Strokes can wipe out a person's ability to do even the simplest tasks, such as writing, walking, and talking. Some studies have shown that the brain cells near the part of the brain affected by a stroke try to pick up some of the workload of the dead cells, and some people's brains do a better job at this than others. Researchers from the University of Maryland and Johns Hopkins University looked at the brains of stroke patients to see if a specific type of physical therapy helped retrain their brains.

What the researchers wanted to know: Does one type of physical therapy help people regain movement by rewiring the brain?

What they did: The researchers recruited patients who had partial loss of motion in one arm due to a stroke and had already been through several months of conventional rehabilitation therapy but weren't back to normal. Half of the patients were given a therapy called BATRAC, bilateral arm training with rhythmic auditory cuing, in which recorded sounds cued them to push two T-bar handles back and forth on a track. The other half, in the control group, had a therapy called dose matched therapeutic exercise, a more common therapy, in which the patients did exercises with their back, shoulder, and affected arm, and opened and closed their fist. Twenty-one of the patients in this study had an fMRI brain scan while they were doing the exercises to see what was going on in their brain.

What they found: Patients who had BATRAC therapy were more likely to have changes in their brain, including in the areas that control voluntary movement, and were more likely to regain function in their affected arm. The researchers are not sure why BATRAC works better than the standard type therapy, though they suspect it has something to do with either its intensity, rhythmic movements, or that people use both arms. This study, say the authors, supports the idea that the brain can rewire itself after a stroke‑and that certain therapies can help.

What it means to you: A previous larger study with some of the same patients showed that BATRAC therapy can help people who have lost partial movement in an arm. This study shows how it works—by rewiring the brain to use other cells to control arm movement. This therapy is relatively new, but successes like this one could make it more widespread.

Caveats: Three out of the 12 patients who received BATRAC therapy did not have any brain changes or improvement in arm mobility. These patients were excluded from the final analysis so that the researchers could measure what changes in the brain were associated with increased mobility, but it may be that this therapy won't work on certain people.

Find out more: For information about treatment and recovery from strokes, for both patients and caregivers, check out this Web page from the American Stroke Association.

Read the article: Luft, A.R. et al. "Repetitive Bilateral Arm Training and Motor Cortex Activation in Chronic Stroke." Journal of the American Medical Association. Oct. 20, 2004, Vol. 292, No. 15, pp. 1853-1861.

Abstract online: http://jama.ama-assn.org