The NOGGINS AND NEURONS Podcast

EPISODE TITLE: Reconnecting With Your Hand After Stroke Parts 1 & 2

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Deb and her level II fieldwork student Zoe talk with two D’Youville students Abigail and Olivia about all topics regarding hands after stroke with emphasis on recovery. We covered:

Introduction from Deb’s level II fieldwork students Zoe: D’Youville student introductions
Topic introduction: Students discuss different hand impairments discussed seen during fieldwork placements
Introduction of flaccidity and static splinting:
- Use as natural as possible if using one
  - Deb and students discussed shoulder girdle for upper extremity during therapy and uses during fieldwork
- Deb made note to “never pull on arm/upper extremity during activities or transfers”
- Schedules and proper don-doff procedures
- Deb made note about not liking low muscle tone splinting unless possibility for subluxation (popping out of shoulder socket) or injury prone with neglect/forgetfullness of that limb
- Neglect and sensory impairment briefly noted with concern for injury
- Strategies with slings for the upper extremity to prevent subluxation of limb if applicable
- Abigail discussed use of trays for UE positioning to prevent injury
- Fear of transferring: getting limb with low sensation and muscle tone stuck
- Discussion of injury prevention seen with untrained providers in hospital settings and the need to train mobilization of patients during transfers for safety
- Deb and students mention the use of kinesiotape (KT) tape for incorporating sensory and awareness of hand positioning for strategy in joint positioning and decrease contracture
- Slight introduction and awareness of preparatory activities and how they are used in OT
- Importance of education for any strategies or interventions is needed for families/caregivers and patients
Spasticity introduction with a statistic found from students research provided
- (https://www.mdpi.com/2077-0383/12/23/7497)
- One combined flexed pattern (shoulder lift, bend elbow, wrist bends) causes shortening of muscles --> possible leading to contracture
- Due to weak extensors flexors dominate leading to limitations of opening the hand for fine motor/precise movements
- 80 % of post-stroke patients present with Upper limb limitations, motor deficits, and hemiplegia (https://www.mdpi.com/2077-0383/12/23/7497)
- ”Upper limb spasticity affects 17–40% of people”
- Abigail and Olivia discuss about patient treatment with spasticity post stroke seen in fieldwork placement
- Olivia and Deb describe vibration technique use within clinics to facilitate muscles that were not activating during movements that were considered “stuck” in this phase of recovery
- Flexors are stronger more often than extensors causing contractures within hands and development of flexion synergy
- Gross grasp/release patterns and statistic found from students research provided
Introduction of electrical stimulation (ESTIM):
- Examples: lifting and dropping towels during cleaning activity; picking up blocks and moving from one side of table to other
- Deb and students explain how electrical stimulation (ESTIM/FES) was used within an intervention/prep activity for gross motor grasp/release patterns and how these can be used during ADL activities
Range of motion (ROM) education and activities to maintain muscle length in order to prevent contractures within the hand and shoulder/upper extremity
- Took not how important to not over work or stretch muscles with force, it can cause more harm than good
- Theraputty is a good tool to use for hand strengthening exercises
- Importance of handouts, caregiver training, and education/mass practice
- Discussed that if patient is bored within room during recovery, to increase mass practice of exercises to regain range of motion (ROM) and strength
Deb mentioned strategies to improve active movement using hand-over-hand (HOH) techniques and resistive training
- Corticospinal tract (26:30) introduction and how it is important with movement within the hand/upper extremity
- This is how flexion synergy can occur due to this impairment
Deb mentioned use of mirror therapy for these patients as a form of intervention to improve fine motor movements using repetition for brain to create neuroplasticity and reorganize brain patterns
- Importance of evidence-based practice for motor relearning strategies and excitement for participation in activities with patients
- Abigail discussed use of mirror therapy in fieldwork placement with shoulder/upper extremity strategies
- Olivia discussed her use of seeing mirror therapy in her fieldwork placements including applying a mirror therapy activity presentation for her final project at her fieldwork placement
- How important is to look back at our biases based on interventions and research to make sure up-to-date and specifically changing
Range of motion (ROM) and thumb exercise importance to regain function within hand
Conclusion of first episode

Second Episode

Deb presents information about a document that should be used when working with stroke providers from Chapter 10 of the EBRSR for motor rehab interventions filled with multiple articles about need for repetition
- In 2017 by Waddle et al. discussing the intensity of task-specific rehab (13.6 hours of task-specific training with x100 reps)
- In 2016 by Lang et al., discussed using 3200 reps of upper limb training
If unable to physically move, patients want to do repetitions for brain engagement and if physically able to move use interventions giving ability to move with repetitions is even better
- ”If you can handle a little bit of frustration, it really helps your outcome!” - Olivia
- Olivia provided small introduction of CIMT acknowledging safety, behaviors, and frustration
Frustration strategies and how to handle these situations with certain patients and stroke survivors using OT knowledge and core principles
Deb mentioned her new private practice with mirror therapy programs and acknowledged her level II fieldwork student Zoe helping with creating mental practice recordings to go along with the action observation videos for patients to use when at home during recovery
- Mentioned Pete and his previous research with Dr. Paige about completing interventions cohesively with time control to improve stroke survivor mobility of the upper limb.
Students discuss two gaming articles on integrating fun and passion with therapy goals by improving fine motor control in hand movement and gross motor patterns with active engagement
- Leap motion controller article (https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2017.00654/full)
- Zoe mentions virtual reality use and Olivia brings up seeing use of it in fieldwork
- Competition to increase reps and sustained attention for improving goals and better outcomes
- Abigail mentioned use of Wii for upper extremity training with active feedback and self competition to improve strength
Important article of sensory feedback leads to mastered fine motor movements (Post-stroke sensory deficits and re-education (https://www.cuh.nhs.uk/patientinformation/post-stroke-sensory-deficits-and-re-education/)
- Sensory remediation: retrain and understand sensory input coming in using stereognosis which is the use of feeling and guessing what you are holding or touching without seeing and increase complexity as it becomes easier with less complex items
- Sensorimotor article using vibration stimulation and mass practice (https://pmc.ncbi.nlm.nih.gov/articles/PMC9918228/): tried to increase threshold for less sensory input to feel what is being touched and increase motor outcomes at the end of the trial
- Students talk about sensory integration interventions seen in fieldwork (sensory bins, prep activities)
Discussed safety within the kitchen such as using utensils, working with hot water, and heat appliances due to decrease sensation or impulsiveness
Interventions and compensatory strategies:
- Different use of adaptive equipment: universal cuffs/built-up handles/dressing tools
- Button hook used buttons and zippers for decreased fine motor movement
- Slip-on shoes and elastic shoe laces for decrease hand strength and coordination
- Women dressing adaptive styles
- Kitchen utensils to assist with hand movement
- Use of dysem for small activities and safety along with during weight bearing activities
Recovery time periods: different for everyone
- Deb’s article (A critical time period of recovery goes beyond 1 year post-stroke by Ballister et al.)
- 3-6 month critical window of heightened neuroplasticity post-stroke, but uncover gradient of enhanced sensitivity to treatment that expands farther beyond the "critical window”
- Student article listed Recovery Time Periods below in Resources
- Deb and students provide articles that can show multiple timelines of recovery time periods
- Neuroplasticity continuously occurs with constant recovery and engagement
Hope is always there for survivors and caregivers if you have positive mindsets to recovery and treatments; not all survivors experience spontaneous recovery or recover at the same time so take your time and remain open-minded
Final remarks for survivors and caregivers from Olivia, Abigail, Zoe & Deb

