I
bet arm recovery would be substantially better from forced use of it
with a lever powered or Rowing wheelchair. But I bet not a single
therapist/doctor has thought of that.
Summary
After stroke, individuals often have persistent difficulty using the arm and hand in
everyday functional tasks that reduces quality of life. Currently available rehabilitation
techniques are not adequate and new protocols are needed that are based on an understanding
of how brain regions work together to produce skilled movement. This research project aims
to improve our understanding of how the brain controls movement after stroke and determine
whether a period of motor practice that targets specific brain regions through the addition
of action selection demands leads to improved arm function. We hypothesize that arm motor
function and the ability to efficiently activate the action selection motor circuit during
movement will improve after training.
Description
Rehabilitation of arm impairment after stroke includes the repetitive practice of functional
tasks. In healthy adults, planning plays a vital role in the control of skilled movement,
however, the behavioral and neural correlates of planning have largely been unexplored in
individuals recovering from stroke. Action selection is an important motor planning process
that engages dorsal premotor cortex (PMd) in controls. While PMd activation is a commonly
reported neural correlate of motor recovery after stroke, the role of PMd in action
selection and motor training are not known. Therefore, the purpose of this study is to
determine the effect of training that includes action selection demands on the behavioral
and neural correlates of movement after stroke. Thirty-eight individuals in the chronic
phase of stroke will be recruited. After completion of clinical measures of impairment and
function, all participants with stroke will complete a motor action selection task and
functional MRI followed by arm training. Arm training will consist of three weeks (15
sessions) of arm motor training (1.5 hours per session) that includes action selection
demands on movement. Follow-up clinical testing will occur at the end of treatment and three
weeks later.
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