Stroke survivors can counterintuitively improve recovery by strengthening their stronger arm
Stroke survivors often grapple with lasting arm problems, and surprisingly, difficulties can emerge in both arms. Individuals may experience a slowdown in completing everyday tasks – up to three times slower with their less-impaired arm compared to a healthy person’s dominant hand. This can lead to frustration, as reliance on the less-impaired arm for activities like eating, dressing, and household chores becomes tiring, and discouraging.
A New Approach to Stroke Recovery
However, recent research published in the journal JAMA Neurology suggests a counterintuitive approach: strengthening the less-impaired arm. A clinical trial involving over 50 patients revealed that training the less-affected arm can improve hand function, and in some cases, even surpass the gains achieved by focusing solely on the more impaired limb.
Understanding Stroke
A stroke occurs when blood flow to the brain is interrupted, either by a blockage or bleeding, causing brain cells to die. Because the brain controls opposite sides of the body, strokes often result in movement problems on one side. Traditionally, stroke rehabilitation has centered on restoring movement to the most impaired arm.
However, research indicates that both sides of the brain contribute to controlling movements in both arms. Damage to one side of the brain can impact movement on both sides. While the arm opposite the brain injury typically experiences significant weakness, the less-impaired arm is often not fully functional either, exhibiting reduced strength, slower movements, and poorer coordination.
The Power of Training the “Good” Arm
Researchers, including those at Penn State, questioned whether training the less-impaired arm could yield positive results. In the clinical trial, participants with chronic stroke and severe impairment in one arm were divided into two groups. One group trained their most-impaired arm, while the other focused on their less-impaired arm. Both groups engaged in five weeks of therapy involving challenging, goal-directed hand movements, including virtual reality tasks.
The results showed that those who trained their less-impaired arm became faster and more efficient at everyday tasks like picking up objects or lifting a cup. These improvements were sustained six months after the training concluded. Researchers believe this lasting benefit stems from a positive feedback loop: as the arm functions better, individuals use it more, reinforcing those gains through daily practise.
Stroke rehabilitation has historically prioritized the most visibly impaired arm. However, for many, full function in that arm may not return. They adapt by relying on their less-impaired arm, but even minor issues with this arm can significantly impact independence and quality of life. Improving the function of the less-impaired arm could make daily tasks easier and less exhausting, even years after a stroke.
Future research will explore combining training of both arms and how these approaches translate to real-world scenarios at home. For many stroke survivors, recovery may not be about restoring what was lost, but about strengthening what remains.
Frequently Asked Questions
What is a stroke?
A stroke occurs when the flow of oxygen-carrying blood to part of the brain is interrupted by a blockage in a blood vessel or by bleeding, causing brain cells to die.
How does a stroke affect arm movement?
Because each side of the brain controls the opposite side of the body, a stroke often causes movement problems on the side of the body opposite the brain injury. However, damage can affect both arms.
What did the recent research find?
The research found that training the less-impaired arm in people living with chronic stroke can improve everyday hand function, and in some cases, even better than focusing only on the most impaired arm.
Could a more holistic approach to stroke rehabilitation, focusing on both arms, lead to greater independence and a better quality of life for survivors?