We hope you enjoyed this episode of Noggins And Neurons. As always, we want to hear from you! Email us at Nogginsandneurons@gmail.com

Show References

-Objectifying Measures of Post Stroke Hand Rehabilitation through Multidisciplinary Scales (https://www.mdpi.com/2077-0383/12/23/7497)

-Effect of Sensory Impairment on Hand Functional Improvement Through Therapy and Sensory Stimulation

(https://pmc.ncbi.nlm.nih.gov/articles/PMC9918228/)

-Post Stroke Sensory Deficits and Re-education (https://www.cuh.nhs.uk/patientinformation/post-stroke-sensory-deficits-and-re-education/)

-Hand Resistive Therapy Exercises (https://journals.lww.com/ijpt/fulltext/2024/06010/therapeutic_putty_based_hand_strengthening.7.aspx)

-Hand Exercises for Finger and Thumb for Stroke Recovery (https://www.baystatehealth.org/articles/handexercises-for-strokerecovery)(https://journals.physiology.org/doi/full/10.1152/jn.91310.2008)

-Isometric and Voluntary Action movements for Hand Post Stroke (https://sci-hub.ru/10.1179/1945511915Y.0000000023)

-Video Gaming Article with Leap Motion Controller for Fine Motor Improvement (https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2017.00654/full)

-Another Gaming Article for Hand Recovery (https://journals.sagepub.com/doi/abs/10.3233/NRE-192829)

-Recovery Time Periods and Critical Window (https://www.hopkinsmedicine.org/health/conditions-and-diseases/stroke/stroke-recovery-timeline)

A critical time period of recovery goes beyond 1 year post-stroke by Ballister et al.

THERAPY PRACTICE RESOURCES:

DEB’S RESOURCES

Beyond the Basics: Motor Recovery Bootcamp (Modified Constraint Induced Movement Therapy Guide)
The OT's Guide to Mirror Therapy
Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
Occupational Therapy Intervention 2 Pack: Scavenger Hunt & Visual Trails for Adults
Noggins And Neurons Podcast Creative Learning & Discussion Guide

PETE’S blog and book, “Stronger After Stroke: Your Roadmap to Recovery” 3rd edition:

Blog: BlogSpot
Book: Stronger After Stroke, 3rd edition

DORO’S OT PRACTICE – The Neuro Hub

REQUEST TO BE A GUEST ON NOGGINS & NEURONS. If you’re passionate about stroke recovery and have information or a story you believe will help others, we’d love help you share it on the show. Complete the guest request form below and let’s see if we’re a good fit!

Guest Request Form
MUSIC: “Soft Inspiration” by Scott Holmes/Scott Holmes Music/scottholmesmusic.com

Stronger After Stroke, Third Edition: Your Roadmap to Recovery

View Details

EPISODE TITLE: Reconnecting With Your Hand After Stroke Parts 1 & 2

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Deb and her level II fieldwork student Zoe talk with two D’Youville students Abigail and Olivia about all topics regarding hands after stroke with emphasis on recovery. We covered:

