Traditional stroke rehabilitation therapy focuses on restoring strength and movement to the more impaired side of the body, but a new randomized clinical trial has revealed that targeted therapy for the less-impaired arm significantly improved movement and control for stroke survivors. The trial, led by researchers from Penn State and the University of Southern California (USC), compared the new approach to the standard best-practice therapy currently in use. The team said the findings, published today (Feb. 2) in JAMA Neurology, demonstrate that motor skills in the less-affected arm can be improved even years after a stroke occurs and could meaningfully enhance quality of life.
"When we train the less-impaired arm, the individuals got better," said Candice Maenza, project manager for the Neurorehabilitation Research Laboratory at the Penn State College of Medicine and first author of the study. "This could improve quality of life and reduce the burden of care for caregivers because stroke survivors with severe paralysis on one side rely on this arm for daily tasks like eating or dressing."
A stroke - when there is an interruption of blood flow to the brain, either due to a blockage or burst blood vessel - can damage parts of the brain that control movement and disrupt communication between the brain and muscles, leading to paralysis, weakness or muscle spasticity that is often focused on one side of the body. Traditional physical rehabilitation focuses on the more impaired side of the body because the lack of strength and movement are so obvious that the arm on the other side of the body may retain function that appears normal, according to study co-author Robert Sainburg, Dorothy F. and J. Lloyd Huck Distinguished Chair in Kinesiology and Neurology at Penn State. Despite the appearance, though, Sainburg said the less-impaired side of the body often loses significant function, resulting in slow and poorly coordinated movements. That's a challenge when that arm needs to compensate for the reduced ability of the more impaired arm.
