Recent times are witnessing innovative approaches to management of strokes. They are helping in the further recovery and also speeding up the recovery rate.
Stroke is a condition wherein the blood supply to the brain tissue stops due to a clot or due to the rupture of blood vessels.
If a stroke patient reaches late to the hospital, newer technologies help in treating the clot by aspirating/ extracting the clot via catheters (special tubes.) These days, CAT scan and perfusion scan in the operating room treat clots and also diagnose further clots that may be present; thus, saving precious time.
Now you can see more intensive physiotherapeutic interventions for recovery too. Now, we begin physiotherapy soon after a stroke as long as the patient can safely tolerate. This quickness helps in early recovery. Based on the status and improvement, we refer the patients to intense rehabilitation services.
Robotic devices are one such innovative interventions that help patients retrain themselves and recover from the damage caused by stroke.
Here a robot with an artificial arm guides patients through a series of voluntary or machine-guided repetitive exercises. Robotic therapy helps in increasing the number of task repetitions for the affected limb. It also helps your doctor monitor the parameters such as speed, direction, the rate of movement, and joint coordination.
AHA/ The American Heart Association has also approved the upper extremity robotic therapy. The robotic therapy can also be clubbed with virtual reality. For instance, the patient can use the robotic device while viewing the computer screen that shows the hand picking up an egg. If the patient squeezes the robotic egg too tightly, the virtual egg cracks. With robotic therapy, patients can perform such repetitive tasks more often thanin the physical presence of a trainer.
Robotic therapy could bring 10% more benefit to patients than conventional therapy. However, all patients may not respond to robotic therapy. But whoever does can show 10% more recovery than conventional therapies. Scientists are working towards making them more customized.
For improving the function of lower extremity body parts/ legs, weight-supported treadmill training helps the patients in learning how to walk. The therapists sit on either side of the treadmill and with the help of the software, they guide the patients to walk.
There is a further advanced version called Hocoma’sLokomat robotic gait training system to speed up the recovery process. With over the ground training, patients can walk for 50 feet with two assistants but with locomotor, patients can walk up to 30 minutes. Thus, locomotor trains the patient’s brain more with required repetitive motions.
Gradually, as the patients progress in their rehab, they can start using wearable functional electrical stimulation devices. Such devices assist the muscles while performing tasks. They also help to increase function, strength, and movement and decrease pain and muscle spasticity. Such devices are custom-fit and stimulate the surface via custom electrodes.
Besides, certain latest therapies such as TMS/ Transcranial Magnetic Stimulation and direct current stimulation help to enhance the brain functions. They are useful as adjuncts to other therapies. When the patients are repetitively performing functional tasks, these therapies help in stimulating the brain activities further. Besides, the patients do not feel the impulses in these innovative therapies though they are effective.
Constraint-induced therapy is another newer form of therapy. Here, they restrict the use of functional limb so that the patient is motivated to start using the affected limb. After the completion of therapy spread over several weeks, such patients showed over 50%:
- Reduction in the time taken to complete the tasks
- Increase in quantity of use
- Increase in quality of use
compared to conventional treatment.
Some innovations such as stem cell therapy and injectable gels are on the way.