Sunday 16 January 2011

Recovery of function after stroke: principles of rehabilitation

In the January 2010 edition of J Rehabil Med neurologist Dr. Hummelsheim H from Rehabilitationszentrum Leipzig, University of Leipzig Germany discusses repetitive training of complex hand and arm movements with shaping is beneficial for motor improvement in patients after stroke http://bit.ly/hlWAnJ The group compared usual therapy to usual therapy plus intensive isolated exercises based on repetitive execution of a sawing and grasping and transport movement.

The group used isolated exercises based in repetitive execution of a sawing and grasping and transport movement.

The group present their finding in a powerpoint document http://bit.ly/f64W58 and other land mark papers that indicate that functional recovery outcome is improved if the rehabilitation physical and occupational therapy program adheres to the following concepts:
Repetitive active movement execution (massed motor practice)
Shaping: Difficulty of the motor tasks is increased in small increments.
Training close to the individual limits of performance
Training of simple movement parameters (strength, velocity etc.)

The HandTutor and ArmTutor system intensively trains simple movement parameters uses virtual functional tasks. The tasks can be set according to the individual patients limits of movement ability and the difficulty of the tasks can be shaped. The feedback gives the patient information on their performance of the tasks and instructions on how to improve their movement. Instruction and feedback is part of the learning cycle and the HandTutor and ArmTutor system teaches the patient how to move their arm and hand and improves functional movement ability.

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