Friday, January 11, 2013

Little = Lots


I love this study. It was a small study that our lab did. Basically we used the NeuroMove and got people to move their wrists and fingers, just a little. The point is, if you can find the X factor that allows for just a little active (under your control) finger and wrist extension, then you can use other options to take you further. But the trick is getting the first few degrees of movement. And we did it. The end.

Visit tia strokes to get more info about signs of a stroke.

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Reporter has TIA on air.

Stroke can rear its ugly self in so many ways. Aphasia is one way. Many thought this was an example...

Multisource political news, world news, and entertainment news analysis by Newsy.com


Further info from the Associated Press

"LOS ANGELES -- The CBS-TV station in Los Angeles says a reporter who spoke incoherently during a segment on the Grammy Awards is feeling fine.


Serene Branson was checked by paramedics immediately after her Grammys report Sunday from outside the downtown Los Angeles arena where the awards where held, according to the station's website.

The young woman's vital signs were normal and she wasn't hospitalized, CBS said. A colleague took her home as a precaution and she said she was "feeling fine" Monday, according to the channel. "

She told her local CBS station last week, "My head was definitely pounding and I was very uncomfortable and I knew something wasn't right. I was terrified and confused. Confused. What had just happened? At that point they sat me down, then my right cheek went numb. My right hand went numb and I lost some sensation in my arm."

Can't talk? Right side numb with no sensation? Its a "complex migraine"? Really? Really?

This lady went through the same thing...





Visit tia strokes to get more info about signs of a stroke.

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G'head. Click the article.




Extry!


Extry!

Visit tia strokes to get more info about signs of a stroke.

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Radio Interview

I did a recent radio interview with Karla Calumet, a very nice professor and radio personality from Perry, Iowa. So get some tea, sit back, and...



Visit tia strokes to get more info about signs of a stroke.

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Small Study. Small Recovery Gains. Big Message.

This is a small study that I was involved in. We used the NeuroMove to get stroke survivors who have no movement in the wrist, to have some wrist extension. This is really important because a little movement can be used to jumpstart much bigger movements. The important line is "However, both groups showed a 21 degree increase in active affected wrist extension after (NeuroMove) use."

Visit tia strokes to get more info about signs of a stroke.

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Selected Talks

 A few of the hundreds of talks I've done on stroke recovery and rehabilitation



Rehabilitation hospitals:

Kessler Institute for Rehabilitation, West Orange, NJ
Magee Rehabilitation Hospital, Philadelphia, PA
Braintree Rehabilitation Hospital, Braintree, MA
Frazier Rehab Institute, Louisville, KY
New England Sinai Hospital & Rehab Center, Stoughton, MA
Mt Sinai Rehabilitation Hospital, Hartford CT
Integris Jim Thorpe Rehabilitation Hospital, Okalahoma City, OK
St. Luke's Rehabilitation Institute Spokane, WA
Casa Colina Hospital for Rehab., Pomona CA
John Heinz Inst. of Rehab. Medicine, Wilkes-Barre Township PA
Grossmont Hospital, San Diego, CA
Main Street Physical Rehabilitation Center, Danbury CT

Academic centers:

The University of Michigan, Ann Arbor, MI
Southern Illinois University Herrin Hospital
University of Cincinnati Hospital, Cincinnati, OH
Ohio State University, Columbus, OH

Hospitals:

Baylor All Saints Medical Center Ft. Worth TX
Medical City Dallas Hospital, Dallas, TX
Atlanta Medical Center, Atlanta, GA
Mount Sinai Hospital, Boston, MA
Catholic Medical Center, Manchester NH
Stamford Hospital Tully Health Center, Stamford, CT
Scottsdale Healthcare, Scottsdale, AZ
Truman Medical Center Lakewood Kansas City
St. John's Health System, Springfield, MO
Inova Mount Vernon Hospital, Alexandria, VA

International:

Georg-Brauchle-Haus, Munich, Germany.
Chinook Regional Hospital, Lethbridge, Canada; simulcast to Alberta Health Services

Visit tia strokes to get more info about signs of a stroke.

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Thursday, January 10, 2013

An Excellent Review (if I do say so myself)






Here is a
review of my book. Me likey!

~

Visit tia strokes to get more info about signs of a stroke.

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Chicks dig smart...

I am currently reading the Cambridge handbook of expertise and expert performance. I do this all the time; I buy really fat books (this one has almost 900 pages) mostly to impress my wife. Then I find myself drawn into them bit by bit. It turns out that this book has quite a bit of information that relates to stroke recovery.

I do a lot of seminars talking to therapists about stroke recovery. I generally push neuroplasticity (“brain rewiring”) as the foundation for all recovery from stroke. And the easiest way to rewire the brain is to do repetition of whatever movement the stroke survivor is trying to recover. The therapists, curious lot that they are, always ask, “How many repetitions of the movement have to happen before the brain rewires?” The problem is that this question cannot be answered with a-one-number-fits-all answer. The number of repetitions needed depends on how much movement there is to begin with, how focused the stroke survivor is in the practice, how complicated the movement is, etc. etc. The very fat book I'm reading says that there is general agreement that to become an expert in anything takes 10 years. We also know that to become a very high-level athlete, musician, or acquire a skill like carpet weaving takes more than 1 million repetitions of the movement(s).




So the question I have is, when does recovery end? After 1 million repetitions? After 10 years? If either of these is in the right ballpark, another question follows, “Why are stroke survivors discharged from therapies within a ye
ar or so of their stroke?”

Visit tia strokes to get more info about signs of a stroke.

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Comments from Attendees



Best instructor ever!  LJ, OTR, Detroit MI

The best course I've taken in my career!  EG, PT, Seattle, WA

One of the best CEU classes I've been to. Speaker was enjoyable, knowledgeable, funny. Never looked at my watch. TW, PT, Huntsville Alabama

Amazing presenter. Very interesting and entertaining. Made the information easy to understand. DS, PT Anaheim, CA

It was nice to have a good amount of material, straight to the point, but still added a sense of comedy. One of the most enjoyable courses i've been to. LL, PT Anaheim, CA

One of the best courses I've ever attended -- will be looking at future courses offered by this company. Really like the down-to-earth approach. Peter is a very engaging speaker and kept my interest throughout the seminar. OTR, , Cherry Hill, New Jersey

Fun! Entertaining! Knowledgeable! LS, SLP, Austin Texas

Never had so much fun in a CEU class. AK, PTA Bloomington, MN

Excellent speaker! Enthusiastic, knowledgeable, able to convey scientific info with relevance for direct clinical application. Great sense of humor and communicator. I enjoyed this course very much! LS, PT, Pittsburgh Pennsylvania

Enjoyable, knowledgeable, and captivating. RB, OT Hauppgue, New York

Great presentation! So informative and enjoyable!! SA, PT, Tarrytown New York

Peter is captivating, makes it simple + emphasizes the take-home message often. LS, PT, Milwaukee Wisconsin

Peter is easy to listen to style made this information very interesting and helpful. 1 practical application to my caseload 2 easy to converse with the instructor with reference material at quick access. Very excellent presentation with helpful information. KA, PT, Amarillo Texas

