A University of Illinois, Chicago discovery may hold the solution to successfully treating recovering stroke victims. After surviving a stroke, these outpatients can go through years of physical therapy in an attempt to regain one of the most important senses we as people have: our sense of balance. Without it, walking and moving become constant challenges, and the fear of falling becomes an everyday struggle. However, Alexander Aruin, a physical therapy professor at UI Chicago, has made a discovery that could change the lives of these stroke survivors for the better.
"When the lower extremities and muscles are weakened after a stroke, people often learn how not to use that side of the body, even after they've recovered a bit," Alexander Aruin says.
During a normal session of physical therapy for post-stroke patients, the goal is to teach the patient to overcome their body's natural tendency to compensate for the weaker side and shift the body's weight to the unaffected side. Patients can overcome this tendency by slightly shifting the body's weight to the weakened side so eventually when walking, the body will subconsciously walk with even weight distribution on both feet instead of compensating for the weaker side. The problem with this normal physical therapy approach is that it can be difficult for a patient to learn to constantly shift their body weight to a side that their body naturally wants to keep weight off of. It can take years to perfect this way of moving, and unfortunately, often times once the sessions are over, the body reverts back to compensating for the weaker side.
Thanks to an NIH funded research campaign, Professor Aruin developed a simple, inexpensive wedge-like insert that, when placed into a patient's shoe, slightly elevates that side of the body to help the patient learn to walk with even weight distribution on each foot. These insoles are less than a half an inch thick, yet have shown to vastly improve the balance in stroke patients, even after physical therapy has ended. In the words of Professor Aruin:
"We tried a purely biomechanical approach. We mechanically lifted the healthy side so the patient cannot resist. The mechanics force body weight to where it is distributed almost 50/50. When patients ambulate in such a condition, they learn how to bear weight equally through both extremities. It's quite simple."
Aruin, along colleagues at the University of Illinois at Chicago and Marianjoy Rehabilitation Hospital in Wheaton, studied two groups of post-stroke patients to study the effects of this "compelled body weight shift." When the patients who only received standard post-stroke physical therapy were compared to those who additionally received the shoe insole, the results were phenomenal. In comparison to the controlled group, those who had the shoe insert also showed more symmetrical body weight distribution, more weight on their affected side, and a faster walking ability. But the most exciting part about this is that those who used the insole continued to show lasting improvements three months after ending the use of the inserts and stopping physical therapy.
The potential for this new treatment is exponential and very exciting. Results of this study have been published in ISRN Rehabilitation and will be published in an upcoming issue of Topics in Stroke Rehabilitation.
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