Saturdays News - Stroke Survivor Takes First Swim

SSTattler - We have two YouTubes/articles:
1 - First swimming after your stroke: First Swim, Pool Lift, Aquatic Rehab, OT Aquatic,
2 - Paralympic Games London & Beijing: Stroke Survivors can compete in swimming & lots of YouTube.

Stroke Survivor Takes First Swim Since Stroke 

Eight months after Steve suffered a large ischemic stroke which left his left side weak and paralyzed, he started aquatic therapy at the Cerebral Palsy pool. Watch him take his first swim in the pool.

 Pro Pool Lift

Aquatic Rehabilitation 

A new program offer through St. Joseph's Health Care is helping people with disabilities get in the swim of things, literally. It's designed to benefit people with conditions like Parkinson's Disease, Osteoarthitis and Stroke by introducing them to aquatic exercise.

Occupational Therapay- Aquatic Therapy Low Back Exercise 1 

Chrissy performing water exercises after a low back injury. Clinical bottom line for occupational therapy practice:

What does the evidence show?

• Land-based therapy and aquatic therapy were found to increase functional ability and decrease pain levels in those who suffer from Low Back Pain (LBP).
• Aquatic therapy significantly reduced the intensity of LBP amongst women in their second half of pregnancy.
• Aquatic therapy decreased the amount of sick-leave required for those suffering from LBP.
• Those in group aquatic therapy programs deteriorated less than those who were not in therapy.
• Moderate to strong evidence that multidisciplinary rehabilitation including strengthening, flexibility training, and cardiovascular endurance along with a cognitive behavioural approach improves function, reduces pain and work loss in patients with chronic LBP.

 

YouTube: London 2012 & Beijing 2008 Paralympic Games

London 2012 Paralympic Games

SSTattler: There are lots kind of sport - Archery thru to Wheelchair Tennis - we will only discuss Swimming. Please look at various sports London 2012 Paralympic Games.

SSTattler: Stroke Survivors can compete in swimming with e.g. hemiplegia, usually, class S7 (freestyle, backstroke, butterfly), SB6 (breaststroke), SM7 (Individual Medley). If want to find your "class" look at Layman’s Guide to Paralympic Classification and look at Swimming Qualification Times Paralympic  - there are very fast!

Definition Hemiplegia From Wikipedia, the free encyclopedia.

Hemiplegia /he.mə.pliː.dʒiə/ is total paralysis of the arm, leg, and trunk on the same side of the body. Hemiplegia is more severe than hemiparesis, wherein one half of the body has less marked weakness. Hemiplegia may be congenital or acquired from an illness or stroke. ....

Definition Paralympic Swimming From Wikipedia, the free encyclopedia.

Paralympic swimming is an adaptation of the sport of swimming for athletes with disabilities. Paralympic swimming is contested not only at the Summer Paralympic Games, but at disabled sports competitions throughout the world. The sport is governed by the International Paralympic Committee, hence the name of "Paralympic" swimming.

Rules for the sport are adapted from those set forth by the International Swimming Federation (FINA). The majority of rules for Paralympic swimming are the same as those for able-bodied competitions. Significant differences include the starting position and adaptations allowed for visually impaired swimmers. Competitors may start a race by standing on a platform and diving into the pool, as in able-bodied swimming, or by sitting on the platform and diving in, or they may start the race in the water. In events for the blind and visually impaired, people called "tappers" stand at the end of the pool and use a pole to tap the swimmers when they approach the wall, indicating when the swimmer should turn or end the race. Competitors in these events are required to wear blackened goggles, so that partially sighted swimmers compete at an even level with those who are totally blind.

Classification

Swimmers are classified according to the type and extent of their disability. The classification system allows swimmers to compete against others with a similar level of function.

Swimmers with physical disabilities are allocated a category between 1 and 10, with 1 corresponding to the most severe types of disability. Physical disabilities of Paralympic swimmers include single or multiple limb loss (through birth defects and/or amputation), cerebral palsy, spinal cord injuries (leading to paralysis or disability in limb coordination), dwarfism, and disabilities which impair the use of joints.

Blind and visually impaired swimmers compete within separate categories, being allocated to categories 11, 12 or 13. Category 11 corresponds to totally blind swimmers, while competitors in category 13 have severe but not total visual impairment.

Swimmers with mental disabilities compete in category 14.

Numbers are combined with a letter prefix depending on the event type. An "S" prefix corresponds to freestyle, backstroke and butterfly, while "SB" corresponds to breaststroke and "SM" to the medley. Hence, a swimmer with severe physical disabilities competing in backstroke may compete in an S3 event, while a blind swimmer in the medley would compete in class SM11.

