Nov 23, 2015 — Fifty years ago, if you could get up and move from a chair on one side of the room to another after a stroke, that was considered a successful stroke recovery. Today, expectations are much higher. Doctors from the Physical Medicine and Rehabilitation Department at University of Utah Health Care are celebrating their 50th anniversary by looking at how much has changed since the department first formed in 1965. In this episode, Dr. Steven Edgley reflects on stroke recovery and rehabilitation then and now, and what the next 50 years might hold.

Interview

Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: Dr. Steven Edgley specializes in stroke rehabilitation. And as we look back at the 50th anniversary of the Physical Medicine and Rehabilitation Department at the University of Utah, let's look at 1965. What was the landscape when it came to stroke rehabilitation? Because I would imagine it was very different that it is today.

Dr. Edgley: I think the main difference from 50 years ago was now we have different expectations for stroke patients. And we know that many stroke patients will recover a great amount of function if they're given the right guidance and therapy.

Interviewer: So back in 1965, if somebody had a stroke, what was their life like? Was it considered by most, even that victim, to be over? "I'm not going to be able to do anything anymore"? Or what did it look like?

Dr. Edgley: At the end of the second world war, the expectations, the reasonable expectation for a stroke patient was to get themselves from the bed to the chair by themselves.

Interviewer: Nothing more?

Dr. Edgley: Nothing more.

Interviewer: What was cutting edge rehabilitation in 1965?

Dr. Edgley: They were just getting started on the concept of eliminating barriers to recovery. And barriers could mean pain, depression, sometimes it's tight muscles spasticity. So in 1965, they were just getting beginning to do a technique of injection for spastic muscles using phenol, which deadens the nerve to the muscle for a short period of time allowing the patients to achieve a better range of motion. We still use phenol today. We have several other techniques today, including some other medications that are superior to phenol in some situations.

Interviewer: So today, the outcomes, or the expectation of outcomes are completely different. I think your story is a testament to what somebody can accomplish after a stroke. You're still practicing medicine, you're helping other stoke survivors recover. Would that have been even conceivable 50 years ago?

Dr. Edgley: It would be very difficult. And so the expectations for someone to return to a professional occupation was just not there. And the resources and guidance was just not there. Today we have a robust group of stroke survivors and a dedicated stroke rehab team to accomplish great things.

Interviewer: Describe what that team looks like today. Because somebody practicing in 1965, 50 years ago, would probably be a little flabbergasted at all the people that are available now.

Dr. Edgley: Well, many of the elements were available back then. But the therapy and the care and rehab minutes spent on the outpatient side long-term is one of the elements is unique now from 50 years ago because we keep working with these patient for as long as they need it.

Interviewer: What's on the horizon? What are we going to be talking about 50 years from today?

Dr. Edgley: Well, hopefully, we will be talking about more proven medications or enhanced recovery and possibly stem cell therapy for stroke recovery.

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