Doctors have been using the same stroke rehab therapy for decades. But now, a new type of treatment involving nerve stimulation has emerged. This new therapy showed positive results in increasing the recovery of some patients.
A lot of people who survive a stroke tend to face trouble using the hand on the affected area. For others, it becomes difficult to use the entire arm.
To aid in regaining the use of their limb, the healthcare professionals recommend rehabilitation therapy. This may include physical therapy in which the patients complete repetitive tasks. It helps to improve the function of the impaired limb.
A recent pilot study published in Stroke suggests combining this rehab service with vagus nerve stimulation. The study found that this combination almost doubled the rate of recovery in patients.
Stroke- An Overview
A stroke refers to a condition in which there is an interruption in the blood flow to the brain. This deprives the brain tissue of nutrients and oxygen. Within minutes, your brain cells begin to die.
A stroke is a medical emergency and requires prompt treatment. Early action can make sure to limit the brain damage and other complications.
There are different causes of stroke. It may be due to the blockage of an artery (ischemic stroke). In other cases, it may occur due to bursting or leakage of a blood vessel.
Sometimes, people tend to experience a reduction in blood flow on a temporary basis. This may produce side effects but does not cause permanent damage.
If you suffered from a stroke, the doctor may recommend medications. These medications are mainly responsible for reducing the risk of suffering from another stroke.
Some commonly prescribed drugs include anti-platelet drugs and anticoagulants. Remember that they only reduce the risk of another episode and do not speed up the recovery.
Under such circumstances, the current study was successful in finding a potential therapy for stroke.
What did the Study Find?
The researchers believe that vagus nerve stimulation (VNS) boosts the neurons in the brain. The effect is particularly evident in neurons that control the movement of the affected arm or hand.
As you stimulate the vagus nerve, it releases certain neurotransmitters in the brain. So if you try opening your hand, the neurons in the brain associated with this task start working. In addition, the neurons with extra neurotransmitters to strengthen the synaptic connections also start working.
How did the Study Take Place?
The pilot study was a part of phase II clinical trial. There were 17 participants all of which experienced a stroke 4 months to 5 years before the study.
During the study, a scientist placed an active VNS device in 8 participants. This device was responsible for delivering electric stimuli to the vagus nerve. The remaining nine participants received an inactive device.
Scientists instructed all the participants to attend sessions of in-clinic rehab therapy. This continued for a period of 6 weeks.
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At the end of six weeks, researchers observed significant improvements in all participants. There was no significant difference in the level of improvement between the two groups.
Following the six-week study, participants continued performing exercises at home. This went on for another 90 days before a follow-up. At the follow-up, the patients with active VNS device showed more improvement in their limb function.
Approximately 88 percent of the participants with active device improved. This was as compared to only 33 percent of the people who received an inactive device.
The participants with an active device improved throughout the phase of the home exercise. On the other hand, those with the inactive device lost some gains they made initially.
Experts believe that there are a lot of therapies that provide improvement while you perform it. However, as soon as you stop, the effects start dropping off. The same was true for those with inactive VNS devices implanted in their bodies.
So what excites the experts about this approach is that it may be able to prevent this drop-off. The stroke patients may not slide back to the baseline as soon as they stop getting a therapy.
The research rendered this approach as reasonably safe. However, three events of adverse effects emerged right after the implantation of the VNS devices.
A Potential Rehab Treatment
In the recent decades, scientists have made advances in the acute treatment of stroke. However, very few developments occurred in this field and long-term stroke recovery.
This study helped open up a new paradigm to manage patients after stroke.
The scientists were previously quite disappointed with the current style of stroke management. This is because most of the time, the care plan focused on the acute care. No similar advances were made in rehabilitation and recovery aspects.
The results of this study are quite promising. However, more research is essential for assessment. It is also important to evaluate the safety of combining the rehab therapy with VNS.
It is quite exciting for the patients of stroke to have an additional adjunctive intervention. This will help them with their motor recovery.
However, the study requires confirmation. For this purpose, experts recommend going for larger trials with more participants in it. It is also worth noting that 3 out of 17 patients suffered from adverse effects. Hence, the potential risk factors and costs of VNS must be weight against the benefits.
To extend their research, the scientists are currently recruiting participants for larger phase III trials.
This trial will help the FDA decide whether VNS is something to be available in the market or not.
A new pilot study established the importance of vagus nerves stimulation for stroke patients. This combined with the regular rehab therapy can double the recovery rate for the patients.
However, experts believe that implanting a nerve stimulator may cause complications. So, more studies are essential before putting this approach to a widespread use.