Swimming at the London 2012 Paralympic Games

Four strokes are used in Paralympic competition: Freestyle (essentially front crawl), Backstroke, Breaststroke and Butterfly. All four strokes feature in the Medley Relay and 200m Individual Medley events; in addition, all of them except Butterfly feature in the 150m Individual Medley events for certain classifications. Races take place in a 50m pool, and may be started in a number of ways: from a standing start; using a dive start from a sitting position on the starting platform; and from within the water.

Swimmers are classified according to how their impairment affects their ability to perform each stroke. Classification numbers 1-10 cover athletes with physical impairments, with class 1 swimmers’ impairment having the greatest impact on their ability to perform strokes, through to class 10 swimmers’ impairment having the least impact. Athletes with a visual impairment compete in classes 11-13, with class 11 having little or no sight, through to class 13 having limited sight. Athletes with an intellectual impairment compete in class 14.

Breaststroke uses greater leg propulsion than any other stroke, therefore athletes with a physical impairment often have a different class for this event compared to Freestyle, Backstroke and Butterfly. This is also taken into account when athletes compete in the Individual Medley. This is shown by the prefix:

• S before the class represents Freestyle, Backstroke and Butterfly events.
• SB before the class represents Breaststroke events.
• SM before the class represents Individual Medley events.

Swimming - Men's 4x100m Freestyle Relay - 2012 London Paralympic Games 

- 34pts Final (SSTattler: each swimming has the classification - at least 2 men have S7 maybe more than 2 ...)

Swimming - Women's 50m Butterfly - S7 - 2012 London Paralympic Games

SSTattler: Tops time 36.03 - excellent!

Swimming - Men's 50m Butterfly - S7 - 2012 London Paralympic Games

SSTattler: Tops time 32.25 - excellent as well!

Swimming Women's 100m Backstroke S7 - Beijing 2008

Australian Katrina Porter wins Gold followed by Kirsten Bruhn from Germany and Dutchwoman Chantal Boonacker.

Swimming Men's 100m Backstroke S7 - Beijing 2008 Paralympic Games

USA's Lantz Lamback takes home the Gold Medal.

Swimming Women's 200m Individual Medley SM7 - Beijing 2008 Paralympic Games

USA's Erin Popovich stays under 3 minutes and wins the 200m medley.

Swimming men's 200m Individual Medley SM7 - Beijing 2008 Paralympic Games

Rudy Garcia Tolson from the USA beats his own world record and wins gold.

Saturdays Comics - Sept/15/2012

For Better and For Worse Lynn Johnston / 2007-05-08 "Lots of tension in your legs ..."	Dilbert Scott Adams / 2012-09-12 "I need to give you some push-back ..."
Garfield Jim Davis / 2012-09-14 "Liz says I need to be more of a thinker ..."	Betty Delainey & Rasmussen / 2012-09-12 "We encourage the use of the express slide."

* For Better and For Worse" is a serious topic of stroke but with a very nice cartoons. It is all about Grandpa Jim had a stroke and 88 further cartoon "strips" that happened to Grandpa Jim. (See as well  the author Lynn Johnston).

** I tried to get low or free price at the people http://www.UniversalUclick.com/ for the images for the cartoons. It was too high for Stroke Survivors Tattler i.e. we are not a regular newspaper and our budget is very low. Fortunately, you will have to do only 1-click more to see the cartoon image, it is legit and it is free using GoComics.com and Dilbert.com.

*** Changed from "Pickles" to "Betty" -- "Betty" is a excellent cartoon and Gary Delainey & Gerry Rasmussen are authors/artists/cartoon-strips and they live in Edmonton.

Saturday - Eclectic Stuff & Articles - Sept/15/2012

Definition:Eclectic(noun) a person who derives ideas, style, or taste from a broad and diverse range of sources.

Eclectic: Regina - Feeling Good as We Get Close to the Fall and Winter

By Regina Price

In the fall and later on — during winter -- makes many of us very sad and worried. But, really, it is the time to contemplate and relish our ideas and write about them -- or think about them -- during the few winter months that we do have.  Sometimes it is the time to learn new things and experience novel things.  It is time to add new things into our lives and practice them – whether it is being an artist type and taking photos, painting or carving wood, going to yoga classes, reading or listening to new music or books.


Last year, I decided to plant bulbs — which I did in the fall because in the spring they could come up early and bloom.  This made me smile and be happy.  It was work — planting about 100 bulbs -- but the flowers were amazing and it made me very proud and excited about the year. This fall, I will be too busy and couldn’t find the time to plant more bulbs but I will sit down and drew a picture of our place and indicate new things that my husband and I can plant in the spring to make our acreage nicer.  It isn’t a nice picture but it will be functional so my husband and me can see it and understand it.

