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Volume 23, Issue 1, Pages 2-5 (2005)


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New Approaches to Enhance Motor Function of the Upper Limb in Patients with Hemiparesis

Mindy F. Levin, PT, PhDcCorresponding Author Informationemail address, Nadine K. Musampa, PTa, Amy K. Hendersonb, Luiz A. Knaut, PTa

Received 29 August 2005; accepted 29 August 2005.

Abstract 

A common finding in patients with hemiparesis due to stroke is that they may use altered movement strategies to perform functional arm and hand movements. Altered movement strategies may be considered compensatory if they substitute the movements that are impaired at the behavioural level and yet lead to the accomplishment of the task at the functional level. Motor compensation may be maladaptive in that it may limit recovery of pre-morbid movement patterns. Studies in patients with stroke suggest that, given optimal training strategies and environments, behavioural recovery (re-appearance of pre-morbid movement patterns) may occur even in patients with chronic hemiparesis. On the other hand, it has also been shown that non-guided therapy may lead to the reinforcement of compensatory movements. The challenge facing rehabilitation professionals is to create optimal training environments based on current notions of plasticity and re-organisation in the central nervous system to maximise behavioural and functional recovery.

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Abstract

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1. 1 Khaw KT . Epidemiology of stroke . J Neurol Neurosurg Psychiatry . 1996;61:333–338 . MEDLINE | CrossRef

2. 2 Kwakkel G , Kollen BJ , Wagennaar R . Therapy impact on functional recovery in stroke rehabilitation: a critical review of the literature . Physiotherapy . 1999;13:457–470 .

3. 3 Levin MF . Interjoint coordination during movements is disrupted in spastic hemiparesis . Brain . 1996;119:281–293 . CrossRef

4. 4 Trombly CA . Observations of improvement of reaching in five subjects with left hemiparesis . J Neurol Neurosurg Psychiatry . 1993;56:40–45 . MEDLINE | CrossRef

5. 5 Cirstea MC , Levin MF . Compensatory strategies for reaching in stroke . Brain . 2000;123:940–953 . CrossRef

6. 6 Roby-Brami A , Fuchs S , Mokhtari M , et al.   Reaching and grasping strategies in hemiparetic patients . Motor Control . 1997;1:72–91 .

7. 7 Michaelsen SM , Levin MF . Short-term effects of practice with trunk restraint on reaching movements in patients with chronic stroke. A controlled trial . Stroke . 2004;35:1914–1919 . CrossRef

8. 8 Cirstea MC , Ptito A , Levin MF . Arm reaching improvements with short-term practice depend on the severity of the motor deficit in stroke . Exp Brain Res . 2003;152:476–488 . MEDLINE | CrossRef

9. 9 Saling M , Stelmach GE , Mescheriakov S , et al.   Prehension with trunk assisted reaching . Behav Brain Res . 1996;80:153–160 . MEDLINE | CrossRef

10. 10 Levin MF , Michaelsen S , Cirstea C , et al.   Use of the trunk for reaching targets placed within and beyond the reach in adult hemiparesis . Exp Brain Res . 2002;143:171–180 . MEDLINE | CrossRef

11. 11 Ustinova KI , Goussev VM , Balasubramaniam R , et al.   Disruption of co-ordination between arm, trunk and center of pressure displacement in patients with hemiparesis . Motor Control . 2004;8:139–159 . MEDLINE

12. 12 Foley NC , Teasell RW , Bhogal SK , et al.   The efficacy of stroke rehabilitation: a qualitative review . Top Stroke Rehabil . 2003;10:1–18 . MEDLINE | CrossRef

13. 13 Keith AR . Treatment strength in rehabilitation . Arch Phys Med Rehabil . 1997;78:1298–1304 . Abstract | Full-Text PDF (1054 KB) | CrossRef

14. 14 van der Lee JH , Wagenaar RC , Lankhorst GJ , et al.   Forced use of the upper extremity in chronic stroke patients: results from a single-blind randomized clinical trial . Stroke . 1999;30:2369–2375 . MEDLINE

15. 15 Taub E , Wolf S . Constraint induced movement techniques to facilitate upper extremity use in stroke patients . Top Stroke Rehabil . 1997;3:38–61 .

