A stroke can change your life in an instant. Symptoms come on suddenly. Facial drooping, arm weakness, or slurred speech can all signal that a stroke is happening. A stroke can take away the ability to walk, talk, or do other daily activities. But survivors can often relearn skills affected by the stroke and overcome losses in ability.
Strokes happen when the brain doesn’t get enough blood flow. This can be caused by blood vessels getting blocked or rupturing. Not enough blood flow means the brain doesn’t get the oxygen it needs. And that can damage the brain.
Depending on how much damage there is, a stroke can lead to life-long disabilities or even death. What problems it causes depends on where damage occurs in the brain. Survivors may have trouble using their arms or legs, talking, or thinking clearly. In more severe strokes, one side of the body may become weak or paralyzed.
Stroke rehabilitation, or “rehab,” is designed to help stroke survivors return to their daily activities. It can help them recover and improve their quality of life. NIH-funded scientists are studying how to make rehab more effective for people recovering from a stroke.
Benefits of Rehab
Rehab can help survivors build back skills they have lost after a stroke. It uses exercises and other therapies to help restore physical function. It also provides strategies to handle remaining problems. For example, a stroke survivor may no longer be able to grasp things with one hand. Rehab can help them learn to use their other hand.
Rehab usually starts at the hospital within 48 hours of a stroke. It relies on a team of specialists who tailor rehab to specific needs. The rehab team may include nurses, physical therapists, and speech-language pathologists.
Skills are lost when brain cell connections become damaged. To regain those skills, brain cells need to form new connections. That process is called remapping. Studies suggest that stroke survivors get better results when they spend more time doing rehab.
“Rehab can boost re-mapping when tasks are repeated and specific,” says Dr. Scott Janis, a neuroscientist at NIH who oversees clinical research on strokes.
Researchers are trying to find out how intense rehab needs to be to get the best results. They are also looking for ways to make rehab more engaging and easier to access. Ongoing studies are focused on restoring language and limb function.
Restoring Muscle Use
After a stroke, survivors can have trouble moving certain muscles. Muscles can become weak, uncontrollable, or paralyzed. Rehab programs can help address these issues. But some survivors have difficulty finding a provider in their area or getting to a clinic.
Dr. Steven Cramer, a stroke neurologist at the University of California, Los Angeles, wants to make rehab easier to access. He’s designed an in-home intensive rehab program for people who need to restore their arm function. All that’s needed is a computer and an internet connection.
“We give participants 1,000 arm movements per session, six days a week, for six weeks,” Cramer explains. “This is massively more than what the typical American patient gets in usual care.”
By ramping up intensity and access, Cramer’s team hopes to boost stroke survivors’ recovery and make rehab more engaging.
“We’re not doing typical stroke rehabilitation,” Cramer explains. “Participants are playing video poker, Mahjong, and shooting ducks. They can also play Stroke Jeopardy to learn more about stroke.”
But the “secret sauce is socialization,” he adds. Every other day, a licensed therapist meets with the program participants online. They give new exercises, review previous ones, and answer questions.
Cramer’s team compared their in-home rehab program to a traditional program conducted in the clinic. Both increased arm functioning and movement a similar amount. Now, they’re testing the impact of adding the in-home program to usual care.
Restoring Language
Strokes can also damage the part of the brain that controls language. At least one out of every four stroke survivors have a condition called “aphasia.” It affects speaking, reading, writing, and/or understanding language.
Not all stroke survivors recover from aphasia, even with speech-language therapy. They often have chronic (long-lasting) problems with language.
Dr. Julius Fridriksson, a neuroscientist at the University of South Carolina, is testing a new approach for patients with chronic aphasia treatment. His group is trying intensive speech-language therapy with brain stimulation.
“We think that applying electrical currents to the brain areas that control language could stimulate the remaining brain cells,” says Fridriksson. Activating those cells could help build back brain connections for language.
To stimulate the cells, the team uses a technique called transcranial direct current stimulation (tDCS). The team places patches that conduct electricity on the outside of the participants’ scalp. It’s used during speech-language therapy.
“Aphasia is a serious condition because people are unable to communicate,” Fridriksson explains. “People with chronic aphasia need better therapy so they don’t experience it the rest of their lives.”
His team has been testing what parts of language therapy brain stimulation can enhance. They’ve found that it can help with remembering names of objects. Survivors with aphasia often have difficulty recalling names of objects they knew before their stroke. Now the team is testing if brain stimulation with language therapy is more effective than therapy alone.
If you care about stroke, please read studies about how to eat to prevent stroke, and diets high in flavonoids could help reduce stroke risk.
For more health information, please see recent studies about how Mediterranean diet could protect your brain health, and wild blueberries can benefit your heart and brain.
Source: NIH.