Also, I have the possibility to listen to some DVD’s to learn new stuff — learning about the memory, aging and about older music.  I can hardly wait.  Perhaps listening to a new story or a course can be very interesting and fun.  Sometimes, going to the library and picking up an old movie makes me feel better.

This year, I will take my granddaughter to the symphony for kids — I will enjoy it as much as she could because watching and listening to her makes me smile and happy.  I might take her to a wilderness centre on a good, warm day to get her to try out cross country skiing and we can trundle around a bit.

Sometimes, it is interesting to go to the mall and watch people -- while enjoying a tea or coffee.  In my past life, I watched people often and it made me think about becoming a psychologist before I become one.  It was very enlightening and educational to watch people.  Now-a-days it is very instructional to watch my two dogs and get ideas what motivates them -- this makes me a good owner.  When I don’t understand whatever they are going, it makes me got to the library and pick out books or DVD’s that would help me.

In the past years, my friend and I decided that we should walk around for about 45 minutes in the winter during sunny days to get rays and feel better.  We went once or twice a month and it helped us both.  I had seasonal affective disorder (SAD) and going walking outside really helped me feel restored.

There are so many opportunities that we could utilize to make our lives better and our emotional stamina stronger.  Let me know what ideas you have to make your lives less stressful and happier …

Eclectic: Jackie - The History of a Fly ...

I was visiting my son and daughter-in-law. Last night when I asked if I could borrow a newspaper.

"This is the 21st century, old woman," he said. "We don't waste money on newspapers. Here, you can borrow my iPod."

I can tell you, that friggin fly never knew what hit it...........

Eclectic: Diane - Last OT Visit.

Diane - The Pink House ITC

Friday was Bob's last home visit with the Occupational Therapist. This is the first time that he actually used all the visits allotted by the insurance company. Usually, therapists discharge him sooner than we expect because, they say, his progress is too slow or they just sort of give up on him.

Bob's new hand splint.

I must say, this OT was the best we've had so far. She taught me how to stretch Bob's neck muscles, perform gentle traction on his spine, how to position him in bed, and how to perform isometric exercises with Bob pushing his head back into my hands. She said she's noticed a definite increase in his neck muscle strength from when we started working with her.

Oh! And she taught me how to tip that wheelchair backward, which is great for washing his hair at the sink. That trick alone is worth its weight in gold.

She also left him with this hand splint. The previous OT said ...

See the full article Last OT Visit from The Pink House On The Corner.

Article: Acorda Therapeutics Announces Initiation of AMPYRA® Proof-of-Concept Study in Patients with Post-Stroke Deficits

I wanted to let you know about a clinical trial for an investigational medication called dalfampridine (Ampyra), for people who are suffering from chronic problems with motor skills more than six months after an ischemic stroke. This study is still recruiting participants at many location in the US.

More details about the study, including sites involved in the research, can be found at: http://clinicaltrials.gov/show/NCT01605825

From the press release "Acorda Therapeutics Announces Initiation of AMPYRA® Proof-of-Concept Study in Patients with Post-Stroke Deficits".

"This proof-of-concept study will assess the safety and tolerability of AMPYRA in people with stable post-stroke deficits after an ischemic stroke. Exploratory efficacy outcome measures will include: changes in walking speed, upper and lower extremity motor and sensory function, manual dexterity, assessment of functional independence in performing activities of daily living, and clinician and subject global impressions of general improvement. The study is expected to include approximately 66 people who have experienced an ischemic stroke at least six months prior to enrollment, by which time the deficits are generally stable. The Company expects to announce initial study results in early 2013. "

Article: Gary - Kathy Spencer's Story Of Recovery After Stroke.

Gary - PEI Blog

I was just reading chapter 11 of the book "The Man With The Bionic Brain" by Dr. Jon Mukand. He tells us of Kathy Spencer and her recovery from stroke. It was in this chapter of this book that I learned about Kathy and her YouTube video.  She tells us how she has used the tools that were available to her while being faithful to her daily exercises. She had learned how to re-teach her brain and by setting a goal to play the piano again, she did what I call "project based stroke recovery".  She became along the way a stroke myth buster and an amazing advocate to persons and families affected by stroke.

 Kathy says it much better than I ever could, so just click on the arrow in the middle of the image below to start the video.

Article: Dean - Green Tea Boosts Memory.

Deans' Stroke Musings

So doctor should we be drinking gallons of green tea while in the hospital? -- Deans' Stroke Musing - Green Tea Boost Memory.

