By a News Reporter-Staff News Editor at Clinical Trials Week -- Doctors at the Rehabilitation Institute of Chicago (RIC) revealed the results of a study wherein 80 percent of stroke survivor participants regained arm and hand use - 30 percent more than possible with standard therapies. The breakthrough study combines for the first time a new, non-invasive brain stimulation technique with traditional occupational therapy (OT) to improve upper limb (arm and hand) movement recovery - and give patients back the independence they lost as a result of their strokes (see also Rehabilitation Institute of Chicago).
Richard L. Harvey, MD, medical director at the RIC Center for Stroke Rehabilitation and lead scientist of this study, researched and developed a new approach to modulate brain healing and improve lasting arm and hand use in stroke survivors. This type of brain stimulation is the only technology that has been shown to deliver greater functional improvements when accompanied with an OT session. Typically, only about 50 percent of post-stroke patients regain full upper limb use through OT alone.(1) The results from RIC's study indicate this combined treatment could increase that success rate to 80 percent.
RIC worked with Nexstim Corporation to apply this novel type of non-invasive brain stimulation - navigated brain stimulation (NBS) - to standard stroke rehabilitation. After a stroke blocks blood to the brain, some regions of the affected brain hemisphere become less active, while some areas on the healthy side of the brain become more active. By externally and painlessly stimulating the overly active parts of the healthy brain with NBS magnetic waves, these targeted parts calm down. The RIC study indicates that when the overly active healthy brain areas quiet down, the stroke-damaged areas respond more fully and sustainably to occupational therapy. This allows the patient to have a better recovery and increased arm use.
"This study represents what could be a significant breakthrough in the treatment of strokes," said Harvey. "Our results indicate that targeting stimulation to the correct area can set up the brain to learn and retain more during traditional stroke rehabilitation. We know that stroke is a leading cause of serious disability and costs the U.S. more than $36 billion each year from lost work days and long-term health care. To these patients, regaining arm use and mobility means increasing their ability and, thus, their quality of life."
Darryl Holmes, one of the 30 stroke survivors with severe arm impairments in this pilot study, had a stroke in 2009 at age 57. After his stroke, his movement was limited. He had trouble using his left side, including his arm and hand, which prevented him from performing many of his regular activities, like driving and writing.
In 2013, Holmes participated in RIC's six-month stroke study and received treatment with NBS in combination with occupational therapy. This study used NBS to stimulate the brain with magnetic waves using a navigation system akin to a GPS map. Adding navigation to regular brain stimulation allows doctors to locate the exact area of the brain that should be inhibited, or calmed down, by this type of stimulation.
"Since the RIC study treatment, I've gone back to work," said Holmes. "I've gone into private practice. I drive a new car. Participating in this research has made me a healthier person, both physically and mentally. I have my life back, and it's good."
The Center for Stroke Rehabilitation at RIC integrates research directly into patient care and is the only federally-designated Rehabilitation Research and Training Center for Stroke, as recognized by the National Institute on Disability and Rehabilitation Research. RIC is the first hospital to run a trial with NBS as an aid to OT in stroke survivors. Now that the pilot study is complete, RIC has expanded the study and currently manages 12 other research centers in a nationwide study - the first large-scale trial of its kind to take a major step toward clinical availability of this treatment.
About The Rehabilitation Institute of Chicago The Rehabilitation Institute of Chicago (RIC) is the nation's leading provider of comprehensive physical medicine and rehabilitation care to patients from around the world. Founded in 1954, RIC has been designated the "No. 1 Rehabilitation Hospital in America" by U.S. News & World Report every year since 1991. RIC sets the standard of care in the post-acute market through its innovative applied research and discovery programs, particularly in the areas of neuroscience, bionic medicine, musculoskeletal medicine and technology transfer. For more information, go to www.ric.org.
(1 )Broeks, JG , GJ Lankhorst, K Rumping, and AJ Prevo. "The long-term outcome of arm function after stroke: results of a follow-up study." Disability and Rehabilitation 21: 357-364. US National Library of Medicine. Web. 29 Apr. 2014.
SOURCE Rehabilitation Institute of Chicago
Rehabilitation Institute of Chicago
Keywords for this news article include: Stroke, Therapy, Hospital, Technology, Clinical Trials and Studies, Rehabilitation Institute of Chicago.
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