Stroke: strengthening weakened muscles
This research was completed on 13 October 2009
Published on 31 January 2008
At least 300,000 people in England are living with disabilities as a result of suffering a stroke.(1) Rehabilitative exercise programmes can help, particularly in the first month after a stroke, but many people cannot take part - because they're partially paralysed or too frail. Researchers think a new treatment, which involves electrical stimulation, might strengthen the weakened muscles of people who can't exercise.
What's the problem and who does it affect?
A leading cause of disability in adults(2)
Every five minutes, someone in England has a stroke - that's 110,000 strokes every year.(1) After suffering a stroke, many people lose the ability to move normally. They may be paralysed or weak on one side of their body, for example, meaning they cannot walk, or reach out to pick something up. Rehabilitative therapies, such as physiotherapy, sometimes aid recovery, especially in the first month. But many people cannot take part - because their paralysis or weakness is too severe. Lack of exercise then means their muscles waste away, making them even weaker. As time goes on, they are also at risk of developing limb deformities and pressure sores, and suffering increasing levels of pain. Sadly, around half of those who survive a stroke are left so badly disabled they become dependent on others, often an elderly spouse, for help with essential everyday activities, such as eating, getting dressed and going to the toilet.(1) Many of these people, and their carers, feel abandoned and neglected. Depression is all too common.
What is the project trying to achieve?
A stroke is a type of brain injury. Symptoms result from the death of nerve cells in the brain. Paralysis, for example, can result from damage to the nerve cells that control muscles. Then, if the muscle isn't used, it becomes weaker and weaker, and its condition deteriorates. This project is a pilot study, investigating whether electrical stimulation has the potential to strengthen weakened muscles. In electrical stimulation, electrodes placed on the skin emit small electrical signals that make underlying muscles contract. The researchers are assessing how electrical stimulation for six weeks affects the strength and structure of muscles, when compared with no treatment, in ten people who are unable to walk properly after suffering a stroke. The researchers are developing a new device, which adapts standard equipment used in electrical stimulation to suit the particular needs of these stroke victims. They are optimising several factors, such as the frequency of the current used and the positioning of the patients' legs.
What are the researchers' credentials?
|Project Leader||Dr A Pandyan PhD|
|Location||School of Health & Rehabilitation and Mathematics Department, Keele University in conjunction with ORLAU, RJAH Orthopaedic Hospital, Oswestry and the Institute for Biophysical and Clinical Research into Human Movement (IRM), Manchester Metropolitan University and the Aintree Stroke Unit, Aintree University Hospitals NHS Foundation Trust, Liverpool|
|Grant awarded||31 October 2007|
|Start date||14 July 2008|
|End date||13 October 2009|
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The Project Leader, Dr Anand Pandyan is a rehabilitation engineer, researching better ways to both assess and treat physical disabilities that result from damage to the nervous system. He has been instrumental in developing a bedside measure of spasticity and has taken part in large studies of the use of electrical stimulation to treat problems in the wrist and shoulder after a stroke. Many different researchers with internationally recognised reputations for excellence are collaborating on this project. They include doctors from the Aintree Stroke Unit, whose pioneering research has improved stroke services nationwide, therapists, nurses, clinical scientists experienced in developing new ways to measure and manage disability, and basic scientists who understand the biological processes that lead to disability.
Who stands to benefit from this research and how?
Keeping muscles strong
The researchers are trying to help people who have lost the ability to walk properly after having a stroke - people who are paralysed, or partially paralysed in one or both legs. As these people cannot take part in rehabilitative exercise programmes, the condition of their leg muscles is likely to deteriorate. Researchers are investigating whether electrical stimulation has the potential to prevent this deterioration, by mimicking the effects of exercise. They believe this might boost people's chances of recovery - possibly helping them to walk again and retain their independence, so improving their quality of life. It might also decrease people's chances of developing complications, such as limb deformities, pressure sores and spasticity. Larger scale clinical trials would be needed to investigate these posibilities. Stroke care currently costs the NHS an enormous £2.8 billion a year in direct costs alone.(1) Electrical stimulation might help decrease costs. It is simple and inexpensive, with one trained professional being able to treat several patients concurrently. Researchers believe electrical stimulation may eventually have even wider benefits - for people with conditions such as cerebral palsy, head injury, spinal cord injury and multiple sclerosis, and elderly people who have become frail.
1. Reducing Brain Damage: Faster access to better stroke care. Report by the controller and auditor general, HC 452 Session 2005-2006, 16 Nov 2005, National Audit Office. 2. Recovery After Stroke, Michael P. Barnes, Bruce H. Dobkin, Julien Bogousslavsky (Eds) Cambridge University Press, 2005