Throughout her esteemed career as a board-certified neurological physical therapy specialist, lecturer and researcher, Kay Wing, PT, DPT, NCS, has always been interested in new technology that has the potential to benefit stroke survivors in her practice, SWAN Rehab (Phoenix, Arizona). When she learned about the Vivistim Paired VNS System, Wing was eager to enroll stroke survivors in the clinical trial based on the research supporting vagus nerve stimulation for ischemic stroke recovery. The results are clear; stroke survivors who participate in paired vagus nerve stimulation in conjunction with their physical therapy improve their hand and arm mobility two to three times more than those who had physical therapy alone. In this post, Wing explains how the FDA-approved Vivistim System works and why its a gamechanger for stroke recovery.By Kay Wing, PT, DPT, NCS What is the Vivistim Paired VNS System?The FDA-approved Vivistim Paired VNS System is a vagus nerve stimulation device that stroke rehabilitation therapists pair with rehabilitation exercises to help improve outcomes (or gains) for stroke survivors even years after theyve had a stroke, potentially generating two to three times more hand and arm function for ischemic stroke survivors than therapy alone.The small pacemaker-like device is placed just under the skin in the upper left chest area during an outpatient procedure. Soon after, the stroke survivor will begin physical or occupational therapy. The therapist will have the stroke survivor repeatedly perform specific rehabilitation exercises designed around each persons specific needs and goals to help them improve their function. During these exercises, the therapist will be sending signals to the persons Vivistim device to send a pulse through the vagus nerve to the brain that helps tell the brain what to relearn.This highly repetitious pairing of vagus nerve stimulation with stroke rehabilitation helps to increase what is known as neuroplasticity , the process of engaging other undamaged parts of the brain to take over the work that had previously been done by the parts of the brain damaged in the stroke.Surviving an Ischemic StrokeAbout 60% of stroke survivors experience persistent upper limb issues for 6 months or more. This fact has both inspired and challenged me personally and professionally. My grandfather survived a stroke when I was in high school but never fully recovered. The feeling that more couldve been done for my grandfather to regain function has guided me throughout my career specializing in neurological physical therapy. The passion that inspired me to open my private practice clinic, Southwest Advanced Neurological Rehabilitation (SWAN Rehab), 25 years ago has consistently been reinvigorated throughout my career as technology evolves and new medical devices are developed that make stroke rehabilitation more effective.My goal is to help stroke survivors experience a better quality of life, especially as it helps them regain the ability to do activities of daily life, such as brushing their teeth, getting dressed, cooking or enjoying a meal. Beyond that, I know its equally as important for stroke survivors to get back to the hobbies that are important to them.Like Joe, who came to SWAN Rehab through Vivistim and really wanted to be able to play his guitar again, restore his antique cars, swing a hammer, squeeze a screw gun and pull a tape measure for his construction projects.Kay performing Joes first assessment.Getting Back to Doing What You LoveThe Vivistim Paired VNS System enabled our SWAN Rehab team to help make these gains, that were so important to Joe, a reality. In traditional physical therapy, we concentrate on improving motor function in the hand and arm with repetitive tasks, such as reaching, buttoning, flipping, stacking, grasping and releasing. With Paired VNS Therapy, however, we incorporate these tasks as we signal the Vivistim device to send an electrical pulse through the vagus nerve to the brain.We repeat these specific repetitive movements over and over again. This repetition is continued with a home exercise program to help achieve the large number of repetitions required to help induce neuroplasticity and relearn how to move. The Vivistim Systems repetitive simultaneous pairing of hand and arm therapy with vagus nerve stimulation is a gamechanger in helping stroke survivors get better results faster because it directly stimulates the brain.Ive seen it firsthand in my clinic. Stroke survivors engaging in traditional therapy see incremental improvement in their hand and arm function over several months. For comparison, stroke survivors who do traditional therapy in conjunction with vagus nerve stimulation get greater improvement in their affected hands and arms within just six weeks.To help Joe get back to doing the things that are important to him, we dedicated some sessions to practice picking up, grasping and using a guitar pick while his therapist signaled the vagus nerve stimulation device with each hand and arm motion. We also had him practice picking up, grasping and swinging a hammer.As a car enthusiast, Joe didnt immediately recognize the correlation between practicing opening jars or cleaning the windows in our clinic as we signaled the Vivistim device during activities that he wanted to get back to, but when he was able to get in his garage and open the gas caps on his car or wash and polish the cars, he was excited about how the benefits of Paired VNS therapy related to his personal goals.Joe will tell you, though, its not an overnight change and doesnt just happen with a couple of hours of in-clinic therapy a few days a week. The Vivistim System also requires stroke survivors to engage in stroke therapy at home, using a magnet that activates the VNS device for 30 minutes at a time while theyre