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Stroke Stroke Treatment

Intense Stroke Rehabilitation May Trigger Lasting Improvements


Author:

Eric Sabo

Medical Reviewer:

David Causey, MBA, MHA, MD

Medically Reviewed On: August 09, 2005

An intense language program can help stroke patients recover some of their ability to speak and understand others, researchers in Germany have found. The specialized intervention, known as constraint-induced aphasia therapy (CIAT), resulted in lasting improvements after 30 hours of training.

Dr. Marcus Meinzer, a psychologist from the University of Konstanz who helped pioneer the technique, said that the secret of CIAT may lie in the speed of the program.

He compares stroke rehabilitation to playing tennis. If you train only once a week, you are hardly in shape or agile enough to get past the first round at Wimbledon. But intense weeks of practice can improve both your fitness and coordination. The same is true for the mental and physical needs of recovering from a stroke.

"Why should the damaged brain do something different only because of one hour of training?" asked Meinzer. Following an intensive schedule, however, the brain quickly readjusts and creates circuits that can increase communication.

About 40 percent of patients who suffer a stroke go on to experience language problems, or aphasia, especially if the attack strikes the left hemisphere, which is considered the language center of the brain. For the study, published in the journal Stroke, Meinzer and colleagues recruited 27 stroke patients who still had difficulty communicating nearly three years after having a stroke.

CIAT uses a simple card game to improve communication. Instead of a regular deck, each set of cards contains 15 pairs with drawings of various objects. Patients were told to ask for the matching card by speaking as much as they could and restraining themselves from using gestures. The cards were arranged so that the drawings became increasingly difficult to describe.

Under the supervision of researchers, patients played three hours of the CIAT card game once a day for two weeks. Some were also instructed to play the game at home and communicate with family members when they wanted. Six months later, 85 percent of the patients showed a significant improvement in their ability to communicate, such as correctly naming pictures and repeating single words or sentences.

Although CIAT is the first coordinated program to show an effect with language, Meinzer said that other rehabilitation efforts could prove helpful, as long as they are vigorous.

"Any well-founded treatment might benefit from a more intensive training schedule." he said.

Still, most patients do not fully recover from a stroke, even with the right training. "There is no such thing as an instant cure." he said. "Improvements are usually related to longer periods of practice."

But Meinzer said the results are heartening nonetheless. Until recently, few thought that language skills could even be partly recovered years after suffering a stroke.

"Improvements after only two weeks of training are quite impressive." he said. "It’s a step up the ladder."

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