Use it or lose it: The HandTutor system enncourages intensive massed exercise practice to regain lost movement ability following stroke

In the past Stroke patients who couldn't use an injured arm or hand were taught to dress and bathe with their good arm. This means the patient was taught a compensatory strategy to achieve the active daily living (ADL) function. This was because until recently scientists thought that when a region of the brain was damaged, its function was lost forever.

However, sophisticated imaging tests of the brain e.g. fMRI have revealed that the brain amazingly can reorganize itself after injury so that when nerve cells die, their functions are taken over by other areas of the brain. This concept is known as neuroplasticity. The concept of neuroplasticity has changed stroke rehabilitation therapy considerably.

"Now we know that if you want to get motor recovery on the affected side, you have to use the affected side—repetitively and intensively," says Richard Zorowitz, M.D., chief of physical medicine and rehabilitation at the Johns Hopkins Bayview Medical Center in Baltimore, Md. "That stimulates the brain to make those new connections."

Neuroplasticity is the principle behind the HandTutor, ArmTutor and LegTutor systems that provide motivating and customized virtual task exercise therapy that allow the patients regardless of their movement ability to do intensive and massed exercise practice.