Task Oriented Training Activities Post Stroke Will Produce Measurable Alterations in Brain Plasticity Concurrent with...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Motor Control

Background:

• Task-oriented training (TOT) aids upper extremity (UE) function recovery after stroke.
• Evidence linking TOT to brain plasticity is limited.
• The Accelerated Skill Acquisition Program (ASAP) is a TOT approach targeting UE movements.

Purpose of the Study:

• Investigate ASAP's effect on brain plasticity in stroke patients.
• Measure changes in corticospinal excitability (CE).
• Correlate these changes with reach-to-grasp (RTG) performance.

Main Methods:

• Eighteen post-acute stroke patients were randomized into an ASAP group (n=9) or a control group (n=9).
• The ASAP group received a 2-hour session; the control group received usual care.
• Corticospinal excitability (CE) and reach-to-grasp (RTG) performance were assessed pre-session and at multiple time points up to 12 days post-intervention.

Main Results:

• Significant alterations in CE, specifically Motor Evoked Potential amplitude in elbow and wrist extensors of the lesioned hemisphere, were observed.
• The ASAP group showed improved RTG execution, including shortened total movement time (TMT).
• ASAP enhanced motor planning (lengthened relative time to maximum hand aperture, RTApmax) and feed-forward control (deceleration time, DT).

Conclusions:

• A single 2-hour ASAP session induces brain plasticity changes in post-acute stroke patients.
• These plasticity alterations correlate with improved reach-to-grasp performance.
• The observed effects persist for at least 12 days, suggesting sustained benefits of task-oriented training.