What does your doctor think about this?
http://www.newswise.com/articles/stroke-recovery-theories-challenged-by-new-studies-looking-at-brain-lesions-bionic-arms
Stroke survivors left weakened or partially paralyzed may be able to
regain more arm and hand movement than their doctors realize, say
experts at The Ohio State University Wexner Medical Center who have just published two new studies evaluating stroke outcomes.
One study analyzed the correlation between long-term arm impairment after stroke
and the size of brain lesions caused by patients’ strokes – a visual
measure often used by doctors to determine rehabilitation therapy type
and duration. The other study compared the efficacy of a portable
robotics-assisted therapy program with a traditional program to improve
arm function in patients who had experienced a stroke as long as six
years ago.
“These studies were looking at two entirely
different aspects of a stroke, yet they both suggest that stroke
patients can indeed regain function years and years after the initial
event,” said Stephen Page, PhD, OTR/L,
author of both studies and associate professor of Health and
Rehabilitation Sciences in Ohio State’s College of Medicine.
“Unfortunately, we know that this is not a message that many patients
and especially their clinicians may be getting, so the patients may not
be reaching their true potential for recovery.”
Size doesn’t matter
Clinicians
frequently tell patients that the bigger the size of the area of their
brains affected by their strokes, the worse that their outcomes will be.
However, in a lead article in the Archives of Physical Medicine and Rehabilitation,
Page’s research team found that there was no relationship between the
size of stroke lesions and recovery of arm function in 139 stroke
survivors. On average, study participants had experienced a stroke five
years earlier.
“Historically, lesion size been thought to
influence recovery, but we didn’t find that to be the case when looking
at regaining arm and hand movement,” said Page, who also runs Ohio
State’s B.R.A.I.N Lab,
a research group dedicated to developing approaches to restore function
after disabling injuries and diseases. “This has important implications
because we know clinicians look closely at lesion volume and may make
decisions about the type and duration of therapy, and that some may
communicate likelihood for recovery to patients based on this size. Many
people think the window for therapy is roughly six months, but we think
it’s much longer.”
Page agrees that the first six months after a
stroke may represent important healing time for the brain, but that
“retraining” it with occupational therapy
can potentially be helpful at any time after the stroke. He says that
his findings support other theories that the health of remaining brain
tissue influences recovery much more than lesion size.
Although
there are many studies that have identified a relationship between
stroke lesion size and overall neurological function, Page’s study is
the first to specifically look at lesion size and upper extremity
outcomes.
Robotic arm as good as traditional therapy
In
the second study, Page’s team demonstrated that stroke survivors using a
portable robotic-assisted arm to perform repetitive task training
showed as much motor recovery as patients who performed similar tasks in
a therapist-guided outpatient setting.
“Our results are
exciting not just because we showed robotics-assisted therapy can offer
equal benefit. We showed that both groups got better, even among
patients who had suffered strokes as long as eight years ago,” noted
Page.
For the study, which was published in the June 2013 issue of Clinical Rehabilitation,
patients performed repetitive exercises that focused on everyday tasks
while supervised by a therapist in an outpatient setting. Half of the
group was randomly assigned to use the robotic arm, a portable device
that is worn over the arm like a brace. When a person tries to move a
weakened arm, the device senses the electrical impulses and helps the
person carry out the movement. A second group performed the same tasks
without the device for the same amount of time and in the same
environment. The group training with the robotic arm performed tasks as
well as their counterparts.
“Therapy can be tiring, expensive,
and resource-intensive. This study is important because it shows us that
in patients with moderate arm impairment, similar benefits can be
derived from using a robotic device to aid with arm therapy as with
manually based rehabilitative approaches,” said Page. “Study
participants who trained with the robotic arm also reported feeling
stronger and more positive about the rehabilitation process.”
Most
of the estimated 80 million stroke survivors worldwide will continue to
have upper body weakness for months after a stroke, preventing them
from accomplishing everyday tasks like lifting a laundry basket or
drinking from a cup. Page says that more research in stroke outcomes
and rehabilitation is needed, and that he hopes families and healthcare
practitioners dealing with stroke will keep the door to recovery open
wider and longer.
“Loss of upper extremity movement remains one
of the most common and devastating stroke-induced impairments. And the
fact is that more stroke survivors are expected yet studies and pathways
to optimize rehabilitative therapy for these millions are not always
emphasized. In particular, we know active rehabilitation programs help
people regain function, but we still don’t know who will benefit the
most from these types of therapy,” said Page. “Both of these studies
give us insights about patients who will respond best – and most
importantly, that we have to give these patients every chance possible
to get better, because they can keep getting better.”
The study using the bionic arm was supported by the American Stroke Association. Both studies were supported by grants (R03 HD062545-02, R01 AT004454-04) from the National Institutes of Health. Click here to see video of a stroke survivor using the bionic arm.
Use the labels in the right column to find what you want. Or you can go thru them one by one, there are only 29,116 posts. Searching is done in the search box in upper left corner. I blog on anything to do with stroke.DO NOT DO ANYTHING SUGGESTED HERE AS I AM NOT MEDICALLY TRAINED, YOUR DOCTOR IS, LISTEN TO THEM. BUT I BET THEY DON'T KNOW HOW TO GET YOU 100% RECOVERED. I DON'T EITHER, BUT HAVE PLENTY OF QUESTIONS FOR YOUR DOCTOR TO ANSWER.
Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.
What this blog is for:
My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.
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