Combining nerve stimulation and upper limb rehabilitation after stroke

This study examined the safety and potential effectiveness of using vagus nerve stimulation (VNS) in combination with rehabilitation to improve upper limb function following stroke. It concluded that VNS is safe and has the potential to improve upper limb function when combined with rehabilitation movements. 

Ischemic stroke refers to an obstruction of a blood vessel that blocks blood reaching the brain. 85% of ischemic stroke patients suffer from arm weakness. Rehabilitation for stroke patients involves therapy sessions over time with movement exercises.

Vagus nerve stimulation involves implanting a stimulator device into the chest which stimulates the vagus nerve in the neck. This signals the cells involved in movement. Stimulating these cell could lead to changes in the brain that enhance movement in the arms. 

This study examined the safety and effectiveness of VNS in arm movement rehabilitation.

20 patients who had a stroke more than 6 months before the trial were included. These patients were randomly separated into two groups, with 9 patients receiving VNS + rehabilitation and 11 receiving rehabilitation only. Patient arm motion was measured before and after rehabilitation.

There were 22 adverse effects (AE) in the VNS group in total, however, only 11 of these were device-related effects. Only one of the device-related effects was of moderate severity, and the patient had his implant removed. There were 10 AEs seen in the rehabilitation only group. None of the AEs were due to the rehabilitation itself.

From the patients who completed the trial, there was an increase in arm function in the VNS + rehab group compared to the rehab only group. 

The study concluded that combining VNS with rehabilitation is safe for stroke patients and has the potential to enhance arm function.

The study focuses on safety of this method rather than effectiveness as the patient group is very small. Larger studies should be run to determine the full effectiveness of VNS.

Discuss rehabilitation options with your doctor.