Helping hand for stroke-hit limbs

The electrodes are placed on the patient's arms

People who have impaired movement after a stroke may benefit from a treatment in which the unaffected arm helps the other to improve.

A study published in a leading medical journal suggests that patients using the technique did better than those using other rehabilitation methods.

During a stroke, the blood supply to a small area of the brain is interrupted, causing tissue damage.

We supported the theory that moving the unimpaired limb along with the impaired limb is better

Dr James Caraugh, researcher

This can affect movement on one side of the body, while leaving the other side intact.

Recovery can be slow, and some patients will never regain full movement.

Researchers at the Centre for Exercise Science at the University of Florida used a technique in which electrical stimulation is used to boost the patient's efforts to move his or her affected arm.

The device responds to attempted muscle movement by delivering an electrical charge.

However, some patients, as well as having electrodes placed on the weak arm, also have them on the "good" arm.

As the bad arm is stimulated, so is the good arm.

Moving cubes

The report, published in the journal Stroke, looked at the progress of 25 patients with an average age of 64.

Some were given the double arm therapy, some just stimulation on the bad arm, while others were given physical therapy but not electrical stimulation.

After six hours of rehabilitation during a fortnight-long period, the patients were reassessed to see if their ability to control wrist and finger movements had improved.

The test of this was how quickly the patient could move one-inch cubes from one side of a desk to another.

Prior to therapy, all had been averaging approximately 18 blocks a minute.

After therapy, the two-sided stimulation group improved to an average of 27 blocks, while those stimulated only in the bad arm improved to 22 blocks.

The "control" sample given physical therapy managed a one-block a minute improvement.

In addition, the testers examined reaction times, where again, the double treatment group fared better than those given one-sided treatment.

New paths to recovery

The theory behind the success of the treatment is that involving both sides of the brain in the process makes it easier for new "pathways" to be created to regain control over muscles.

Dr James Caraugh, who conducted the study, said that hand and finger movement was vital to these patients.

He said: "Many can't hold a bottle of water and move it to their mouths.

"It's difficult for them to eat or write if their dominant hand is affected.

"The study shows that that stimulation and bilateral movements are better than only stimulation. We supported the theory that moving the unimpaired limb along with the impaired limb is better."

Dr David Cohen, a consultant in stroke medicine at Northwick Park Hospital in London, said that while early studies into electrical stimulation were "promising", it was too early to draw conclusions about its benefits.

He said: "One of the problems is that while there is a lot of money available to research new drugs for stroke, there is relatively little to research physiotherapy and potential treatments such as this, because they won't make any money for pharmaceutical firms."