Every four seconds, someone in the United States suffers a stroke. Annually, more than 795,000 people in the United States have strokes. Strokes can be fatal, but if an individual survives a stroke, he or she might still be permanently disabled.
A stroke is the loss of blood flow to an area of the brain.
This loss of blood flow deprives brain cells of glucose and oxygen. If the deprivation occurs for too long, this can cause permanent damage or death. There are two types of strokes, ischemic and hemorrhagic.
Ischemic strokes occur when a blood vessel that supplies the brain is blocked. This develops as a result of fatty deposits on the vessel lining. The blockages that occur in an ischemic stroke are the same sort that can cause a heart attack, if the blockage is located in the heart instead of the brain. These are the most common type of stroke, with 87% of strokes classified as ischemic.
A hemorrhagic stroke is when a blood vessel that supplies the brain bursts. The blood from the burst vessel compresses the surrounding tissue, causing damage to the tissue while also depriving the brain of blood.
A stroke can result in several debilitating conditions.
If he or she gets prompt medical attention, a stroke survivor could potentially suffer no lasting effects. However, many people who have a stroke will have some lasting evidence of it.
The potential after-effects of a stroke include:
- Loss of motor control
- Sensory disturbance
- Aphasia (language problems)
- Emotional disturbance
- Thinking and memory problems
These issues can range from minor, such as difficulty swallowing or one hand that’s weaker than the other, to major, such as paralysis of one side of the body or the inability to speak or write.
Approximately 33% of stroke survivors will require help caring for themselves. Of that 33%, 70% are unable to return to their previous jobs. More than half of these individuals will be unable to return to any job at all.
Rehabilitation is vital to lessen the effects of a stroke.
Rehabilitation will typically start as soon as a stroke victim is stabilized in the hospital, often within 24-48 hours after the stroke occurs. As stated on WebMD, “The sooner you begin stroke rehabilitation, the more likely you are to regain lost abilities and skills.”
Traditional stroke rehab involves an entire team of professionals. A physician coordinates the team of rehab specialists and oversees the individual’s overall health. Rehab nurses help individuals re-learn how to do personal tasks like use the bathroom and bathe. Speech-language pathologists help with overcoming difficulties with speech after a stroke.
Therapists are also an important part of the rehab team. Occupational therapists help with specific tasks, such as personal grooming or meal preparation. Physical therapists focus on motor and sensory issues. For those who suffer from paresis, or partial paralysis, or sensory disturbances like pain, a physical therapist often offers the most help.
There is a well-established connection between arm paresis and pain after a stroke, particularly shoulder pain.
For example, a 2006 study conducted by Ingrid Lindgren at Lund University Hospital observed an increased risk of shoulder pain for those who suffered from impaired arm motor function. More recently in 2013, Dr. Martin O’Donnell at the Population Health Research Institute in Canada concluded that:
“Chronic pain syndromes are common after ischemic stroke and are associated with increased functional dependence and cognitive decline.”
Repetition of isolated movements is typically the basis of a physical therapist’s plan to counteract paresis. For painful sensory disturbances, tapping, stroking, or range-of-movement exercises are often suggested. If the pain is resistant to therapy, there are several different potential treatments, such as medications, injections, or electric stimulation.
Robotic rehab, however, may provide another new way to treat paresis and pain that result from strokes.
Robots have been used as part of comprehensive rehab plans in the past, such as the self-adaptive robot used in a study in Italy. This robotic rehab therapy guided movements to make certain that they were done in the most beneficial way. For example, because of paresis, it might be easier for a stroke survivor to lean his or her entire torso forward instead of flexing his or her elbow. The robotic rehab would make sure that the elbow was flexed to encourage improved motor function.
The rehab robot was also capable of being tailored to each specific individual’s level of disability. Additionally, the robotic rehab device was capable of automatically adapting to the individual’s changing performance level. Because the self-adaptive robot adjusted to the increased performance level, it challenged individuals to increase their motor function and mobility.
A new study about robotic rehab therapy, headed by Professor Robert Riener at the Sensory-Motor Systems Lab, was published in The Lancet Neurology. In this study, an exoskeleton-like robot called ARMin was utilized. Tasks were visible on a screen via computer simulation while the individual did them, so that he or she could watch.
This method could be particularly helpful for those with severe paresis, because the rehab robot can help carry out tasks. Additionally, the visualization of tasks on a screen may be beneficial. For example, pouring a glass of water can be difficult for someone with severe paresis. Attempting to relearn how to do this with real water might be frustrating. However, by using ARMin the robot, stroke survivors can practice the task of pouring a glass of water as many times as they want while watching the task on the screen, without fear of spilling a drop. Also, this therapy could potentially be carried out at home, enabling stroke survivors to carry out their own rehabilitation.
The results of this study suggested that the use of this exoskeleton-like robotic rehab led to slightly increased motor functionality, but the results were only slightly better than those of conventional therapy.
Have you known someone who suffered from a stroke?
Image by Lee Haywood via Flickr