I can see numerous different reasons and I am not medically trained.
1. The motor cortex area that controlled the arm was damaged and in the penumbra.
2. The motor cortex area that controlled the arm muscle is dead.
3. The pre-motor cortex was in the penumbra.
4. The pre-motor cortex is dead.
5. The executive control was in the penumbra.
6. The executive control area is dead.
Non-use is really only applicable in cases 1,3,5
http://nnr.sagepub.com/content/27/5/439.abstract?etoc
Abstract
Background. Arm nonuse, defined as the
difference between what the individual can do when constrained to use
the paretic arm and what
the individual does when given a free choice to use
either arm, has not yet been quantified in individuals poststroke. Objectives. (1) To quantify nonuse poststroke and (2) to develop and test a novel, simple, objective, reliable, and valid instrument,
the Bilateral Arm Reaching Test (BART), to quantify arm use and nonuse poststroke. Methods.
First, we quantify nonuse with the Quality of Movement (QOM) subscale
of the Actual Amount of Use Test (AAUT) by subtracting
the AAUT QOM score in the spontaneous use condition
from the AAUT QOM score in a subsequent constrained use condition.
Second,
we quantify arm use and nonuse with BART by
comparing reaching performance to visual targets projected over a 2D
horizontal
hemi–work space in a spontaneous-use condition (in
which participants are free to use either arm at each trial) with
reaching
performance in a constrained-use condition. Results. All participants (N = 24) with chronic stroke and with mild to moderate impairment exhibited nonuse with the AAUT QOM. Nonuse
with BART had excellent test-retest reliability and good external validity. Conclusions.
BART is the first instrument that can be used repeatedly and
practically in the clinic to quantify the effects of neurorehabilitation
on arm use and nonuse and in the laboratory for
advancing theoretical knowledge about the recovery of arm use and the
development
of nonuse and “learned nonuse” after stroke.
No comments:
Post a Comment