16. 16 Nakayama H , Jorgensen HS , Raashau HO , et al.   Recovery of upper extremity function in stroke patients: the Copenhagen stroke study . Arch Phys Med Rehabil . 1994;75:394–398 . MEDLINE | CrossRef

17. 17 Thielman GT , Dean CM , Gentile AM . Rehabilitation of reaching after stroke: task-related training versus progressive resistive exercise . Arch Phys Med Rehabil . 2004;85:1613–1618 . Abstract | Full Text | Full-Text PDF (116 KB) | CrossRef

18. 18 Schneiberg S, Lamarre C, Bibeau A, et al. Effect of constraint therapy on motor control of the arm in children with cerebral palsy. Conference on Cerebral Palsy: New Directions in Research and Practice, 2004, Montreal, Quebec. (Abstract)

19. 19 Ada L , Canning C , Carr JH , et al.   Task specific training of reaching and manipulation . In:  Bennett KMB ,  Castiello U editor. Insights into Reach and Grasp Movement . North Holland: Elsevier; 1994;p. 239–265 .

20. 20 Levin MF . Should stereotypic movement synergies seen in hemiparetic patients be considered adaptive? . Behav Brain Sci . 1996;19:79–80 . CrossRef

21. 21 Michaelsen SM , Luta A , Roby-Brami A , et al.   Effect of trunk restraint on the recovery of reaching movements in hemiparetic patients . Stroke . 2001;32:1875–1883 .

22. 22 Michaelsen SM , Jacobs S , Roby-Brami A , et al.   Compensation for distal impairments of grasping in adults with hemiparesis . Exp Brain Res . 2004;157:162–173 . MEDLINE

23. 23 Michaelsen SM, Dannenbaum R, Levin MF. Task-specific training with trunk restraint on arm recovery in stroke. Randomized Control Trial. Stroke. [In press]

24. 24 Holden MK , Dyar T . Virtual environment training: a new tool for neurorehabilitation . Neurol Report . 2002;26:62–71 .

25. 25 Viau A , Feldman AG , McFadyen BJ , et al.   Reaching in reality and virtual reality: a comparison of movement kinematics in healthy subjects and in adults with hemiparesis . J NeuroEng Rehab . 2004;1:11–18 .

26. 26 Knaut LA, Henderson AK, Levin MF. Virtual reality program for retraining the upper limb in stroke patients. Progress in Motor Control V, 2005, Penn State University, State College, Pennsylvania. (Abstract)

27. 27 Stanton D , Foreman N , Wilson P . Uses of virtual reality in clinical training: developing the spatial skills of children with mobility impairments . In:  Riva G ,  Wiederhold BK ,  Molinari E editor. Virtual Environments in Clinical Psychology and Neuroscience: Methods and Techniques in Advanced Patient-Therapist Interaction . Amsterdam: IOS Press; 1998;p. 219–232 .

28. 28 Holden M , Todorov E , Callahan J , et al.   Case report: virtual environment training improves motor performance in two stroke patients . Neurol Report . 1999;23:57–67 .

29. 29 Holden MK , Dyar T , Callahan J , et al.   Motor learning and generalization following virtual environment training in a patient with stroke . Neurol Report . 2000;24:170–171 .

30. 30 Merians AS , Jack D , Boian R , et al.   Virtual reality-augmented rehabilitation for patients following stroke . Phys Ther . 2002;82:898–915 . MEDLINE

31. 31 Deutsch JE , Latonio J , Burdea GC , et al.   Rehabilitation of musculoskeletal injuries using the Rutgers ankle haptic interface: three case reports . Eurohaptics . 2001;1:11–16 .

32. 32 Deutsch JE , Merians AS , Burdea GC , et al.   Haptics and virtual reality used to increase strength and improve function in chronic individuals post-stroke: two case reports . Neurol Report . 2002;26:79–86 .

33. 33 Riess TJ . Gait and Parkinson's disease: a conceptual model for an augmented-reality based therapeutic device . Stud Health Technol Inform . 1998;58:200–208 . MEDLINE

34. 34 You SH , Jang SH , Kim YH , et al.   Virtual reality-induced cortical reorganization and associated locomotor recovery in chronic stroke: an experimenter-blind randomized study . Stroke . 2005;36:1166–1171 . CrossRef

35. 35 Rizzo A. A SWOT analysis of the field of virtual rehabilitation. In: Proceedings of the Second International Workshop on Virtual Rehabilitation, New Jersey, 2003: 1–2. (Abstract)

a School of Rehabilitation, University of Montreal, Quebec, Canada

b Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada

c School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada

Corresponding Author InformationReprint requests and correspondence to: Dr. Mindy F. Levin, Physical Therapy Program, School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada

PII: S1013-7025(09)70052-1

doi:10.1016/S1013-7025(09)70052-1


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