The National Institutes of Health recently renewed funding for Penn State researcher Robert Sainburg, which will allow him to begin testing his rehabilitation intervention in treating the “unaffected” hand in stroke patients. The first cycle of this grant funded a series of basic science experiments to determine how each brain hemisphere contributes unique processes to the control of each arm, while the renewal is a large, 2-site, clinical intervention study that seeks to improve the lives of stroke survivors.
Sainburg, professor of kinesiology and neurology, in collaboration with Carolee Winstein, University of Southern California professor of biokinesiology and physical therapy, will expand on the findings of the previous grant period which found that stroke-induced brain lesions can substantially limit non-paretic arm function, the arm that was previous thought to be unaffected by stroke.
“We hypothesize that the deficits in the brain’s ability to control the patient’s ‘good’ hand interfere with doing everyday tasks. These deficits make it much harder for those who rely on this hand for function to be independent,” said Sainburg.
While it is known that each hand is controlled by one side of the brain, this is only true for very basic aspects of motor control. Sainburg explained that both sides of the brain contribute to control of each hand. Therefore, a lesion to one side of the brain will cause motor deficits in both hands.
Handedness results from specialization of each side of the brain to coordinate different aspects of a task, such as planning the direction and speed of a reaching movement, or correcting the movement due to unexpected events in the environment.
Severe stroke damage to specific areas in the brain can produce severe paresis in one hand, while the other arm, in comparison, seems to remain functional, yet its movement is often impaired.
“We have specifically developed this intervention to focus on treating the problems in the ‘good’ hand since most current rehabilitation interventions tend to ignore this hand and put all their effort into the paretic hand. Since these patients really only have the one 'good' hand to carry out their daily tasks, if we get it better, they’ll be much more efficient in performing their activities of daily living, which is the main goal of rehabilitation,” said Sainburg.
The intervention utilizes virtual reality technology; patients practice different tasks with their non-paretic arm in a virtual setting that they can later translate into movements that allow them to live more independently.
The study will rely on the integration of Sainburg’s and Winstein’s laboratories, bringing together their experience in studying brain hemisphere specific motor deficits in stroke survivors and Winstein’s research in stroke clinical trial interventions.
“I look forward to starting our study and seeing the results from our intervention because it has the potential to have a big impact on the future of stroke rehab,” said Sainburg.