Ok - here's one:
susanne, denmark
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Fra: Spinal Cord Injury Peer Net <[EMAIL PROTECTED]>
Til: [EMAIL PROTECTED] <[EMAIL PROTECTED]>
Dato: 8. december 2000 18:52
Emne: New Therapy Helps Stroke Victims Recover Arm Movements
New Therapy Helps Stroke Victims Recover Arm Movements
St. Louis, Nov. 30, 2000 � Researchers at Washington University
School of
Medicine in St. Louis have found that a new technique called
constraint-induced movement (CIM) therapy, or forced-use therapy,
allows
stroke patients to improve motor functions, even if therapy does
not begin
until 14 days after their stroke. The results from this pilot
study appear
in the December issue of the journal Stroke.
Each year, roughly 730,000 Americans suffer a temporary loss of
blood flow
to the brain, known as an ischemic stroke. Many survivors have
difficulty
moving one of their arms and consequently struggle to perform
normal routine
activities, such as getting dressed.
Although interventions during or immediately after a stroke have
improved
greatly in recent years, no currently available treatments
facilitate motor
recovery several days, months or years after a stroke. "Millions
of people
who had a stroke some time ago are looking for some way to
improve," says
Alexander W. Dromerick, M.D., first author of the study.
"Research on stroke
prevention and early intervention isn�t going to help them."
Dromerick is an
associate professor of neurology and of occupational therapy at
the School
of Medicine.
Traditional rehabilitation therapies try to optimize the use of
the
unaffected limb. "Rehabilitation focuses on the return to
independence,"
Dromerick explains. "The typical approach has been that we don�t
care how
you get dressed as long as you do it."
Such methods help compensate for stroke-induced disability but do
not
attempt to treat the impairment, the researchers point out. "We
want you to
dress independently, but we want you to do it because you have
recovered
strength and coordination, not because you�ve learned a trick for
one-handed
dressing," Dromerick says.
CIM therapy, scientists argue, helps patients regain strength and
coordination. The treatment encourages use of the impaired arm as
much as
possible rather than promoting dependence on the healthy limb.
Dromerick and colleagues randomly placed 23 patients who had
suffered an
ischemic stroke within the previous 14 days into two groups: The
control
group received traditional occupational therapy that focused on
compensatory
techniques. The other group received CIM therapy that focused on
the
affected arm. In between sessions, the CIM patients wore a padded
mitten on
the healthy hand for at least six hours per day. The mitten
discouraged them
from using this hand. Both groups had therapy for two hours a
day, five days
per week, for 14 days.
Twenty of the 23 patients completed treatment. One patient in the
CIM group
recovered sufficiently to be discharged before the end of the 14
days. Two
patients in the traditional therapy group failed to complete
treatment
because one died and one had a second stroke. No patient withdrew
because of
pain or frustration.
At the end of these 14 days of therapy, the CIM patients showed
more
improvement in overall arm strength and coordination than
patients who
received traditional therapy. They were particularly improved at
pinching
tasks, such as those critical to buttoning a shirt or picking up
a fork. In
some functional tasks, like getting dressed, they did better.
"People who
received the experimental treatment were certainly as independent
as the
other patients, and there were some indications that the group as
a whole
was more independent," says Dromerick.
He and his colleagues hope to study a larger patient group to
investigate
this effect further and to find out how long the positive effects
last.
Using imaging techniques, they will examine the effects of
treatment on
stroke-related brain lesions. To evaluate motor recovery, they
will use
kinematic assessment techniques. Although others have detected
changes in
the brain after forced-use therapy, it is not known whether these
changes
result from routine clinical care or from this particular
treatment.
"This study suggests that there�s another therapeutic window for
stroke
patients," says Dromerick. "It�s becoming clear that the
activities a person
engages in can affect recovery and that those interventions can
impact the
person�s ability to perform their normal social roles." He and
his
colleagues are eager to see how these interventions translate
into
structural changes in the brain.
Dromerick AW, Edwards DF, Hahn M. Does the application of
constraint-induced
movement therapy during acute rehabilitation reduce arm
impairment after
ischemic stroke? Stroke, 31. December, 2000.
Funding from The American Heart Association and The McDonnell
Foundation.
The full-time and volunteer faculty of Washington University
School of
Medicine are the physicians and surgeons of Barnes-Jewish and St.
Louis
Children's hospitals. The School of Medicine is one of the
leading medical
research, teaching and patient-care institutions in the nation.
Through its
affiliations with Barnes-Jewish and St. Louis Children's
hospitals, the
School of Medicine is linked to BJC Health System.
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Note: This story has been adapted from a news release issued by
Washington
University School Of Medicine for journalists and other members
of the
public. If you wish to quote from any part of this story, please
credit
Washington University School Of Medicine as the original source.
You may
also wish to include the following link in any citation:
http://www.sciencedaily.com/releases/2000/12/001208074028.htm
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