Stroke Rehabilitation Reaches a Threshold
2008

Stroke Rehabilitation Reaches a Threshold

publication Evidence: moderate

Author Information

Author(s): Han Cheol E., Arbib Michael A., Schweighofer Nicolas

Primary Institution: University of Southern California

Hypothesis

If motor retraining after stroke increases spontaneous arm use sufficiently, then the patient will enter a virtuous circle in which spontaneous arm use and motor performance reinforce each other.

Conclusion

The study suggests that there is a threshold of spontaneous arm use that, when exceeded, allows for continued improvement in motor performance without further therapy.

Supporting Evidence

  • Motor training with the affected arm can reverse the loss of cortical representation after stroke.
  • Repeated attempts to use the affected arm can lead to further improvements in motor performance.
  • The model predicts that if spontaneous arm use is above a certain threshold, training can be stopped.

Takeaway

If stroke patients use their affected arm enough, they can get better at using it, but if they don't use it enough, they might just get worse.

Methodology

A computational model of bilateral hand use in arm reaching was developed to study interactions between adaptive decision making and motor relearning after motor cortex lesion.

Limitations

The model simplifies the coding of reach movements and does not account for how activity of motor cortex neurons correlates with joint torque and muscle activity.

Digital Object Identifier (DOI)

10.1371/journal.pcbi.1000133

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