cooking, washing dishes, folding laundry, playing with their children, getting dressed, or any other daily activity.Video Player00:0000:29 First Success, Then ProgressIts always been my philosophy that therapy has to be challenging to keep stroke survivors motivated. I like the Vivistim Paired VNS System because it fosters this philosophy by helping stroke survivors first achieve success by completing tasks in therapy and then continuing to make progress toward their functional goals with the at-home therapy. With Vivistim, stroke survivors are actively engaged, challenged and motivated throughout the recovery process.Paired VNS Therapy is such a breakthrough medical technology for stroke rehabilitation because it helps stroke survivors improve their hand and arm function two to three times more than traditional stroke rehabilitation alone. Of the hundreds of medical devices and innovative therapy techniques Ive implemented in my practice, nothing else has been clinically proven to help stroke survivors achieve this level of improvement in such a short timeframe and in the chronic phase of stroke.If youre a stroke survivor who wants to improve your level of hand and arm mobility even if its been some time since you had your stroke, I hope my experience, Joes improvements as well as those of other stroke survivors encourage you to take the Vivistim survey to see if Paired VNS Therapy is right for you.Video Player00:0000:09 About Kay Wing PT, DPT, NCSKay Wing, PT, DPT, NCS, is the founder of Southwest Advanced Neurological Rehabilitation (SWAN Rehab) and an adjunct professor at Northern Arizona University and A.T. Still University. As a board-certified specialist in neurological physical therapy, Dr. Wing is passionate about working with clients recovering from strokes, traumatic brain injuries and other neurological diseases. Keen on innovation and advancing whats possible in neurological physical therapy, Dr. Wing has authored several peer-reviewed journal articles and led numerous clinical trials. As such, shes won prestigious awards throughout her 40-year-career, leading her peers to regard her as an esteemed physical therapist.

Act FAST For a Stroke!  Stroke is an emergency and a brain attack. Learn how to act FAST and call 911 at the first sign of stroke.Recognizing stroke symptoms can be easy if you remember to think FAST. Use FAST to remember the warning signs:F= Face            Ask the person to smile. Does one side of the face droop?A= Arms           Ask the person to raise both arms. Does one arm drift downward?S= Speech        Ask the person to repeat a simple phrase. Does the speech sound slurred or strange?T= Time            If you observe any of these signs, its time to call 911May is Stroke Awareness Month. The National Stroke Association has easy ways for you to learn more about stroke before it happens to you or someone else. If you have any questions, please call us at 303-444-4040.

More than 750,000 Americans experience a stroke every year. Readjusting to life after a stroke can be overwhelming, but SYNERGY HomeCare Gerontologist Dr. Macie Smith has tips for a successful home-based recovery. When focusing on stroke recovery at home, be sure to review all of the information you received from the hospital and/or rehab facility. This will include any new medications that have been prescribed. It will also include information about in-home care providers for physical therapy, occupational therapy and speech therapy. If there are prescriptions for any durable medical equipment like a walker or gait belt, make sure to understand how to use them properly.As you recalibrate to your at-home routine, it is important that you stick to the prescribed therapy sessions and that you do the prescribed exercises in between home visits from your therapists.The biggest focus of stroke recovery is getting ones strength back. But its equally important to recognize that a full recovery from a stroke may mean having a new baseline of ability and function. That means you may not get back to what you had before the stroke. Doing your therapy will mean that you get as much back as you possibly can.Another important component of recovery relates to understanding the recovery journey, which is specific to each person. Knowing what to expect during recovery can help manage expectations so frustration or despair doesnt set in. Talk with the doctors and therapists to get a clear picture on how much progress you might expect to make over specific time periods.Pay attention to your or your loved ones mental state during this period of recovery. An extreme sad mood lasting longer than two weeks may be a sign of depression, which will need to be addressed.The bottom line is that there are a lot of moving parts during stroke recovery at home. Family caregivers may be overwhelmed and need some assistance with activities of daily living. Respite care for the family caregiver may also be warranted.SYNERGY HomeCare offers highly personalized levels of quality care as early as pre-discharge from the hospital, and our Stroke Recovery program specializes in supporting a recovery plan at homethe best place to be.To learn how SYNERGY HomeCare can support you following a stay in the hospital, click here.Dr. Macie P. Smith is a licensed gerontology social worker who is focused on helping families support their aging loved ones through long-term care. Specifically, Dr. Smith educates caregivers on how to care for seniors with dementia. She is an advocate for specialized care and assists others in finding a way to provide a better quality of life for individuals with Alzheimers or dementia. Dr. Smith has dedicated over 22 years of her life working in gerontology and assisting families in finding personalized solutions for dementia care. For more information, please call 720-204-5788.