From Australasian Science:

It has long been believed that drinking green tea is good for the memory. Now researchers have discovered how the chemical properties of China’s favorite drink affect the generation of brain cells, providing benefits for memory and spatial learning. The research is published in Molecular Nutrition & Food Research.

“Green tea is a popular beverage across the world,” said Professor Yun Bai from the Third Military Medical University, Chongqing, China. “There has been plenty of scientific attention on its use in helping prevent cardiovascular diseases, but now there is emerging evidence that its chemical properties may impact cellular mechanisms in the brain.”

Professor Bai’s team focused on the organic chemical EGCG, (epigallocatechin-3 gallate) a key property of green tea. While EGCG is a known anti-oxidant, the team believed it can also have a beneficial effect against age-related degenerative diseases.

“We proposed that EGCG can improve cognitive function by impacting the generation of neuron cells, a process known as neurogenesis,” said Bai. “We focused our research on the hippocampus, the part of the brain which processes information from short-term to long-term memory.”

The team found that EGCG boosts the production of neural progenitor cells, which like stem cells can adapt, or differentiate, into various types of cells. The team then used laboratory mice to discover if this increased cell production gave an advantage to memory or spatial learning.

“We ran tests on two groups of mice, one which had imbibed EGCG and a control group,” said Bai. “First the mice were trained for three days to find a visible platform in their maze. Then they were trained for seven days to find a hidden platform.”

The team found that the EGCG treated mice required less time to find the hidden platform. Overall the results revealed that EGCG enhances learning and memory by improving object recognition and spatial memory.

“We have shown that the organic chemical EGCG acts directly to increase the production of neural progenitor cells, both in glass tests and in mice,” concluded Bai. “This helps us to understand the potential for EGCG, and green tea which contains it, to help combat degenerative diseases and memory loss.”

This paper is published as part of a collection of articles bringing together high quality research on the theme of food science and technology with particular relevance to China. Browse free articles from Wiley's food science and technology publications including the Journal of Food Science, Journal of the Science of Food and Agriculture, and Molecular Nutrition & Food Research.

Eclectic: Randy - The Edmonton Symphony Orchestra presents - Robbins Pops - From Stage to Screen

SATURDAY, SEP 15, 2012, 8 – 10PM

Location Enmax Hall, Winspear Center
                (4 Sir Winston Churchill Square)
City / Town Edmonton
Event Venue Winspear Centre
Description Ashley Brown and Sherwood Park’s 
                own Ryan Silverman journey from 
                the glamour of the silver screen 
                to the excitement of Broadway’s 
                great hits!
Event Category Concerts / Performances, 
                Performing Arts / Culture
Cost            $89 Dress Circle, $79 Terrace, $64 Orchestra, 
                $49 Upper Circle, $36 Gallery, $20 Orchestra Front
Link            www.edmontonsymphony.com …

Ashley Brown (Broadway’s Mary Poppins) and Sherwood Park’s own Ryan Silverman (star of The Phantom of the Opera on Broadway) journey from the glamour of the silver screen to the excitement of Broadway’s great hits, including West Side Story, Guys and Dolls, Brigadoon, My Fair Lady, Star Wars and more.

Steven Reineke, conductor
Ashley Brown, vocalist
Ryan Silverman, vocalist

Eclectic:Monty - How Did They Know?

Something in the universe that is greater and deeper than human intelligence. The elephant's journey to pay respect, but how did they know ...?

Lawrence Anthony, a legend in South Africa and author of 3 books including the bestseller, The Elephant Whisperer, bravely rescued wildlife and rehabilitated elephants all over the globe from human atrocities, including the courageous rescue of Baghdad Zoo animals during US invasion in 2003.

On March 7, 2012 Lawrence Anthony died.

He is remembered and missed by his wife, 2 sons, 2 grandsons & numerous elephants. Two days after his passing, the wild elephants showed up at his home led by two large matriarchs. Separate wild herds arrived in droves to say goodbye to their beloved man-friend'. A total of 31 elephants had patiently walked over 12 miles to get to his South African House.

Witnessing this spectacle, humans were obviously in awe not only because of the supreme intelligence and precise timing that these elephants sensed about Lawrence's passing, but also because of the profound memory and emotion the beloved animals evoked in such an organized way: walking slowly - for days - making their way in a solemn one-by-one queue from their habitat to his house.

Lawrence's wife Francoise, was especially touched, known that the elephants had not been to his house prior to that day for well over 3 years! But yet they knew where they were going. The elephants obviously wanted to pay their deep respects, honouring their friend who'd saved their lives - so much respect that they stayed for 2 days 2 nights without eating anything.