I liked the mix of humor that the instructor used during his lecture. I was drawn into the lecture from the first slide. I didn't look at my watch once! I was not bored at all and will bring a lot of this information into my therapy sessions. PT, Milwaukee Wisconsin

Excellent in all areas! Never a dull moment. I was very interested in the correlation of research to clinical practice and methods to it adapt to individual settings. PT, Green Bay Wisconsin

Incredible range of very practical information, backed by research. Peter, you have a new fan! I plan to utilize the research options and share with peers. SF, PT Bloomington, MN

Very enjoyable presentation. Peter’s enthusiasm and knowledge made the course very helpful. His experience on the topic makes him great to learn from. J.U: OTR/L. Minneapolis Minnesota

Great presenter -- appreciate the humor throughout! (And being so laid back) LY, OTR Minneapolis Minnesota

Easy to listen to. Presented information in a manner that made complex concepts understandable. Great background info on topic and yet covered actual useful treatment information thoroughly. This was one of the best seminars I ever attended on stroke (I have been a therapist for 27 years). I wish some of my coworkers had attended so we could trial some of these techniques together. DK, OTR/L. Minneapolis Minnesota

Well spoken, interesting, enjoy the humor. Great information on resources, and search engines that will be beneficial for future use. Appreciated the research and evidence-based information. SS, OTR/L. Minneapolis Minnesota

This seminar is making me think outside the box in contrast to what I've been told works in stroke recovery. Peggy, OTR, Harrisburg Pennsylvania

Excellent with focus on material and really driving the point home. Humor was much appreciated! Becky, PT Harrisburg Pennsylvania

I appreciate the OT portions -- often I attend seminars and there is only a few brief mentions of OT, yet the seminar is marketed to OTs. DT, Bethlehem Pennsylvania

Enjoyed Mr. Levine's presentation style and thoroughly appreciated his sense of humor Donna Marie, COTA, Valley Forge, PA

Peter was a dynamic, interesting and effective speaker. I like his informal style. I greatly appreciate the relevance of the mCIT program and the materials provided in the appendix. It was wonderful to see clinically relevant info so early in the presentation. OTR, King of Prussia, PA

Very good mix of lecture visual aids and demonstration. It is a benefit to have access to the tools presented making it much more likely to be applied to clinical practice. A J., DPT, Baton Rouge Louisiana

Instructor is knowledgeable and gives seminar in everyday language. Easy-to-understand. CB, PT, Baton Rouge Louisiana

Peter sense of humor kept my attention span. Thank you for a wonderful course! JG, OT, Baton Rouge Louisiana


Extremely knowledgeable, clinical and research based which loaded me with a ton of information and references! Enjoy the humor! This seminar provided tools and info I can use in the clinic to help my stroke patients recover! I enjoyed it all! Examples of tests and articles were very helpful. AC, COTA, Athens Georgia

This seminar was informative and presented in an effective/entertaining manner. RS, PTA, Athens Georgia

The instructor was entertaining and kept my attention. Good presentation. The research study information was beneficial along with special tests. Really appreciate the appendix information. DL, PT, Athens Georgia

Things lively and entertaining but very informative. Gave good research details to back up practical hands-on information. PT, Athens Georgia

Very good presentation. He took valuable information and presented it in an understandable manner. GG, PTA, Athens Georgia

This seminar was interesting and kept my attention. It provided practical application of studies into clinical practice. LP, OTR, Athens Georgia

The instructor was actually in holding my attention throughout the conference, not boring, lively. The tone of the instructor was the most beneficial part of the program. JG, PTA, Augusta Georgia

Peter is able to effectively blend scholarly material in layman's understanding with a healthy dose of humor and self deprecation. He provides a simplified an understandable version of brain injury that can be communicated to patients/family. A broad and concrete passive program -- generously accented with your. Informative -- even for a non-therapist. BM, NHA, Augusta Georgia

Very easy to follow. Utilizes techniques such as humor and entertainment to keep audience focused. JH, OT, Augusta Georgia very good, informative with the information given (websites, etc.) for further information and research. DL, PT, Augusta Georgia

Mr. Levine is an excellent speaker. I like how he incorporates humor into the context of the subject. As a speech language pathologist, I can continue to collaborate and consult with PTs and OT services in regards to a patient's ability to recognize body part and follow simple/complex directions within the context of treatment. CB, MS, SLP, Augusta Georgia

Very knowledgeable; "loved" his use of humor and great PowerPoint presentation to include graphics, etc.; very dynamic speaker!! His overall presentation was very effective and kept my attention. Excellent seminar!! CT, OT, Augustine Georgia

Excellent examples and reference handouts in the appendix. Will utilize material in practice. Peter was hilarious and very knowledgeable! Made learning fun! Great job! PT, OT, Augusta Georgia

Best speaker in CEU course I have attended in the last four years since I have lived in Atlanta. TO, OT, Atlanta Georgia

Very dynamic presentation. The most beneficial part was about evidence-based practice and starting small with articles makes it more approachable. CC, PT, Atlanta Georgia

Balance of humor and the slew of info available, excellent leads on new resources, research, and ideas. HG., OT, Atlanta Georgia

Memorable! CH, PT, Austin Texas

Very clever presenter who keeps interest up entire session. Slides were excellent. KL, OTR, Austin Texas


Easy-to-follow, entertaining, enjoyed the presentation. Presented research in an understandable manner. KL, OTR, Austin Texas

Knowledgeable, clever and interesting. Presenter is a researcher with also some clinical experience. MR, PT, Austin Texas

Fantastic info. Info I received allows me to increase knowledge of treatments with stroke patients. AR  COTA, Austin Texas

Lighthearted enough to keep your attention... serious enough to make it well worth my time area DH, PT, Austin Texas room

Very good. Class interesting. Great seminar. TA, LPTA, San Antonio Texas

Gave excellent up-to-date material clearly and unequivocally area clear-cut examples of what does and does not work with stroke recovery. The description of modified constraint induced therapy. Good use of humor. Excellent teacher. Made complicated points easy to understand. Good evidence. Kimberly Vogel, associate professor, UTHSCSA

Organized, interesting, funny, easy to listen to. ST, PT, San Antonio Texas

Great! Enjoy! ML, C from one room OTA, San Antonio Texas

He kept my attention. He was interesting and had a great sense of humor. His knowledge and organization of materials was great and easy to follow!!!! AH, OT, San Antonio Texas

I enjoyed the presentation. The instructor did very well with motivating students and keeping us involved. Everything was relevant information. Updated information was excellent for me. JV will room, OTA, San Antonio Texas

Excellent -- well researched in current approaches. JS, OTR, Houston Texas

Very good presenter, enjoyed learning from him. DB, OTR, Houston Texas

Very flexible and kept attention. Seminar manual with appendix of testing tools and references were most beneficial. LL, PTA, Houston Texas

I enjoyed the humor, practical examples, updated research. He kept me awake and an active listener/learner. The videos, practical examples and the content was presented in a very brief, concise way. AS, PTA, Houston Texas

He knew when to speak loudly or change the subject to keep the audience's attention. The most beneficial was demonstration of tests, tests in the back of the manual, references and basic knowledge review. JT, PTA, Houston Texas

