Every year 700,000 Americans suffer a stroke every year. Approximately 85% of these individuals survive the stroke, but 75% of stroke victims are left with disabilities ranging from mild to very severe. Disabilities resulting from stroke can have a devastating impact on family, quality of life and productivity.
Studies show that the majority of individuals over 50 in the US do not know the warning signs of a stroke: These warning signs require urgent and immediate action–if they are observed, an individual should call 911 immediately:
SUDDEN numbness or weakness of face, arm or leg – especially on one side of the body.
SUDDEN confusion, trouble speaking or understanding.
SUDDEN trouble seeing in one or both eyes.
SUDDEN trouble walking, dizziness, loss of balance or coordination.
SUDDEN severe headache with no known cause.
(from the National Stroke Association, www.stroke.org)
The National Stroke Association warns that Immediate action is essential, because the majority of strokes are ischemic strokes (blood clots). The damage will become much worse if not treated immediately. In addition,a major, devastating stroke is often preceded by a minor stroke with temporary symptoms. Immediate medical attention to the symptoms of a minor stroke can sometimes enable an individual to avoid a much more severe stroke.
Not all strokes are fatal, but most are debilitating to some degree. Statistic compiled by the University of Medicine and Dentistry of New Jersey (http://www.theuniversityhospital.com/stroke/stats.htm) show that:
10 percent of stroke victims recover almost completely.
25 percent of stroke victims recover with minor impairments.
40 percent of stroke victims experience moderate to severe impairments requiring special care.
10 percent of stroke victims require care in a nursing home or other long-term care facility.
15 percent die shortly after the stroke.
7.6 percent of ischemic strokes and 37.5 percent of hemorrhagic strokes result in death within 30 days.
Until very recently, disabilities that stopped showing improvement after physical therapy and speech therapy were considered to be permanent. Dramatic new advances in neuroscience have greatly enhanced the level of rehabilitation that is possible for stroke victims. Particularly notable is the work of Edward Taub, Ph.D.
Through extensive research, Dr. Taub discovered that the brains of many stroke victims go into “cortical shock,” a condition that can last from two to six months. During this time, the individuals try to move body parts or use mental skills impacted by the stroke, and are unable to do so. This produces a state of “learned nonuse,” similar to learned helplessness. As this happens, the brain map governing movement for the affected area shrinks to half of its original size, on average. However, after the period of cortical shock ends, the brain map can be rebuilt and movement recovered to a surprising degree.
Taub’s stroke recovery programs were developed from animal research which showed that learned nonuse could be overcome and many functions restored if an individual was highly motivated to use the affected part and did so for several hours every day. To create the essential motivation, part of the treatment in a Taub clinic involves limiting the use of the stroke victim’s good side. For example, a person with a stroke that has disabled his right arm and hand will have his left hand put in a sling or in a thick mitt, making it necessary for the stroke victim to use the impaired limb. Repetitive motions are practiced, starting with easy, general motions and moving to more skillful, more precise ones. Individuals practice putting golf balls in a large can, moving cans on and off of shelves, feeding themselves with the disabled hand, and a variety of other movements.
Conventional physical therapy stroke rehabilitation has typically involved one hour sessions three times a week. Taub therapy is much more intensive, involving therapy sessions that last six hours a day, and are done for ten to fifteen consecutive days. Patients often become fatigued and stop to take a nap before finishing a session.
Taub’s results are impressive. Brain imaging studies show that the brain map for movement of the affected body part doubles in size during the course of therapy. Other studies have shown that 80 percent of stroke victims whose arm movement has been impaired by stroke experience substantial improvement. Another study showed that even individuals who suffered a stroke four years before Taub therapy improve significantly, and this includes individuals who have had severe chronic strokes.
Taub’s principles of stroke rehabilitation have recently been adapted to help recover the use of affected legs, and to rehabilitate individuals who have lost their speech ability. Some very dramatic work has also been done with children affected by cerebral palsy. Taub has also been working on a software program for individuals who are unable to come to his clinic.
Edward Taubs CI clinic is located at the University of Alabama. For more information go the the website, http://www.uabmedicine.org/locations/taub-therapy-clinic-overview
Taub’s research and treatment was recently publicized in the book “The Brain that Changes Itself” by Norman Doidge, MD. The development of Taub’s method and the outcome research on its effectiveness is found in this book in chapter 5, pp 132-165 Even so, a large percentage of Americans remain unaware of the level of rehabilitation that is possible for many stroke survivors.