Then one morning, they left, making their long journey back home.

Article: Sharon - What Treatment Should You Expect After A Stroke? Best Practice Guidelines.

Worldwide, to ensure that patients get appropriate treatment, stroke professionals have sifted through the research evidence and designed guidelines for the most effective treatments.

In the United States, the American Stroke Association best practice guidelines are “Get with the Guidelines, 2009.”  In Canada,  the Canadian Stroke Network has developed comprehensive recommendations for best practices – the “Canadian Stroke Strategy Stroke Best Practice Recommendations Update 2010.”

There are many way that stroke survivors and care-partners can use the best practice guidelines:

• If you are new to stroke, you can see what treatment you should expect.
• If you are newly discharged home from the hospital or from rehabilitation 
• If you had a stroke many years ago you can compare the treatment you received with best practices. 

Let’s see how someone with a mild stroke might use the Best Practice Guidelines.

In Alberta, about 40% of people diagnosed with stroke or TIA go either to their family doctor or to an emergency facility. They are experiencing mild symptoms like slight numbness in their arm, tingling in their fingers, or they might have some trouble finding words or speaking.

The Canadian Stroke Network Best Practice Guidelines refer to this as “non-disabling stroke.”  Mike (not his real name) had this experience:

Mike drove himself to emergency because he had some numbness in his right arm.  When he arrived he had some trouble explaining to the triage nurse what was wrong, but he was able to give her his health care card and answer the simple questions she asked.  While he waited for the doctor, he noticed that the numbness was getting better. The doctor said it was likely a TIA (transient ischemic attack) and sent him for a brain scan.  Indeed, after the doctor saw the scan, he told Mike that it was a TIA. The doctor checked to see if Mike was taking daily aspirin to prevent another stroke and complemented Mike on coming to emergency so quickly, “Many people would not have even come to emergency with your symptoms. ”  He recommended that Mike make an appointment with his family doctor as early as possible.   He explained that with Alberta’s electronic health record, his doctor would have a record of this emergency visit.  

So according to the Best Practice Guidelines (Page 55) what should Mike expect when he calls his family doctor? The guidelines for TIA or non-disabling stroke recommend:

“All patients with suspected transient ischemic attack or non-disabling ischemic stroke should   undergo an assessment that includes an electrocardiogram, brain imaging, and non-invasive vascular imaging (for carotid territory transient ischemic attacks or non-disabling strokes) within seven days of symptom onset, and have a consultation with a stroke specialist [Evidence Level B].”

Why is this important?

• Stroke recurs in 20% of patients, most commonly within the first year after TIA or minor stroke, most within the first 90 days.  
• The risk of stroke after TIA or minor stroke is 8-12% at 7 days and 11-15% at one month. 
• Patients suffering a second stroke are likely to have increased impairment and spend more time in hospital and rehabilitation (Malewezi, 2011). 

So one would expect that the earlier that Mike sees the doctor, has these assessments done, and follows the treatment recommendations that he will be at much lower risk of having a larger stroke.  The Best Practice Guidelines recognize this:

“Patients presenting with transient ischemic attack or non-disabling ischemic stroke and motor or speech symptoms should optimally have the assessment on the day of symptom onset. ”

What happened to Mike?

When Mike was driving home after the doctor discharged him from emergency, he noticed that he was having some trouble reading the road signs. It was 3 AM so there wasn’t much traffic. Still, he was anxious about the small changes he was noticing and worried about another stroke, so when he arrived home he asked his son to check on him.  The following day he called his family doctor. He noticed that he had trouble remembering the doctor’s phone number.  He made an appointment to see the doctor later in the week and then went off to work.  He couldn’t believe how tired he was at work.  He assumed he was fatigued because he hadn’t slept much.

Many people with mild stroke experience problems like Mike’s.  They may have trouble remembering things, feel fatigued, or have difficulty balancing a check book or reading.   The Canadian Stroke Network Best Practice Guidelines recommend a Comprehensive outpatient assessment for impairments:

Patients with non-disabling ischemic stroke who are not admitted to hospital should be considered for referred for a comprehensive outpatient assessment of functional impairment, which should include a cognitive evaluation, screening for depression, screening of fitness to drive, and functional assessments for potential rehabilitation treatment [Evidence Level B]. 

See the guidelines for Supporting patients and families through transitions and Patient and Family education Link:

Consult the Canadian Stroke Network Best Practice Guidelines.

References: Malewizi, E. (2012). Stroke policy and secondary prevention: how well are we adhering to these guidelines. British Journal of Neuroscience Nursing. 7(6), 684-690.

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