Excellent! New and older research materials relevant to the topic. Presented well. DL, PT, Houston Texas

Wonderful, brilliant, humorous speaker! Couldn't go to sleep even if I wanted to -- whish I could absorb all his knowledge. SS, OTA, Houston Texas

Great speaker, very engaging, loved the humor. JR, OT, Thousand Oaks California

Thoroughly enjoyed this seminar, especially the jokes/humor; made it easier to keep my attention. I am fairly new to the SNF setting and I found this seminar to be informative. I wish I had taken this course sooner. Very concise and the instructor was very engaging. MN, OT, Thousand Oaks California

Thank you for your research and dedication! Please keep presenting this material! RP, PT, Thousand Oaks California

Exceptionally informative. NOT BORING. Witty. Promoted research. Very forward minded. Captured my interest on what could be a boring topic -- research and familiar technical information. Speakers ability to relate research information to clinical practice was most beneficial. He he, OT, Thousand Oaks California

Liked it a lot. Like watching an episode of Daniel Tosh and I LOVE Daniel Tosh. Helpful and useful information to boot! LS, OT, Thousand Oaks California

Very, very funny! J R-V, OT, Thousand Oaks California

Made learning fun and great resources provided. Able to back it up with research. JD, OT, Thousand Oaks California

Great speaker. Info related to clinical use -- straightforward regarding research substantiating methods. MC, PT, Anaheim California

Funny, easy to listen to with moving art within the slides to break up serious lives. Appreciate his understanding of research and dedication to stroke results. Speaker is just easy to listen to. Appreciate the research reviews. AB, PT, Anaheim California

Appreciate the humor/great slides. Great review of neurology. LU, OT, Anaheim California

Excellent course, I loved the instructor's humor. LB, PT, Anaheim California

Peter is able to present information in an entertaining way, keeps the ideas flowing and is very informative. CS, DPT, Anaheim California

Instructor made learning environment comfortable and engaging while teaching topic. DO, PT, San Diego California

Very personable and used humor well. Easy-going and made it fun. MK, PTA, San Diego California

The instructor was excellent. KL, speech pathologist, San Diego California

The instructor's humor and connection to the audience with empathy was effective in assisting with learning. MC, OT, San Diego California

Peter presented his (potentially dry) research material in an entertaining and funny way! KW-G, PT, San Diego California

Peter did a great job presenting the information well and matching it to affected ways to practice the evidence-based methods. It was great!. TG, OT, San Diego California

Excellent resources, studies, etc. Mr. Levine was informative and entertaining. RO, DPT, San Diego California

Great speaking ability, at our level, good variation of voice and sense of humor. Easy-to-follow with great anecdotal evidence presented for every point made. Most beneficial was research presented in clinical terms so that we can take it straight to the clinic. RA, PT, San Diego California

Very good job of bringing a large amount of information into a very manageable and useful amount. Excellent presenter. NT, PT, Cleveland Ohio

Great speaker -- kept it interesting and relevant. Great info on neuroplasticity and modified constraint induced therapy. JD, PT, Cleveland Ohio

You did an excellent job of capturing your audience. Some lectures that I have attended were very boring -- this definitely was entertaining. I found it beneficial that some basic components were covered in the beginning of the lecture. You define neuroplasticity and talked about the penumbra as the part of the brain that will become plastic. MY, PT, Akron Ohio

He has such an excellent grasp of difficult material. Many concepts seem simple. DB, OT, Akron Ohio

Speaker used good pacing, simple explanations and humor to increase learning. Really appreciate completeness of handout especially references and websites. Speech therapist, Akron Ohio


Well done. In joy the humor! You have inspired me to refer to more research and bring into the clinical setting. FM, PT, Youngstown Ohio

One of the best presentations I attended in 30 years. EB, OT, Boardman
Ohio

Great!!! KW, PTA, Boardman Ohio

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It was great to be provided with significant amounts of resources. Most courses focus on PT. Appreciate OT focus as well. Very beneficial. Love the speaker. Did a great job. TP, OT, savanna Georgia

Very interesting to hear from a speaker that is actually working inside a lab (research). LR, PT, Charleston South Carolina
Mr. Levine is very knowledgeable related to research practices of stroke recovery. Enjoyed learning about historical practices. Especially relevant personally to me; I'm in the process of working on my doctorate here it KD, OT, Charleston South Carolina

Full of humor, down-to-earth, very usable info. As a speech language acknowledges a learned a lot about PT/OT approach to stroke. PM, speech pathologist, Charleston South Carolina

Very organized and knows his stuff. JF, OT, Charleston South Carolina

Excellent PowerPoint presentation. Good review of outcome measurement tools -- strengths/disadvantages. The most beneficial part of the program was the review of history of stroke and earlier interventions and they are effectiveness in the provision of treatment. Instructors shimmer is a plus! HP, PT, Charleston South Carolina

Concise, thorough presentation with good videos/PowerPoint. JB, PTA, trust and South Carolina

This program gave me more info on constraint induced therapy. Also suggested lots of websites to keep abreast. Everything was useful. JS, OT, Charleston South Carolina

Knowledgeable, refreshingly dry yet refined. JC, OT, Charleston South Carolina

Peter has a huge knowledgebase about the latest stroke research and effective treatment options based on research! :-) very informative and Full of interesting knowledge! Easy to listen to and entertaining :-) AW, PT, Columbia South Carolina

I enjoyed the presentation and appreciated his efforts to actually number and asked her historical info. Content was great. MW, OT, Columbia South Carolina

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Use of humor and stories help keep it interesting. Info is very easy to apply practice right away. Peter is an excellent speaker! AK, OT, Ewing New Jersey

indeed. Easy-to-understand. Inc. personal experiences and/or examples. KN, PT, senior rehab program manager

Great speaker, well-informed, great presence to teach and maintain attention of his audience. Thoroughly explains CIT for me in all settings. LG, OT, Eatontown New Jersey

Peter was very engaging and humorous. He presented material in a very comprehensible manner. CK, OT, Eatontown New Jersey

very knowledgeable, funny, keeps your attention. MS, OT, Tinton Falls, New Jersey

Overall excellent program. ER, PT, Eatontown New Jersey

Very engaging, knowledgeable, funny. Lecture was great! LD, OT, Eatontown New Jersey

Slides were interesting -- he expanded and thankfully does not read the material to participants. I thought this was the best program I've attended in 10 years! The speaker is easy-to-understand, talked loudly and clearly and had a wealth of information! I truly enjoy his lecture! BS, OT, Eatontown (Long branch) New Jersey

Peter's knowledge plus humor me the course a great learning experience. Good examples and quick references to facilitate carryover to patients. Easy-to-follow course info. Not too much time spent on etiology -- which captured my interest from the beginning. DS, OT, Eatontown/Tinton Falls New Jersey

Made everyone feel comfortable; funny and entertaining. JR, OT, Long branch/Tinton Falls New Jersey Mr. Levine is an excellent speaker, very knowledgeable, funny and engaging! I really enjoyed this course. JF, PT, Tinton Falls New Jersey

Excellent, knowledgeable and prescient! Very interesting all through. KN, PT, new Brunswick New Jersey

