Hope for stroke survivors as researchers improve arm function with simple treatment: 'Can improve movement even years later'

Research indicates that electrical stimulation of the spinal cord could enhance mobility in the arms and hands of those who have experienced a stroke.

Every year, approximately 100,000 individuals in the UK suffer a stroke. This medical condition, caused by an interruption in blood flow to the brain, stands as one of the primary causes of death in the nation, resulting in about 34,000 fatalities annually.

In the UK, around 1.4 million people have survived a stroke, many of whom endure lasting disabilities such as muscle weakness and impaired movement. This often leads to significant challenges in using their arms, hands, or feet.

However, recent research published in the journal Nature Medicine offers a glimmer of renewed optimism.

Scientists from the University of Pittsburgh have employed a method known as cervical epidural spinal cord stimulation. This technique aids the brain in reconnecting with weakened muscles, leading to noticeable enhancements in arm strength and mobility for seven stroke survivors involved in the study.

These promising results suggest the potential for a new treatment option for individuals facing difficulties with upper limb function.

Marco Capogrosso, assistant professor of neurological surgery at the University of Pittsburgh, and the study’s co-senior author, said the approach may ‘rapidly help people move their arms better, even years after a stroke’.

He added: ‘The stimulation works mostly as an assistive technology – when it’s on, people can move better. By stimulating the spinal cord, we can immediately allow residual connections between the brain and the spinal cord to work more efficiently, enabling better movement.’

Improving arm and hand mobility for stroke survivors may be possible through electrical stimulation of the spinal cord, research suggests

Improving arm and hand mobility for stroke survivors may be possible through electrical stimulation of the spinal cord, research suggests

The technique, conducted in a trial period of four weeks with participants who had an average age of 50, was found to bring a range of improvements to muscle strength.

With the stimulation switched on, shoulder flexion – the movement involved in raising the arm – improved by 28 per cent on average. Elbow extension improved by 35 per cent, while grip strength increased by 55 per cent. 

Overall, participants experienced an average 32 per cent increase in arm strength while the stimulation was active. 

The device used in the study has been employed for decades to treat chronic pain, but this is the first time it has been tested as a way of restoring arm function in stroke survivors. 

Researchers found that all participants experienced immediate improvements in strength when the stimulation was on, regardless of the severity of their impairment. 

Furthermore, spasticity – a condition in which there is an abnormal increase in muscle tone or stiffness – was also reduced among all participants.

George Wittenberg, professor of neurology and physical medicine and rehabilitation at University of Pittsburgh, said: ‘From a clinical perspective, even modest improvements in arm strength or control can make a meaningful difference in daily life of stroke survivors. 

‘Some of the improvements we measure may look small from the outside, but many stroke survivors are just on the verge of being able to do something important. Even a small change in motor function can be very significant if it helps someone button a shirt, open their hand or return to an activity they care about.’

Despite the encouraging results, researchers found that motor function declined when the stimulation was discontinued.This suggests the technology currently works primarily as an assistive device when active rather than a permanent cure.

However, the team say the findings warrant larger clinical trials. They have already begun recruiting participants for a longer study to further assess the effects of spinal cord stimulation on its own and in combination with physical therapy. 

Professor Capogrosso added: ‘This study represents the conclusion of our initial feasibility phase and an important step toward real-world clinical application. 

‘Our goal is to develop a technology that could eventually be used in everyday life, not just in the clinic. 

‘These results give us confidence that spinal cord stimulation could become a practical, implantable option for helping stroke survivors use their arms when it matters most.’

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