New Treatment Helps in Stroke Recovery

Alternate applications of heat and cold improved function in paralyzed arms, hands

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By Ed Edelson
HealthDay Reporter

THURSDAY, Nov. 3, 2005 (HealthDay News) -- A technique called thermal stimulation -- an alternate application of heat and cold -- improved the function of paralyzed arms and hands of stroke patients in a Taiwanese study.

Up to 85 percent of stroke patients suffer impairment of an upper limb, and while existing rehabilitation techniques can be effective, they tend to be costly and complicated, explained Fu-Zen Shaw, an associate professor of biological science and technology at National Chiao Tung University. He is lead author of the report, which appears in the Nov. 3 issue of Stroke.

"We looked at whether a simple, easily used and inexpensive technique could improve motor and sensory recovery in stroke patients within a short time," he said.

Thermal stimulation is used in orthopedic rehabilitation, and it is also used to treat dysphagia, difficulty in swallowing that can be caused by a stroke or other conditions, Fu-Zen Shaw added. But this is the first reported trial of the method in stroke rehabilitation, he said.

The trial included 46 stroke patients. Half got standard rehabilitation therapy, the other half standard treatment plus thermal stimulation.

Those patients had five sessions a day for six weeks. Each session lasted 20 to 30 minutes, with alternate applications to a hand and wrist of a cold pack, whose temperature was just above freezing, and a hot pack, whose temperature was 167 degrees Fahrenheit.

"Thermal stimulation can simultaneously activate a large brain area," Shaw explined. "This great activation of brain areas may be beneficial for functional reorganization and neural plasticity of the brain, which may be helpful for readjusting the motor control circuitry."

The treatment also has a psychological effect, he said. "The generation of reflexive behavior or enhancement of voluntary movement of the paretic [paralyzed] hand may stimulate or create a hope for stroke patients," Shaw said. "This psychological driving force for actively using the paretic hand cannot be ignored."

The thermal stimulation patients had significantly better recovery on four of six measures of function, including changes in sensation, grasping strength and ability to bend the wrist, the researchers said.

Because of the small number of patients, "the same experiment should be performed in a large population to demonstrate the effect of thermal stimulation," Shaw said.

"In fact, we are going to collect data from a larger population," he added. "We hope that we can distinguish the effect of thermal stimulation on different groups of stroke patients."

But even now, Shaw and his colleagues are using the technique to treat stroke patients. "We see great improvement in our patients now," he said.

More information

Information on stroke is available from the American Stroke Association.

SOURCES: Fu-Zen Shaw, associate professor, biological science and technology, National Chiao Tung University, Hsinchu, Taiwan; Nov. 3, 2005, Stroke

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