Science: A helping hand for stroke sufferers

By ANNA DAVIES People who have suffered strokes which affect one side of their body are being helped to open their paralysed hands by an electrical nerve stimulator. The device, currently being tested in the US, can help to treat spastic hemiplegia, a condition in which the hand is fixed in a clenched fist which prevents the fingers from being straightened. The most common outcome of a stroke is paralysis of the left or right side of the body (although a brain tumour or an injury to the brain can have a similar effect). While people often recover some movement, in a large number of people who have had a stroke this movement is partial and the hand and arm may remain useless. Immediately after a stroke, the paralysed hand is flaccid. But it will become clenched permanently if efforts are not made to keep the fingers open and straight. Patrick Crago and his colleagues at the Rehabilitation Center of Case Western Reserve Hospital in Ohio have successfully opened the hands of seven stroke victims. The electrical nerve stimulator they have developed stimulated the nerves in the forearm via electrodes which were fixed to the skin with adhesive patches. To achieve functional opening of the hand, the device simultaneously stimulated two nerves that control the muscles to the hand – the extensor digitorum communis and the ulnar nerve. Similar techniques used for helping people with injuries to the spinal cord regain some use of their arms and legs have been successful in the past, so there is optimism for the new technique. Carl Billian, a specialist in rehabilitating stroke patients who has been involved in the study, comments that opening the hand in this way remains ‘somewhat artificial’. But it enables the hand to hold or support objects and assist the ‘normal’ hand,
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