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Stroke Rehab: It's Never Too Late

Stroke survivors it is never too late to regain what you've lost.
Strokes are the third leading cause of death in this country.

They are the leading cause of disability among adults.  It was once thought that whatever mobility stroke survivors had after two years, that's all they would ever get, but researchers are developing new technology that's proving that fact wrong.

Seven years ago, Todd Daniels couldn't stand on his own.

"I suffered a brain injury, a traumatic brain injury," Todd Daniels told Ivanhoe.

As a result, Todd suffered a stroke.

"My family was told I would always need to be in a nursing home and I would never walk again," Todd said.

Determination is finally proving the experts wrong.

Todd is one of the first to use a new bionic arm, tested at The Ohio State University to help him regain movement.

"The pads pick up the intention, or the desire, for the patient to move. Then, the robot detects that and basically amplifies that desire to move," Stephen Page, PhD, Associate Professor of Occupational Therapy, The Ohio State University Wexner Medical Center, told Ivanhoe.

For Todd, the study's been a success.

"When he first started the study, the only time he could actually do any motion was involuntarily. So, now he's doing it voluntarily," Heather Tanksley, Occupational Therapy Student, The Ohio State University, told Ivanhoe.

Dr. Page believes with the repetitive use of the bionic arm, a patient's brain is being rewired.

"Areas that maybe weren't being used or dedicated to a certain movement, like moving the arm, can actually be used," Dr. Page said.

Also, just how much a stroke patient is improving is, for the first time, being measured by the same technology used in your smart phone.

"When we turn it one way, or the another way, the screen change-so it's sensitive to movement," Dr. Page said.

Accelerometers, which measure the acceleration and direction of body movements, are placed on each ankle, both arms, and across the chest. 

"We are able to determine how well, how fast, and how efficiently a stroke survivor is moving," Dr. Page explained.

"Just gaining some motion back was just a huge step," Todd explained.

Dr. Page believes that stroke patients in recovery, even ten years after a stroke and possibly throughout the rest of their lives, can continue to increase their mobility.
He hopes the bionic arm will be able to go home with the patients to help them do simple tasks around the house more easily.

BACKGROUND:  A stroke or “brain attack” occurs when a blood clot blocks an artery or a blood vessel breaks, disrupting blood flow to an area of the brain.  When either of these things happens, brain cells begin to die and brain damage occurs.  Whenever brain cells die during a stroke, abilities controlled by that area of the brain are lost.  These abilities include speech, movement, and memory.  (Source: www.stroke.org)

SMART PHONE TECHNOLOGY:  People love their smartphones, but many of us take for grant the technology that is packed into our phones and tablets.  Researchers at The Ohio State University Wexner Medical Center are inspired by it.  They are the first to test the innovative approach that combines blue tooth technology with a computer program that charts the movement of a patient’s arms and legs during rehabilitation.  “These moving body parts are in a constant state of motion, but with this technology we can figure out how they are all working together. This gives us the ability to objectively, precisely, figure out at the bedside or in a rehab facility, how well someone is improving,” Stephen Page, PhD, FAHA, an occupational therapist at The Ohio State University Medical Center, was quoted as saying. Six sensors are placed on the participants’ arms, legs, and chest. As the person walks the sensors relate information to each other and back to a computer that charts how and where the person is moving.

Researchers are using this new technology to evaluate progress in a study that is combining electrical muscle stimulation, which has been used to improve muscle function for decades, with active motion on a recumbent bicycle.  The goal of the study is to determine whether the combination of active motion and electrical stimulation provides added benefit for the patient through neuroplasticity, or retraining the brain.  The first part of the study will examine ten people.  Over the course of ten weeks, half of the participants will get the electrical stimulation on their legs while biking, and the other half will get a placebo.  (Source: http://medicalcenter.osu.edu/Pages/index.aspx)

“BIONIC ARM”:   Dr. Stephen Page says that close to 80 percent of stroke survivors have difficulties with arm movement.  Most therapists have assumed for many years that there was only a small window of opportunity to rehabilitate arms that were damaged by a stroke.  They would focus on the arms in the early stages of rehab.  Dr. Page launched a new study to help change this notion.  The study uses a hi-tech elbow brace known as “bionic arm.”  “All of our muscles have what’s called EMG or electromyography. It is essentially a signal that our muscle sends out when it’s moving, or attempting to move,” he said.  “When the patients attempt to move, even if it’s slow, or not even visible, this device will magnify those attempts to move and the robot inside will kick in and help them to move the rest of the way,” Dr. Page was quoted as saying.  Researchers believe that the brain can actually be retrained to move the arm on its own, regardless of how long ago a patient had a stroke. They think the repetitive use of the “bionic arm” will rewire the patients’ brains.  (Source: http://medicalcenter.osu.edu/Pages/index.aspx)

 For More Information, Contact:

Steve Page, PhD, OTR/L, FAHA
Associate Professor of Occupational Therapy
The Ohio State University Wexner Medical Center
stephen.page@osumc.edu
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