READER’S DIGEST
July• 2019 | 77could be helped with the right ther-
apy – or really any therapy, since for
many, no attempts at rehabilitation
are made beyond the first few weeks.
Yet a 2014 paper in the journalTo p i c s
in Stroke Rehabilitationasserts that
there’s impressive evidence to show
that more optimism is warranted.
Many people can and do recover
function long after stroke.
The most dramatic evidence of
this was documented in a case study
of a man from Toronto, Canada. For
22 years after an ischaemic stroke in
1979, his left hand was completely
non-functional. But a year after he
began swimming in 2001 it began to
show signs of life. Spurred by this,
he began intensive physical therapy.
Within two more years he was able
to pick up coins with his previously
paralysed hand. When doctors per-
formed an MRI, they found the reason
why: his brain had begun to ‘rewire’
itself, bypassing tissue destroyed by
the stroke to make new connections.
The ability to re-route around long-
standing damage is known as brain
plasticity. But in the early stages after
a stroke, affected neurons are some-
times damaged but not destroyed. If
neurons are able to recover, function
may return sooner and more fully.
“If somebody shows even a f licker
of movement in a completely flaccid
limb in the first 30 days, I view it as
a very promising sign,” says Dr Heidi
Fusco, an assistant professor of reha-
bilitation medicine. “I have patients
who are still recovering two, three
years after their ischaemic stroke,
and they continue to improve.” It’s
time to think more optimistically
about stroke recovery, and give more
people a chance.
Professor Hummel envisions a
future where that can more readi-
ly occur. “We have to get away from
one-suits-all therapy ideas to person-
alised precision therapy,” he says. His
research focuses on discovering ‘bio-
markers’ that could one day help doc-
tors know in advance which therapies
will work best for which patients, and
which parts of the undamaged brain
should be stimulated to encourage
new neurons to take on the functions
of sectors that stroke destroyed.
“What’s most important to recog-
nise is that stroke is a treatable dis-
ease,” says Professor Muir. “We have
things that are effective, and simple
stuff matters as much as complicated
stuff.”IT’S A BUG’S LIFEPeople who can’t distinguish between
etymology and entomology bug me in ways
I cannot put into words.@IITALWR