Bringing back movement

I had not heard of the alternate use theory before this, wonder if she tested for damaged brain areas or dead brain areas? My pet peeve that researchers don't have a repeatable starting point for their therapies.
http://www.thehindu.com/life-and-style/metroplus/article2548684.ece

She teaches the brain to make new connections; connections which could help stroke victims regain the ability to move a finger, hand, leg or arm. Preeti Raghavan, MD, and the ‘brain' behind the Motor Recovery Research Laboratory at the Rusk Institute of Rehabilitation Medicine, the premier rehabilitation hospital in New York State, believes in the awesome potential of the human body.

For many years now, Dr. Raghavan has been reverse engineering the neural pathway of movements. “Even if a part of the brain has been affected by stroke, the person can still relearn the movement — through an alternate pathway in the brain,” she says. Dr. Raghavan studied medicine at the Annamalai University and later at New York before going on to make path-breaking findings.

It all began when she started studying how people perform movements. Think of this; we never consciously calculate the amount of pressure or the extent of the turn we need to give our fingers to hold a spoon, open a tap or shake hands. “But actually, even a simple movement requires complex planning, which we learn and store in our memories for reuse,” Dr. Raghavan explains.

Using alternate connections

Four years ago, Dr. Raghavan was studying movement in stroke patients by using a simple grip device with sensors that measured forces produced by fingers when a movement is executed. “These people couldn't work out the force required to grasp and lift the object. Their old memories had been erased by the stroke, and new memories were not allowed to be formed, because of the damage to the neurological tissue,” she recounts. It was then that Dr. Raghavan made the amazing discovery that, if the same people lift the object with the intact hand and then repeat the movement with the affected hand, the affected hand is able to learn to perform the movement! “The idea is to use alternate connections. Amazingly, our brains have developed many redundant neural pathways for the same function. We utilise those preserved parts of the brain to revoke the lost function,” Dr. Raghavan adds.

For instance, one of Dr. Raghavan's patients was a young musician who had had a successful bone marrow treatment for cancer, and later had a stroke. He recovered from it enough to run marathons, but still couldn't manage movements such as holding a toothbrush, or tying shoe laces. Now, with Dr. Raghavan's strategies, this young man is ‘learning' to do it!

“Advances in research such as in Dr. Raghavan's lab are increasing the understanding of cerebral physiology and function needed to build the necessary framework for better treatments specific to individuals with unique injuries. The work in Dr. Raghavan's lab is a great example of translating basic sciences into clinical practice — and is creating excitement in neuroscience advances,” says Steven Flanagan, MD, clinical professor and chairman, Department of Rehabilitation Medicine and medical director, Rusk Institute at NYU Langone Medical Center.

Music and movement

Dr. Raghavan also zeroed in on musicians as subjects of study, because, musicians happen to be among the most dexterous users of their limbs. This is how she discovered that professional pianists who activate their upper back muscles while playing the piano tend not to suffer from overuse strain or injuries, compared to those who use just their fingers and arms. “It is a popular misconception that muscles are just tissues for execution of action. But muscles are also important for our kinesthetic sense. That is how expert musicians know how to apply just enough force,” she remarks. She uses such insights to help stroke victims and others in regaining optimum use of their limbs. Dr. Raghavan is also studying how listening to music and patterning rehabilitation exercises alongside musical rhythms may enhance the speed of recovery tremendously. “Rhythm assists movement because, we move in space and time”, she says.

Working with her team of doctors, engineers, statisticians, physical and occupational therapists, Dr. Raghavan is helping stroke victims and others get movement back into their lives. Finally, some advice for all of us: “We are moving all day long. The hierarchy of movement has to be efficient; otherwise it can lead to trouble.”