New rehabilitation techniques for stroke patients

This article reviews recent research on new stroke rehabilitation techniques. Several new approaches are briefly presented.

Rehabilitation after stroke is generally aimed at recovering as much muscle function as possible (motor function). There are two main areas of intervention: improving muscle function (ability to perform daily activities, fine movements etc.) and improving muscle strength (many patients experience weakness in the affected limbs). The general principles of rehabilitation typically involve exercise training but several new techniques have been proposed in recent years.

This paper briefly discusses several new trials testing new methods of stroke recovery. Some trials were already completed while others are still going on.

1. Medications. In a study involving 118 patients, the antidepressant fluoxetine was found to improve recovery outcomes 3 months after stroke. Participants began taking the drug within 10 days of stroke onset.
2. Early mobilization. An ongoing trial is currently testing whether getting out of bed and beginning rehabilitation very early, within 24 hours of stroke onset, under the guidance of qualified personnel can help improve long-term outcomes.
3. Treadmill training with body weight support. A large trial involving 408 stroke patients tested whether treadmill exercise started within 2 months of stroke onset yielded better outcomes than an exercise program started 6 months after stroke or a home exercise program started 2 months after stroke. Results showed that 52% of all patients improved their walking ability after 1 year, regardless of the assigned intervention. However, there was an increased risk of falls with early treadmill exercises.
4. Robotics. An analysis of several trials involving 666 patients found that robotic or mechanical arm training devices improved arm function but did not improve arm strength.
5. Virtual reality and special video games for stroke recovery were found to mildly improve muscle function, but not muscle strength.
6. Transcranial magnetic stimulation. This method involves stimulating the brain after stroke using magnetic fields. It was found that patients with small strokes may obtain slight improvements in motor function with magnetic stimulation of healthy areas of the brain.

New approaches to stroke recovery are currently being researched, with some methods more beneficial than others. Adequate exercise programs and possibly medication offer the most promise to improve stroke outcomes. The modest benefits of the other techniques still need to be confirmed in larger trials with long participant follow up.

Each patient has specific recovery goals that should be adressed by selecting rehabilitation techniques that suit individual needs. Overall efficacy and potential risks need to be considered in each case.

You should consult with your doctor and physical therapist to establish a recovery plan that is personalized to your needs.