Introduction from Deb’s level II fieldwork students Zoe: D’Youville student introductions
Topic introduction: Students discuss different hand impairments discussed seen during fieldwork placements
Introduction of flaccidity and static splinting:
- Use as natural as possible if using one
  - Deb and students discussed shoulder girdle for upper extremity during therapy and uses during fieldwork
- Deb made note to “never pull on arm/upper extremity during activities or transfers”
- Schedules and proper don-doff procedures
- Deb made note about not liking low muscle tone splinting unless possibility for subluxation (popping out of shoulder socket) or injury prone with neglect/forgetfullness of that limb
- Neglect and sensory impairment briefly noted with concern for injury
- Strategies with slings for the upper extremity to prevent subluxation of limb if applicable
- Abigail discussed use of trays for UE positioning to prevent injury
- Fear of transferring: getting limb with low sensation and muscle tone stuck
- Discussion of injury prevention seen with untrained providers in hospital settings and the need to train mobilization of patients during transfers for safety
- Deb and students mention the use of kinesiotape (KT) tape for incorporating sensory and awareness of hand positioning for strategy in joint positioning and decrease contracture
- Slight introduction and awareness of preparatory activities and how they are used in OT
- Importance of education for any strategies or interventions is needed for families/caregivers and patients
Spasticity introduction with a statistic found from students research provided
- (https://www.mdpi.com/2077-0383/12/23/7497)
- One combined flexed pattern (shoulder lift, bend elbow, wrist bends) causes shortening of muscles --> possible leading to contracture
- Due to weak extensors flexors dominate leading to limitations of opening the hand for fine motor/precise movements
- 80 % of post-stroke patients present with Upper limb limitations, motor deficits, and hemiplegia (https://www.mdpi.com/2077-0383/12/23/7497)
- ”Upper limb spasticity affects 17–40% of people”
- Abigail and Olivia discuss about patient treatment with spasticity post stroke seen in fieldwork placement
- Olivia and Deb describe vibration technique use within clinics to facilitate muscles that were not activating during movements that were considered “stuck” in this phase of recovery
- Flexors are stronger more often than extensors causing contractures within hands and development of flexion synergy
- Gross grasp/release patterns and statistic found from students research provided
Introduction of electrical stimulation (ESTIM):
- Examples: lifting and dropping towels during cleaning activity; picking up blocks and moving from one side of table to other
- Deb and students explain how electrical stimulation (ESTIM/FES) was used within an intervention/prep activity for gross motor grasp/release patterns and how these can be used during ADL activities
Range of motion (ROM) education and activities to maintain muscle length in order to prevent contractures within the hand and shoulder/upper extremity
- Took not how important to not over work or stretch muscles with force, it can cause more harm than good
- Theraputty is a good tool to use for hand strengthening exercises
- Importance of handouts, caregiver training, and education/mass practice
- Discussed that if patient is bored within room during recovery, to increase mass practice of exercises to regain range of motion (ROM) and strength
Deb mentioned strategies to improve active movement using hand-over-hand (HOH) techniques and resistive training
- Corticospinal tract (26:30) introduction and how it is important with movement within the hand/upper extremity
- This is how flexion synergy can occur due to this impairment
Deb mentioned use of mirror therapy for these patients as a form of intervention to improve fine motor movements using repetition for brain to create neuroplasticity and reorganize brain patterns
- Importance of evidence-based practice for motor relearning strategies and excitement for participation in activities with patients
- Abigail discussed use of mirror therapy in fieldwork placement with shoulder/upper extremity strategies
- Olivia discussed her use of seeing mirror therapy in her fieldwork placements including applying a mirror therapy activity presentation for her final project at her fieldwork placement
- How important is to look back at our biases based on interventions and research to make sure up-to-date and specifically changing
Range of motion (ROM) and thumb exercise importance to regain function within hand
Conclusion of first episode

Second Episode

Deb presents information about a document that should be used when working with stroke providers from Chapter 10 of the EBRSR for motor rehab interventions filled with multiple articles about need for repetition
- In 2017 by Waddle et al. discussing the intensity of task-specific rehab (13.6 hours of task-specific training with x100 reps)
- In 2016 by Lang et al., discussed using 3200 reps of upper limb training
If unable to physically move, patients want to do repetitions for brain engagement and if physically able to move use interventions giving ability to move with repetitions is even better
- ”If you can handle a little bit of frustration, it really helps your outcome!” - Olivia
- Olivia provided small introduction of CIMT acknowledging safety, behaviors, and frustration
Frustration strategies and how to handle these situations with certain patients and stroke survivors using OT knowledge and core principles
Deb mentioned her new private practice with mirror therapy programs and acknowledged her level II fieldwork student Zoe helping with creating mental practice recordings to go along with the action observation videos for patients to use when at home during recovery
- Mentioned Pete and his previous research with Dr. Paige about completing interventions cohesively with time control to improve stroke survivor mobility of the upper limb.
Students discuss two gaming articles on integrating fun and passion with therapy goals by improving fine motor control in hand movement and gross motor patterns with active engagement
- Leap motion controller article (https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2017.00654/full)
- Zoe mentions virtual reality use and Olivia brings up seeing use of it in fieldwork
- Competition to increase reps and sustained attention for improving goals and better outcomes
- Abigail mentioned use of Wii for upper extremity training with active feedback and self competition to improve strength
Important article of sensory feedback leads to mastered fine motor movements (Post-stroke sensory deficits and re-education (https://www.cuh.nhs.uk/patientinformation/post-stroke-sensory-deficits-and-re-education/)
- Sensory remediation: retrain and understand sensory input coming in using stereognosis which is the use of feeling and guessing what you are holding or touching without seeing and increase complexity as it becomes easier with less complex items
- Sensorimotor article using vibration stimulation and mass practice (https://pmc.ncbi.nlm.nih.gov/articles/PMC9918228/): tried to increase threshold for less sensory input to feel what is being touched and increase motor outcomes at the end of the trial
- Students talk about sensory integration interventions seen in fieldwork (sensory bins, prep activities)
Discussed safety within the kitchen such as using utensils, working with hot water, and heat appliances due to decrease sensation or impulsiveness
Interventions and compensatory strategies:
- Different use of adaptive equipment: universal cuffs/built-up handles/dressing tools
- Button hook used buttons and zippers for decreased fine motor movement
- Slip-on shoes and elastic shoe laces for decrease hand strength and coordination
- Women dressing adaptive styles
- Kitchen utensils to assist with hand movement
- Use of dysem for small activities and safety along with during weight bearing activities
Recovery time periods: different for everyone
- Deb’s article (A critical time period of recovery goes beyond 1 year post-stroke by Ballister et al.)
- 3-6 month critical window of heightened neuroplasticity post-stroke, but uncover gradient of enhanced sensitivity to treatment that expands farther beyond the "critical window”
- Student article listed Recovery Time Periods below in Resources
- Deb and students provide articles that can show multiple timelines of recovery time periods
- Neuroplasticity continuously occurs with constant recovery and engagement
Hope is always there for survivors and caregivers if you have positive mindsets to recovery and treatments; not all survivors experience spontaneous recovery or recover at the same time so take your time and remain open-minded
Final remarks for survivors and caregivers from Olivia, Abigail, Zoe & Deb

We hope you enjoyed this episode of Noggins And Neurons. As always, we want to hear from you! Email us at Nogginsandneurons@gmail.com

