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I don't recall posoting this at all, Ray ----- Original Message ----- From: "Douglas Way" <[log in to unmask]> To: <[log in to unmask]> Sent: Monday, May 14, 2007 3:48 PM Subject: Re: Electrical Stimulation Therapy > does anybody know what's going on with this study? > > rayilynlee <[log in to unmask]> wrote: Could this EST be what Randy is > taking part in? > > Hope arises for gains long after stroke > Stimulation, therapy tested > By Carey Goldberg, Globe Staff | December 21, 2006 > It has been nearly 10 years since a stroke left Jim Porter with an > all-but-useless left hand and a weakened left arm. In the old days, he > would > have had no options: conventional wisdom long held that after a few months > of recovery, stroke survivors never get any better. > But in recent years, the stroke rehabilitation field has junked what some > called its "nihilism " as research has increasingly shown that the brain > continues to change all through life -- suggesting that under the right > conditions, the nation's 5 million stroke survivors may be able to improve > even years later. > That shift of thinking brought Porter, now 70, from his Nashua home to > Spaulding Rehabilitation Hospital in Boston this week. He hoped to qualify > for a study just getting underway there. Researchers will implant > electrical > stimulators just inside the skulls of stroke survivors, aiming to help > their > brain rewire enough to restore movement to their arms and hands. > "I'd go through anything to get my left hand back," Porter said. > Electrical stimulation is one of many methods that researchers are > exploring > as ways to induce these later gains. They include new forms of physical > therapy and intensive exercise tailored for long standing weakness, drugs, > devices, and even futuristic methods using stem cells or gene therapy. > In general, "we're still limited in how much we can influence the recovery > process," said Dr. Joel Stein , chief medical officer at Spaulding, who is > overseeing the electrical stimulation study. "But in the last 10 or 15 > years, we've recognized that there is recovery of the brain to a > meaningful > degree, and, equally important, we can influence that recovery." > Just last month, the Journal of the American Medical Association published > a > rigorous study of 220 stroke survivors that found that even months after a > stroke, intensive, guided exercise could help restore some hand and arm > function in patients with poorly functioning limbs. Called > "constraint-induced movement therapy," or "forced use," the method > involved > restraining the patient's "good" arm in a sling, forcing the "bad" arm to > work more during intense, repetitive exercises. > An editorial in the journal noted that despite decades of research, it > remains unclear how far stroke survivors can improve with such > "interventions that harness the learning powers of the human brain." But, > it > said, "a little more excitement in the lives of stroke survivors can only > be > good." > The significance of that study is not the specific method used, but its > demonstration that "intensive, repetitive practice improves recovery," > said > Pamela Duncan , a professor of physical therapy about to start work at > Duke > University. > Ultimately, said Duncan, an expert on stroke rehabilitation, late recovery > from stroke is likely to entail "a cocktail of therapies," one that will > inevitably still entail a great deal of work by the patient. > One hurdle to pursuing these later-stage therapies is that most insurance > currently does not cover rehabilitation after a patient's recovery > plateaus. > Typically, once progress stalls, the "recovery" period is officially over, > and reimbursement for rehabilitation ends. > As research shows ever more convincingly that it is worthwhile for stroke > survivors to keep trying, insurance companies may be persuaded to cover > more > treatment. But more likely, a new system will be required to get stroke > survivors the help they need, perhaps through programs based in > communities, > Duncan said. > And even if all the conditions are perfect, she warned, it is important > for > patients to realize that there may be limits to their recovery: "If > patients > could get up and be totally normal again, we would already have known > this," > she said. > When their brains falter, stroke survivors may someday have the option of > drugs that enhance learning to help improve their recovery, said Dr. Lee > Schwamm , director of acute stroke services at Massachusetts General > Hospital. Perhaps in a decade or so, he said, drugs could accomplish what > the implant does, boosting the brain's ability to rewire. > Other distant prospects include the use of stem cells and gene therapy to > promote new pathways in the brain, he said. > Researchers are hoping to learn how to implant stem cells in stroke > survivors' brains and coax them to grow into replacement neurons. But > trying > to grow new tissue in the brain carries the risks of causing seizures -- > already a danger for stroke survivors -- or brain tumors, Schwamm said. > Jim Porter volunteered for the first major national study of the > electrical > stimulation device after hearing it advertised on a Boston radio station. > During the study, the device is turned on while the stroke survivor > intensively exercises a disabled limb. After about two months, the implant > is removed, but any improvements are expected to remain. > The theory is that low levels of electrical stimulation, when applied > during > exercise, can boost brain activity over a necessary threshold in an area > next to a damaged area, helping it take over lost functions, Stein said. > Results in rats, monkeys, and some human patients have been promising, > though they brought partial improvement rather than a cure. > Porter said he was excited about signing up for the brain implant study, > known by the code-name EVEREST. "I've never been in a study before," he > said. > "Better later than never," Stein replied. > But when Richard Hughes , the lead physical therapist on the study, put > Porter through a standardized test of arm and hand movements to score his > level of disability, Porter made it only to 21, despite his best efforts. > He had needed to score 28 to qualify for the study, because people with > intermediate levels of weakness are believed to have better potential to > improve than those with more severe impairments. A 28 is about comparable > to > the level of movement required to pick up and drop a washcloth. > After his rejection, Porter did not hide his disappointment and anxiety: > "It's been 10 years," he said. "I don't know if I'll ever get this arm > back. > I was so confident I'd pass this -- overconfident." > But it took him only about a minute to bounce back. "I'm not going to give > up," he said. "I'm not a quitter." > For more information about the study, call 617-726-9143. > Carey Goldberg is reachable at [log in to unmask] > > ---------------------------------------------------------------------- > To sign-off Parkinsn send a message to: > mailto:[log in to unmask] > In the body of the message put: signoff parkinsn > > > ---------------------------------------------------------------------- > To sign-off Parkinsn send a message to: > mailto:[log in to unmask] > In the body of the message put: signoff parkinsn > ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn