Article

Stroke rehabilitation assumes motor learning
contributes to motor recovery, yet motor learning in stroke has received little
systematic investigation. Here we aimed to illustrate that despite matching
levels of performance on a task, a trained patient should not be considered equal
to an untrained patient with less impairment. METHODS:
We examined motor learning
in healthy control participants and groups of stroke survivors with
mild-to-moderate or moderate-to-severe motor impairment. Participants performed a
series of isometric contractions of the elbow flexors to navigate an on-screen
cursor to different targets, and trained to perform this task over a 4-day
period. The speed-accuracy trade-off function (SAF) was assessed for each group,
controlling for differences in self-selected movement speeds between individuals.
RESULTS: The initial SAF for each group was proportional to their impairment. All
groups were able to improve their performance through skill acquisition.
Interestingly, training led the moderate-to-severe group to match the untrained
(baseline) performance of the mild-to-moderate group, while the trained
mild-to-moderate group matched the untrained (baseline) performance of the
controls. Critically, this did not make the two groups equivalent; they differed
in their capacity to improve beyond this matched performance level. Specifically,
the trained groups had reached a plateau, while the untrained groups had not.
CONCLUSIONS: Despite matching levels of performance on a task, a trained patient
is not equal to an untrained patient with less impairment. This has important
implications for decisions both on the focus of rehabilitation efforts for
chronic stroke, as well as for returning to work and other activities.

Langue : ANGLAIS