Helping stroke patients get back on their feet
How can people recovering from stroke become better walkers? Not faster walkers, but straighter. Applying equal weight to each leg.
CPSR researcher Dr. Kara Patterson wants to find out.
“After stroke, people rely more on the stronger side than the weaker leg,” says Dr. Patterson, who worked as a physiotherapist in Toronto and Chicago before completing her Masters and PhD at the University of Toronto.
The problem with favoring one side over another is it could lead to joint pain, arthritis on the strong side and loss of bone density on the weaker side.
“I’m looking at ways to fix the gait pattern,” she says. Her research involves determining how people relearn tasks after stroke with both verbal and visual cues.
A study of 60 patients, now under way, will develop new recommendations for physiotherapists on how to provide the best teaching for stroke patients.
One innovative approach, tested at Toronto Rehab and now the focus of a research study, is a variation on a proven therapy called Mirror Box, which is traditionally used for strengthening the arm. Dr. Patterson and colleagues are using what looks like the base of a rowing machine bisected by a mirror that reflects the patient’s strong leg. It provides the illusion that both the weak and strong legs are working at equal strength during therapy – and patients’ brains are tricked by the visual cue.
“The brain believes the affected leg is moving along with the unaffected leg,” Dr. Patterson says. “The theory is that, by producing this visual illusion of the weaker leg working as well as the stronger leg, it creates a sensory experience that in combination with the repeated leg exercise leads to neuroplastic change in the brain that eventually translates to improved function.”
Patients will be recruited into a study of the new therapy with training three times a week for four weeks, involving a control group that does the same movements without the illusion of the mirror. Afterwards, balance and walking abilities will be compared in both groups.
Dr. Patterson says she was drawn to stroke while working as a physiotherapist because she had more questions than answers.
“I think everyone’s life has been touched by stroke,” she says. “My grandmother had a stroke and I remember, even as a young person, how I was struck with the sudden impact it has on someone’s life.”
She wants to make a difference.