Show References

-Objectifying Measures of Post Stroke Hand Rehabilitation through Multidisciplinary Scales (https://www.mdpi.com/2077-0383/12/23/7497)

-Effect of Sensory Impairment on Hand Functional Improvement Through Therapy and Sensory Stimulation

(https://pmc.ncbi.nlm.nih.gov/articles/PMC9918228/)

-Post Stroke Sensory Deficits and Re-education (https://www.cuh.nhs.uk/patientinformation/post-stroke-sensory-deficits-and-re-education/)

-Hand Resistive Therapy Exercises (https://journals.lww.com/ijpt/fulltext/2024/06010/therapeutic_putty_based_hand_strengthening.7.aspx)

-Hand Exercises for Finger and Thumb for Stroke Recovery (https://www.baystatehealth.org/articles/handexercises-for-strokerecovery)(https://journals.physiology.org/doi/full/10.1152/jn.91310.2008)

-Isometric and Voluntary Action movements for Hand Post Stroke (https://sci-hub.ru/10.1179/1945511915Y.0000000023)

-Video Gaming Article with Leap Motion Controller for Fine Motor Improvement (https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2017.00654/full)

-Another Gaming Article for Hand Recovery (https://journals.sagepub.com/doi/abs/10.3233/NRE-192829)

-Recovery Time Periods and Critical Window (https://www.hopkinsmedicine.org/health/conditions-and-diseases/stroke/stroke-recovery-timeline)

A critical time period of recovery goes beyond 1 year post-stroke by Ballister et al.

THERAPY PRACTICE RESOURCES:

DEB’S RESOURCES

Beyond the Basics: Motor Recovery Bootcamp (Modified Constraint Induced Movement Therapy Guide)
The OT's Guide to Mirror Therapy
Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
Occupational Therapy Intervention 2 Pack: Scavenger Hunt & Visual Trails for Adults
Noggins And Neurons Podcast Creative Learning & Discussion Guide

PETE’S blog and book, “Stronger After Stroke: Your Roadmap to Recovery” 3rd edition:

Blog: BlogSpot
Book: Stronger After Stroke, 3rd edition

DORO’S OT PRACTICE – The Neuro Hub

REQUEST TO BE A GUEST ON NOGGINS & NEURONS. If you’re passionate about stroke recovery and have information or a story you believe will help others, we’d love help you share it on the show. Complete the guest request form below and let’s see if we’re a good fit!

Guest Request Form
MUSIC: “Soft Inspiration” by Scott Holmes/Scott Holmes Music/scottholmesmusic.com

View Details

EPISODE TITLE: Winning the Fight Against ALS - Part 2

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Doro and Deb continue to talk about Amyotrophic Lateral Sclerosis (ALS) or, Lou Gehrig’s Disease with Dr. Tedone, the founder of the Deanna Protocol and his daughter, Deanna, who was diagnosed with ALS 13 years ago.

In this podcast, Dr. Vincent Tedone and Deanna Tedone discuss:

