Fort Collins
It is lunchtime, and in the Occupational Therapy Annex at Colorado State University, Judy Herb and Dean Ross are doing what comes unnaturally.
Each is eating with a stroke-damaged hand.
This would be easier and much less messy if their good hands weren’t in mitts that left them useless.
As ingredients from Herb’s and Ross’ sub sandwiches squeeze through uncovered but unresponsive fingers, the two diners keep reminding themselves that this is science.
Herb, 62, and Ross, 77, are part of an experiment involving “constraint-
induced therapy.” That’s a fancy way to say that Herb and Ross cover their undamaged hands with bulky mittens to force them to use their stroke-damaged appendages.
Before lunch, Herb and Ross had taken turns tossing and collecting dice for the game Yahtzee. They alternated playing Perfection, a small-child’s game where participants must grasp thin plastic stems to place shapes in a frame.
This is the kind of thing they do six hours a day, every day, for two weeks.
Experiment director and CSU professor Matt Malcolm refers to the tedium as “therapeutic tasks.” Earlier research has shown this therapy works better than leaving patients mittless, Malcolm explains. Now, he and a staff of grad-school trainers test to see how the glove fits for mass medical consumption. Getting thousands of stroke victims into clinics six hours a day isn’t practical, Malcolm said. CSU will compare progress of patients in home-based constraint programs with those in the lab.
To go with six hours of daily exercise in the lab or at home, experiment participants must swear to wear mitts at least 90 percent of their waking hours.
It is an exercise in humility, not pain, said Herb, who completed the two-week program in September and has returned to test the concept of a “booster session.”
“Nothing hurts,” she said. “It just doesn’t work.”
A January 2004 stroke paralyzed Herb on her right side. She gave up on miracle cures long ago. Now, she measures victory by the inch. Her right thumb, once frozen in a flexed position against her palm, moves. She walks almost normally but still talks with a slur. She’d simply like to drive a car again.
Ditto for Dean Ross, who had a stroke eight years ago. Wednesday was his second day of constraint-induced therapy. He rides to CSU from Cheyenne with Herb and her husband. “You automatically want to reach with your right hand,” Ross said, as his left hand wrestled with the cap on a water bottle. “One thing about a stroke, it teaches you patience.
“I’ll try anything to get better. Before, they tried to teach you to live with what you had. These people try to get you back to where you were.”
Everyone knows that’s impossible. Still, it isn’t what the discussion entails.
“What we’re looking for,” said training supervisor Court Church, “is some kind of quality-of-life improvement.”
More improvement than stroke victims who don’t wear mitts.
Lunch is over, and it’s time to get back to work, as if eating wasn’t tough enough.
Trainer Katie Miller stacks cans of Spam, sardines, evaporated milk and tuna on a shelf and tells Ross to move them one shelf higher.
“Now, take a step back and do it again,” Miller says, forcing Miller to stretch his injured arm and hand higher.
“Shall we time you and see if you can do it faster?” Miller asks, adding yet another physical challenge.
Across the room, Herb digs into a box of balls and plays catch with Church. Sometimes, she can’t will her contracted muscles to release the ball from her hand.
“It’s hard,” she said. “But it isn’t punishment. The first day, you’re excited. The second day, you realize there’s more of this ahead. The third day, you’re willing to keep going because of hope.”
Her words hang in the air longer than her throws.
Regardless of what the data reveal, the essence of the stroke-therapy experiment in CSU’s lab is hope.
Without it, it’s tough to be a one-handed human guinea pig.
Jim Spencer’s column appears Monday, Wednesday and Friday. He can be reached at 303-954-1771, jspencer@denverpost.com or blogs.denverpost.com/spencer.
