New Developments in Stroke Rehabilitation

• Robotic devices are being developed to improve the rehabilitation of extremities by providing passive range of motion and measurement of improvements in mobility and strength.
• Research is ongoing to evaluate the effectiveness of neuromuscular electrical stimulation to promote recovery in stroke patients.
• Investigators are trying to define the optimal intensity and duration of stroke rehabilitation.
• Exciting additional areas that are being contemplated regarding stroke rehabilitation are electrical stimulation over muscle surfaces to help them contract for simple movements; electromechanical devices to help in reaching for objects; direct stimulation of areas of the cortex that direct movements of the arms and legs; learning more about using mental imagery of actions since this stimulates the same area of the brain as actual movement.
• Neuropharmacological agents - it is thought that augmenting chemical neurotransmitters such as levodopa that appear to be reduced after a stroke may optimize the possibilities for activity-dependent relearning. Some early trials have shown that when dopamine drugs were combined with physical or speech therapy, there was a positive effect on stroke rehabilitation efforts.
• Scientists are working on virtual-reality systems that show the virtual environment of the patient and a device on the patient's hand records measurement as they move their hands into cyberspace. The games promote grasping, reaching, and manipulation.
• Researchers are exploring the possibility that agents such as stem cells, bone-marrow cells or other types of cells may promote regeneration or may bridge the site of injury to enable greater connectivity with cells around it. The ultimate goal of stoke recovery is to restore lost brain tissue or at least to stimulate the repair process for tissue that has been damaged by replacing lost cells, stimulating the growth of axons and dendrites (parts of nerve cells), or to stimulate the proliferation of new nerve cells. Both treatments (use of stem cells and bone marrow cells) have shown promise in animal models. Although research in this area is just in its infancy, the potential value of these treatments would be great and provides an exciting prospect for researchers.
• Information regarding ongoing clinical studies in your area can be obtained at the Clinical Trials Listing Service at http://www.centerwatch.com