I'm sure this won't help us for at least 40 years but you could challenge your doctor to describe how this is different from your current stroke protocol.
http://news.psu.edu/story/273127/2013/04/15/research/new-model-how-brain-functions-are-organized-may-revolutionize
A new model of brain lateralization for movement could dramatically
improve the future of rehabilitation for stroke patients, according to
Penn State researcher Robert Sainburg, who proposed and confirmed the model through novel virtual reality and brain lesion experiments.
Since the 1860s, neuroscientists have known that the human brain is
organized into two hemispheres, each of which is responsible for
different functions. Known as neural lateralization, this functional
division has significant implications for the control of movement and is
familiar in the phenomenon of handedness.
Understanding the connections between neural lateralization and motor
control is crucial to many applications, including the rehabilitation
of stroke patients. While most people intuitively understand handedness,
the neural foundations underlying motor asymmetry have until recently
remained elusive, according to Sainburg, professor of kinesiology and
neurology and participant in the neuroscience and physiology graduate
programs at the University's Huck Institutes of the Life Sciences.
Research by Sainburg and his colleagues in the Center for Motor Control
and published in the journal Brain has revealed a new model of motor
lateralization that accounts for the neural foundations of handedness.
The discovery could fundamentally change the way post-stroke
rehabilitation is designed.
"Each hemisphere of the brain is specialized for different aspects of
motor control, and thus each arm is 'dominant' for different features
of movement," said Sainburg. "The dominant arm is used for applying
specific force sequences -- such as when slicing a loaf of bread with a
knife -- and the other arm is used for impeding forces to maintain
stable posture, such as holding the loaf of bread. Together these
specialized control mechanisms are seamlessly integrated into every day
activities.
"Our research has shown that this integration breaks down in neural
disorders such as stroke, which produces different motor deficits
depending on whether the right or left hemisphere has been damaged,"
Sainburg continued. "Traditionally, physical rehabilitation
professionals have used the same protocols to practice movements of the
paretic arm, regardless of the hemisphere that has been damaged. Our
research shows that each arm should be treated for different control
deficits, and it also indicates that therapists should directly retrain
patients in how to use the two arms together in order to recover
function."
In preparing to test their model, Sainburg and his team selected
study participants from the New Mexico Veterans Administration Hospital
and Penn State Milton S. Hershey Medical Center based on specific
criteria in order to accurately distinguish the motor control mechanisms
specific to each brain hemisphere. Participants were then asked to
perform a series of tasks on a virtual reality interface, programmed and
designed by Sainburg, which allowed the researchers to record detailed
3D position and motion data. The data for all the participants' hand
trajectories and final positions were then aggregated to compare the
effects of left versus right hemisphere damage on different aspects of
control.
"Our results indicated that while both groups of patients showed
similar clinical impairment in the contralesional arm, this was produced
by different motor control deficits," Sainburg said. "Right hemisphere
damaged patients were able to make straight movements that were directed
toward the targets, but were unable to stabilize their arms in the
targets at the end of motion. In contrast, left hemisphere damaged
patients were unable to make straight and efficient movements, but had
no difficulty stabilizing their arms at the end of motion. These results
confirmed that each hemisphere contributes unique control to its
contralesional arm, verifying why our arms seem different when we use
them for the same tasks."
Results mirror those of Sainburg's prior studies of motor deficits in
unilateral stroke patients, focused on the ipsilesional arm, which
formed the basis for his model of lateralization.
"Because both arms in stroke patients show motor deficits that are
specific to the hemisphere that was damaged, we have concluded that the
left arm is not simply controlled with the right hemisphere and vice
versa," Sainburg said. "This is a revolutionarily new perspective on
sensorimotor control: each hemisphere contributes different control
mechanisms to the coordination of both arms, regardless of which arm is
considered dominant."
Sainburg and his colleagues are currently designing follow-up studies
that will aid the development of new rehabilitation protocols
addressing the specific motor deficits associated with each hemisphere.
This work was supported by grants from the National Institutes of
Health, National Institute for Child Health and Human Development,
Department of Veterans Affairs Research and Development Medical Merit
Review, and Rehabilitation Research and Development.
Read the unabridged article by Seth Palmer on the website of the Huck Institutes of the Life Sciences.
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