stroke

Takeaways from Dr. Belagaje’s Stroke Recovery Live Chat

Stroke Recovery ChatThank you to everyone who joined us on May 28, for our live chat on Stroke Recovery. There were some great questions and we hope you found stroke neurologist, Dr. Samir Belagaje’s discussion informative. If you missed the chat, feel free to review the full chat transcript.

There was such a good response, we didn’t have time to address all of the questions you submitted during the chat, so we will answer those below:

Question: What other things can be done besides going to a recovery center?

Samir BelagajeDr. Belagaje: Certainly one can develop a home exercise/rehabilitation plan and continue to work on improving their stroke related deficits in that fashion. However, I strongly recommend that stroke recovery be completed under the guidance of a health care expert in that area or going to a stroke recovery center. They can look at medications which may be adversely affecting the recovery process, start new ones, screen/treat for depression, and provide opportunities to participate in clinical trials which would allow one to get access to latest technology and developments.

Question: Does the brain actually recover from a stroke or are you just ‘retraining’ different parts of your brain? How is it recovering?

Samir BelagajeDr. Belagaje: Great question! People recover from stroke in 3 major ways:

  • Adaptation– In this method, people just “learn to live with deficits” and find ways to adapt or get along with them. Examples would be the use of prisms in eye glasses for post-stroke visual problems or using a cane/walker to help with walking. Another example would be for a person to learn to feed themselves with their opposite hand
  • Regeneration– this involves growing new brain cells and them getting to the area of stroke and repairing that area. This is the way that stem cells and other biotherapeutics may help. It is an exciting area for stroke recovery research.
  • Rewiring– this is probably the major way of stroke recovery in the brain and the mechanism most therapy is geared towards. It is also the way that you are alluding to in your question when you talk about “retraining different parts of the brain”. Most therapy is geared towards getting those undamaged parts of the brain to rewire and take over the function of the damaged portions

Question: My dad lives in the UK and suffered a stroke. What can he do to help himself?

Samir BelagajeDr. Belagaje: Sorry to hear about your father. It really depends how long ago his stroke was and what kind of deficits he has post-stroke. In general terms, he should continue to stay as active as possible and continue to work on his deficits with therapy/rehab team. I would also encourage family and close friends to monitor for post-stroke depression symptoms and alert his health care providers if they notice depression symptoms.

Question: How do you regain normal vision after stroke?

Samir BelagajeDr. Belagaje: Admittedly, post-stroke vision deficits are challenging as we don’t have as good and effective and proven visual rehab therapy/techniques compared to some other deficits. If her stroke is greater than 6 months, I would recommend seeing a neuro-ophthalmologist for possible prisms in the glasses (this would be an adaptation technique I mentioned in an answer to another question). In addition, working with an occupational therapist (OT) may also help to improve visual field deficits and develop compensation techniques.

 

 

 

Stroke Awareness Month Events at Emory Healthcare

Stroke EventsAccording to the American Heart Association, stroke is the leading cause of adult disability in the United States. In recognition of May as National Stroke Awareness Month, Emory Healthcare encourages you to learn the signs, symptoms and risk factors for stroke. Mark your calendar for the following events:

Community Stroke Fair

When: Wednesday, May 13, 2015; 11:00 am to 2:00 pm
Where: Emory University Hospital Midtown Medical Office Tower Lobby
Why:

  • Learn the signs and symptoms of stroke
  • Free blood pressure screening
  • Ask a neurologist about stroke care
  • Hear about stroke rehabilitation programs
  • Speak to a pharmacist
  • Get your BMI checked
  • Free gift bags

5K Scrub Run and Community Health Festival

When: Saturday, May 16, 2015; 8 am to 11am
Where: Emory Johns Creek Hospital parking lot
Why:

  • Learn the signs and symptoms of stroke
  • Free glucose and cholesterol
  • Free blood pressure screening
  • Get your BMI checked

Stroke Awareness Fair

When: Tuesday, May 19, 2015; 10 am to 2 pm
Where: Emory Clinic Motor Lobby between buildings A and B
Why:

  • Learn the signs and symptoms of stroke
  • Understand how to manage blood pressure, exercise properly and maintain a healthy diet
  • Talk with experts about stroke prevention and response for suspected stroke

Stroke LIVE Chat

stroke-recovery-chat

 When: Thursday, May 28, 2015; 12:00 pm to 1:00 pm
 Where: Online
 Why:

  •  Learn about stroke recovery and rehabilitation from Dr. Samir Belagaje, stroke neurologist at Emory  University and Director of Stroke Rehabilitation at the Marcus Stroke Center. Dr. Belaje will answer  questions during a LIVE interactive chat.

Chat Sign Up

Stroke is an emergency. If you or someone around you is experiencing signs or symptoms of stroke, CALL 911 immediately.

