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Author:
Tim Anderson

You've suffered a right-hemisphere stroke, meaning the right side of your brain was impacted. The physical results, however, affect the left side of your body, resulting in weakness and partial paralysis. You've spent a harrowing three days on multiple hospital units, endured the poking and prodding of who-knows-how-many doctors and nurses and even, if you're not mistaken, a curious mechanic who happened to be passing through.

It's time to go home. The thought of your own food and your own bed leaves you anxiously studying each excruciatingly slow tick of the clock. You're not in great shape, but you have a few positive things working in your favor and, thank goodness, the right side of your body is humming along nicely. Not that it won't be hard, but while you undergo therapy to regain the use of your left arm, you can still work your way through your daily routine with your right. Who ever said it takes two good hands to work a fork?

Not so fast.

You watch in horror as the doctor hands your wife a white cotton strap, about three inches wide, and says, "Use this to tie down his right arm first thing each morning. It will help him regain the use of his left arm more quickly." What? The stroke must have affected your ears as well. Surely you heard that wrong...

Not at all. The therapy is known as Constraint-Induced Movement Therapy (CIMT) and it is currently being studied at Emory University and six other medical centers across the country. The theory is relatively straightforward - to improve a non-function extremity it must be utilized to the fullest extent. There is no reasonable call for rest and recovery when the issue is stroke. The call of the day is action, the sooner the better.

Emory and the other centers participated in the Extremity Constraint-Induced Therapy Evaluation (EXCITE) clinical trial. The trial involved 222 patients who had suffered strokes, primarily due to ischemia, a blockage of the flow of blood to the brain. One group received standard rehabilitative care and the second group received the constraint-induced, CIMT, therapy. The CIMT therapy involved restraining the productive, non-affected, hand or limb and forcing the patient to utilize the weakened hand to perform a variety of daily tasks. The capabilities of each group were assessed on a standardized Motor Activity Log and included tasks such as turning on a light, opening a drawer, putting on socks, answering the telephone and using a fork or spoon.

The results are promising. Patients treated with CIMT exhibited both quantitative and qualitative improvement that was superior to the standardized treatment group. The CIMT group was able to complete tasks at an 11% higher rate than the control group and they completed their tasks, on average, 50% faster. The researchers are pleased with the initial results and believe that further studies are warranted.

You've survived your first day at home. As you ponder your circumstances you find a new wave of motivation washing over your weary body. Your wife takes no notice as you study the three-inch strap that secured your good arm to your side for much of the day. You look back and forth from the strap to your wife, then sit back and ponder the day you will once again have full use of both arms. Suddenly, you feel like reading Stephen King.

Tim Anderson is a freelance writer who has a special interest in medical topics. Visit his blog at http://medicalmigrant.blogspot.com/.

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A Quick Note From The Publisher... If you like the article above, you may be interested in the following article which is also related to Stroke... You Can Prevent Stroke If you’ve ever witnessed someone suffer a stroke, you understand the humbling nature of this disease. It can reduce the mightiest human being to an immobile, helpless creature. Impairment of crucial functions like speech, walking, and control of bowel and bladder can wrench control from the body in a moment. Even perpetually youthful TV personality Dick Clark was struck down by stroke at age 75, despite the outward appearance of perfect health. Clark’s stroke resulted in a six-week hospital stay and, judging from fragmented reports, significant disability. Stroke can be like a devastating fire that strikes without warning, leaving only smoldering rubble. Stroke can so ravage basic bodily functions that often all you can hope for is to regain a portion through rehabilitation. The disease process that underlies stroke requires decades—30 or 40 years—to develop. With that much lead time, why aren’t we better able to detect or stop this crippling disease? The truth is that we are able to predict many, if not most, strokes. Advances in imaging technology allow detection of atherosclerotic plaque that cause stroke years before it becomes a threat. Progress in deciphering the causes of stroke has also leapt forward. Unfortunately, your neighborhood physician still focuses on diagnosing the crisis rather than anticipating it. Physicians prefer to deal with catastrophes and are just not that interested in prevention. Most physicians ask: “Is it time to operate or not?” The medical community obsesses over procedures like carotid endarterectomy (surgical removal of plaque) or carotid stents. Even when a person is afforded the warnings of a “mini-stroke”, or transient ischemic attack (TIA), little more is done once it’s determined that surgery is not necessary—even though...