Phil Herbert was working on his computer at home in November 2021 when his right arm suddenly stopped responding.
‘I was trying to close a window on the computer but couldn’t get my right arm to work the mouse,’ recalls Phil, 56, an architect from Loughborough.
Worried, and with his speech also becoming slurred, Phil called 999 but was told it would be four hours before an ambulance could attend.
So he called his son, who in turn contacted Phil’s ex-wife, who rushed him to hospital. Tests confirmed he’d had a stroke.
‘I was paralysed down my right side and lost most of my ability to speak,’ says Phil.
After months of rehabilitation, Phil recovered much of his speech and could walk with a stick but still couldn’t move his right arm.
More than three years on, he now has hopes of regaining strength in it thanks to a new gadget – which clips on to his ear – that is currently being trialled to restore movement and mobility in patients’ arms after a stroke.
The £2.5 million trial, being spearheaded by Sheffield Teaching Hospitals NHS Foundation Trust, involves stimulating a nerve in the ear with mild electrical pulses generated by a device that can be placed in a pocket.
Phil Herbert’s right arm suddenly stopped working and his speech became slurred in November 2021
Phil’s experienced debilitating weakness in his arm since the stroke, which had no obvious cause
After regaining his speech, he now has hopes of regaining strength in it thanks to this new gadget
Leads from the device connect to a tiny earpiece that sends a gentle current to the nerve in the ear.
Results from previous studies suggest stimulating the nerve at the same time as the patient tries to move the affected arm can restore electrical signals and, in turn, reduce arm weakness.
It’s thought the device improves the transmission of nerve signals from the brain to the arm, telling it when and how to move.
For the trial, patients use the ‘ear tickler’ for one hour a day, five days a week, for 12 weeks, and the arm needs to be moving while the nerve is being stimulated. The study, which started in November 2023, involves around 240 patients.
The doctors leading the clinical trial describe it as ‘very exciting’, predicting it could change the lives of thousands of patients who have had strokes.
More than 100,000 people each year in the UK have a stroke and about a third are left with permanent arm weakness.
Almost 80 per cent of strokes are ischaemic, which means a blood clot blocks blood supply to the brain, causing damage. The remainder are haemorrhagic strokes, where a weakened blood vessel ruptures and bleeds into the brain. The new device is for ischaemic strokes.
Arshad Majid, a professor of neurology at Sheffield University, who is leading the trial, said: ‘Arm weakness after a stroke impacts on all aspects of living and it’s a significant problem for those who survive a stroke.’
The £2.5million trial involves nerve in the ear with mild electrical pulses generated by a device that can be placed in a pocket
Current treatment involves intensive physiotherapy, but it has limited effect. The idea behind the new trial is that the electrical impulses stimulate a branch of the vagus nerve – the largest nerve in the body, which runs from the brain to the abdomen and is involved in controlling a range of functions, from swallowing to heart rate and digestion.
Vagus nerve stimulation is already used to treat epileptic seizures, usually through a stimulator that is placed just beneath the collar bone and wired up to the brain.Its success in reducing seizures prompted doctors to investigate whether the same therapy could help restore movement and strength after a stroke.
The decision to set up the new UK trial followed a study that showed vagus nerve stimulation worked well using an implanted pulse generator – the device, given to 120 patients from the US, Canada and the UK, was activated by waving a wand over the chest.
Doctors are now looking to see if they can get the same result without having to surgically place any equipment. Professor Majid said with the ear zapper, a patient feels only a slight tingling sensation.
‘The main advantage is that unlike the earlier trial, it’s anon-invasive treatment,’ he said.
‘The patient doesn’t need to come into hospital and can do the therapy in their own home. They are given exercises to do and we check in on them every two weeks by video call.’
Chris Price, a professor of stroke research at Newcastle University, who is not involved in the current trial, says: ‘The clever thing with this study is that it’s stimulating a branch of the vagus nerve that goes to the ear.
‘If it shows good results, then it’s an interesting and exciting development for stroke rehabilitation.
‘It isn’t about making a paralysed arm come back to life; it is people who have had some recovery improving even more. Using a small piece of technology that is easy to wear and helps patients show improvement is something that we don’t currently have.’
The idea behind the new trial is that the electrical impulses stimulate a branch of the vagus nerve – the largest nerve in the body (file photo)
Phil spotted details of the ear-stimulator trial on social media and contacted the researchers.
He’s experienced debilitating weakness in his arm since the stroke, which had no obvious cause.
Initially his daughter Isobel, now 22, looked after him.
‘After six months I could walk without a stick, and with a pronounced limp, and my speech had improved significantly,’ he says. ‘I could get myself dressed and into the shower but I couldn’t use my right arm much.’
He started the 12-week trial back in January 2024 and is now back at work full-time.
In the past six months he has also started playing badminton and he can now lift his right arm above his head.
‘I’ve got more movement so I can open and close kitchen cupboards,’ he says.‘I still can’t use my fingers, so I can’t hold a pen or type with my right hand, but I’m hoping to be able to use my fingers more – that’s my goal.’
