The Upper Limb and Stroke
Arm weakness is common after stroke and its treatment is recognised as an area of considerable need.1 Approximately 85% of patients with stroke present with arm weakness2 and 60% of stroke survivors with poorly functioning arms at one week do not recover meaningful function by six months.3 Arm weakness is a major factor contributing to disability following stroke.4Current treatment for arm weakness typically comprises intensive, task-specific and repetitive rehabilitative interventions or occasionally methods such as constraint induced movement therapy and robotic therapy.5 A recent meta-analysis and large-scale trials show the effects of current treatments for arm weakness to be modest.6,7 Improvement in arm function should improve quality of life for stroke survivors, reduce co-morbidities associated with loss of independence, and reduce cost to the health care system.8
Neuroplasticity and Recovery
Neuroplasticity is the brain’s ability to form new neural pathways in response to injury or disease. It has been a target for the treatment of many neurological disorders including epilepsy and tinnitus. Recent studies have suggested that augmentation of neuroplasticity is required to more fully recover motor function.9 Novel techniques that drive the growth of new neural pathways related to motor function are needed; vagus nerve stimulation (VNS) may achieve this.