MEDICAL RESEARCH UPDATE.
A recent study reveals the promise of a new rehabilitative therapy for people who have limb paralysis due to stroke. After a stroke, some cells that may control limb movements remain in shock and, therefore, cannot function. According to the study's authors, each time a person tries to use the limb with paralysis and fails, the failure gets reinforced and the limb falls into a state of "learned helplessness."
The new therapy, called constraint-induced-movement therapy, forces the person to use the affected limb to do familiar, everyday tasks. Edward Taub, MD, a neurologist at the University of Alabama-Birmingham, and his staff have found that by immobilizing the unaffected arm for a strict regimen of six hours a day and at least two weeks straight, the brain can relearn to use the affected arm. Results of the 13-person study showed that all of the participants had regained nearly full use of their affected limbs after the therapy (preliminary tests show that the therapy is as effective on legs as it is on arms, but more studies are being done to confirm this.). The study also found that the therapy worked for individuals who have lived decades with limited use of a limb due to stroke.
Stroke expert and Duke University Medical Center Professor Larry Goldstein, MD, however, cautions that the study has "big limitations" because there was no control group, and is based on a significantly small number of people. "Is it promising?" he asked. "Yes. Is it proven? No." This study was published in the June 2000 issue of Stroke.
SHUNTING IN YOUNG ADULTS WITH SPINA BIFIDA PROVES POSITIVE
Researchers who studied 23 young adults with spina bifida and hydrocephalus (which is assumed to be controlled) have discovered that cerebrospinal fluid shunting can improve neuropsychological functioning. The results of studies done six months before and six months after the surgical placement of a shunt show "significant improvements..... in verbal and visual memory, motor coordination, and attention and cognitive flexibility." Younger children with hydrocephalus may benefit most from shunting, say researchers, due to the "greater plasticity of the young brain." According to Maria Antonia Poca, MD, and her colleagues at the University of Barcelona, the "improved cognitive functions will probably lead to clinical, educational, and social benefits." To view this study, refer to the May 2000 issue of the Journal of Neurology, Neurosurgery, and Psychiatry.
YOUNG ADULTS ON DIALYSIS ADVISED TO MONITOR CORONARY-ARTERY CALCIFICATION
According to results of electron-beam computed tomography (CT)(*) tests performed on 39 people (ages 7 to 30) with end-stage renal disease, researchers have discovered, among the study participants between ages 20 and 30, a proportionately high incidence (14 out of 16) of vascular calcification compared to results of tests done on a control group of 60 healthy young people (of which only 3 participants showed signs of the calcification.) Among the younger participants in the study (those under 20-years-old), however, there was no evidence of coronary-artery calcification.
William G. Goodman, MD, and his colleagues at the University of California-Los Angeles view the high levels of calcification found in the elder portion of the group as a function of the build-up of large doses of calcium that young people on dialysis take--up to 6,000mg/day--to rid the bloodstream of phosphorus, which is a common complication of renal failure. Though still unproven, Dr. Goodman suggests a decreased dependence on calcium to purge the blood of phosphorus. "We would encourage a reduction in file amount of calcium that is used, and perhaps patients should rely on other compounds that bind phosphorus that do not contain calcium." This study can be found in the May 18 issue of the New England Journal of Medicine. (*)(A CT scan is a method of taking pictures of the inside of the body using an ultra-thin x-ray or electron beam.
RESEARCH FOR PARENTS OF CHILDREN WITH DISABILITIES PROVES THE IMPORTANCE OF EMPATHY AND SUPPORT
Based on analysis of audio-taped interviews, two researchers reaffirm the positive impact mutual support can have among parents of children with disabilities. After studying the parents of 63 children born with a congenital upper-limb deficiency, S.M. Kerr and J.B. McIntosh, both from the University oil Glasgow in Scotland, found that during the first few months after their baby's birth, support from family, friends, and health professionals alone was not sufficiently helpful to the parents. To cope with the feelings of isolation and concern about the future, the research showed that parents of children with disabilities were only adequately supported upon making contact with other parents of children with disabilities--in this case, those whose children also had limb deficiencies. Such contact proved to be a much-needed stress-buffering influence, as it provided emotional, social, and practical support. The study, which can be found in the July 2000 issue of Child: Care, Health and Development in an article entitled "Coping When a Child Has a Disability: Exploring the Impact of Parent-to-Parent Support," concluded that parents of children with disabilities are "uniquely qualified to help each other." The article also encourages healthcare professionals to recognize this fact and take steps to connect parents with the appropriate organizations and contacts that can offer support.