Basic Stroke Rehab Principles – How to drive Neuroplasticity

_______________________________________________________________________________________

1.  Use it or Lose it - any attempt to use the involved arm or leg will help with the process of re-training your brain.  The more you don’t use your arm, the more your brain gets comfortable with not using your arm, and the harder it is to START using your arm!  Some have called this “learned non-use.”

2.  Progressive challenge – the difficulty of the exercise or task must be increased as your ability improves.  In other words, keep challenging yourself!  If it’s not difficult, you aren’t getting the most from your rehab time.

3.  Specificity – If you want to recover the ability to open a door with your affected hand, then you should practice opening a door with your affected hand….or at least components of that task.  In other words, your rehab exercises or activities should be specific to the tasks or abilities you want to recover.  Spending hours each day on an arm pedaling machine will not necessarily help you recover the ability to open a door (although the general exercise and use of that arm will still be beneficial for you).

4.  Repetition – it takes MANY repetitions of an activity or exercise to stimulate the neural re-wiring required for improvement.  (Now read number 2 again….the repetitions must be challenging)

5.  Intensity – a considerable amount of concentration should be involved.  If you perform your entire rehab routine while paying more attention to your television than your affected arm, you are not driving neural re-wiring to any beneficial extent.  Focus entirely on the task at hand, and don’t be afraid to give yourself rest breaks when you know that your concentration is fatigued.

Neuropla…..WHAT?!

• If you are confused about the difference between the initial stages of recovery, and the recovery that can occur months or even years after a stroke, read this article called “Is your Stroke Recovery Slowing Down?”

What is Levodopa? Can it help with stroke rehab?

_____________________________________________________________________________________

Levodopa, or L-Dopa, is the precursor of the chemical dopamine.  Dopamine is an important neurotransmitter in the brain, which has many functions, including some control of movement.  In fact, the inadequate production of dopamine is thought to cause the movement difficulties in people with Parkinson’s disease.  Therefore, administration of L-Dopa is a fairly common and effective treatment for improving the movement of Parkinson’s patients.

Below I’ve listed several studies that have investigated the use of L-dopa to enhance stroke recovery.  It seems promising!  And L-dopa is available in many forms, some of which are fairly easy to obtain.  (Such as herbal sources like Mucuna Pruriens, also known as the velvet bean.)  But there are possible side effects of L-Dopa, so don’t order a year’s supply of velvet bean just yet!  Ask your doctor about this potential treatment!

Does It Work?

有沒有效呢？

In 2001, Lancet published a study that compared 3 weeks of treatment with Levodopa to a placebo group.  They found that “levodopa is well tolerated and, when given in combination with physiotherapy, enhances motor recovery in patients with hemiplegia. In view of its minimal side-effects, levodopa will be a possible add- on during stroke rehabilitation.”

In 2008, The Archives of Physical Medicine and Rehabilitation published a small German study that analyzed the effects of 3 doses of L-dopa prior to one session of physical therapy vs physical therapy alone.  Their results showed a significant improvement in what they called “procedural motor learning” of the involved hand (improved reaction time and performance of new movements and tasks with the hand).

The Journal of Neurological Science published a study in 2009 which compared 20 patients receiving L-dopa and speech therapy to 19 patients receiving a placebo and speech therapy.  The group receiving L-dopa “experienced greater language improvement in verbal fluency and repetition, compared to the placebo group.”

Here’s an interesting blog about written by somebody with personal experience with the use of L-dopa for stroke recovery:

Bottom-Line:

The studies on Levodopa suggest that it could be helpful in stroke recovery, both motor recovery and speech improvement.  There are possible side-effects, so ask your doctor if this treatment might be worth trying.