Force stroke victims to use weakened arm - study

CHICAGO, Nov 1 (Reuters) Stroke victims forced to use a weakened or partially paralyzed arm by having their working arm or hand restrained in a sling or mitt recover more quickly, researchers said.

In a study of 222 patients, those who underwent ''constraint-induced'' therapy within three to nine months of their strokes were more capable of performing an array of tasks in follow-up tests than those who were not forced to use their affected arm.

Participants in the study were instructed to wear the restraint -- either a sling or a cumbersome mitt -- during waking hours for two weeks. They also underwent physical therapy for several hours on weekdays, during which they wore the restraint.

Most had suffered an ischemic stroke, the most common type where blood flow is temporarily blocked to part of the brain.

In previous studies, images taken of patients' brains undergoing the constraint therapy showed it stimulated areas that control the stroke-affected arm.

The constrained patients scored much higher on physical tests up to a year later when compared with stroke patients who underwent customary rehabilitation. Usually patients undergo some physical therapy, which can be followed by drug treatment and instructions to perform exercises.

''We found a 24 per cent improvement in the amount of activity the patients receiving constraint-induced therapy could do in 30 different tasks, and a 65 per cent improvement in the quality of the movement,'' said study author Steven Wolf of Emory University in Atlanta yesterday.

More than 730,000 Americans enter a hospital for stroke each year, and 85 per cent of the 566,000 survivors develop weakness or partial paralysis on one side of their body, the report in this week's issue of the Journal of the American Medical Association said. Up to three-quarters of stroke survivors lose some degree of functioning on that side for three months to a year.

An editorial accompanying the study said neuroscientists and clinicians tend to underestimate the ability of stroke patients to recover, based therapy techniques that did not help.

''Despite decades of research and discovery, there is still no clear idea as to the maximal amount of benefit that can be achieved with interventions that harness the learning powers of the human brain. A little more excitement in the lives of stroke survivors can only be good,'' commented Andreas Luft of the University of Tubingen, Germany, and Daniel Hanley, of Johns Hopkins University in Baltimore.

Total U S health care spending on victims of strokes amounts to billion in direct and indirect costs, and the aftereffects can be debilitating to both body and spirit.

REUTERS MS KP0928