Fine motor skills are often taken for granted. For most people, it takes little or no thought to write a note, fold laundry, or turn a doorknob. But for Matt G. — who is re-learning these skills at age 55 after a stroke left him with limitations in his right arm and hand — it’s extremely hard work.
Surviving a Life-Threatening Ski Accident
Matt was no stranger to the challenging terrain at Jackson Hole Ski Resort in Wyoming. He was a dedicated athlete and had skied these trails before. But on this particular day in January 2021 while he and his son were navigating the mountain, Matt caught an edge of his ski on an exposed tree root that triggered a perilous fall.
“This was our last run of the day because there wasn’t much fresh snow,” says Matt. “When I fell, I thought I would pop right back up. But I didn't. The next thing I know, I was sliding down the mountain faster and faster with no control.”
Critical Caregivers Act Fast
Matt careened toward rocks at high speed and hit with tremendous force. Ski patrollers saw his fall and harnessed a sled to take him to the clinic at the mountain’s base, where he was transported to a nearby hospital. He had broken ribs, a punctured lung, a bruised heart, and a dissected carotid artery, which triggered a stroke.
In need of urgent lifesaving care, Matt was transported by helicopter to a trauma center in Salt Lake City, Utah, where surgeons placed a stent in his artery to restore blood flow to Matt’s brain thus saving his life.
The Long Journey to Restore Function
“When I woke up in the intensive care unit after surgery, I was thankful to be alive but my whole right side was paralyzed. I couldn’t eat, breathe, talk, or swallow on my own, and I was connected to feeding and breathing tubes,” says Matt. “Eventually I regained the use of my whole body, with the exception of my right arm and hand.”
After four weeks of intensive inpatient therapy, Matt had improved enough to return home to New Jersey to continue his rehabilitation. For the next two years, he pushed his body to its physical and mental limits. He also incorporated holistic services at the Chambers Center for Well-Being. In time, Matt’s balance returned, his speech and cognition improved, and his sensory perception normalized. But, despite all these advancements, his arm function plateaued.
Breakthrough Technology for Ischemic Stroke Survivors
A family friend who works at the Foundation for Morristown Medical Center told Matt’s wife Ellen about a new procedure called Vivistim® Paired VNS, a treatment for stroke survivors with long-term arm and hand impairments.
Ellen immediately reached out to Ronald Benitez, MD, a neurosurgeon and stroke specialist at Atlantic Health System who specializes in the Vivistim System. After multiple discussions and a thorough evaluation, Matt qualified as a candidate. The team worked arduously to obtain insurance approvals and scheduled his surgery for the implantable device.
Exponential Improvements Keep Coming
Dr. Benitez implanted the device into Matt’s chest and connected it to his vagus nerve. Two weeks later, Matt began intensive therapy with Atlantic Health System occupational therapist Michelle Darling, specially trained in paired vagus nerve stimulation (VNS) rehabilitation. Matt committed to three 90-minute sessions each week for six weeks.
“He is working really hard to hone his motor skills and work towards new goals,” says Michelle. “We’re using Vivistim to rewire the neural pathways from Matt’s brain to his arm, hand and fingers. When we trigger the nerve, we exponentially enhance neuroplasticity. Each time we meet, we notice subtle functionality changes, which are the building blocks to improve his finger dexterity.”
Progress Can Be Found in the Numbers
Over the course of 18 therapy sessions, Michelle triggered the device at the peak point of action while Matt complete hundreds of repetitions for various exercises and functional tasks.
He also uses the device at home, up to eight times a day for 30-minute sessions at the gym, eating meals or doing housework. Matt’s tireless effort has improved his fine motor speed from one minute and 36 seconds to 34 seconds. It has also improved his score on an upper extremity assessment tool by 38%.
“It's really exciting that occupational therapy has such an impactful tool that allows people who have plateaued to continue to improve and engage in meaningful everyday activities,” says Michelle.
Matt agrees, acknowledging that frustration and exhaustion have also been part of his progress and that his family and friends were his motivation to forge on — even at his lowest points. “Vivistim is really working for me,” he says. “I love my sessions with Michelle because we drive improvements.”
“My speech is better, my energy is better, and I'm stronger across the board. I can eat using my right hand for the first time in two and a half years. I’ve really come to appreciate how valuable therapy is in recovery, and I have no inclination to stop.”
Breakthrough Treatment and Multidisciplinary Care for Stroke Survivors
Ronald Benitez, MD, is an Atlantic Health System neurosurgeon, stroke specialist, and medical director of endovascular neurosurgery at Atlantic Health System. He is the first neurosurgeon in New Jersey to use The Vivistim® System as a promising new FDA-approved breakthrough technology to improve upper extremity motor function in ischemic stroke survivors.
Atlantic Health System has provided this life-changing treatment to more than 20 stroke survivors. Each patient’s journey begins with a surgical procedure to implant the device, a two-week recovery, and a commitment to six weeks of intensive in-office and at-home therapy.
To be considered for the Vivistim System, the following criteria must apply:
- be a survivor of an ischemic stroke
- be in the chronic stages of recovery (six months post stroke or longer)
- have a level of upper extremity function (based on an assessment)
- commit to six weeks of intensive therapy, three times a week for 90-minute sessions
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