Introduction and Purpose of the Podcast 0:01
Pete Levine's Absence and Podcast Continuation 1:46
Discussion on ALS Diagnosis and Neurofibrillary Tangles 3:01
- Dr. Tedone explains that it takes at least two years for a definitive ALS diagnosis due to reluctance from the medical profession.
- Neurofibrillary tangles are found in the cerebral spinal fluid, indicating cellular energy deficiencies.
- Gene mutations are linked to abnormal protein formation, which can cause cancer.
- Dr. Tedone argues that infections, not gene mutations, may be the root cause of cancer.
- Borrelia Infection and Its Impact on Health 6:05
- Dr. Tedone discusses the role of Borrelia infection in various diseases, including arthritis, rheumatoid arthritis, psoriatic arthritis, lupus, and cancer.
- Cortisone suppresses inflammation but does not address the underlying infection, leading to disease progression.
- Treatment for Borrelia includes opening cysts with metronidazole, using oregano oil or artemisinin to open biofilms, and administering antibiotics.
- The treatment protocol involves alternating antibiotics every three months to prevent resistance.
- Testing for Borrelia Infection and Case Studies 10:01
- Dr. Tedone mentions the Accu Dart infectious disease test and the need for provocative tests before serology tests.
- Dr. Tedone shares two case studies: one where a patient's worsening condition was linked to his wife's co-infections, and another where an emergency room doctor's wife's condition was attributed to Borrelia.
- The discussion highlights the importance of consistent treatment and the challenges of finding accurate tests for Borrelia.
- Deanna's Protocol and Its Benefits 18:54
- Dr. Tedone and Deanna discuss the Deanna Protocol, which includes caprylic acid and coenzyme Q10, and its benefits in maintaining mental acuity and energy.
- Dr. Tedone shares personal experiences of using the Deanna Protocol and its positive effects on his and his wife's health.
- The protocol is designed to support nerve cell communication and improve cognitive function.
- Dr. Tedone emphasizes the importance of consistency in following the protocol for effective results.
- Advice for Newly Diagnosed Patients 20:31
- Doro asks Deanna for advice for newly diagnosed patients.
- Deanna advises maintaining a regimented medication regimen and surrounding oneself with supportive, informed individuals.
- The importance of challenging oneself and maintaining a positive attitude is highlighted.
- Dr. Tedone shares a quote from his book, emphasizing the importance of persistence and continuous learning.
- Challenges and Research in ALS Treatment 33:15
- Dr. Tedone discusses the challenges of conducting research and the need for clinical feedback to guide research efforts.
- The Deanna Protocol has shown promising results in ALS patients, with an 80% approval rating in a study by USF.
- The protocol is compared favorably to dorozolamide, which blocks glutamate, in terms of symptom management and disease progression.
- The discussion includes the need for better tests and the importance of funding for research.
- Funding and Support for Research 42:28
- Deanna mentions the challenges of funding and the importance of donating to organizations that directly support research.
- The Winning the Fight Foundation is highlighted as a reliable organization for donations, with 99% of funds going directly to research.
- The foundation is a 501(c)(3) organization, making donations fully tax-deductible.
- Doro encourages listeners to visit the foundation's website for more information and to support the research efforts.
- Conclusion and Final Thoughts 48:33
- Deb thanks the guests for sharing their stories and research, emphasizing the importance of spreading awareness.
- Dr. Tedone and Deanna express their gratitude for the opportunity to share their experiences and research findings.
- The episode concludes with a call to action for listeners to share the podcast with others who may benefit from the information.
- Contact information for the podcast and the foundation is provided for further inquiries and support.
- Resources and References:
- ALS specific websites & show References
  - Als.org
  - I Am ALS
  - Winning The Fight
  - National Institute of Neurological Disorders and Stroke-Amyotrophic Lateral Sclerosis (ALS)
- Deanna's Book
  - The Deanna Protocol _ Book
- Dr. Tedone's Treatment
  - The Deanna Protocol Website
- Maintaining Optimal Quality of Life
  - Support groups
  - Proper equipment & Knowledge of use
  - RESOURCES:
    - ALS Association-enter zip code to find assistance in your state. In FL: General Inquiries
      - 813-637-9000
        infoFL@als.org
    - Community support groups & counseling
    - Transportation assistance
    - Equipment loan bank-people with ALS can borrow assistive equipment on long term basis
    - Assistance finding & obtaining community & government resources
    - Multidisciplinary medical care under one roof
    - FAAST-FLORIDA ALLIANCE FOR ASSISTIVE SERVICES & TECHONOLGY: org
      - FAAST is a program designed to provide assistive technology to Floridians with disabilities and their loved ones. This program offers a range of activities, including device loans, demonstrations, reutilization, and training, to ensure Floridians have access to the latest in assistive technology. Additionally, FAAST provides information and assistance, as well as a financing program available state-wide. With a commitment to accessibility and innovation, FAAST is leading the way in assistive technology in the state of Florida.
    - CENTER FOR ASSISTIVE TECHNOLOGY-University of Buffalo
      - The Center for Assistive Technology (CAT) is a non-profit organization that conducts research and provides educational and service programs to increase consumer knowledge related to assistive technology for persons with disabilities.
      - CAT is also the Western New York Regional Center for the New York State TRAID Program, for which it coordinates information on technology-related expertise and resources for people with disabilities.
    - SHEPHERD CENTER-CENTER FOR ASSISTIVE TECHNOLOGIES Atlanta, GA
      - The Center for Assistive Technologies at Shepherd Center helps individuals regain independence after a neurological injury or condition. Challenges with mobility and cognitive function can impact daily activities like using devices, controlling home environments, and driving. Our team develops, tests, and customizes assistive technologies to support rehabilitation, empowering you to navigate life with greater ease and autonomy.
    - UPMC CENTER FOR ASSISTIVE TECHNOLOGY-Pittsburgh, PA
      - The CAT is an interdisciplinary center comprising multiple outpatient clinics that offer a variety of services to assist you.
    - University of North Carolina Wilmington Center for Assistive Technology
    - Miami University Center for Assistive Technology Oxford, OH
    - Assistive Technology Center New Jersey
    - Utah Center for Assistive Technology
    - University of South Carolina Assistive Technology ProgramWe hope you enjoyed this episode of Noggins And Neurons. As always, we want to hear from you! Email us at Nogginsandneurons@gmail.com

THERAPY PRACTICE RESOURCES:

DEB’S RESOURCES

+ Beyond the Basics: Motor Recovery Bootcamp (Modified Constraint Induced Movement Therapy Guide)
+ The OT's Guide to Mirror Therapy
+ Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
+ Occupational Therapy Intervention 2 Pack: Scavenger Hunt & Visual Trails for Adults
+ Noggins And Neurons Podcast Creative Learning & Discussion Guide (Free for podcast members)PETE’S blog and book, “Stronger After Stroke: Your Roadmap to Recovery” 3rd edition:


+ - Blog: blogspot.com
    - Book: Stronger After Stroke, 3rd editionDORO’S OT PRACTICE – The Neuro Hub

REQUEST TO BE A GUEST ON NOGGINS & NEURONS. If you’re passionate about stroke recovery and have information or a story you believe will help others, we’d love help you share it on the show. Complete the guest request form below and let’s see if we’re a good fit!

+ Guest Request Form
+ MUSIC: “Soft Inspiration” by Scott Holmes/Scott Holmes Music/scottholmesmusic.com

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EPISODE TITLE: Winning the Fight Against ALS-Part 1 (with Deanna Tedone and Dr. Vincent Tedone)

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Doro and Deb talk about Amyotrophic Lateral Sclerosis (ALS) or, Lou Gehrig’s Disease with Dr. Tedone, the founder of the Deanna Protocol and his daughter, Deanna, who was diagnosed with ALS 13 years ago.

In this podcast, Dr. Vincent Tedone and Deanna Tedone discuss:

