Mirror Symmetric Bimanual Movement Priming Can Increase Corticomotor Excitability and Enhance Motor Learning

'Can increase' IS NOT GOOD ENOUGH.  Do the fucking research that tells us yes/no whether it works or not. This laziness needs to stop. And in 8 years there was no followup to come up with a protocol or declare it worthless.  And measuring excitability or priming or motor evoked potentials does nothing for survivors, you measure functional movements which survivors actually care about. Think for once what survivors want.

Mirror Symmetric Bimanual Movement Priming Can Increase Corticomotor Excitability and Enhance Motor Learning

2012, PLoS ONE


Mirror Symmetric Bimanual Movement Priming Can Increase Corticomotor Excitability and Enhance MotorLearning
Winston D. Byblow 1,4*,

 Cathy M. Stinear3,4, 

Marie-Claire Smith 1,3, 

Lotte Bjerre 2, 

Brian K. Flaskager 2,

Alana B. McCambridge 1
1 Movement Neuroscience Laboratory, Department of Sport & Exercise Science, The University of Auckland, Auckland, New Zealand,
 2 Center for Sensory-MotorInteraction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark,
 3 Neurology Research Group, Department of Medicine, TheUniversity of Auckland, Auckland, New Zealand,
 4 Centre for Brain Research, The University of Auckland, Auckland, New Zealand

Abstract

Repetitive mirror symmetric bilateral upper limb may be a suitable priming technique for upper limb rehabilitation after stroke. Here we demonstrate neurophysiological and behavioural after-effects in healthy participants after priming with 20 minutes of repetitive active-passive bimanual wrist flexion and extension in a mirror symmetric pattern with respect to the body midline (MIR) compared to an control priming condition with alternating flexion-extension (ALT). Transcranial magnetic stimulation (TMS) indicated that corticomotor excitability (CME) of the passive hemisphere remained elevated compared to baseline for at least 30 minutes after MIR but not ALT, evidenced by an increase in the size of motor evoked potentials in ECR and FCR. Short and long-latency intracortical inhibition (SICI, LICI), short afferent inhibition (SAI) and

interhemispheric inhibition (IHI) were also examined using pairs of stimuli. LICI differed between patterns, with less LICI after MIR compared with ALT, and an effect of pattern on IHI, with reduced IHI in passive FCR 15 minutes after MIR compared with ALT and baseline. There was no effect of pattern on SAI or FCR H-reflex. Similarly, SICI remained unchanged after20 minutes of MIR. We then had participants complete a timed manual dexterity motor learning task with the passive handduring, immediately after, and 24 hours after MIR or control priming. The rate of task completion was faster with MIR priming compared to control conditions. Finally, ECR and FCR MEPs were examined within a pre-movement facilitation paradigm of wrist extension before and after MIR. ECR, but not FCR, MEPs were consistently facilitated before and after MIR,demonstrating no degradation of selective muscle activation. In summary, mirror symmetric active-passive bimanual movement increases CME and can enhance motor learning without degradation of muscle selectivity. These findings rationalise the use of mirror symmetric bimanual movement as a priming modality in post-stroke upper limb rehabilitation.
Citation:
 Byblow WD, Stinear CM, Smith M-C, Bjerre L, Flaskager BK, et al. (2012) Mirror Symmetric Bimanual Movement Priming Can Increase Corticomotor Excitability and Enhance Motor Learning. PLoS ONE 7(3): e33882. doi:10.1371/journal.pone.0033882
Editor:
 Alessio Avenanti, University of Bologna, Italy
Received
 June 6, 2011;
 Accepted
 February 23, 2012;
 Published
 March 22, 2012