Stroke Rehabilitation Clinical Trial a Top International Trial

Rehab Clinical TrialAt Emory, clinical trials are at the core of our mission and we are proud to offer them to our patients. Groundbreaking scientific advances and medical treatments available today have been made possible because of volunteer participation in clinical trials and research.

In fact, one of the thousands of clinical trials conducted at Emory was just identified as one of the 15 top international clinical trials ever published for physical therapy and rehabilitation.

The EXCITE (Extremity Constraint-Induced Therapy Evaluation) trial, led by Emory University’s Steven Wolf, PhD, PT, professor of rehabilitation medicine at Emory University, was created to teach stroke patients to use their stroke-affected arm rather than their “good” arm. Conducted almost a decade ago, the clinical trial was found to have a significant impact in stroke rehabilitation, which set the stage for many future trials.

Each year, more than 795,000 people in the United States suffer from a stroke and many stroke survivors experience partial paralysis on one side of the body. The EXCITE trial enrolled 222 patients who had suffered a stroke, predominantly an ischemic stroke, within the previous three to nine months.

During the trial, participant’s less-impaired hand was restrained and/or immobilized by placing a mitt around the “good” arm in an effort to encourage use of the affected extremity. Participants engaged in daily repetitive tasks and behavioral therapy sessions, which included training in tasks such as opening a lock, turning a doorknob or pouring a drink. Only use of the affected arm was allowed during exercise.

“Often, stroke rehabilitation focuses on teaching patients how to better rely on their stronger limbs, even if they retain some use in the impaired limbs, creating a learned disuse,” says Wolf. “This trial was just the opposite and focused on the impaired limb, which proved to be a valuable form of rehabilitation. We are so pleased and honored that this clinical trial has been found to be a top 15 trial amongst an international jury of experts.”

Wolf, and other Emory University researchers partaking in the national trial, studied participants to determine if the intervention improved motor function, as compared to no therapy at all. Patients were evaluated using the Wolf Motor Function Test (named after Wolf), which is a measure of laboratory time, strength-based ability and quality of movement.

Research investigators found that over the course of a year from the beginning of therapy, the group undergoing constraint-induced therapy showed greater improvements than the control group in regaining function.

“Results showed that constraint-induced movement therapy produced statistically significant and clinically relevant improvements in arm motor function that persisted for at least one year at follow-up,” says Wolf. “This trial was the first large multi-center, randomized controlled trial in stroke rehabilitation that lay the ground work for many other trials to follow.”

The EXCITE trial was funded by the National Institutes of Health from 2000-2005 and the results were published in JAMA in 2006. For the past 15 years, PEDro, a database located and supported within the George Institute for Global Health in Australia, has reviewed clinical trials, guidelines and reviews of work related to rehabilitation and physical therapy. During that time period, around 28,000 trials and manuscripts dating back as far as 1929 were reviewed. The free database is used by thousands of physiotherapists and others interested in rehabilitation from more than 200 countries. Out of the 15 trials highlighted by PEDro, only two were clinical trials based in the U.S.

Click to learn more about clinical trials at Emory, or call 404-778-7777.

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Emory Honors World Stroke Day

World Stroke DayOn this Wednesday, October 29, people all across the globe will celebrate World Stroke Day. This day was established in 2006 to raise public awareness of the warning signs of stroke. Our teams at Emory Healthcare work daily in the fight to treat and end stroke. Last year, Emory Healthcare treated over 1800 stroke patients at our hospitals, and approximately 300 patients received intensive rehabilitation care post-stroke at the Emory Rehabilitation Hospital – a total surpassing 2,000 patients.

We are passionate about stroke prevention – especially since 80% of strokes are preventable – and have created outreach teams that screen and educate members of the community throughout metro-Atlanta. To date in 2014, our teams have reached over 1,000 community members and counting.

Recognizing stroke early and getting immediate medical attention is key in reversing potential damage to your brain. Remember to ACT F.A.S.T. if you suspect that you or someone else around you is experiencing a stroke. If you notice the following signs, you should call 911 immediately:

F: Facial droop; uneven smile

A: Arm numbness or weakness

S: Slurred speech, difficulty speaking or understanding

T: Time to call 911 and get to the nearest stroke center immediately

In line with World Stroke Day, Georgia Governor Nathan Deal recently signed a proclamation declaring October 29th Georgia Stroke Awareness Day, in which he encourages all citizens to seek education on adequate prevention and recognition of signs/symptoms of stroke.

As we promote stroke prevention and timely recognition in our communities, we remind you that you have the power to end stroke – and Emory is here to help. We invite you to visit our website for further information on stroke prevention, recognition and treatment.

Lastly, we would like to thank all the teams playing a role in our efforts, and share with them this campaign as we continue our fight to end stroke.

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