Engaging, current, comprehensive, enjoyable. AMV, OT, East Brunswick New Jersey

Went to bed at 2 AM got up at 6 AM was afraid to fall asleep. DID NOT! It was REALLY interesting and I liked it. RN, MS PT, East Brunswick New Jersey

Great presentation -- very relaxed, knowledgeable, and VERY funny!! Haven't been to a course where the instructor worked so many laughable lines into a serious subject like stroke. Really good presentation -- really good speaker, very funny and made his subject interesting!! KM, OT, East Brunswick New Jersey

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Islip, NY. 6/28/11
White Plains, NY. 6/29/11
Hempstead, NY. 6/30/11

Speaker was motivational and well-versed in his knowledge of the information. Good seminar. LM, PT, Islip New York

great presentation and material was presented in an easily understandable manner. JC, OT, Islip New York

very good! Liked manner of presentation. Not boring. Good resources for information after courses over. D0, PT, White Plains New York

very well done; good speaker -- very knowledgeable. Great presentation; highly recommended it and truly enjoyed it. Thank you! JM, PT, White Plains New York

I enjoyed it very much. It kept me awake, interested in wanting to try it in my practice. I found it very interesting. Rh, PT, White Plains New York

Excellent speaking voice, delivery, slides and discussion. Great course -- highly recommend to all colleagues working in various settings. DD, OT, White Plains New York

he is very knowledgeable, fun and very interactive throughout the seminar. Fun and enjoyable entire seminar. Entire course was very educational and improved my knowledge about stroke. IP, OT, White Plains New York

Very interesting -- and a great sense of humor -- 19 a long day interesting and not boring. RF, PT, rehab coordinator, White Plains New York

Excellent, interesting, humorous. JI, PT, Westbury New York
Knowledgeable and interesting. It was good. Great course -- great, interesting speaker. JL, OT/coordinator, Westbury New York

Will come informative, entertaining. It was great! Reinforce all that I am doing to rehabilitate my mother. Also gave me some new information to use and develop new ideas. KG, Dr. of education, associate professor, Westbury New York

His knowledge of material and self-effacing humor kept my interest throughout the class. SA, PTA, Westbury New York

===============================

sense of humor terrific and helps keep on task. LC, PT, Albany New York

presentation style very engaging, able to maintain connection with the audience. PC, OT, Albany New York

Mr. Levine presented this topic very well and easily understood -- thank you! Entire presentation was thorough and well organized and instructed.
EC, PTA, Albany New York

excellent presentation -- presenter is engaging in numerous -- great job explaining each area of the presentation. I found the presentation extremely beneficial -- great resources in the appendix as well. Really enjoyed it! JC, OT, Hartford Connecticut

excellent interaction with the audience, easy-to-follow. References/handouts very useful and informative. LZ, OT, Hartford Connecticut

Easy-to-follow, brings real experience as clinician. MV, PT, Harvard Connecticut

The instructor provided many comprehensive resources that will be useful for me in my clinical practice. The instructor presented materials in a comprehensive, easy to understand fashion. SD, OT, Hartford Connecticut

style presentation for silicate and excitement to put into practice knowledge gained. The most beneficial part of this program for me is organization of material I had partial familiarity with into a cohesive whole. HB-D, OT, Providence Rhode Island


Excellent. Subject interesting as it can be "dry" at times. ML, OT, Providence Rhode Island


=========================
very good presentation technique -- makes of practical and didactic information. Gail Byrd, PT, Alexandria Virginia

Mr. Levine is a very gifted instructor -- made the material fun and relevant, and gave us a perspective for sifting through evidence-based data without getting overwhelmed by it. The most beneficial part was instruction on how to find, and evaluate all the new data that is out there. I am an OT returning to work after a couple years accidents, so this was particularly good for feeling I could get back to "current." CW, OT, Alexandria Virginia

Excellent presenter, very knowledgeable, humorous, relaxed environment/lecture. MT, OT, Alexandria Virginia

Pete was very personable and seems to enjoy presenting -- made me laugh a lot! AL, PTA, Frederick Maryland

He was very entertaining and knowledgeable. MW, OT, Frederick Maryland

Excellent educator, expansive knowledge base. Engaging -- provided a broad view of available research to either support or refute both new and existing treatment strategies. Broad knowledge on sensory reeducation. CP, OT, Frederick Maryland

I like his laid-back, practical approach to teaching. He must know because he's a PTA originally how hard will it is to sit and listen to hyper cerebral information/talk. All of it was beneficial. So much so that I never found myself drifting off -- which is hard for me to keep in check. I have been to A LOT of stroke recovery seminars in the past decade (including other CIMT courses). I would love it if someone would acknowledge that not every stroke survivor "fits the mold" and then explore best practices for all stroke survivors at all levels of recovery. You came closer to doing this than most other presenters. Today was a good use of my time. You always risk that after 15 years of practice and one day courses that it will be repetitious info or poorly put together, but not the case today. Therapists, Frederick Maryland

Very entertaining as well as informative! Therapists, Frederick Maryland


Excellent speaker  -- great sense of humor :-) AS, PT, Baltimore Maryland

Very informative and practical to take back to the clinic. MM, OT, Baltimore Maryland

Mr. Levine is a wonderful and entertaining speaker who presents in a clear and concise way evidence-based means of stroke recovery methods. Therapist, Baltimore Maryland

Excellent seminar, very informative and very well presented. Excellent speaker, good pace throughout lecture. MW, PTA, Baltimore Maryland

Excellent presentation, varied material, very good speaking ability for teaching material. Able to highlight important points. Showed a progression of research. How one new development lead to the next. And the need for the more research. SK, OT, Baltimore Maryland

============================

When very well organized, very knowledgeable, very passionate about subject matter. Visual presentation was fantastic! Very informative! Thank you! JG, OT, Portland Maine

Thoroughly enjoyed this seminar. Peter is a very engaging presenter. KB, PT, Portland Maine


Wonderful presentation/explanation of neuroanatomy and function in a simplistic manner; incorporation and focus on EBP greatly appreciated. EB, DPT, Portland Maine

Instructor was engaging, well spoken, knowledgeable, entertaining... hell attention. Nice presentation, got me to think outside of the box in acute rehab setting for CVA. Thanks! RL, OT, Portland Maine

The instructor did a good job keeping the audience interested and involved in presentation. I liked the connection of treatment ideas to functional task for patient. MH, COTA, Manchester New Hampshire

Excellent -- first Neuro course for me -- excited to review some of the topics presented today. Exceptional knowledge and dedication to the field of the instructor. JG, PTA, Manchester New Hampshire

Excellent. Cool. Laid back. RG, OT, Manchester New Hampshire

Very informative and down to earth/understandable. A relaxed and friendly atmosphere -- with encouragement to learn. Overall informative with the latest/update research in a fun method. PD, PT, Manchester Hampshire

Enjoy this side comments, The presentation pace at a good speed for learning. JP, OT, Boston Massachusetts


I enjoyed this seminar. The websites given for research information and book suggestions were extremely informative. KM, PTA, Boston Massachusetts

Engaging, enthusiastic, lively presentation style. Tied all information into treating/clinical use. Good review of research. GS, PT, Boston Massachusetts

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Not boring! First seminar that I didn't feel like I would doze off! SP, PT, rehab manager, Syracuse New York

I enjoyed the intermittent humor. I love having tools for measuring outcomes in the foundation of places to go for information. Great class. I have some great tools and information to bring back and educate my fellow OT's so we can all start providing better therapy for patients. SM, OT, Rochester New York

Great energy and interesting presentation. Stories and life experiences help cement information. LC, OT, Rochester New York

Very knowledgeable in multiple aspects of stroke rehab. And funny! :-) LS, PTA, Rochester New York

Very informative -- good use of humor. BR, OT, Rochester New York

Peter's ability to combine humor, personal experience in clinical knowledge allow for an incredibly effective learning experience. His humor allow for the emotional response that allows for greater potential of learning.

Instructor related well to both PTs and OTs in attendance. Very personable, down-to-earth report with his audience. My attention the entire time. Presented with new information to use in my clinical work. Stimulated me to think about research and evidence-based approaches. This course is excellent the way it is! CG, PT, Buffalo New York

good humor -- keeps it lively. MJJ, PT, Buffalo New York

very knowledgeable, entertaining with presentation here the most beneficial part was the instructor's knowledge of neuroscience. MP., PT, Buffalo New York

Excellent. JS, OT, Buffalo New York

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Excellent speaker -- keeps it real and entertaining. The day flew by -- and I know I'll go back to the clinic and apply what I learned. Clinician, Tallahassee Florida

enjoy his humor. JM, OT, Pensacola Florida good presenter. Interesting material. Very encouraging for research opportunities, encouraging to try cases these. Good review of synergies in stroke characteristics. TK, PT, Pensacola Florida

Peter is so informative and enjoyable to learn from. DK, OT, Pensacola Florida

very engaging. He catch your attention by injecting humor in the presentation. LG, COTA, Pensacola Florida

very knowledgeable, entertaining, held my attention throughout. PZ, speech therapist/director of rehab, Pensacola Florida

the speaker was excellent! Very knowledgeable and funny! KH, OT, Pensacola Florida

presented in a well rounded and effective way while keeping presentation light with humor. Great job! I enjoyed the history and humor. OT, Pensacola Florida

the instructor was flexible and funny. TA, OT, Pensacola Florida

very knowledgeable; broad base of information; good sense of humor -- Audience engaged. AB, speech therapist, Pensacola Florida

Very good. I appreciate his dedication and passion. I found this information to be very evidence-based (lots of research noted) I also love the stories and history :-) EP, PT, Pensacola Florida


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Very professional, easy going, great sense of humor. JH, OT, Schaumburg Illinois

absolutely entertaining. Fabulous. LH, PT, Schaumburg  Illinois

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One of the few instructors who kept me engaged for the entire course. Greqat presenter! CH, OT, Kansas City, KS

Peter was knoledgeable, humerous, and interesting to listen to. He had helpful information presented in a way that was easy to understand and applicable to practice. KR, OT, Kansas City, KS

Very good, easy to understand + relateable to my field. Thanks for using humor  KS, PTA, Kansas City, KS

Excellent presentation, evcellent information, excellent speaker. Very helpful- offers email + support beyond the seminar! RC, OT Columbia MO

Relaxed, easy to follow, humerous, RF, PTA, Columbia MO

Very engageing, kept my attention, humerous  KH PTA, Columbia MO

I feel I was able to get all the current research as wellas practial tools all in one day. TE, PT, Columbia MO

Excellent. DH, OT, Columbia MO

Does a good job of keepinhg the presentation moving, good sence of humor, easy to listen to. JU, PT, Columbia MO

Most informative day I've had in years and years. JS OT, Columbia MO

Showed great enthusiasm for topic. Made topic interesting and challenging, but easy to follow. Very knowledgeable. AA, OT, Columbia MO

Well worth price and my time. Mr. Levine was able to make time fly by during course  LL, PT, St. Louis MO

Instructor was very knoledegable about subjest + was enthusiastic. He kept my attention and related material to pertinant clinical expirences. KC, DPT, St. Louis MO

I really enjoyed the course. Feel like I learned avluable info. KM, PTA St. Louis MO

Well organized. Excelletnt job ob bridging the gap of information between "research" world and "clinician therapy" world. LH, OT, St. Louis MO
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Enjoyed his humor, very interesting, nice review plus new info. Useful, applicable material, good historical perspective, latest research, correcting some common myths. SH, PT, Cedar Rapids Iowa

Excellent speaker. Very knowledgeable on topic and provide visual demonstration for some topics. Good sense of humor. Great info thanks. Good treatment ideas. A D., OT, Cedar Rapids Iowa

excellent course. Great information. Speaker was very knowledgeable, quick presentation. Excellent. Would recommend to other therapists. MN, OT, Cedar Rapids Iowa
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excellent, informative seminar. JS, PT, Wichita Kansas

Presents a lot of useful information in a way that keeps your attention. MH., PT, Wichita Kansas

I love the style of presentation... humor, personal experiences, research. JW, OT, Wichita Kansas

great resources for clinical implementation. Great instructor! Great info! Thank you! LW, OT, Wichita Kansas

It has been a long time since I have attended a seminar that held my attention 100%! How full and use.! Thank you! DM, PT, Wichita Kansas

great course -- a lot of treatment information for treatment of spasticity and sensory impairment. Thanks! LW, OT,. Tulsa Oklahoma

Very good -- interesting -- entertaining -- makes me want to read more. Excellent. PT, Tulsa Oklahoma

Very good -- interesting -- keeps audience involved -- practical. LC, OT, Tulsa Oklahoma
Enjoyed it! Informative and fun. JY, PTA, Tulsa Oklahoma

Very informative and entertaining. SS, PT, Oklahoma City Oklahoma

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Mr. Levine has an extremely solid grasp on the methoeds of stroke recovery! IP, RN, Charlotte, NC

Nice to have an instructor that is both knowledegable and humerous! Got a lot of hands-on info. DO, OT, Raleigh, NC

Great job! JT-W, PT Raleigh, NC

Great program! Best cont. ed. I've been to in years! DF, OT, Raleigh, NC

Enetrtaining, funny, captivating RG, PT, Raleigh, NC

Excellet presenter. Kept my attention and kept material intersting. AH, OT, Raleigh, NC

Awesome speaker!  CK, OT, Raleigh, NC

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Very informative. Greatly appreciated the fact that research was more recent and up-to-date. L L-M, PTA Dallas Texas

Excellent seminar! One of the best I've been to in years! DE, OT, Dallas Texas

Seems incredibly knowledgeable; very easy to listen to and kept my attention well. JM, OT, Dallas Texas

Loved the humor! This can be a dry topic but Pete kept it interesting. CT, OT, Dallas Texas

Peter Levine presented a  aseminar that was very educational, easy to incorporate into my practice + very entertaining. SN, OT, Dallas Texas

Good information on clinical tests and their applications for outcome measures especially. Subject interesting with related clinical and personal anecdotes. JB, PT, Dallas Texas

Appreciated humor and personal history of the pioneers in Neuro rehab. Eager to use CIT. Practical ideas for treatments. KM, PT, Fort Worth Texas

presentation from the instructor was presented well, very knowledgeable, plenty of information, yet instructed in a way that was entertaining. MB, speech therapist, Fort Worth Texas

