Wednesday, January 28, 2009

Young Stroke Survivors: Unique Ambitions Drive recovery.


Young stroke survivors are interesting to those of us in stroke-specific rehabilitation research because there is so much raw material and raw potential. Many younger stroke survivors have the effects of the stroke as the only problem they have. They are often on no medications, they have tons of energy and they are not willing to give up the balance of their life.

I was asked to write an article about young stroke survivors for ADVANCE for Directors in Rehabilitation. You can find the article here.

Disclaimer: Many times when I write an article it gets edited in the most...interesting ways. If something seems missing (like, say, words) don't blame me! In any case, you'll get the gist.

Friday, January 23, 2009

A Lot To Live Up To: "The Magic Cure for Spasticity Reduction"


More than any other aspect of stroke recovery, stroke survivors and therapists ask me about spasticity. Are there effective treatments? Can spasticity be eliminated? What do I do?

There are many treatments for spasticity, but all of them are Band-Aids. That is, they don't eliminate spasticity; they mask it or temper it. Treatments range from injections that temporarily "quiet" the offending muscles (i.e. Botox, phenol blocks) to drugs that usually work systemically (which means they hit all your muscles and usually have a global sedative effect). There are surgeries that snip a nerve rootlet here or a tendon there (these are permanent and nor reversible; they eliminate spastcicty, but also eliminate the potential for the muscle ever to come back.)

There is one answer, however. It is outlined in this article I wrote recently.

Trust me, I did not make up the headline.

Monday, January 12, 2009

Bilateral Training

Assume you never had a stroke. If you are right-hand dominant and you are trying to do something equal and opposite (like drumming) your right hand will slow so the left hand can keep up.

But it works in the opposite as well...your left hand will be able to drum faster, will have better trajectory and make fewer mistakes if you do the drumming with both hands at the same time... together. The right hand essentially trains the left hand.

After a stroke the unaffected "good" arm/hand will train the "bad" arm/hand. It's called 'bilateral transfer'. This transfer of info from one limb to the other, some scientists think, happens below the brain; right through the spinal cord, as if the two limbs are communicating directly. this may be one of the (many, many) reasons the legs usually come back sooner; bilateral transfer is used constantly during the one activity the legs are most involved in...walking. Want it to sound more scientific-y? Here's my slide for it...

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