Experimental stroke therapy helps Kirk

Good luck and experimental therapy may have helped U.S. Sen. Mark Kirk recover more extensively than he would have with standard care after he suffered a stroke in January.

The 52-year-old is making excellent progress, according to medical experts not involved in his care, who watched a video released this week by the Illinois Republican’s office in which Kirk is seen climbing stairs and walking on a treadmill with a therapist’s help.

Kirk credits lead researcher and physical therapist T. George Hornby at the Rehabilitation Institute of Chicago, whose work may change standard therapy for stroke patients. During Kirk’s nine weeks participating in Hornby’s research, he walked nearly 15 miles and climbed 145 flights of stairs.

“We basically treat them like athletes,” said Hornby, who is testing what happens when stroke patients walk 10 times farther than they would in a standard physical therapy session.

Instead of walking once down an unobstructed hallway, for example, a patient is asked to walk around obstacles, to walk while things are bumping into him and to climb stairs. “We’re really pushing them to the limit on how hard they can work,” the researcher said.

First to enroll in the new Hornby-led study, Kirk was randomized into the experimental arm of the trial, rather than into the control group of patients who got standard therapy for comparison, Hornby said.

That was pure luck, said Hornby, who said he felt no pressure to make sure Kirk got the experimental therapy and he believes Kirk would have stuck with the study if he had been randomly placed in the control group. The final results of the study aren’t yet clear, but Hornby’s preliminary work pointed toward promising improvements with the intensive therapy.

Back at his Highland Park home, Kirk says on the video that he’s in touch with his office several times a day and is helping U.S. Sen. Dick Durbin, an Illinois Democrat, find a replacement for U.S. Attorney Patrick Fitzgerald, who announced his resignation in May.

Outside medical experts said the senator appears to be making excellent headway.

Cleveland Clinic stroke specialist Dr. Shazan Hussain said the video shows the senator has made outstanding progress and “likely will continue to get better and better.” Asked whether Kirk might permanently need a cane to walk, Hussain said: “It’s hard to know that for sure, but it seems likely he’s going to require some kind of walking aid, like a cane.”

Hussain noted the stigma that still exists among the general public about stroke and said he would encourage a patient like Kirk to deal with it by getting back to normal activities and routines, as the senator demonstrates he is doing in the video by meeting with other lawmakers. The doctor also praised Kirk for being an ambassador for stroke patients by putting out the video, which could inspire others.

“This will be helpful to show people they can improve after a stroke because people potentially can get discouraged (during rehabilitation). I really compliment him on that,” Hussain said. He noted that the type of stroke Kirk suffered, caused by a tear in the carotid artery on the right side of his neck, is unlikely to happen again.

Houston stroke expert Dr. Gerard Francisco, the chief medical officer of noted rehab center TIRR Memorial Hermann, watched the video and saw “a pretty remarkable recovery.”

“I’m sure he worked hard toward this and it shows. It’s quite significant,” Francisco said, observing that Kirk seems engaged in his treatment and is getting “cutting edge therapy” at a reputable center. His redintegration into his work life is also a very encouraging sign, Francisco said.

Like Hussain, Francisco said he would expect Kirk to recover even more of his mobility and speech, but added it’s hard to make predictions during a stroke patient’s first year of therapy. Francisco noted a slight stutter in Kirk’s speech, while praising the senator’s clarity and inflection.

“His speech was very clear. On very rare occasions, when he stuttered it was negligible,” Francisco said. “I heard it probably only because I was listening for it.”

Strokes can damage parts of the brain affecting mood, and the stress of relearning simple tasks and adjusting to stroke-caused impairments also can lead to depression. Asked about that possibility, Francisco said depression is much more common when a stroke damages the front left part of the brain. Kirk’s stroke blocked blood flow to the right side of his brain.

Stroke is the fourth-leading cause of death in the United States, and each year, about 795,000 Americans suffer a stroke. Some strokes are caused by bleeding in the brain, but most are caused by blocked blood flow, like Kirk’s stroke.

“I released this video to make sure that people know what my condition is, to be an example to other Illinois families,” Kirk says on the video. “I want to thank the people of Illinois for their patience with this patient to recover from a big stroke.”

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