Damn it all, it is NOT learned nonuse. It
is the actual inability to use it because of dead neurons. If you had
dead brain rehab protocols, this fake learned nonuse idea would cease to
exist! What multiverse do we need to send you back to where this does ONE DAMN THING towards stroke recovery?
Quit blaming the patients for not recovering and blame the doctor and therapists for knowing nothing on how to get survivors recovered!
Do you blithering idiots ever actually think about why stroke patients don't recover?
learned nonuse (11 posts to May 2018)
nonuse (14 posts to May 2013)
Quantifying Nonuse in Chronic Stroke Patients: A Study Into Paretic, Nonparetic, and Bimanual Upper-Limb Use in Daily Life
Marian E. Michielsen, MSc†, Ruud W. Selles, PhD, Henk J. Stam, MD, PhD Gerard M. Ribbers, MD, PhD,
Johannes B. Bussmann, PhD
ABSTRACT. Michielsen ME, Selles RW, Stam HJ, Ribbers
GM, Bussmann JB.
Arch Phys Med Rehabil 2012;xx:xxx.
Objective:
To quantify uni- and bimanual upper-limb use in
patients with chronic stroke in daily life compared with healthy
controls.
Design:
Cross-sectional observational study.
Setting: Outpatient rehabilitation center.
Participants: Patients with chronic stroke (n=38) and healthy
controls (n=18).
Intervention:
Not applicable. (This is precisely why learned nonuse research should never be done! It does nothing to get survivors recovered! I'd have you all fired!)
Main Outcome Measures:
Upper-limb use in daily life was
measured with an accelerometry based upper-limb activity
monitor, an accelerometer based measurement device. Uni-
manual use of the paretic and the nonparetic side and bimanual
upper-limb use were measured for a period of 24 hours. Outcomes were expressed in terms of both duration and intensity.
Results:
Patients used their unaffected limb much more than
their affected limb (5.3h vs 2.4h), while controls used both
limbs a more equal amount of time (5.4h vs 5.1h). Patients used
their paretic side less than controls used their nondominant side
and their nonparetic side more than controls their dominant
side. The intensity with which patients used their paretic side
was lower than that with which controls used their nondominant side, while that of the nonparetic side was higher than that
of the dominant side of controls. Finally, patients used their
paretic side almost exclusively in bimanual activities. During
bimanual activities, the intensity with which they used their
affected side was much lower than that of the nonaffected side.
Conclusion:
Our data show considerable nonuse of the paretic side, both in duration and in intensity, and both during
unimanual and bimanual activities in patients with chronic
stroke. Patients do compensate for this with increased use of
the nonparetic side.(As they should since you incompetently
don't know about the research that shows using the good side helps
recover the bad side!
Exercising the good side to recover the 'bad' side. December 2012)
Key Words: Ambulatory monitoring; Motor activity; Rehabilitation; Stroke; Upper extremity. © 2012 by the American Congress of Rehabilitation MedicineFIFTY TO 70% OF PATIENTS with stroke suffer from
long-term motor deficits of the upper limb,
1
with a decreased use of the paretic upper extremity in daily life.
2
Be-
cause this latter may have a great impact on the manner in
which a patient is able to participate in daily life activities,
maximizing purposeful use of the upper extremity in daily life
is a key factor in motor rehabilitation following stroke.
While it is clear that a decreased motor capacity of the
paretic arm influences the use of both extremities, the exact
changes in upper-limb use following stroke are not yet fully
understood. Regarding the paretic upper extremity, many studies have shown that there is no 1-on-1 relation between motor
impairment and functional use.
3,4
This may be related to the
phenomenon of learned nonuse,
5
which describes how patients
will have “learned” not to use the paretic side to its full
capacity.
6
Brain injury causes structural damage to motor path-
ways as well as depression of neural excitability near the
lesion. Decreasing activity of the upper extremity leads to a
further reduction in excitability and as such starts a vicious
circle of decreasing excitability and decreasing activity.
7
Even less is known about the consequences of stroke on the
nonparetic side. Motor performance of the nonparetic side may
be impaired compared with that in healthy subjects, showing,
for instance, decreased speed and consistency of performance.
8
In addition, it has been shown that patients with acute stroke
have a more reduced use of the nonparetic side in daily life than
do healthy subjects.
9
On the other hand, it is generally assumed
that post stroke the nonparetic side will be used more to compensate for the decreased use of the paretic side. However, to
our knowledge, this has not been investigated in patients with
chronic stroke.
Overall many questions on techniques to optimize the function of the paretic extremity after stroke still need to be answered. The optimal rehabilitation technique is still not defined, and different approaches in reducing upper-extremity
paresis are distinguished.
7
Several therapies have been developed to improve the use of the nonparetic arm in daily life. For
example, constraint-induced movement therapy (CIMT),
10,11
or forced use,
12
reported as a beneficial treatment option for
motor recovery of the arm,
13
prevents the use of the nonparetic
upper limb and aims to counterbalance the learned nonuse.
CIMT is an augmentative technique,
7
a high-intensity, uni-
manual training aiming to counterbalance the vicious circle of
decreasing excitability and decreasing activity. Furthermore,
CIMT has aspects of task specific exercising. Bilateral training
programs have also been developed, for example, with rhythmic
More at link.
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