The development of the Deanna Protocol
- Dr. Vincent Tedone describes his research and the development of the Deanna Protocol, which includes AKG and GABA.
- Deanna experienced significant improvements in muscle symptoms and functional abilities after receiving the AKG and GABA combination.
- The Deanna Protocol was tested on ALS mice, showing suppressed muscle symptoms, slowed disease progression, and increased energy production.The findings were documented in a paper and a book, "The Deanna Protocol: Winning the Fight for Neurodegenerative Diseases."
Discovery of Borrelia Infection
- In 2015, Deanna was tested for a Borrelia infection, which was positive, despite previous negative results from commercial laboratories.
- Deanna developed severe meningitis, and Dr. Vincent Tedone convinced the infectious disease doctor to treat her with IV antibiotics.
- The IV antibiotics successfully treated Deanna's pain, and she continued the post-antibiotic regimen until 2018.
- Dr. Vincent Tedone believes that all neurodegenerative diseases are caused by infections, primarily Borrelia.
- Challenges and Resistance in Medical Research
- Dr. Vincent Tedone discusses the challenges and resistance he faced when trying to get academic institutions to fund clinical trials for the Deanna Protocol.
- He emphasizes the importance of treating the cause of the disease rather than just the symptoms.
- Dr. Vincent Tedone shares anecdotal evidence of the Deanna Protocol's effectiveness in treating Alzheimer's disease and other neurodegenerative diseases.
- He highlights the need for further research and the potential for the Deanna Protocol to be effective in treating various neurodegenerative diseases.
- Clinical Experience and Intensive Therapy
- Doro, shares her clinical experience working with Deanna and the intensive therapy program they designed.
- Deanna's progress and improvements were significant, and the traditional ALS progression did not occur.
- Doro emphasizes the importance of not treating Deanna like she has ALS and the positive changes observed in Deanna's muscle building and overall function.
- The discussion shifts to the role of glutamate, AKG, and GABA in the Deanna Protocol and their impact on nerve cell communication.
- Impact of Borrelia Infection and Immune System
- Dr. Vincent Tedone explains the impact of Borrelia infection on the immune system and the body's response to inflammation.
- He describes the role of the gut microbiome in controlling the brain and the potential link between vaccines and autism.
- The conversation touches on the importance of the immune system in maintaining health and the potential impact of mRNA vaccines on the immune system.
- Dr. Vincent Tedone discusses the common denominator in neurodegenerative diseases and the potential for the Deanna Protocol to be effective in treating various conditions.
- Conclusion and Future Research
- Dr. Vincent Tedone expresses his frustration with the lack of focus on the cause of diseases and the need for further research.
- He shares anecdotal evidence of the Deanna Protocol's effectiveness in treating Alzheimer's disease and other conditions.
- The discussion highlights the importance of treating the cause of diseases rather than just the symptoms.
- The episode concludes with a call for further research and the potential for the Deanna Protocol to revolutionize the treatment of neurodegenerative diseases.

Resources and References:* ALS specific websites & show References + Als.org + I Am ALS + Winning The Fight + National Institute of Neurological Disorders and Stroke-Amyotrophic Lateral Sclerosis (ALS) * Deanna's Book + The Deanna Protocol _ Book * Dr. Tedone's Treatment + The Deanna Protocol Website * Maintaining Optimal Quality of Life + Support groups + Proper equipment & Knowledge of use + RESOURCES: - ALS Association-enter zip code to find assistance in your state. In FL: General Inquiries * 813-637-9000
infoFL@als.org - Community support groups & counseling - Transportation assistance - Equipment loan bank-people with ALS can borrow assistive equipment on long term basis - Assistance finding & obtaining community & government resources - Multidisciplinary medical care under one roof - FAAST-FLORIDA ALLIANCE FOR ASSISTIVE SERVICES & TECHONOLGY: org * FAAST is a program designed to provide assistive technology to Floridians with disabilities and their loved ones. This program offers a range of activities, including device loans, demonstrations, reutilization, and training, to ensure Floridians have access to the latest in assistive technology. Additionally, FAAST provides information and assistance, as well as a financing program available state-wide. With a commitment to accessibility and innovation, FAAST is leading the way in assistive technology in the state of Florida. - CENTER FOR ASSISTIVE TECHNOLOGY-University of Buffalo * The Center for Assistive Technology (CAT) is a non-profit organization that conducts research and provides educational and service programs to increase consumer knowledge related to assistive technology for persons with disabilities. * CAT is also the Western New York Regional Center for the New York State TRAID Program, for which it coordinates information on technology-related expertise and resources for people with disabilities. - SHEPHERD CENTER-CENTER FOR ASSISTIVE TECHNOLOGIES Atlanta, GA * The Center for Assistive Technologies at Shepherd Center helps individuals regain independence after a neurological injury or condition. Challenges with mobility and cognitive function can impact daily activities like using devices, controlling home environments, and driving. Our team develops, tests, and customizes assistive technologies to support rehabilitation, empowering you to navigate life with greater ease and autonomy. - UPMC CENTER FOR ASSISTIVE TECHNOLOGY-Pittsburgh, PA * The CAT is an interdisciplinary center comprising multiple outpatient clinics that offer a variety of services to assist you. - University of North Carolina Wilmington Center for Assistive Technology - Miami University Center for Assistive Technology Oxford, OH - Assistive Technology Center New Jersey - Utah Center for Assistive Technology - University of South Carolina Assistive Technology Program

We hope you enjoyed this episode of Noggins And Neurons. As always, we want to hear from you! Email us at Nogginsandneurons@gmail.com

THERAPY PRACTICE RESOURCES:

DEB’S RESOURCES

Beyond the Basics: Motor Recovery Bootcamp (Modified Constraint Induced Movement Therapy Guide)
The OT's Guide to Mirror Therapy
Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
Occupational Therapy Intervention 2 Pack: Scavenger Hunt & Visual Trails for Adults
Noggins And Neurons Podcast Creative Learning & Discussion Guide (Free for podcast members)

PETE’S blog and book, “Stronger After Stroke: Your Roadmap to Recovery” 3rd edition:

- Blog: blogspot.com
- Book: Stronger After Stroke, 3rd edition

DORO’S OT PRACTICE – The Neuro Hub

REQUEST TO BE A GUEST ON NOGGINS & NEURONS. If you’re passionate about stroke recovery and have information or a story you believe will help others, we’d love help you share it on the show. Complete the guest request form below and let’s see if we’re a good fit!