Informative, fun, enjoy it. I like being reminded of how neuroplastic our brain cells are and how that can affect our therapeutic approaches towards disability is caused by stroke's. NB, PTA, Fort Worth Texas

Wonderful! JJ, speech anthologist, Fort Worth Texas


Impressive, interesting. PL, PT, Little Rock Arkansas

Enjoyable presentation while covering the topics. BR, PT, Little Rock Arkansas

Logical, rational and easy to understand and follow. MS, PT, Little Rock Arkansas

Enjoyed variety of references and examples. Very interactive. AH, PT, Little Rock Arkansas

entertaining as well as informative. AJ, PTA, Little Rock Arkansas

Very comprehensive! I especially like how you "demystify" rehab treatment. Too many therapists think their approach (NDT, PNF, etc.) while the "end all be all" but sometimes the research just supports good old-fashioned hard work and empowering patients. JD, DPT, Little Rock Arkansas

Awesome -- loved it -- learned a lot! PM, PTA, Little Rock Arkansas
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excellent delivery of information -- subtle humor. PT, OT, Nashville Tennessee

excellent course, speaker kept me engaged. Robotic humor to break up the seriousness of the course. Second time I've heard him speak. I like the fact that he doesn't have a "I am better" complex, made speaker more down-to-earth; "keeps it simple" -- what's missing in field today. TS, COTA, Nashville Tennessee

Mr. Levine explained all the techniques and information in a way that was easy to comprehend. SJ, OT, Nashville Tennessee

Interesting and knowledgeable speaker. Information provided was relevant and practical and up-to-date. JR, OT, Nashville Tennessee

Really enjoy the course. AC, PT, Nashville Tennessee

Entertaining speaker! AK, OTD., Nashville Tennessee

Excellent. TH, OT, Nashville Tennessee

Terrific. Peter Levine used a good dose of humor to keep information fresh and interesting. TG, OT, Nashville Tennessee

Great instruction and presentation. CP, PTA, Nashville Tennessee

He gave excellent tools that can be easily implemented in my work environment; funny, easy to listen to. Excellent course, appreciate instructors accessibility for e-mail/contact in the future for assistance; inspires me to work harder! AM, OT, Nashville Tennessee

Very entertaining! AF, PT, Knoxville Tennessee

Simplified many things for me. AM, DPT, Knoxville Tennessee

Good discussion on what drives neuroplastic change. Good review of neurology and it was beneficial to look at stroke recovery from more of a PT/OT point of view. JP, SLP, Knoxville Tennessee

Enjoyable. Easy-going. Humerus. Knowledgeable. Explained in a chronological order how the present-day techniques involved. BR, PT, Knoxville Tennessee

Great! Excellent knowledge of subject matter and great delivery. SM, PT, Knoxville Tennessee

Very enjoyable; made it interesting for the type of material. MM, PTA, Knoxville Tennessee

 Presenter was very knowledgeable and entertaining. AW, SLP, Johnson City Tennessee

Great presentation! Kumar was greatly appreciated during presentation to make it interesting. CL, OT, Johnson City Tennessee

Great presenter, entertaining, funny, made a complex/dry topic "research" interesting! JP, CCC SLP Sacramento, CA

Excellent from start to finish. Highly recommended to my colleagues. KS, DPT, San Jose California

Fantastic dynamic speaker. Held my attention throughout. B B., DPT, San Jose California

Excellent; funny, understandable, practical. TB, OT, Allentown Pennsylvania

Easy to follow, that my interest throughout the presentation. JE, PT, King of Prussia Pennsylvania

Easy to follow, that my interest throughout the presentation. JE, PT, King of Prussia Pennsylvania
Peter was very informative and made the information easy to understand and apply to practice. Peter did an excellent job at captivating his audience in transferring his interests and obvious passion to audience understanding. LD, OT, Indianapolis Indiana

Awesome! MK, OT, Indianapolis Indiana

Very knowledgeable, he made big day go by/good flow. The Neuro review was great! AC, SLP, Athens Georgia

even though I am an SLP, a great deal of the covered material about neuroplasticity could translate to my field of practice. Thank you for making course enjoyable :-). MB, SLP, Athens Georgia

excellent course and instructor. Not boring. The listener engaged. I have been waiting for P. Levine to return to this area. Very glad I was able to attend. JW, DPT, Athens Georgia

So entertaining! Enjoyed laughing and learning... thanks! JQ, OT, Atlanta Georgia

practical, interesting, humorous (which is very important for me explanation point) AF, PT, Atlanta Georgia

He made an otherwise potentially dry topic very approachable and entertaining. JB, PT, Atlanta Georgia

Très Bien!! VD-S, OT, Atlanta Georgia

So refreshing to have a presenter with such a wide knowledge base be able to present in such a relaxed, easy-to-understand manner and at the same time throwing some humor. The first seminar I've ever attended that I really enjoyed material And the speaker!! OT, Atlanta Georgia

He was very funny and spoke in a manner that was easy to understand. Mr. Levine was an excellent speaker. I finally understood, a little, where PTs" tees are talking about. He took material full of professional jargon and made it accessible. MJW, SLP, Atlanta Georgia

one of the best presenters I've encountered in 20 years. Enjoyed it :-). KL, PT, Atlanta Georgia

First course I've attended in which it was okay to laugh, interact, and have fun learning! MS, OT, Atlanta Georgia

Very interesting, interactive, and applicable. KH, DPT, Augusta Georgia

Very informative + entertaining. Very evidence- based, taught me how to find current research easily, good course- to- clinic info. KB, PT, Kenosha Wisconsin

Visit tia strokes to get more info about signs of a stroke.

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A Good Excuse to Watch Football


When I worked at the Kessler Institute, a big rehab hospital in New Jersey, I worked with exercise physiologist Quin Bond. He changed my perspective about stroke recovery. The way athletic trainers and exercise physiologists look at stroke recovery is different from the way therapists typically view it. Therapists generally view recovery from stroke as a finite proposition. There is a beginning and an end. Most of scientific medicine views stroke recovery the same: finite. Exercise physiologists tend to see stroke recovery is infinite. Athletic trainers, the same. If you're used to working with athletes you're used to people who see progress is infinite. Athletes are always trying to make themselves better at their sport, stronger and faster. There is no difference between athletes and stroke survivors. Stroke survivor simply lower-level athletes playing higher stakes game.

There's very little that works with athletes that doesn't work with stroke survivors. Every fundamental concept in athletic training can be superimposed on stroke recovery. Again, lower-level, but the same basic concepts hold true. Training concepts that athletes use can be used to recover from stroke. Basic concepts such as multiple hours (massed) practice, weight training, cardiovascular training, pushing the limits of ability and cross training, etc. all work superimposed on stroke recovery. The bottom line is that stroke survivors should see athletes as inspirational figures.
The photo is of Steve Prefontaine who exemplified the pursuit of the infinite.

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2 welcome mentions...













Click to make larger!

On the left: The American Stroke Association's magazine, Stroke Connection.
On the right: George Mason University's magazine, Mason Spirit. I'm an alum. You can also click here to find a quick blurb about the book on the GMU magazine website.

