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Five New Frontiers in Stroke Rehabilitation Therapy


Every year, technology advances and we gain a better understanding of the human brain – how it works, how it breaks down, and how to repair it when it’s damaged. Strokes are one of the most devastating events that can strike this delicate, complex organ. There is now more hope of recovery than ever before. These therapies can assist rehab therapists, compensate for permanent muscle weakness, rewire the damaged brain and nervous system, and maybe even reverse the damage altogether.

Botulinum Toxin Therapy
Many stroke survivors who have paresis (weakness in a limb) struggle with the muscles stiffening. This makes it a challenge to move the limb voluntarily or to strengthen it. Studies are underway using Botulinum toxin, in the forms of Botox and Myobloc, to see if they can relax those clenched muscles. This would help with the physical therapy the survivor is getting to restore the function of their limb.

Robotic Therapy
Various robots are being used as part of rehab therapy on a weakened or paralyzed limb. They act like exercise machines, with specialized shapes depending on what body part they are working on. For example, one robot might strap to the calf and foot, to support them while the stroke survivor works on their ankle mobility.

The repeated motion offered by this device retrains the nerves and muscles. As the ankle improves, the resistance can be raised to further strengthen the area. These robots can offer ‘physical therapy’ multiple times a day, even when the physical therapist is not on hand.

Electrical Stimulation of the Limbs
This therapy is becoming more common around the country. The nerves of the weakened arm or leg are directly stimulated with a weak, painless electrical signal. This causes the muscle to contract, which strengthens the limb and, with enough repetition, can reawaken nerves that aren’t working as they should be.

Magnetic Brain Stimulation
In this noninvasive, experimental therapy, a wand-like device that radiates a magnetic field is waved over or pressed against the stroke survivor’s head. This stimulates the electrical signals in the brain. Early studies suggest it encourages the brain to rewire itself. If motor functions are lost due to damage in that area, the nearby areas of the brain may begin taking over that job. This technique is still in testing but early clinical studies look optimistic.

Stem Cell Therapy
All of these therapies are designed to make the most of the surviving neurons, and encourage them to work more efficiently. This last experimental therapy may actually re-grow tissues that have been lost.
This therapy technique involves extracting stem cells from recent stroke patients’ bone marrow. These are infused into the damaged areas of the brain via the major arteries. The stem cells attach and encourage new blood vessels to grow. These blood vessels are vital to feed the nearby damaged tissues. There is also hope that the stem cells can protect neurons that were damaged but not totally killed off, which further boosts stroke recovery.
This technique is in early phases of study, but appears promising. It offers hope for anyone who has suffered this kind of injury, and seems to work especially well on patients who have had the most severe strokes and face the greatest disabilities.