I absolutely hate these pontifications on nonuse. Solve the damn problem of dead brain rehab and this nonuse problem goes away. SOLVE THE CORRECT PROBLEM!
Use It and Improve It or Lose It: Interactions between Arm Function and Use in Humans Post-stroke
2012, PLoS Computational Biology
Yukikazu Hidaka
1
, Cheol E. Han
1,2
, Steven L. Wolf
3
, Carolee J. Winstein
4
, Nicolas Schweighofer
4
*
1 Computer Science, University of Southern California, Los Angeles, California, United States of America, 2 Brain and Cognitive Sciences, Seoul National University, Seoul,
Republic of Korea, 3 Department of Rehabilitation Medicine, Emory University, Atlanta, Georgia, United States of America, 4 Biokinesiology, University of Southern
California, Los Angeles, California, United States of America
Abstract
‘‘Use it and improve it, or lose it’’ is one of the axioms of motor therapy after stroke(WHY?). There is, however, little understanding
of the interactions between arm function and use in humans post-stroke. Here, we explored putative non-linear interactions
between upper extremity function and use by developing a first-order dynamical model of stroke recovery with longitudinal
data from participants receiving constraint induced movement therapy (CIMT) in the EXCITE clinical trial. Using a Bayesian
regression framework, we systematically compared this model with competitive models that included, or not, interactions
between function and use. Model comparisons showed that the model with the predicted interactions between arm
function and use was the best fitting model. Furthermore, by comparing the model parameters before and after CIMT
intervention in participants receiving the intervention one year after randomization, we found that therapy increased the
parameter that controls the effect of arm function on arm use. Increase in this parameter, which can be thought of as the
confidence to use the arm for a given level of function, lead to increase in spontaneous use after therapy compared to
before therapy.
Citation: Hidaka Y, Han CE, Wolf SL, Winstein CJ, Schweighofer N (2012) Use It and Improve It or Lose It: Interactions between Arm Function and Use in Humans
Post-stroke. PLoS Comput Biol 8(2): e1002343. doi:10.1371/journal.pcbi.1002343
Editor: Jo ¨ rn Diedrichsen, University College London, United Kingdom
Received October 4, 2010; Accepted November 21, 2011; Published February 16, 2012
Copyright: ß 2012 Hidaka et al.
This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: This work was funded in part by grant NIH RO3 HD050591-02, R01 HD065438, and R01 HD 37606 and by the National Research Foundation of Korea,
Ministry of Education, Science and Technology (R32-10142). The funders had no role in study design, data collection and analysis, decision to publish, or
preparation of the manuscript.
Competing Interests: The authors have declared that no competing interests exist.
* E-mail: schweigh@usc.edu
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