Go Pats!



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Two Great Tastes

Figuring out what helps a stroke survivor recovery may involve finding that one magic bullet. But it probably won't. It will probably be a few magic bullets, a smattering of magic hand grenades and a ton of magic TNT. Enough of this explosive rhetoric!

The point is, recovery requires multiple recovery strategies. As time goes on, the combination of strategies will change.

There is a tendency among many researchers to focus on their little piece of the pie. They'll pioneer treatment "X". They'll develop treatment "X". They'll advocate "X" and they'll cling to "X" forevermore.

Our lab takes a bit of a different tact. If different things work for different survivors at different times you damn sure better have a feel for the whole ball o' wax.

Here is a recent study our team did fusing "Two great tastes that taste great together".

Bon appetit!

Visit tia strokes to get more info about signs of a stroke.

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Wednesday, January 9, 2013

Survivor Must Haves

There are two publications, both free, that provide information that may be essential to recovery. If you are really on the ball regarding emerging recovery technologies, then these may be a bit low-level. But even if you do a good job of figuring out what's new in the stroke recovery game, these two magazines will still be helpful.

Stroke Smart and Stroke Connection. Great articles (usually of the feel-good variety), research updates (in easily read format) and advertisements. And its the ads that I read it for because some of the technologies that our lab tests, as well as others form smaller manufacturers are in these mags. Basically, SS and SC are quick and easy ways to keep on top of whats goin' down. Order them on line or call them.

Stroke Smart 800-787-6537

Stroke Connection 1-888-478-7653

Visit tia strokes to get more info about signs of a stroke.

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Do We Really Use Only 10% Of Our Brains?

For decades "they" have been trying to sell us that we only use 10% of our brain. They were saying this before we could take pictures of the brain working, with MRI. So even if they were right we wouldn't know. Now we can see what parts of the brain are used. Turns out, "they" were wrong. We use 100%. This is important for stroke survivors because rewiring the brain after stroke asks more from your brain. And after stroke there is less brain to work with.
Here's a link to an article I wrote for StrokeSmart magazine about the 10% brain myth.

Visit tia strokes to get more info about signs of a stroke.

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Another Exellent Book.


Here is another book I like a lot. It's a bit more for clinicians than stroke survivors, but it is actually a pretty easy read. Click on the photo to see my Amazon review of this great book.

Visit tia strokes to get more info about signs of a stroke.

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The Secret to Recovery. Period.


I think I've found the answer to recovery from stroke. Honestly. Call the Nobel committee. The answer may be in the first Q&A in this article I wrote with the help of John Farrell of Saebo. And realize, you don't need any equipment to do this, Saebo or otherwise.

If you have any questions, email me 'cause it gets a bit complicated. Intuitive, but complicated.

Visit tia strokes to get more info about signs of a stroke.

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Q&A

I get so many questions about stroke recovery from survivors and caregivers and therapists. Many of the questions are sad. Survivors and their loved-ones often contact me when they don't have any resources providing direction towards further recovery.

I could probably write a book of questions and answers I get.

Instead, I wrote an article.



___

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brainu

Exercise, does it help after stroke? Of course it does, but the word exercise is so broad it's darned near meaningless.

One of the things that's confusing is the way that clinicians have historically used the word exercise. They have almost always meant "doing a movement against resistance." The focus is generally on muscle building. But, although they're weakened, the muscles of stroke survivors are usually strong enough to do whatever. And the peripheral neurology is still intact. All the nerves outside of the brain injury are doing just fine.
So the question becomes, why all the emphasis on muscle building?

The muscles are working. What's not working is the brain. Can exercise be directed at the brain? Yup. But the emphasis should come off of muscle strengthening and onto repetitive practice.
Part of the confusion is that both kind of exercises (muscle building and repetitive practice) crossover. For instance, just working on muscle building will also drive some changes in the brain. Conversely, repetitive practice of movement will build muscle. Another thing that adds confusion is that fatigue is such a huge issue among stroke survivors. So exercise for the sake of building muscle (as well as cardiovascular exercise) is important. Still, the emphasis should be on the brain. I suppose you could simplify it as that old athletic training saying: "Less weight, more reps." Sort of. For more clarity please see this article.

Visit tia strokes to get more info about signs of a stroke.

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Need an Aggressive Physiatrist, Neurologist or Therapist?

If you're looking for aggressive teammates in your quest towards recovery, there are ways of finding them.

If you are looking for an aggressive therapist, I would suggest you do this: click here and look at the lower right corner of the page where it says "Find a Saebo Therapist." Enter your zip and click "search". These therapist are uniformly trained in a particular form of recovery (Saebo). But I find that the therapist trained in this way tend to be on the leading-edge of technology, and tend to aggressively pursue recovery and their patients.

Most of the people listed are going to be OTs. If you're looking for an aggressive PT, and there is no PT on the list, I would suggest calling the OTs on the list and asking for PT that they recommend.

If you are looking for an aggressive neurologists and physiatrists click here. Do three things:
1. At the top of the page enter your ZIP code
2. In the middle of the page click on the circle next to "Upper Limb Spasticity"
3. At the bottom of the page click "submit".

Doctors that administer Botox for spasticity reduction tend to be of the aggressive variety.

If you are looking for a physiatrists in your area click here and follow the prompts.


 ~

      Visit tia strokes to get more info about signs of a stroke.

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      Tuesday, January 8, 2013

      Hemi Man. One Bad Dude.


      Here's an article I wrote recently for Advance for Directors in Rehabilitation. They added a really cool graphic. I call Him "Hemi Man".

      I basically say that they way rehabilitation is delivered to stroke survivors is a problem before it even starts. It turns out that you need waaaay more practice to recover from stroke than payers are willing to bankroll and clinics are able to provide. Check it out.

      Visit tia strokes to get more info about signs of a stroke.

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      Another Radio Interview

      I did interview today with "PT Talker". It's about driving plastic changes in the brain after stroke of course. So sit back, relax and...


      ~

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      Puts Things In Perspective, Don't It?

      Who is the person who has had the most neuroplastic change in their brain? Michael Jordan? Eddie Van Halen? Yo-Yo Ma? Einstein?

      I've always claimed that it is Michelle Mack. But it seems there are many of these miracles.



      Visit tia strokes to get more info about signs of a stroke.

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      Stroke Recovery: Easy Concepts and Hard Work

      Let’s face it. There is a lot of bad information about stroke recovery. And the cheaper it is to publish information (I’m talking to you Internet) the lower the quality becomes.

      Much of the info on stroke recovery is either stale or unreliable. Most of it falls into 2 categories:

      1. Filtered through the medical model. This info tends to be stereotypic, redundant, risk free and out of date.
      2. Unsubstantiated or weakly substantiated. This info is usually written by caregivers or stroke survivors themselves.