Guest Request Form
MUSIC: “Soft Inspiration” by Scott Holmes/Scott Holmes Music/scottholmesmusic.com

View Details

EPISODE TITLE: ALS: The Classic Medical Perspective

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Doro and Deb talk about Amyotrophic Lateral Sclerosis (ALS) or, Lou Gehrig’s Disease. We covered:

What is ALS?
Signs & symptoms of ALS including:
- Affects voluntary muscles-hands, forearms, legs.
Early symptoms include:
- Fasciculations- spontaneous, uncontrolled discharges of motor neurons; irregular twitchings: Muscle twitches in the arm, leg, shoulder, or tongue
- Muscle cramps
- Tight and stiff muscles (spasticity)
- Muscle weakness affecting an arm, a leg, or the neck
- Slurred and nasal speech
- Difficulty chewing or swallowing
- Difficulty walking, picking up objects, fine motor tasks
Ongoing/Later symptoms:
Chewing food and swallowing (dysphagia)
Drooling (sialorrhea)
Speaking or forming words (dysarthria)
Breathing (dyspnea)
Unintended crying, laughing, or other emotional displays (pseudobulbar symptoms)
Constipation
Maintaining weight and getting enough nutrients
Frontotemporal dementia
- Dementia that affects the frontotemporal lobe.
- Affects thinking, talking, walking, and socializing.
- FTD and other frontotemporal disorders are a common cause of early-onset dementia, often appearing when people are in the prime of life.
- - Families often suffer, as they struggle to cope with the person's daily needs as well as changes in relationships and responsibilities.
Risk Factors (National Institute of Neurological Disorders & Stroke)-Having a risk factor does not mean a person will or will not get a disease
- Age—Although the disease can strike at any age, symptoms most commonly develop between the ages of 55 and 75.
- Biological sex—Men are slightly more likely to develop ALS than women. However, at older ages, men and women are equally likely to be diagnosed with ALS.
- Race and ethnicity—Whites and non-Hispanics are most likely to develop the disease, but ALS affects people of all races and ethnic backgrounds.
National Institute of Neurological Disorders & Stroke/ALS.org
Some studies suggest military veterans are about one and a half to two times more likely to develop ALS, although the reason for this is unclear. Possible risk factors for veterans include exposure to lead, pesticides, and other environmental toxins. Some studies have also shown that head injury can be associated with higher risk for ALS, but more research is needed to understand this connection.
For about 90% of all cases, there’s no known family history of the disease or presence of a genetic mutation linked to ALS.
For 5-10% of all cases, there’s a known family history of the disease. This is often called familial ALS.

ALS.org

In families with familial ALS, there is a 50% chance each offspring will inherit the gene mutation and may develop the disease.
Medical treatment-involves medications
Common PT & OT interventions
- Assistive technology & Communication devices
  - OBI – independence with feeding
  - Battery-operated salt & pepper shakers
  - Steady spoon if tremors are present
  - Built up handle utensils
  - Eazy Hold grip aids
  - Universal cuff
  - Divided Dish
- GUS communication devices
ALS specific websites & show References
- org
- I Am ALS
- Winning The Fight
- National Institute of Neurological Disorders and Stroke-Amyotrophic Lateral Sclerosis (ALS)
Maintaining Optimal Quality of Life
- Support groups
- Proper equipment & Knowledge of use
- RESOURCES:
  - ALS Association-enter zip code to find assistance in your state. In FL: General Inquiries
    - 813-637-9000
      infoFL@als.org
  - Community support groups & counseling
  - Transportation assistance
  - Equipment loan bank-people with ALS can borrow assistive equipment on long term basis
  - Assistance finding & obtaining community & government resources
  - Multidisciplinary medical care under one roof
  - FAAST-FLORIDA ALLIANCE FOR ASSISTIVE SERVICES & TECHONOLGY: org
    - FAAST is a program designed to provide assistive technology to Floridians with disabilities and their loved ones. This program offers a range of activities, including device loans, demonstrations, reutilization, and training, to ensure Floridians have access to the latest in assistive technology. Additionally, FAAST provides information and assistance, as well as a financing program available state-wide. With a commitment to accessibility and innovation, FAAST is leading the way in assistive technology in the state of Florida.
  - CENTER FOR ASSISTIVE TECHNOLOGY-University of Buffalo
    - The Center for Assistive Technology (CAT) is a non-profit organization that conducts research and provides educational and service programs to increase consumer knowledge related to assistive technology for persons with disabilities.
    - CAT is also the Western New York Regional Center for the New York State TRAID Program, for which it coordinates information on technology-related expertise and resources for people with disabilities.
  - SHEPHERD CENTER-CENTER FOR ASSISTIVE TECHNOLOGIES Atlanta, GA
    - The Center for Assistive Technologies at Shepherd Center helps individuals regain independence after a neurological injury or condition. Challenges with mobility and cognitive function can impact daily activities like using devices, controlling home environments, and driving. Our team develops, tests, and customizes assistive technologies to support rehabilitation, empowering you to navigate life with greater ease and autonomy.
  - UPMC CENTER FOR ASSISTIVE TECHNOLOGY-Pittsburgh, PA
    - The CAT is an interdisciplinary center comprising multiple outpatient clinics that offer a variety of services to assist you.
  - University of North Carolina Wilmington Center for Assistive Technology
  - Miami University Center for Assistive Technology Oxford, OH
  - Assistive Technology Center New Jersey
  - Utah Center for Assistive Technology
  - University of South Carolina Assistive Technology Program

We hope you enjoyed this episode of Noggins And Neurons. As always, we want to hear from you! Email us at Nogginsandneurons@gmail.com

THERAPY PRACTICE RESOURCES:

DEB’S RESOURCES

Beyond the Basics: Motor Recovery Bootcamp (Modified Constraint Induced Movement Therapy Guide)
The OT's Guide to Mirror Therapy
Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
Occupational Therapy Intervention 2 Pack: Scavenger Hunt & Visual Trails for Adults
Noggins And Neurons Podcast Creative Learning & Discussion Guide (Free for podcast members)

PETE’S blog and book, “Stronger After Stroke: Your Roadmap to Recovery” 3rd edition:

- Blog: blogspot.com
- Book: Stronger After Stroke, 3rd edition

DORO’S OT PRACTICE – The Neuro Hub

REQUEST TO BE A GUEST ON NOGGINS & NEURONS. If you’re passionate about stroke recovery and have information or a story you believe will help others, we’d love help you share it on the show. Complete the guest request form below and let’s see if we’re a good fit!

