Brain circuits have effectively been fried, by the oxygen shortage precipitated by the block or break in the blood vessel.
Recovery depends on rewiring those circuits.
Rewiring takes time, hours of repetition, as the brain establishes new neuronal pathways, grows familiar with them and finally is able to run them by default.
It takes guts and determination.
Rewiring the circuits
For some stroke survivors the rewiring process is seamless and recovery is complete.
For others, the road to recovery is long, protracted and imperfect.
For some, recovery never happens.
Researchers from Jena University in Germany, think they may have found a way to speed up the rewiring process, their solutions are particularly useful for people grappling with arm troubles.
All it requires is a dab of cream and a little restraint.
Being tied down
To force patients to use the dud arm, the team use a technique known as Constraint-Induced Movement Therapy – CIMT for short.
CIMT puts the “good” arm in a “straight jacket”, leaving the “bad” arm to do EVERYTHING, unassisted.
EVERYTHING includes a range of tasks such as
- stacking small toy blocks
- putting tiny pins in a perforated board
- normal daily activities like washing and eating
Restraining the “good” arm, on its own, seems to encourage the development of new circuits, to get the “bad” arm moving.
The research team wondered, if tying up the “good” arm further, using a little pharmacology, would further speed up the formation of new circuits.
The short cut in a tube
To test the more restraint is more effective idea, the research team enrolled 36 stroke survivors who were having difficulties with motor skills in their arm/hand.
All 36 patients were given CIMT, but half of them received additional restraint prior to the exercise therapy. This additional “restraint” was not physical, but pharmacological.
The researchers applied a local anesthetic cream to the forearm of the “good” arm. The local anesthetic numbed the “good” arm, lowering its sensitivity and ability to move/respond to stimuli.
A bump to the right
As expected, all patients improved. CIMT works well.
But, the patients who had the local anesthetic smeared on to their “good” arm, performed even better.
The neuronal vacuum
Using magnetoencephalographic imaging, the team unravelled just how restraining the arm, revved up the healing process.
The local anesthetic temporarily interrupted nerve impulses into the brain…………….
A little surprised, the neighboring cells in the brain responded by firing off, more than usual. This heightend firing, causes the hand to be a tiny bit more sensitive.
The enhanced sensitivity, translated to improved performance, in both the “good” arm and the “bad” arm.
Trick worth trying
Restraining the “good” arm physically and pharmacologically is relatively easy to arrange.
If you or a loved one is battling to improve mobility following a stroke, spending the morning in a “straight” jacket, playing a few games, is worth a try.
PS. In the afternoon, you may want to try a round of golf – the secret to recovery from a stroke is PRACTISE, PRACTISE, PRACTISE.
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