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Innovative electrical stimulation glove improves hand function in stroke patients

stroke-signs*Stem cell therapy restores arm, hand movement for paralyzed man
*Obesity does not predict equal risk for all stroke types, study finds

Scientists have made two major breakthroughs in the treatment of stroke patients and paralysis. The two independent studies were published in MedicalNewsToday.A novel therapy has been devised for survivors of stroke with hand weakness to help improve hand function through the use of a glove that delivers electrical stimulation.

Also, a 21-year-old man left paralyzed after a spinal cord injury has regained the use of his arms and hands, thanks to an experimental stem cell treatment performed by researchers from the Keck Medical Center at the University of Southern, United States (U.S.).

Meanwhile, being overweight or obese is associated with a number of known risk factors for stroke. However, new research shows that excess weight has varied effects on different types of stroke.

Hundreds of thousands of people in Nigeria have a stroke each year, and the fatality is usually very high. Recovery from a stroke can take weeks, months, or even years. While some people fully recover from a stroke, others have long-term or lifelong disabilities.

Paralysis – an inability to move some parts of the body – or partial paralysis can result from stroke and cause weakness on both or one side of the body. Although rehabilitation does not “cure” the effects of stroke by reversing the brain damage caused, rehabilitation can help survivors relearn skills that are lost when part of the brain is damaged.

Paralysis usually affects the side of the body opposite to the side of the brain damaged by stroke, and it may affect the face, arm, a leg, or the entire side of the body.Often the paralysis prevents the patient from being able to open a hand. A common rehabilitation technique to assist with improving muscle strength and potentially restoring hand function is using low levels of electric current to stimulate the paralyzed muscles and open the hand. A therapist is in control of the intensity of the stimulation, cycle time, and the number of repetitions.Wearable technology puts patient back in control

According to new research published in the American Heart Association journal Stroke, researchers at the MetroHealth System, Case Western Reserve University, and the Cleveland Functional Electrical Stimulation Center have developed a therapy whereby patients can be in control of the stimulation to their weak hand.

The electrical currents are delivered using a glove with sensors. By wearing the glove on their unaffected hand and opening their fingers, the affected side receives a similar amount of stimulation to open the weakened hand. This wearable technology put the patient back in control of their hand while enabling them to participate in electrical stimulation therapy.

“Based on positive findings from our previous studies, we sought to determine if the new glove-controlled hand stimulation therapy could be more effective than the common therapy in improving hand dexterity in patients who are more than six months past their stroke,” says Dr. Jayme S. Knutson, senior author of the study and an assistant professor of Physical Medicine and Rehabilitation at Case Western Reserve University School of Medicine in Cleveland, Ohio.

Meanwhile, in March of this year, Kristopher (Kris) Boesen, from Bakersfield, CA, was involved in a car accident, in which he suffered severe trauma to his cervical spine that left him paralyzed from the neck down and unable to breathe without assistance.

Doctors told Kris that he might never regain the use of his limbs; current surgical procedures for spinal cord injury focus on stabilizing the spine to prevent further damage, but they rarely improve movement and sensation.Kris then learned of a clinical trial – led by Dr. Edward D. Wirth III, chief medical director of Asterias Biotherapeutics – looking to enroll patients with spinal cord injury.

The ongoing trial is testing a novel therapy involving injections of AST-OPC1 – an agent consisting of oligodendrocyte progenitor cells (OPCs) that derive from embryonic stem cells. OPCs are the myelin-forming cells of the brain and spinal cord that help nerve cells to function.

According to Asterias Biotherapeutics – the developer of AST-OPC1 – preclinical trials of the agent in models of spinal cord injury have shown it leads to “reduction of the size of the injury cavity, restoration of the protective ‘myelin’ coating on nerve cells, production of factors that stimulate nerve cell growth, and recruitment of blood vessels to deliver oxygen and nutrients to the site.”

In order to take part in the trial – named “SCiStar” – patients need to be able to breathe without the help of a ventilator. Though it normally takes three weeks to wean a patient off assisted breathing, with the help of a dedicated respiratory team, Kris managed it in five days.After further tests, he was confirmed as being eligible to take part in the trial.

Improvements in motor function seen within two weeks of treatment.In April of this year, Kris underwent the injection procedure, overseen by Dr. Charles Liu, director of the Neurorestoration Center at the University of Southern California (USC).

The procedure involved the injection of 10 million AST-OPC1 cells directly into the cervical spinal cord.Within two weeks of the treatment, Kris began to achieve some movement in his arms and hands. Within three months, he regained the ability to engage in a number of everyday tasks, such as writing his name, feeding himself, operating a motorized wheelchair, and hugging his family.

“As of 90 days post-treatment, Kris has gained significant improvement in his motor function, up to two spinal cord levels,” says Dr. Liu. “In Kris’ case, two spinal cord levels means the difference between using your hands to brush your teeth, operate a computer or do other things you wouldn’t otherwise be able to do, so having this level of functional independence cannot be overstated.”

According to the National Spinal Cord Injury Statistical Center, each year, there are approximately 17,000 new cases of spinal cord injury in the United States, with vehicle accidents being the leading cause.

While the researchers are unable to say whether Kris will regain the use of his legs, they are encouraged by his case and hope AST-OPC1 will continue to improve quality of life for patients with spinal cord injury.“With this study, we are testing a procedure that may improve neurological function, which could mean the difference between being permanently paralyzed and being able to use one’s arms and hands. Restoring that level of function could significantly improve the daily lives of patients with severe spinal injuries.”

To take part in the SCiStar trial, patients must be aged 18-69, and they must be in a condition that is stable enough to receive AST-OPC1 injections 14-30 days after spinal cord injury.A recent study, published in Neurology, investigated the prevalence of different stroke types in overweight and obese women.

The investigation used data from 1.3 million women in the United Kingdom with an average age of 57. Over the course of the 12-year study, 20,549 had a stroke.Among women with a healthy weight – body mass index (BMI) 22.5-25 – 0.7 percent had an ischemic stroke and 0.5 percent had a hemorrhagic stroke.

Within the 228,274 obese women (BMI 30 or above), one percent had an ischemic stroke and 0.4 percent had a hemorrhagic stroke.“We found that the risk of ischemic stroke […] is increased in overweight and obese women. By contrast, the risk of hemorrhagic stroke […] is decreased in overweight and obese women.

Our findings add to the growing body of evidence that different types of stroke have different risk profiles.”The findings show that for every five-unit increase in BMI, the ischemic stroke risk increased by 21 percent. For hemorrhagic stroke, every five-unit increase in BMI gave a 12 percent decrease in risk.

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