Three-time Stroke Survivor Regains Substantial Arm and Hand Function Through Paired Vagus Nerve Stimulation

The University of Maryland Medical System (UMMS) is the first in Maryland to offer rehabilitation for stroke recovery through paired vagus nerve stimulation, an emerging approach that can improve arm and hand function for many people after an ischemic stroke. Pairing an implanted device, called Vivistim, with intensive physical and occupational rehabilitation exercises, this is a new option for stroke survivors months or even years after their stroke occurred.

After three strokes beginning in 2022 left her with little use of her right arm and hand, Baltimore City resident Linda Tanner chose the University of Maryland Rehabilitation & Orthopaedic Institute (UM Rehab & Ortho) for specialized rehabilitation following implant of the Vivistim device at a Delaware hospital. As a vital part of UMMS, the specialty care hospital plays an essential role in the recovery journey for patients across the Mid-Atlantic states. Now it is the first in Maryland with therapists specially trained in paired vagus nerve stimulation for stroke recovery to help patients regain function, independence and quality of life.

"For many patients who have been told they've recovered as much as they ever will, this treatment offers something incredibly important: the possibility of regaining arm and hand function," said Robynne Braun, MD, PhD, Director of Inpatient Rehabilitation Medicine Services at the University of Maryland Medical Center (UMMC), the UMMS flagship academic medical center in downtown Baltimore, and Associate Professor of Neurology at the University of Maryland School of Medicine (UMSOM). She is also Co-Director of the Inpatient Stroke Rehabilitation Unit at UM Rehab & Ortho.

Tanner's first stroke in December 2022 left her unable to move her right hand and wrist and weakened most of the right side of her body. After months of physical, occupational and speech therapy, she regained enough function to return to work before suffering a second stroke in November 2023. Just months later, she experienced a third stroke.

"Each time I felt like I was making progress with my recovery, another stroke would set me back and I'd have to start over," Tanner said.

Tanner refused to accept that she had reached the end of her recovery journey. After nearly two years of evaluations, insurance hurdles and sheer persistence, she had the Vivistim device implanted and began the intensive rehabilitation program at UM Rehab & Ortho.

How the therapy works

Paired vagus nerve stimulation includes a small device, typically implanted in the chest area, to stimulate the vagus nerve. During physical therapy sessions, stimulation is paired with targeted exercises to strengthen the brain's response to rehabilitation. Originally approved to treat drug-resistant epilepsy and later treatment-resistant depression, the therapy was approved by the U.S. Food and Drug Administration in 2021 to improve arm and hand function in people with moderate-to-severe arm and hand weakness from an ischemic stroke.

Prior to therapy, Tanner was unable to meaningfully lift her right arm and had little functional use of her right hand.

She has since regained substantial strength in both. Tanner can now hold her arm at a 90-degree angle, use her right hand to open doors and fold clothes and do reps with a kettlebell. Her current goal is regaining finger movement, as recovery often progresses from the shoulder and arm downward toward the wrist and hand.

"I can move my arm and my hand. None of that I could do before," she said.

She continues therapy several times each week and remains focused on goals many people take for granted, such as writing and picking up her grandchildren with both hands. As the first patient in Maryland to receive paired vagus nerve stimulation, Tanner hopes her experience encourages other stroke survivors to continue pursuing recovery opportunities.

"Don't give up. Keep fighting for what you're entitled to. There are options," she said.

UMMS plans to offer the implant procedure this year, allowing patients to receive evaluation, implantation and rehabilitation close to home.

"Linda had to travel out of state for her implant," said Dr. Braun. "Our goal is to make the entire treatment pathway available here in Maryland."

A new timeline for stroke recovery

Recovery is usually fastest in the first few months after a stroke, but that's not necessarily where it ends. With targeted therapies, many patients continue to improve months or years later. Paired vagus nerve stimulation, for example, may boost the response to rehabilitation by strengthening remaining neural connections, bringing underused pathways into play and increasing the brain's chemical messengers.

"The brain is remarkably adaptable, even years after a stroke," said Dr. Braun. She notes that in a pivotal 2021 clinical trial, patients who received paired vagus nerve stimulation were about twice as likely to make meaningful gains in arm and hand function.

Today, more stroke patients survive and recover with less disability than ever before, thanks to advances in emergency stroke care, coordinated treatment systems and rehabilitation.

"The biggest breakthroughs in stroke care have come from getting the right patient to the right treatment as quickly as possible and then providing coordinated follow-up care throughout recovery," said Seemant Chaturvedi, MD, neurologist at UMMC and Medical Director of the UMMS Clinical Stroke Network.

He added, "We've seen dramatic improvements in survival and outcomes because stroke care is no longer confined to a single hospital stay. It begins with rapid recognition in the field, continues through advanced interventions such as thrombectomy and specialized inpatient care, and extends into rehabilitation and long-term recovery. Every step matters."

Maryland's largest stroke care network

The UMMS Clinical Stroke Network treated more than 3,300 stroke patients and performed more than 200 thrombectomies in FY26, the highest volume in Maryland. In partnership with the Maryland Institute for Emergency Medical Services Systems and EMS agencies statewide, UMMS helps ensure rapid stroke identification and transport to the most appropriate level of care. UMMC serves as the Comprehensive Stroke Center for the UMMS Clinical Stroke Network, which includes Primary Stroke Centers at UMMS hospitals in Glen Burnie, Largo, La Plata, Easton, Towson and Bel Air. It also includes specialized programs such as the University of Maryland Young Stroke Center and UM Rehab & Ortho.

Stroke care is part of UMMS' nationally recognized neuroscience program, a referral destination for advanced neurological therapies including deep brain stimulation, focused ultrasound, epilepsy care and innovative stroke recovery interventions. Through partnerships with UMSOM and the University of Maryland Medicine Institute for Neuroscience Discovery (UM-MIND), clinicians and researchers continue to advance new approaches to restoring neurological functions previously deemed unrecoverable.

Images, b-roll and interview of Linda Tanner are available for media download here.

About the University of Maryland Medical System

The University of Maryland Medical System (UMMS) is an academic private health system, focused on delivering compassionate, high-quality care and putting discovery and innovation into practice at the bedside. Partnering with the University of Maryland School of Medicine and University of Maryland, Baltimore who educate the state's future health care professionals, UMMS is an integrated network of care, delivering 25 percent of all hospital care in urban, suburban and rural communities across the state of Maryland. UMMS puts academic medicine within reach through primary and specialty care delivered at 11 hospitals, including the flagship University of Maryland Medical Center, the System's anchor institution in downtown Baltimore, as well as through a network of University of Maryland Urgent Care centers and more than 150 other locations in 13 counties. For more information, visit umms.org.

About the University of Maryland Rehabilitation & Orthopaedic Institute (UM Rehab & Ortho)

UM Rehab & Ortho's team of physicians, nurses, therapists, and healthcare professionals specialize in comprehensive rehabilitation for neurological, orthopedic, musculoskeletal, cardiac, and other complex conditions and injuries. Working in collaboration with UMMS hospitals, referring physicians, case managers, and care teams, UM Rehab & Ortho helps bridge the transition from acute hospital care to specialized rehabilitation and recovery. Through this integrated approach, UM Rehab & Ortho extends the System's commitment to high-quality, patient-centered care that helps individuals overcome challenges, restore function, and achieve their fullest potential. For more information, visit https://www.umms.org/rehab.