Physiotherapy linked to stroke recovery

Paul Mayne // Western NewsTwenty-three years after a stroke compromised use of his left arm, John Humphrey’s (pictured) brain began to re-wire itself and some recovery took place in both the left and right hemispheres. Dr. David Spence, a professor of Neurology and Clinical Pharmacology at the Schulich School of Medicine & Dentistry, penned a recent paper on the Windsor resident’s recovery journey.

After he had a stroke at age 15, John Humphrey’s left arm was useful “only as a paperweight” while he studied his way through high school, college and university.

He was happy to be alive – to have survived after blood clots had formed, then raced to his brain one day when he was picking up suitcases en route home from a train trip to Toronto with his family. He was in hospital for five months and back in school the following spring. Strength quickly returned to his left leg, but his left shoulder, arm and hand were dead weight.

Dr. David Spence, a professor of Neurology and Clinical Pharmacology at the Schulich School of Medicine & Dentistry, was Humphrey’s specialist almost from the beginning and saw him for check-ups.

Conventional medical wisdom says in patients with stroke, recovery will happen within six months – if it happens at all.

For Humphrey, it wasn’t happening. For him, it was disappointing, but not unexpected, that each visit to the doctor was no different from the visit that preceded it.

He pursued a career in journalism and, an avid hockey fan, used his right hand to type game stories and analyses for local and national publications.

“When I couldn’t move my arm for years, I thought, it’s probably not going to come back and I should move on. But I still worked at keeping it loose, just in case it ever came back.”

Twenty-three years after the stroke, in an effort to get more fit and lose weight, Humphrey began to swim regularly. After a while, his left hand began to twitch, at first almost imperceptibly, and then more noticeably on command.

He called Spence who arranged an appointment.

SPENCE

“I was amazed,” Spence recalled. “Swimming had somehow started to trigger recovery in his brain and in that hand.”

A functional MRI showed that Humphrey’s brain had begun to re-wire itself and some recovery had taken place in both the left and right hemispheres.

That recovery was the subject of a short paper, Motor Recovery Beginning 23 Years After Ischemic Stroke, co-authored by Spence in the Journal of Neurophysiology this summer.

Humphrey started in on an intensive course of physiotherapy in Windsor, where he lives. Today, 37 years after a stroke and using a hand he once couldn’t command to do anything, he can pick up small coins from a table and grasp a hand in a handshake.

“I think he can keep on improving,” Spence said.

Humphrey is convinced of it, too.

“I’m working on strengthening my shoulder now. This is only the start and I’m going to get stronger. I will never quit.”

He credits Dr. Robert Teasell of Parkwood Institute with continuing to believe he could recover. And he credits Spence with transforming his life. “He’s ‘The Guy.’ He saved my life. Whatever I’ve become, it’s because of him.”

Humphrey has produced a short YouTube video showing what he has been able to achieve and speaks frequently at stroke prevention and recovery events. “This is my calling in life, to be a stroke advocate and prove it can be done.”

Meanwhile the authors of the Journal of Neurophysiology paper – who also include Teasell, Peter Soros of University of Lubeck and Daniel Hanley of Johns Hopkins – said there are other lessons to be learned. “This case provides impetus not only to more intensive and prolonged physiotherapy, but also to treatment with emerging modalities such as stem cell therapy, exosome and micro-RNA therapies,” the paper stated.