Vol 1: Brain
According to the
National Stroke Association:
million Americans are living with the effects of a stroke.
the course of a lifetime, four out of every five American
families will be impacted by stroke.
- Two-thirds of stroke survivors in the U.S. are
mild to moderately impaired and able to live
No one is ever prepared for this
sudden, catastrophic event. Yet it is an all-too-frequent
occurrence. The United States has millions of stroke survivors (see
article to the right). In addition, there are the millions of husbands,
wives, and children who live with and care for stroke survivors, whose
lives are also impacted.
Clearly, stroke is a huge problem. Unfortunately,
it is not yet well understood. This much we know: Roughly:
- 10% of stroke survivors recover almost completely
- 25% recover with minor impairments
- 40% sustain moderate to severe impairments requiring
- 10% require placement in a long-term care facility
- 15% die shortly after the stroke
Recovery from stroke is unpredictable, with some
remarkable improvements occurring. Some brain cells may be only
temporarily damaged - not killed - by the stroke and may resume
functioning. In some cases, the brain can reorganize its own
functioning. One region of the brain may "take over" for
another, damaged region.
To maximize recovery, rehabilitation starts as soon as
possible after the stroke--in as little as two days after the stroke, with
Depending upon the stroke's severity, rehabilitation may
include re-learning of basic skills like eating, dressing, and
walking. And it may occur in any of several environments:
- a hospital rehab unit
- a sub-acute care unit
- a rehabilitation hospital
- home therapy
- home and outpatient therapy
- a long-term care facility which provides therapy
Regardless of where it is provided, though, the goal of
rehabilitation remains the same: to improve function so that
the survivor becomes as independent as possible.
exercise may aid stroke recovery
An ordinary mirror may help stroke patients who have
lost muscle control on one side of their body to regain that control.
Nine survivors who were at least six months past their
strokes were given "mirror therapy." A mirror was
positioned behind each patient's unaffected arm. The patient then
practiced moving both arms symmetrically while watching the reflection of
the unaffected arm.
Improvements in coordination
were seen after four weeks of this therapy (Lancet, June 12,
Seniors who take a brisk walk are providing their brains
with a helpful workout. Such walking boosts memory and sharpens
judgment, according to a recent study conducted at the University of
Illinois and reported in the journal Nature.
Anaerobic exercise -
stretching and weight-lifting - failed to produce similar cognitive improvements.
Electrical stimulators called BIONs may
soon help keep paralyzed muscles from wasting. Tests are being
conducted in which BIONs the size of a grain of rice are injected into
immobilized or paralyzed muscles. These electrodes are then
activated by the patient, using a portable control box. The BIONs
act as artificial neurons, prompting muscles to contract. This helps
maintain muscle bulk and strength and prevent joint pain and deformity.
Assuming the testing goes well, BIONs may
become available to the public within several years. (Reported in Prevention.)
Two or more significant blows to the head while playing
sports can harm teen-agers' thinking abilities for years to come. So
conclude several recent studies reported in the Journal of the American
Medical Association (Sept, 1999).
&qugt;This is a major public health issue that has been
given short shrift," states one of the study leaders, Michael W.
Collins, neuropsychologist at Henry Ford Health System.
It is estimated that more than 62,800 concussions occur
annually in the U.S. among high school students. In the past, most
attention has gone to college and pro sports, with high school athletics
being largely ignored.
In a similar vein, amateur soccer players scored lower
on tests of memory and planning than other amateur athletes did.
Repeated blows to the head may be the cause.
Within the next year, researchers could begin human
testing on a promising Alzheimer's vaccine.
The vaccine works by prompting the immune system to
destroy protein that forms destructive plaque in the brain of Alzheimer's
patients. In animal tests, it prevented plaque formation in
young mice and reversed plaque buildup in older mice. (Nature,
July 7, 1999)
A small-scale safety trial is currently underway.
If the vaccine performs well, it could be tested on a larger scale