Computer program aids stroke victims

by Mickie Barg

Some college students spend hours staring at television monitors numbing their brains, but patients in the University’s physical therapy program do the same to stimulate theirs.
The program’s new study has stroke patients focusing on a computer screen following a digital wave with their fingers, and so far the results have been impressive.
A stroke-patient study at the University’s physical therapy and rehabilitation department documents how a focused and precise movement like moving a finger up and down can significantly improve brain activity and physical movement.
A stroke occurs when a blood vessel to the brain bursts or is blocked causing stoppage in blood flow and nerve cells become deprived of oxygen and die. As a result, the parts of the body controlled by the affected areas of the brain become nonfunctioning.
Previous research indicates the right side of the brain controls the left side of the body, but in stroke recovery the other side of the brain generally takes over both tasks.
“What has not been shown is the extent of effects rehabilitation can have on the brain and actually help the brain switch sides,” said James Carey, professor in the physical medicine and rehabilitation department.
Carey said insurance companies are reluctant to pay for rehabilitation of stroke victims because the switch of brain function can happen on its own. Insurers want proof the exercises can make greater improvements before they decide to pay for rehabilitation.
The National Insitute for Disability and Rehabilitation Research granted the University $300,000 for a three-year study for stroke research.
“We review the research and hope it produces good results and helps people,” said Dennis Dykstra, head of the physical medicine and rehabilitation department.
The study tests three factors in stroke victims: brain waves, hand-eye coordination and small-motor skills.
A functioning magnetic resonance imaging test is done prior to and during the rehabilitation to indicate areas in the brain used during specific tasks.
The rehabilitation then consists of a series of hour-long treatments using a device invented by Carey and others in the department. Patients watch a line on a computer screen and follow its up-and-down movement with their finger.
“The patients get very fatigued at first with the intense concentration needed to chase the line with finger movement,” Carey said. “But after the first session or two, they enjoy the challenge, finding it fun, and their function improves.”
In the functioning MRI the patients wear a helmet with a mirror attached to see the tracking target. They try to follow the lines by using their finger movement and the brain activity is recorded.
“The (functioning MRI) uses a machine more powerful than the usual hospital magnet. It shows how much of the brain is active during finger lifting,” Carey said.
The laboratory tests show the value of the treatment, but the functional ability out of the laboratory also is necessary.
Finally, the subjects do a series of tests — such as grabbing and moving blocks from one area to another — before and after therapy sessions. The subjects’ functional activity improved as well.
Prior to treatment, one patient could grasp and move an average of eight blocks in three separate trials, but after the monitor tests the average increased to 18.
The study subjects are all from the Twin Cities area and are required to have some initial finger movement. A subject cannot have metal in the body and must be at least six months removed from the stroke.
Kirsten Ness, professor of physical medicine, said the treatment helps map patients’ brains.
“It gives us the opportunity to learn how people with damaged brains learn,” she said.
According to the American Heart Association, more than 11,000 Minnesotans suffered a stroke in 1998. Strokes are the leading cause of serious, long-term disability in the United States.

Mickie Barg covers the Medical School and welcomes comments at [email protected]