3164 EXCIT-ING News for stroke victims

The acronym EXCITE stands for Extremity Constraint-Induced Therapy Evaluation, a trial that shows if stroke victims have intensive physical therapy and the "good" limb is restrained so that it doesn't "help" then the patient experienced remarkable improvement in 2 weeks over the traditional treatment (which can range from no treatment after concluding formal rehabilitation to drug or physiotherapeutic interventions). The study appeared in the November 1 issue of JAMA, "Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: the EXCITE randomized clinical trial," (Vol. 296,no. 17, p. 2095).

"This study demonstrates that for up to 30% of the stroke population, individuals with upper extremity impairment who have some initial movement capability can use a relatively inexpensive rehabilitative approach to improve upper extremity function and that this effect will persist for at least one year," the study's principal investigator, Steven Wolf, PhD, of Emory University School of Medicine in Atlanta, Georgia, told Medscape.

"This intervention is not difficult to implement but it does require a great deal of cooperation in both the clinical and home environments. We live in a world where we have a multi-billion dollar drug industry, which has conditioned patients to believe that everything can be fixed with a pill and that they don't have to take any responsibility for their own health. But this is not the case with catastrophic injury and patients have to understand this," Dr. Wolf said."

I think this study has implications beyond stroke victims. Whether it is friends, family, spouses, or the federal government, sometimes we need to allow people to get stronger by not helping them so much.