Hands on treatment

NICK EICHER, HOST: Coming up next on The World and Everything in It: a new treatment for people paralyzed by strokes.

Every year, nearly 800,000 people in the U.S. suffer a stroke. About eight out of ten stroke survivors are left with some paralysis. Typically, the effect will be to just one side of the body with the muscles in their faces, arms, and legs unable to function as they used to.

PAUL BUTLER, HOST: But a University of Pittsburgh research team is helping stroke victims get as much of their lives back as they can.

WORLD’s Mary Muncy brings us the story.

SOUND: [Cutting steak]

MARY MUNCY, REPORTER: Cutting a steak is definitely a two-handed exercise, as I rediscovered recently. And it’s something Heather Rendulic didn’t think much about until 2011, when she had a series of strokes that rendered her left side almost completely paralyzed. At their anniversary dinner last year, Rendulic watched her husband take his first bite of steak.

HEATHER RENDULIC: I just want to get in there. But I have to say, Oh, wait, Honey, can you please cut up my steak for me?

Her husband took her plate and cut up her steak for her. He did it gladly, like he always does.

RENDULIC: I'm feeling, you know, kind of childlike, like when my mom used to have to cut up my food when I was a toddler, and not a 33 year old woman on a wedding anniversary dinner with her husband.

Rendulic had her first stroke when she was 22.

RENDULIC: I was otherwise a very healthy, young adult, there's no history or family history.

The doctors said she had a cavernous angioma. It’s basically a cluster of weak blood vessels in the brain or spinal cord. The only known cure is surgery, but Rendulic’s was too deep in her brain to operate.

RENDULIC: So I was told to just live my life as best I could, and hopefully it wouldn't bleed again. But unfortunately, for me, it bled five times over 11 months.

Her fifth stroke almost completely paralyzed her left side, but it also moved the cavernous angioma so that they could operate.

RENDULIC: I was very blessed that they were able to completely cure me of cavernous angioma. They removed the lesion entirely.

But she was still paralyzed. She eventually relearned how to walk, but she still can’t use her left arm. She’ll probably never have full function again.

RENDULIC: I always tell people, I live one handed in a two handed world.

It’s typically much harder for people to regain function in their upper limbs rather than their lower limbs after a stroke.

WAYNE FENG: My name is Wayne Feng. I’m a stroke neurologist, also physician scientist in stroke recovery. I direct the Stroke Program at Duke University.

Feng says walking, or locomotion, is controlled by a different part of the brain than upper limb function, and strokes more often affect the part of the brain that controls someone’s upper limbs.

Also, walking doesn’t require very precise movements. It’s just plant your foot, balance for a second, plant the other foot.

Contrast that with picking up a glass of water. Your arm has to move to the cup without hitting it, grab the cup, then lift it with just enough force to bring it to your mouth but not so much force that the water launches out over the top.

But the task still isn’t done. Then you have to tip the water into your mouth and set the cup down.

FENG: A lot of patients, they just cannot, you know, recover their arm function. But I wouldn't say two thirds of the patients or more than that, they will gain the ability to to walk.

Researchers like Feng have been trying to develop technology to restore function in the upper limbs, and the University of Pittsburgh is now in the trial stage of a spinal implant that could do just that.

Rendulic participated in one of the trials. Surgeons placed electrodes in her spinal column to help rebuild the pathways between her brain and her arm.

FENG: It’s basically using electro stimulation, that's, you know, that's a currency in humans. We use electricity to communicate.

The electricity basically runs along highways from our brains to our extremities and back again, sending signals like grab that, that’s warm, set that down. But a stroke can wreck that highway.

FENG: So that time you turn on a stimulation, you basically amplify the signal you send from the brain to your arm.

The implant creates a bridge or an alternate route for those signals to go across. Other types of technology stimulate the brain to give stronger signals, rather than creating a bridge. But this method is more precise, though it doesn’t work for everyone.

While Rendulic saw a lot of success, the other patient in the trial saw very little.

Feng says the researchers need more information on what types of stroke patients this kind of stimulation can help.

FENG: I'm thinking it is probably five to ten years, but we also learn a lot from what they learn from this.

After the trial, Rendulic had to have the electrodes removed, but not before she got a surprise.

She was sitting in the lab, surrounded by her family when the researchers brought out a steak.

RESEARCHER: You’re cutting it!

RENDULIC: I’m cutting it!

It was surreal, because it was something I never thought I would do again. But it also gave me so much hope of like the opportunities of what this technology will do for not only me but other people.

MUNCY: Reporting for WORLD, I’m Mary Muncy.

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