Guest Request Form
MUSIC: “Soft Inspiration” by Scott Holmes/Scott Holmes Music/scottholmesmusic.com

✨Google Podcasts ✨iTunes ✨Spotify

View Details

EPISODE TITLE: A Battle In The Mind: Exploring Emotions of Survivors, Caregivers, and Loved Ones

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Deb and Doro talk with D’Youville University students Christin Chan and Sophie Turner about the psychosocial impact of stroke and brain injury. We covered:

Mental health challenges post-stroke, ABI, and TBI
The role of occupational therapy in addressing mental health
Improving psychosocial support for survivors and caregivers
Best practices for supporting survivors
Post-injury affective symptoms and disorders
Non-pharmacological treatment for behavioral disturbances among TBI/ABI patients

We hope you enjoyed this episode of Noggins And Neurons. As always, we want to hear from you! Email us at Nogginsandneurons@gmail.com

Show References

Faircloth, C. A., Boylstein, C., Rittman, M., & Gubrium, J. F. (2005). Constructing the stroke: Sudden-onset narratives of stroke survivors. Qualitative Health Research, 15(7), 928. doi:10.1177/1049732305277842

Goldfinger, J. Z., edmondson, D., kronish, I. M., fei, K., balakrishnan, R., tuhrim, S., & horowitz, C. R. (2014). Correlates of post-traumatic stress disorder in stroke survivors. The official journal of stroke and cerebrovascular diseases : The official journal of national stroke association, 23(5), 1099–1105. https://Doi.org/10.1016/j.jstrokecerebrovasdis.2013.09.019.

Howlett, J. R., Nelson, L. D., & Stein, M. B. (2022). Mental health consequences of traumatic brain injury. Biological Psychiatry, 91(5), 413–420. https://doi.org/10.1016/j.biopsych.2021.09.024

Kumar, R., Kumar, A., & Singh, A. (2019). Psychosocial impact of Brain Injury: A Review. Indian Journal of Neurosurgery, 08(01), 011–015. https://doi.org/10.1055/s-0039-1687713

Raya-Ruiz, M. A., Rodríguez-Bailón, M., Castaño-Monsalve, B., Vidaña-Moya, L., Fernández-Solano, A. J., & Merchán-Baeza, J. A. (2022). Study protocol for a non-randomised controlled trial: Community-based occupational therapy intervention on mental health for people with acquired brain injury (COT-MHABI). Plos One, 17(10) doi:10.1371/journal.pone.0274193

Ritter, J., Dawson, J., & Singh, R. K. (2021). Functional recovery after brain injury: Independent predictors of psychosocial outcome one year after TBI. Clinical Neurology and Neurosurgery, 203, 106561. https://doi.org/10.1016/j.clineuro.2021.106561

Simpson, E. K., Ramirez, N. M., Branstetter, B., Reed, A., & Lines, E. (2018). Occupational therapy practitioners’ perspectives of mental health practices with clients in stroke rehabilitation. OTJR: Occupational Therapy Journal of Research, 38(3), 181. doi:10.1177/1539449218759627

Terrill, A. L., Schwartz, J. K., & Belagaje, S. R. (2018). Best practices for the interdisciplinary rehabilitation team: A review of mental health issues in mild stroke survivors. Stroke Research and Treatment, 2018, 1. doi:10.1155/2018/6187328

Tjokrowijoto, P., Kneebone, I., Baker, C., Andrew, N. E., Stolwyk, R. J., & Stolwyk, J. (2023). Supplemental material for mental health support after stroke: A qualitative exploration of lived experience. Rehabilitation Psychology, doi:10.1037/rep0000527.supp

Wenzel, R. A., Zgoda, E. A., St. Clair, M. C., & Knecht-Sabres, L. J. (2021). A qualitative study investigating stroke survivors’ perceptions of their psychosocial needs being met during rehabilitation. The Open Journal of Occupational Therapy, 9(2), 1. doi:10.15453/2168-6408.1691

Wiart, L., Luauté, J., Stefan, A., Plantier, D., & Hamonet, J. (2016). Non pharmacological treatments for psychological and behavioural disorders following traumatic brain injury (TBI). A systematic literature review and expert opinion leading to recommendations. Annals of Physical and Rehabilitation Medicine, 59(1), 31–41. https://doi.org/10.1016/j.rehab.2015.12.001

THERAPY PRACTICE RESOURCES:

DEB’S RESOURCES

Website: Creative Concepts In Occupational Therapy
Beyond the Basics: Motor Recovery Bootcamp (Modified Constraint Induced Movement Therapy Guide)
The OT's Guide to Mirror Therapy
Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
Occupational Therapy Intervention 2 Pack: Scavenger Hunt & Visual Trails for Adults
Noggins & Neurons Podcasts In Education-ready-made lesson plans for educators
Noggins And Neurons Podcast Creative Learning & Discussion Guide
PETE’S blog and book, “Stronger After Stroke: Your Roadmap to Recovery” 3rd edition:
- Blog: com
- Book: Stronger After Stroke, 3rd edition

DORO’S OT PRACTICE – The Neuro Hub

REQUEST TO BE A GUEST ON NOGGINS & NEURONS. If you’re passionate about stroke recovery and have information or a story you believe will help others, we’d love help you share it on the show. Complete the guest request form below and let’s see if we’re a good fit!

Guest Request Form
MUSIC: “Soft Inspiration” by Scott Holmes/Scott Holmes Music/scottholmesmusic.com

✨Google Podcasts ✨iTunes ✨Spotify

View Details

EPISODE TITLE: A Battle on the Mind: Exploring Emotions of Survivors, Caregivers, and Loved Ones

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Deb and Doro talk with D’Youville University students Christin Chan and Sophie Turner about the psychosocial impact of stroke and brain injury. We covered:

Mental health challenges post-stroke, ABI, and TBI
The role of occupational therapy in addressing mental health
Improving psychosocial support for survivors and caregivers
Best practices for supporting survivors
Post-injury affective symptoms and disorders
Non-pharmacological treatment for behavioral disturbances among TBI/ABI patients