Stroke Victims Exercise the Body to Exercise the Mind
June 2, 2000 -- When blood flow to the brain is cut off during a stroke, the
lack of oxygen can have truly devastating results. For years, doctors have been
advocating physical therapy after a stroke, but costs are many, and guarantees
are few. Although physical therapy can appear to work outwardly, with some
improvement physically, now there is evidence to suggest that long-term changes
actually occur mentally, with undamaged brain cells "stepping up" to
take the place of damaged cells.
This is the first evidence, researcher Edward Taub, PhD, tells WebMD, that a
physical therapy can have a direct impact on the brain.
Taub, who is a behavioral neuroscientist and professor of psychology at the
University of Alabama at Birmingham, says his research team has developed a
highly intensive form of physical therapy that, in a relatively short period of
time, delivers results so impressive that not only the body, but also the brain
itself shows significant improvement.
The team developed constraint-induced movement therapy about a decade ago.
The hallmark of the treatment is that it produces a very large improvement in
the ability to use the arm weakened by the stroke in everyday living
situations, Taub says. He explains that basically, a victim's "good"
arm is restrained for 90% of their waking hours, for either two or three
consecutive weeks, depending on how much rehabilitation they need, so that they
will use the affected arm more.
During treatment, patients spend seven hours of each weekday in training at
the clinic, with only a one-hour break. "It is that concentration ... that
we [believe to be] the therapeutic factor," he tells WebMD.
Taub had already demonstrated that this technique was very effective at
restoring arm function, and earlier work did show dramatic brain changes
immediately following the therapy. In this latest work, the team examined
whether those brain changes would last, and if they really impacted quality of
According to the report, published in the June issue of the journal
Stroke, Taub's team evaluated 13 men and women, aged 33 to 73 years,
who'd suffered a stroke six months to 17 years prior to the study.
The researchers used a type of high-tech imaging similar to MRI to map brain
activity to determine if changes occurred in the brain during and after
Following therapy, all subjects showed remarkable improvement in their
ability to perform tasks. The improvement remained unchanged during the entire
six months, and according to Taub, several subjects continue to function just
as well now that two years have passed. Brain mapping scans showed dramatic
increases in function and activity in the specific areas of the brain that
control the affected arm. According to Taub, the therapy effectively
"rewires the brain" almost back to normal.