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We are inviting people with Stroke to participate in a research study to examine how the brain learns new movements. This research will be conducted at the University of British Columbia. If you are eligi-ble and decide to participate, you will complete 9 sessions that in-volve practicing new movements using your stroke affected arm after you receive stimulation to your brain. Each visit will last about 1-2 hours. You may also have two MRI scans, one on day 1 and one on day 9.

This research is being conducted by Dr. Lara Boyd PT, PhD, CRC, Director of the Brain Behavior Labora-tory. If you are interested or have questions related to the research at the Brain Behavior Laboratory please contact her lab personnel.

People with aphasia and relatives explain what living with aphasia is like and how Connect has made a difference to their lives. You may like to show this DVD to your patients and clients.

Need counselling?
Harry Clarke has aphasia himself so he knows from personal experience what it feels like to live with aphasia. He is also a trained counsellor and has given many people with aphasia the emotional support they need to get their lives back on track. You can refer your clients direct to Harry AND it's completely FREE!

Teaching stroke patients to sing "rewires" their brains, helping them recover their speech, say scientists.
By singing, patients use a different area of the brain from the area involved in speech.
If a person's "speech centre" is damaged by a stroke, they can learn to use their "singing centre" instead.
Researchers presented these findings at the annual meeting of the American Association for the Advancement of Science (AAAS) in San Diego.

An ongoing clinical trial, they said, has shown how the brain responds to this "melodic intonation therapy".
Gottfried Schlaug, a neurology professor at Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, US, led the trial.

The therapy is already established as a medical technique. Researchers first used it when it was discovered that stroke patients with brain damage that left them unable to speak were still able to sing.

Professor Schlaug explained that his was the first study to combine this therapy with brain imaging - "to show what is actually going on in the brain" as patients learn to sing their words.

Most of the connections between brain areas that control movement and those that control hearing are on the left side of the brain. "But there's a sort of corresponding hole on the right side," said Professor Schlaug.

"For some reason, it's not as endowed with these connections, so the left side is used much more in speech.
If you damage the left side, the right side has trouble [fulfilling that role]."

But as patients learn to put their words to melodies, the crucial connections form on the right side of their brains.
Previous brain imaging studies have shown that this "singing centre" is overdeveloped in the brains of professional singers.
During the therapy sessions, patients are taught to put their words to simple melodies.

Professor Schlaug said that after a single session, a stroke patients who was are not able to form any intelligible words learned to say the phrase "I am thirsty" by combining each syllable with the note of a melody.
The patients are also encouraged to tap out each syllable with their hands. Professor Schlaug said that this seemed to act as an "internal pace-maker" which made the therapy even more effective.
"Music might be an alternative medium to engage parts of the brain that are otherwise not engaged," he said.

Dr Aniruddh Patel from the Neurosciences Institute in San Diego, said the study was an example of the "explosion in research into music and the brain" over the last decade.
"People sometimes ask where in the brain music is processed and the answer is everywhere above the neck," said Dr Patel.
"Music engages huge swathes of the brain - it's not just lighting up a spot in the auditory cortex."

Dr Nina Kraus, a neuroscientist from Northwestern University in Chicago, also studies the effects of music on the brain.
In her research, she records the brain's response to music using electrodes on the scalp.
This work has enabled her to "play back" electrical activity from brain cells as they pick up sounds.
"Neurons work with electricity - so if you record the electricity from the brain you can play that back through speakers and hear how the brain deals with sounds," she explained.

Dr Kraus has also discovered that musical training seems to enhance the ability to perform other tasks, such as reading.
She said that the insights into how the brain responds to music provided evidence that musical training was an important part of children's education.

TORONTO: A Wii bit of therapy using virtual reality game technology provided measurable benefits to stroke patients taking part in a small pilot study, researchers reported Thursday.

The Canadian study focused on upper body motions, and made use of the games Wii tennis and Wii "Cooking Mama," which involves players moving as if they're cutting up vegetables, slicing meat or shredding cheese.

For comparison purposes, a second group of stroke patients was assigned to non-video game recreational pursuits, including the block-stacking and balancing game Jenga and playing cards.

