期刊
JOURNAL OF NEUROENGINEERING AND REHABILITATION
卷 12, 期 -, 页码 -出版社
BMC
DOI: 10.1186/s12984-015-0039-z
关键词
Stroke rehabilitation; Hemiparesis; Upper extremity; Physical therapy; Learned non-use; Reinforcement-based motor therapy
资金
- ICREA Funding Source: Custom
Background: Stroke-induced impairments result from both primary and secondary causes, i.e. damage to the brain and the acquired non-use of the impaired limbs. Indeed, stroke patients often under-utilize their paretic limb despite sufficient residual motor function. We hypothesize that acquired non-use can be overcome by reinforcement-based training strategies. Methods: Hemiparetic stroke patients (n = 20, 11 males, 9 right-sided hemiparesis) were asked to reach targets appearing in either the real world or in a virtual environment. Sessions were divided into 3 phases: baseline, intervention and washout. During the intervention the movement of the virtual representation of the patients' paretic limb was amplified towards the target. Results: We found that the probability of using the paretic limb during washout was significantly higher in comparison to baseline. Patients showed generalization of these results by displaying a more substantial workspace in real world task. These gains correlated with changes in effector selection patterns. Conclusions: The amplification of the movement of the paretic limb in a virtual environment promotes the use of the paretic limb in stroke patients. Our findings indicate that reinforcement-based therapies may be an effective approach for counteracting learned non-use and may modulate motor performance in the real world.
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