Stroke: Care with Stumbling Blocks (Part 1)

by Wiebke Heiss/MEDICA.de

A stroke is like a bolt from the blue. Many times the consequence is a lifelong disability. Research into prevention and rehabilitation of the disease makes progress but the results reach the patients in clinical everyday life only slowly.15/08/2009

A man lies on a white bed holding a Walkman in his right hand listening to piano music. He is not just passing leisure time, he is actually doing strong mental work. It is the year 2004 and Walter Steiner* had suffered a stroke – all of a sudden he had a break down in his kitchen – and is now in hospital. His goal: He wants to reanimate the little finger of his left hand - in time with the piano music.

Each year, about 250,000 people suffer a stroke in Germany. A blood clot hinders oxygen to reach nerve cells in the brain or a vessel bursts destroying billions of brain cells causing paralysis, speaking problems or cognitive disorders. In the case of a blood clot it may be possible to dissolve it with drugs - as long as the patient reaches the hospital in time. This lysis therapy can only be used up to four and a half hours after the attack. No other treatment exists in this acute phase and doctors can only try to limit the damage caused by a stroke.

Ten years ago, a competence network had been founded in Germany in order to improve the management of stroke patients since it had become obvious that there were many treatment deficits in prevention, acute therapy and rehabilitation of strokes. „The competence network is supposed to introduce research results faster into clinical treatment“ Christian Nolte the Charité in Berlin explains. „However, there is no way to be sure that really all new approaches get directly to the patient, there is no way to control this.“

An experience that Walter Steiner made, too: He was paralysed on one side after waking up in hospital. The doctor said: „You will never be able to move your arm again.“ The federal civil servant did not accept the prognosis and decided to try a kind of self therapy. „I knew that the brain has many cells in reserve“, the 71 year old says today. „Therefore, I began to concentrate on my fingers.“ Many hours each day he imagined to move his digits until - after weeks - he actually did move his little finger to touch his thumb. Today, the pensioner uses its arm as he did years before.

Walter Steiner exercised instinctively an ability that has been known to researchers for many years. He made use of an extraordinary potential of the brain: Studies show that our thinking organ can change up to a high age, meditation and training can change brain structures measurably. This knowledge is the basis of measures such as the Forced-Use-Therapy where the healthy hand of a person with hemiplegia is fixed in order to make it useless. That forces the patient to concentrate on the paralysed hand which in turn causes new neuronal networks in the brain to develop. The result is that paralysed people that had suffered a stroke years ago are again able to train their harmed hand.

- Part 1: Care with Stumbling Blocks
- Part 2: Experts to the Front