For Immediate Release

Contact: John M. Martino
Phone Number:  (215) 895-1186
Date: 05/03/01

Methods For Stroke Recovery Have Changed in Past Decade

It was a common theory in the medical community that after a stroke, a person's chances of full recovery decreased dramatically if there were no improvements in the first six months of rehabilitation.  Since the brain's cells lack the ability to regenerate as other cells, it was thought that a stroke was an untreatable condition. That outlook has changed over the past 10 years.  According to Susan Barker, associate professor of physical therapy at University of the Sciences in Philadelphia, research has shown that the brain's cells can change and adapt to perform other functions.  This capacity for change is known as brain plasticity, defined as the ability of the nervous system to adapt to changed circumstances, to find new ways of learning, sometimes after an injury or a stroke.

"In this process, fewer cells will take over the functions that more cells used to do before," explains Barker, who is certified by the American Board of Physical Therapy Specialties as a neurologic clinical specialist.  "For example, if cells in the brain that used to control right hand motion are damaged, cells nearby that used to control the right elbow will start to be able to control the right hand.  The cells have the ability to change their function and connections.  This justifies what we've known intuitively in the clinic, that people can improve from stroke even years after a stroke."

A method to enhance brain plasticity is through a rigorous rehabilitation program.  In the past, physical therapists were cautious about asking people to work with effort during recovery from a stroke and didn't put pressure on them.  That has all changed.  Therapists realize that intense workouts are needed if a patient wants to recover his or her full range of motion.  "A high intensity workout is a key element to help a patient recover from a stroke," says Barker.  "It challenges the nervous system and makes it go through the plasticity."  Another important element that promotes brain plasticity is task specificity.  This means that the activities that a person engages in during rehabilitation should be individualized to that person's unique deficits following stroke.  Not just any exercise will do; only individualized activities promote plasticity.

Over the past decade, new innovations, such as better drugs and technological advances, have helped the recovery process.  One innovation that is starting to receive a lot of positive feedback as a training tool is virtual reality.  Through this technology, patients can actually see the fruits of their labor.  They can see their hands picking up a glass and putting it on a shelf or see their legs walking in and out of an obstacle course.  "In the real world, patients often can't see much results," says Barker, "but in virtual reality, it is immediate gratification for them to see what it is like to do the same routine actions that they were accustomed to doing.  It gives them more confidence that they will get better."

Barker says new research and breakthrough technological advancements will help to improve the chances of recovery after stroke in the next 10 years.  She adds that newer acute care methods, diagnostic procedures and more powerful drugs will be realized.  "Look at what we have learned and achieved over the last decade," she says.  "Things will definitely get better in the next decade.  I think we will see better preventive procedures developed, and in turn see a decrease in the overall incidence of stroke."  

To arrange an interview, contact John M. Martino at (215) 895-1186, or e-mail: j.martin@usip.edu.

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