilities offered by the time, an alternative has been created that allows both, family members and patients, to learn to perform therapeutic exercises from comfort of your home. Telerehabilitation is the main purpose of the Italian physiotherapist Valerio Sarmati, specialist in post-stroke rehabilitation for 15 years. Through the use of technology, he can guide them in the execution of exercises that involve brain and physical functions, which together allow them to regain movement. For this reason, he has developed two video guides, one of them focused on the recovery of right hemiplegia and language functions, while the other is dedicated to the recovery of left hemiplegia. In this way, patients or family members who acquire it have access to 95 instructional videos and an online consultation with the Dr. that will be immediately scheduled for their attention. In the first meeting, the medical history of each patient is analyzed, the diagnosis is defined and specific guidance is provided for their case. In addition, they can join a private support group on Facebook, where people who are part of this community share experience and testimonies that serve as motivation for all new patients. With the professional accompaniment and the explanatory videos, patients and families will feel guided at all times...

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The movements of awakening: The window about the future

There is a very particular phenomenon that many hemiplegia patients often report to me, which I consider important to expose. “When I wake up in my bed in the morning, I can barely move my hand a bit, but later in the day, I can’t do it” Let’s try to think over and focus on some plausible hypotheses to understand this phenomenon, which I personally define as “the window on the future.” In the morning, why can we move the arm and hand better, compared to the rest of the day? Trunk support There is a big difference between the situation we live in the morning and the one we experience during the day and it is the position of our body. When we are lying down we have one less effort to do: control our trunk. Going back in your memory, in the first days after having suffered the stroke, you or your family member will remember that it was probably more difficult to keep your spine straight even if you were sitting down. A classic test is observing the ability to maintain trunk control while sitting in bed without any support either from behind or to the sides, such control is often absent in the first few days after stroke. Regardless of calling it “trunk” or “column”, names that presage static functions and make little movement, our...

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