Four million Americans are living with the effects of a stroke.
In 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 independently.

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 special care
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 stable patients.

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.

"Mirror" 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, 1999).

Walking benefits seniors' brains

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.

Artificial neurons exercise weak muscles

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.)

Teen athletes at risk from blows

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.

Promising Alzheimer's vaccine

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 later.