Despite new diagnosing and treatment modalities, stroke continues to be the third largest cause of mortality in Canada and the leading cause of disability. A recent study shows that a novel therapy may be able to alleviate some of the disability that accompanies stroke. A group of scientists have reported that Constraint-Induced Therapy (CIT), increases the use and function of upper extremities in patients who have suffered a stroke. CIT is intensive in that it is administered 5-7 hours a day for two weeks and emphasizes forced use of the paretic limb while constraining the other, functional limb. The researchers used focal transcranial magnetic stimulation to map the cortical motor output area of a hand muscle, on both sides of the body, in 13 stroke patients in the chronic stage of their illness both before and after a 12-day-period of CIT. After treatment, the size of the muscle output area in the affected hemisphere was significantly enlarged, corresponding to a greatly improved motor performance of the paretic limb. The researchers hypo-thesize that the shift in the centre of the output map in the affected hemisphere spurrs the recruitment of adjacent brain areas. This improvement was still evident in follow-up examinations up to 6 months after treatment, demonstrating the possibility of a long-term alteration in brain function.
Sources
- Liepert J, Bauder H, Miltner WHR, TaubE, Weiller C. Stroke 2000 31: 1210-1216.
- Brickner, Elizabeth M.. American Journal of Medicine. April 1996; 100(4): 465-474.
- Statistics Canada, Health Canada, Heart and Stroke Foundation of Canada. Heart disease and stroke in Canada. Toronto: Heart and Stroke Foundation of Canada; 1997.