"The study showed that patients randomized to the virtual reality using the Wii gaming technology achieve greater performance in terms of their motor function, four weeks after the intervention," said Dr. Gustavo Saposnik, a neurologist at St. Michael's Hospital in Toronto.

Changes in fine and gross motor function were shown in their speed and grip strength, he said.

The findings of the study, conducted at the Toronto Rehabilitation Institute, were presented in San Antonio, Texas, at the American Stroke Association's International Stroke Conference.

The study involved 20 patients aged 41 to 83 who had suffered mild to moderate strokes. Rehabilitation began within two months of the stroke, and they all received an intensive program of eight sessions, 60 minutes each, over a two-week period.

Patients in both groups were seated during therapy, and they were instructed to primarily use their affected arm.

Saposnik said those randomized to the Wii therapy had a seven-second difference in greater performance compared to the others, which he described as "meaningful."

"In other words, imagine that you have for every task you are doing, instead of doing that in 20 seconds, it will take you 27 seconds for each activity that you do on a daily basis. That would be an impressive prolonged time."

"The results are hopeful initial steps. But at this point we are not recommending stroke patients to play with the Wii. We are looking forward to having the results of a larger study, which is already underway."

Physiotherapists in a number of locations have been incorporating video game technology into their practices in recent years.

Vera Fung, a member of the Canadian Physiotherapy Association and a clinical researcher at St. John's Rehab Hospital in Toronto, says she's not surprised by the stroke research.

About two years ago, her institution conducted a study asking for clinical perspectives on the use of Nintendo Wii technology for helping not only stroke patients, but also cardiac transplant patients, amputees, those in burn rehab and patients with total knee and hip replacements.

"The clinicians actually were in agreement that games like Wii tennis, 'Cooking Mama,' as well as games like 'Big Brain Academy' and finally a driving simulation game, which all of the participants trialled and commented on, they all found that such games had the potential to restore motor function," she said.

As well, they found there was potential to improve balance and standing tolerance, while patients were motivated to participate.

"We are struggling in rehab to engage people in activities that represent tasks that they need to do that are fun to do, that challenge them, and this study is encouraging from those perspectives," said Gail Creaser, also a member of the physiotherapy association and a lecturer at Dalhousie University in Halifax.

The technology is not expensive compared to a lot of hospital and rehab equipment, she noted.

The pilot study found no adverse effects in terms of safety. For instance, no one experienced nausea or dizziness. And Creaser said that because these systems are wireless, patients and staff don't need to worry about tripping on cords, except for the cord connecting the television to the wall outlet.

"Wii is small and can be taken to different places very, very easily. Ours is carted around on a trolley," she said.

But use of virtual reality game technology is a new field and studies providing evidence of the benefits have been lacking, she noted.

"To see somebody at least starting to do randomized studies is certainly hopeful," she said.

Fung said a randomized controlled trial is also underway at St. John's Rehab to look at 60 knee replacement outpatients who are using the "Wii Fit" application.

"It's really encouraging to know that there are centres as well as ourselves that are taking the leap to put some evidence-based clinical trials ... out there, so that we can hopefully validate the use of Nintendo Wii as an acceptable treatment intervention for rehab."

After three years of planning and preparation, stroke patients in British Columbia are seeing on-the-ground benefits from the BC Stroke Strategy.

The Strategy is an integrated plan that takes a coordinated approach to improving stroke along the continuum of care - from public awareness and primary and secondary prevention, through acute treatment to rehabilitation and community re-integration.

To read about BC's Stroke Strategy please go to:

http://www.bcstrokestrategy.ca

The Canadian Stroke Network

**This Program is currently on hold until further notice, please feel free to contact us (604) 688 3603 with any questions

The Stroke Recovery Association of BC and GF Strong Rehabilitation Centre are in the process of implementing a new stroke peer mentoring program to support individuals with stroke. This is a one year pilot and partnership between our two organisations with the hope of expanding the program in the future. Ten peer mentors have recently completed eleven weeks of training in preparation for being matched up with a partner.

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