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Press release

How hands learn to grasp again

A special training method reactivates movement patterns lost after a serious neural injury

Being able to pick up things again, to walk again, that is what victims of serious hand or leg injuries wish for most. Nerve damage has interrupted the connection to the brain and the use of these limbs has become impaired. Surgery can reconstruct neural pathways but the movements previously carried out have been "forgotten". However, with a new therapeutic method they can be reactivated.

"Surgical excellence is not the only thing that matters in the quest to give patients back the ability to use their limbs," explains University Professor Dr. Hanno Millesi of the Wiener Privatklinik: "We repair neural defects caused by accidents or injuries via nerve transplantation. But despite successful surgery some patients are not able to move their arms the way they used to or cannot carry out particular hand movements." This indicates that the affected muscles cannot be controlled arbitrarily. This can lead to flaccid paralysis. Changes at the location of the injury are not the only result: structural changes also take place in the brain; the related brain areas gradually change their function and structure.

Prof. Millesi explains further: "The brain, stimulation transfer of nerves in all regions, muscles and the organ itself form one unit, and therefore need to be treated as such, if the aim is therapeutic success."

New visual research methods have shown that there is a strong connection between motoric abilities and the movement patterns stored in the motor memory. If a trauma disrupts the smooth functioning of the nerves, the brain will also begin to store movement patterns acquired after the injury (for example through long periods of immobilisation or certain relieving postures etc.). The result is a blockage of the system, and the patient loses the ability to use his hand to pick up things.

The so-called intention-triggered Myofeedback (IMF) approach helps patients to reactivate original movement patterns. Although memory of these patterns might have faded with time it is still stored somewhere in the long-term memory of the brain. It has only been superimposed by pathological patterns acquired after the injury.

This therapeutic method is based on three aspects – the power of the patient’s thoughts, the sensation of impulses, and repetitive exercise. First of all sensors are attached to the patient's limb, for example to the appropriate muscle areas of a paralysed hand. The patient then has to use willpower and imagine the movement he used to be able to carry out. The Myofeedback device even picks up very weak neural activity in the paralysed muscles, amplifies it and returns it in form of a muscle stimulation. Regular repetition improves the patient's physical sensation. After receiving training at the clinic patients are advised to exercise four times a day for half an hour, using the portable device, until they have regained arbitrary movement in the affected limb.

And this is even possible if patients have been living with their disability for several years. Prof. Millesi states that: "8 out 10 patients, who started with the therapy an average of 7 years after the neural damage, experienced significant improvements as early as 8 or 9 weeks later."

Source: Kronenzeitung Vienna from 1 April 2006 (Medizin aktuell, Eva Rohrer)