For years, stroke rehabilitation has focused mainly on the more impaired side of the body.
But a new study published in JAMA Neurology has shown that targeted therapy for the less-affected arm—the one that appears to function better—can bring big improvements in movement and independence for stroke survivors.
This therapy could even help people who had strokes years ago.
The clinical trial was led by researchers from Penn State and the University of Southern California (USC). They found that working to improve the “good” arm helped stroke survivors complete daily tasks more quickly and efficiently, reducing the need for help from others and improving quality of life.
After a stroke, many people lose strength and movement on one side of their body. Because of this, doctors and therapists usually focus on helping that more damaged side regain function.
However, even the arm that seems to work normally can lose coordination and speed due to the brain injury. Since stroke survivors rely…
The study builds on decades of research showing that both sides of the brain help control movement. This means a stroke that affects one side of the brain can lead to problems in both arms. Despite this, there have been no proven therapies aimed at improving the less-impaired arm—until now.
In the study, 53 people who had suffered a stroke at least three months earlier were enrolled. All of them had severe weakness on one side and depended on their other arm to do daily activities.
Participants were split into two groups. One group received targeted training for their less-impaired arm, while the other received the current standard therapy for the more-impaired arm.
The new therapy included both real-life dexterity exercises and special virtual reality games. These games were designed to target the type of brain injury each person had.
People with damage to the left side of the brain played a fast-paced shuffleboard-like game to train planning and coordination. Those with right-side damage played a tracing game that trained precision movements. After these games, participants moved on to…
The group receiving this new therapy showed strong improvements. They were 12% faster on a standard test of hand skill, which includes picking up small objects and pretending to feed oneself.
What’s more, these improvements lasted at least six months after the therapy ended. The researchers believe that once people gain a little more function, they use that arm more often in daily life, which leads to further progress over time.
In contrast, the control group received best-practice therapy for the more-impaired arm, including stretching and exercises. While helpful, this approach did not produce the same gains in hand function for the arm they relied on most.
The findings suggest that stroke rehabilitation programs should look at both sides of the body and provide therapies that make the most of the abilities patients have. Rather than just compensating for the lost function in the impaired arm, therapy can actually make the less-impaired arm work better.
The research team hopes to combine this targeted therapy with other types of rehabilitation to help people regain even more function. By focusing on the arm stroke survivors use every day, this new approach could help many people live more independently and reduce the burden on caregivers.
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