New hope in stroke rehabilitation
CMAJ 2000;163(1):83
For the first time, research has shown that stroke victims who undergo intense rehabilitation not only recover some movement but also alter how their brain works in the long term (Stroke 2000;31:1210). Researchers at the University of Alabama at Birmingham claim they are on the brink of a revolution in rehabilitation.
Researchers found that 13 chronic stroke patients who had lost the use of an arm regained some movement after 12 days of intense therapy. For 6 hours daily, the subjects' good arm was tied down and therapists helped them perform arm movements, such as picking up objects or spooning food, with their weakened arm. Subjects reported that a "switch [eventually] flipped" and they were able to perform tasks that were previously impossible.
Scans of the subjects revealed that before rehabilitation, the area of the cortex that controls hand movement was much smaller on the brain's stroke-damaged side. After treatment, the area almost doubled in size. Six months later, motor performance remained high and the size of the cortical area in both hemispheres was nearly identical.
Not only does this offer hope for stroke patients, but it is also further proof that the brain adapts better after injury than scientists once thought. — Barbara Sibbald, CMAJ
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