Specialized Arm Exercises for Stroke Recovery

Program May Help Brain Adjust, Study Shows

From the WebMD Archives

Oct. 19, 2004 -- Specialized arm exercises may actually lead to brain changes during stroke recovery, a new study shows.

The results were seen in a stroke recovery program called BATRAC (bilateral arm training with rhythmic auditory cueing).

BATRAC differs from regular workouts and traditional therapeutic exercises. It uses sound cues to signal participants to start pushing or pulling on two T-bar handles, either using both arms at the same time or taking turns with each arm.

BATRAC was recently compared to traditional stroke recovery exercises by researchers including Andreas Luft, MD, of the gerontology and medicine departments at the University of Maryland School of Medicine in Baltimore, Md.

Having studied BATRAC before, Luft and colleagues already knew that it improved arm function during stroke recovery.

This time, they wanted to see how BATRAC affected the brain during stroke recovery.

Best Exercises for Stroke Recovery

Twenty-one patients in stroke recovery took part. Their strokes occurred an average of four years prior to the start of the study. They all had limited movement on one side of their bodies but were still able to move their stroke-affected arm.

The researchers randomly assigned participants to try BATRAC or to do traditional stroke recovery exercises such as opening a closed fist, bearing weight on the stroke-affected arm, and moving the shoulder blade and upper spine.

Both stroke recovery groups did their exercises for one hour a day, three times per week, for six weeks.

Functional magnetic resonance imaging (fMRI) was done to see whether the stroke recovery workouts affected their brains.

All but three of the nine BATRAC exercisers showed brain activation during the arm movements.

When all stroke recovery patients were taken into account, there was no significant difference between the BATRAC and regular treatment groups. However, when the researchers looked specifically at the BATRAC stroke recovery patients that showed fMRI brain changes, their arm function improved significantly more than the others.

The traditional rehabilitation group showed "no significant changes in the activation on either side of the brain," write the researchers in the Oct. 20 issue of the Journal of the American Medical Association.

BATRAC may help the brain reorganize itself during stroke recovery, they say.

It's too early to tell what makes BATRAC work. The use of both arms, the rhythm of the sound cues, or the intensity of the exercises might contribute.

The researchers don't dismiss traditional therapeutic exercises, noting that those routines could have brain benefits not seen in this study due to its small size.

Larger studies are needed to explore BATRAC's effects during stroke recovery, they say.

Show Sources

SOURCES: Luft, A. Journal of the American Medical Association, Oct. 20, 2004; vol 292: pp 1853-1861. "This Week in JAMA," Journal of the American Medical Association, Oct. 20, 2004; vol 292: p 1789.

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