Stimuli and desire linked to help stroke patients

Innovative research restores hand function

Once-paralyzed stroke victims are regaining arm and hand functions thanks to an innovative treatment developed by University of Toronto and Toronto Rehabilitation Institute researchers.

The treatment, outlined in the January Neuromodulation, uses a neuroprosthesis that stimulates muscles with electrical pulses, mimicking the intricate movements along the hand and arm. Simultaneously, the patient concentrates on the movement itself, gradually reconnecting the damaged neuronal connection with the patient’s free will.

“Most therapies do not actively encourage the patient to think about what they’re doing, so there is no connection to the brain to do it,” says the paper’s lead author, Professor Milos Popovic of U of T’s Institute of Biomaterials and Biomedical Engineering (IBBME) and the Toronto Rehabilitation Institute. “We hypothesized that the central nervous system has reserves, and even if one part of the brain has been damaged, another reserve can be tapped into to produce movement.”

In the study, Popovic and colleagues did a randomized clinical trial on patients who had lost hand and arm movement; 85 per cent of stroke patients never recover movement. The control group received standard physiotherapy and occupational therapy, while the treatment group trained with the neuroprosthesis in addition to the standard therapy. “In the treatment group, we showed that after 16 weeks, we can restore some of their reaching and grasping functions,” says Popovic. “This progress did not appear in the control group. It’s all about linking the desire to heal with the stimulated movements.”

Popovic soon hopes to find an industry partner to build the technologically advanced neuroprosthesis and to persuade other institutions to use the approach.