      Don’t get me wrong; both the medical model and survivors and caregivers provide valuable information. I have long believed that the secret of recovery is locked within stroke survivors who have gone the furthest on the road to recovery. The problem is that, as much as it’s a cliché, every stroke is different. There are tons of variables, including:

      1. Sequelae (health problem related to the stroke)
      2. Comorbidities (health problems unrelated to the stroke)
      3. Motivation of the stroke survivor (The more motivated, the more recovery)
      4. Recourses (time, energy, helping hands, money, etc.)
      5. Age (generally, the younger, the better the outcomes)

      And there are a hundred other variables that can affect recovery. One of the most important is the location of the area killed by the stroke. A pea sized stroke in one area leaves the survivor unable to talk. In another area the survivor walks great, but can’t use their arm. In yet another area, a pea-sized dead zone allows for a relatively easy and full recovery. So when a stroke survivor writes a book about recovery, they are really writing about their recovery. And because of the variables mentioned, each journey through recovery, and each recovery endpoint, is unique.

      I wrote a book about stroke recovery. I wrote it because I have been involved in stroke recovery research for a decade and I have learned a thing or two. Writing a book was easy because there is plenty to report on. Researchers from around the globe are adding their voice to an ever expanding ball of knowledge. And that ball, like much of science, is not perfect. It is misshapen and complicated and hard to visualize all at once. Part of this is because there are many different sciences involved. Input from neuroscience, physiatry, biomedical engineering, physical and occupational therapy and others makes the whole ball hard to conceptualize. But what is emerging from all these complexities are remarkably simple concepts.

      I have come to a few basic conclusions about stroke recovery. Here is a list of core principals that can be used by any stroke survivor to promote recovery.

      -Recovery is hard work. If it’s easy, you’re doing it wrong.
      -The absolute foundation of recovery from stroke is neuroplastic rewiring of the brain.
      -What drives recovery are relatively simple concepts that have been used by athletes (and other hyper-skill learners), since the beginning of time.
      -Recovery is best served by
        1. Repetitive practice of movements…
        2. …that are related to a task or tasks…
        3. …that is/are important to the stroke survivor and that are practiced…
        4. …many hours a day…
        5. …and are made more challenging as skill is acquired.

      Electrical stimulation can be used to help stroke survivors recover in many ways including:

      1. Keeping soft tissue (including muscle, blood vessels and nerves) elongated
      2. Jump starting movement in survivors who have little or no movement
      3. Reestablishing sensation in survivors who have sensation loss
      4. building strength in muscles that are not quite ready to move on their own
      5. Stroke survivors should stretch more than they do.
      6. Stroke survivors should “bank” (develop a reserve of) cardiovascular (heart/lung) and muscular strength.
      7. Measuring recovery from stroke is essential to recovery from stroke. During different periods of recovery can accelerate, slow and stall. During the slow and stall periods—periods when most survivors give up—measuring small improvements is necessary. A bunch of small improvements = large improvement.
      8. You have to do it yourself (DIY). This DIY concept is essential in 2 ways:
      • Only you can rewire your brain.
      • If you have to rely on therapists and other clinicians to reach you highest level of potential recovery, you’ll run out of time and money before you’re done.
      Focus on 2 things;
        1. Making sure that you are not allowing soft tissue to shorten. If it shortens permanently, it doesn’t matter how much “recovery” you get, the joint will not be able to move.
        2. Driving brain rewiring change towards recovery. How do you know if your brain is changing? A “Yes” to the following questions will help determine if you are rewiring your brain:
        • Are your limbs moving better?
        • Can you feel your limbs more?
        • Is your balance getting better?
        • Is your hand able to grasp wider objects?
        • Are you walking faster?
        • …and much more will tell you if you are rewiring your brain. Remember, the foundation of relearning movement is changes in the brain, not in the limbs. Although the limbs get credit, it’s the brain moving those limbs. The limbs tell us what is going on in the brain.

      The basics of recovery from stroke are simple. The work required is difficult. Recovery from stroke, even years after the event, is available to any stroke survivor. The key is to bring your focus and power to your own quest for recovery.


      Visit tia strokes to get more info about signs of a stroke.

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      Bilateral Training

      Assume you never had a stroke. If you are right-hand dominant and you are trying to do something equal and opposite (like drumming) your right hand will slow so the left hand can keep up.

      But it works in the opposite as well...your left hand will be able to drum faster, will have better trajectory and make fewer mistakes if you do the drumming with both hands at the same time... together. The right hand essentially trains the left hand.

      After a stroke the unaffected "good" arm/hand will train the "bad" arm/hand. It's called 'bilateral transfer'. This transfer of info from one limb to the other, some scientists think, happens below the brain; right through the spinal cord, as if the two limbs are communicating directly. this may be one of the (many, many) reasons the legs usually come back sooner; bilateral transfer is used constantly during the one activity the legs are most involved in...walking. Want it to sound more scientific-y? Here's my slide for it...



      Visit tia strokes to get more info about signs of a stroke.

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      The Upward Spiral of Recovery

      There is a common suggestion among many in the "alternative medicine" industry expressed in the question: "If it means less business, why would your doctor want you to be healthy?” A strict emphasis on healthy lifestyle including diet and exercise would be like the proverbial "Apple a day" – keeping the doctor away. Doctors who do this – who keep themselves away as much as they can – are the best doctors. And therapists who "keep themselves away" are the best therapists.

      Many pathologies allow for a definitive discharge point. The patient who has had a knee replacement gets therapy, and then goes home to live the rest of his life. But neurological disorders are different. Many, from Parkinson's to multiple sclerosis, are progressive. But what of non-progressive neurological disorders like stroke and traumatic brain injury? Does this "Apple a day" philosophy work? Is there a point at which these populations no longer need therapists?

      Many patients with acquired brain injury believe that they will always need therapists. Most see therapists as essential to the recovery process, no matter how long (months, years, decades) it takes for them to achieve their highest level of potential recovery. But this view is incorrect.

      There is a point at which therapists are no longer the fulcrum for recovery. Nor should they be for reasons that range from financial to practical. At discharge stroke survivors are, and should be, in complete control of their own recovery. During the chronic phase of recovery from stroke, the speed of recovery slows. In the chronic stage the physiological action of recovery is based on a lot of self-directed hard work.

      Much of what is required is relatively simple, and revolves around the broad concept of repetitive practice. In order to take charge, stroke survivors need the tools to initiate and follow an "upward spiral of recovery.” This term is used to describe the path to the highest level of potential recovery. The "upward spiral of recovery" is driven by real-life demands for everything from coordination to cardiovascular strength.


      Visit tia strokes to get more info about signs of a stroke.

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      Monday, January 7, 2013

      Stroke Recovery: How to make sense of “it all”



      I did an interview with Tom Haynes of the mighty Stroke Central. You have to scroll past the Jill Bolt Taylor/My stroke of insight stuff.

      Tom culled questions from his members. Interesting questions. Tough questions.

      Visit tia strokes to get more info about signs of a stroke.

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      The Feel of Recovery



      Here is an article I wrote last month. It describes, theoretically at least, how to get sensation back after stroke. Turns out, nothing new under the sun. Getting back sensation is the same as getting back movement. Repeated attempts at feeling drives the brain to be better at feeling.

      There are 2 ways of retraining feeling: active and passive. Passive seems to be more for tactile stuff, active is more for proprioception (the feel of movement).

      But movement and sensation double back on each other. Movement affects sensation because if you can't move the brain stops listening for movement. And if you can't feel, your movement goes haywire.

      Visit tia strokes to get more info about signs of a stroke.

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