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Use it and improve it or lose it: interactions between arm function and use in humans post-stroke
Yukikazu Hidaka1, Cheol E Han, Steven L Wolf
1Computer Science, University of Southern California, Los Angeles, California, USA.
Plos Computational Biology
|July 5, 2012
Summary
Constraint-induced movement therapy (CIMT) enhances arm use post-stroke by increasing confidence in using the arm, even with limited function. This therapy promotes greater spontaneous arm use by improving the relationship between arm function and its utilization.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Biomedical Engineering
Background:
- The principle 'use it and improve it, or lose it' guides motor therapy post-stroke.
- Understanding the interplay between arm function and arm use after stroke is limited.
Purpose of the Study:
- To explore non-linear interactions between upper extremity function and use in stroke recovery.
- To develop and validate a dynamical model of stroke recovery incorporating these interactions.
Main Methods:
- Utilized longitudinal data from participants in the EXCITE clinical trial receiving constraint-induced movement therapy (CIMT).
- Developed a first-order dynamical model of stroke recovery.
- Employed a Bayesian regression framework to compare models with and without function-use interactions.
Main Results:
- The model incorporating interactions between arm function and arm use provided the best fit to the data.
- Constraint-induced movement therapy (CIMT) significantly increased a key model parameter.
- This parameter reflects the 'confidence' to use the arm relative to its function, leading to increased spontaneous use post-therapy.
Conclusions:
- Non-linear interactions between arm function and use are crucial in stroke recovery.
- Constraint-induced movement therapy (CIMT) positively modulates the relationship between arm function and use, enhancing spontaneous arm engagement.
- The findings support the 'use it and improve it' axiom by demonstrating a mechanism through which therapy improves arm utilization.
