New Technology Helps Stroke Survivors Regain Function

RICHMOND, Va. (May 27, 2025) — After not having arm or hand function for years, new technology paired with occupational therapy is giving stroke survivors like 76-year-old Debby Robertson a second chance at upper-extremity mobility. In April 2023, Robertson was taking care of her husband when she experienced a stroke, leaving her unable to walk or use the right side of her body. “My right hand was stuck in a fetal position like it was curled in on itself,” Robertson said.

However, Vivistim, a FDA-approved vagal nerve stimulation device, can enhance recovery among individuals who have experienced a stroke when combined with rehabilitative therapy. Implanted by a neurosurgeon in an outpatient procedure, Vivistim is placed underneath the skin in the chest—similar to a pacemaker—with coils that extend to the neck and wrap around the vagus nerve.

While vagal nerve stimulation has been used for decades to treat epilepsy, Vivistim is the first device being utilized to address upper-extremity deficits caused by stroke. Michaela Torraca, OTD, OTR/L, occupational therapist and clinical leader for Stroke and Brain Injury at Sheltering Arms Institute’s Hanover outpatient center, has been overseeing Robertson’s Vivistim treatment for several months. “I’m really excited that we’re able to offer this service and technology because we have so many stroke survivors who reach a point where they are functionally plateauing and are seeking out some other method to jumpstart those connections in their brain,” Torraca said. “It’s, in my opinion, one of the next steps in stroke recovery and rehabilitation to strengthen brain connections and ultimately improve arm and hand function.”

Ideal candidates for Vivistim are individuals who experienced their stroke at least six months ago and have some ability to grasp and release objects with movement in at least two fingers. Because the therapy involves intense physical activity, candidates must be able to functionally use their hand to some degree.

Once Robertson had the device implanted in January 2025, she began a six-week intensive therapy protocol at Sheltering Arms Institute. During each session, Torraca uses a remote control to trigger vagus nerve stimulation as Robertson completes functional tasks during therapy. Robertson also has a magnet at home she can swipe over the implant to activate the device while she completes her home exercises or additional functional tasks.

The outcomes, collected every 10 visits with Vivistim-specific assessments, have shown improvement in fine motor control and functional abilities of the arm affected by the stroke. “I have seen fairly significant progress in upper-extremity functional use in day-to-day tasks, whether that’s cooking, laundry, bathing, or driving,” Torraca added.

Robertson is thrilled with the improvements she’s experienced with this technology saying, “I made soup last weekend and I didn’t have to ask for any help, even though opening cans and packages are usually really hard for me. I’m just happy to represent something that shows promise for individuals with strokes.”

Currently, Sheltering Arms Institute offers occupational therapy in conjunction with the Vivistim implant at its Hanover outpatient center to help patients regain the most function in their upper extremities.

If you or someone you know may be interested in the Vivistim implant, ask your physician if you are eligible. The Vivistim website also has helpful information to see if you are a good candidate.

 

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About Sheltering Arms Institute

Sheltering Arms Institute is a non-profit and donor-supported state-of-the-science physical rehabilitation hospital and network of outpatient centers that brings together the brand and clinical reputation of Sheltering Arms and the nationally ranked programs and research of VCU Health through a joint venture. Ranked #1 in Virginia and #19 in the nation by U.S. News & World Report, the Institute blends advanced technology, research, and evidence-based clinical treatment to create an innovative, transdisciplinary model of rehabilitative care that facilitates superior outcomes for patients. For more information, please visit ShelteringArmsInstitute.com.