Preserved motor skill learning in acute stroke patients

Baguma, Marius; Doost, Maral Yeganeh; Riga, Audrey; Laloux, Patrice; Bihin, Benoît; Vandermeeren, Yves

doi:10.1007/s13760-020-01304-7

Cited by 12 publications

(9 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The results are consistent with the finding that the ability to adapt to visuomotor rotations 8 – 11 or forces applied to the arm during point-to-point reaching movements 7 , 42 , 43 is reduced in chronic stroke. The findings are also broadly consistent with skill learning studies that revealed a reduction in the ability to learn motor sequences, 14 , 15 navigate through virtual environments with varying accuracy demands, 44 , 45 and track moving stimuli with the arm after stroke. 46 …”

Section: Discussionsupporting

confidence: 86%

Assessing Impairments in Visuomotor Adaptation After Stroke

Moore

Piitz

Singh

et al. 2022

Neurorehabil Neural Repair

View full text Add to dashboard Cite

Background: Motor impairment in the arms is common after stroke and many individuals participate in therapy to improve function. It is assumed that individuals with stroke can adapt and improve their movements using feedback that arises from movement or is provided by a therapist. Here we investigated visuomotor adaptation in individuals with sub-acute and chronic stroke. Objective: We examined the impact of the stroke-affected arm (dominant or non-dominant), time post-stroke, and relationships with clinical measures of motor impairment and functional independence. Methods: Participants performed reaching movements with their arm supported in a robotic exoskeleton. We rotated the relationship between the motion of the participant’s hand and a feedback cursor displayed in their workspace. Outcome measures included the amount that participants adapted their arm movements and the number of trials they required to adapt. Results: Participants with stroke (n = 36) adapted less and required more trials to adapt than controls (n = 29). Stroke affecting the dominant arm impaired the amount of adaptation more than stroke affecting the non-dominant arm. Overall, 53% of participants with stroke were impaired in one or more measures of visuomotor adaptation. Initial adaptation was weakly correlated with time post-stroke, and the amount of adaptation correlated moderately with clinical measures of motor impairment and functional independence. Conclusion: Our findings reveal impairments in visuomotor adaptation that are associated with motor impairment and function after stroke. Longitudinal studies are needed to understand the relationship between adaptation and recovery attained in a therapy setting.

show abstract

Section: Discussionsupporting

confidence: 86%

Assessing Impairments in Visuomotor Adaptation After Stroke

Moore

Piitz

Singh

et al. 2022

Neurorehabil Neural Repair

View full text Add to dashboard Cite

show abstract

“…For example, a recent study from Baguma and colleagues assessed motor skill learning in subacute stroke patients by changes in speed/accuracy trade-off in a tracking circuit task. 12 Although the authors found that patients could learn the task, this study did not have a control group and did not control for differences in task execution, which may have under-estimated their learning ability and missed enhancement.…”

Section: Introductionmentioning

confidence: 88%

Reinforcement Learning Is Impaired in the Sub-acute Post-stroke Period

Branscheidt

Hadjiosif

Anaya

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: Neurorehabilitation approaches are frequently predicated on motor learning principles. However, much is left to be understood of how different kinds of motor learning are affected by stroke causing hemiparesis. Here we asked if two kinds of motor learning often employed in rehabilitation, (1) reinforcement learning and (2) error-based adaptation, are altered at different times after stroke. Methods: In a cross-sectional design, we compared learning in two groups of patients with stroke, matched for their baseline motor execution deficit on the paretic side. The early group was tested within 3 months following stroke (N = 35) and the late group was tested more than 6 months after stroke (N = 30). Two types of task were studied: one based on reinforcement learning and the other on error-based learning. Results: We found that reinforcement learning was impaired in the early but not the late group, whereas error-based learning was unaffected compared to controls. These findings could not be attributed to differences in baseline execution, cognitive impairment, gender, age, or lesion volume and location. Conclusions: The presence of a specific impairment in reinforcement learning in the first 3 months after stroke has important implications for rehabilitation. It might be necessary to either increase the amount of reinforcement feedback given early or even delay onset of certain forms of rehabilitation training, e.g., like constraint-induced movement therapy, and instead emphasize others forms of motor learning in this early time period. A deeper understanding of stroke-related changes in motor learning capacity has the potential to facilitate the development of new, more precise treatment interventions.

show abstract

“…Over 3 consecutive days, subjects were trained with the CIRCUIT task (Figure 1 , previously used with a nonrobotic setup in HI and chronic stroke patients 21 , 25 , 26 and in a pilot study in acute stroke 27 ). Subjects were seated in front of the REAplan screen, with their height adjusted so that their forearm was supported by a gutter and their elbow flexed 90° with the shoulder in a neutral position.…”

Section: Methodsmentioning

confidence: 99%

Evidence of Motor Skill Learning in Acute Stroke Patients Without Lesions to the Thalamus and Internal Capsule

Riga

Gathy

Ghinet

et al. 2022

Stroke

Self Cite

View full text Add to dashboard Cite

Background: It is currently unknown whether motor skill learning (MSkL) with the paretic upper limb is possible during the acute phase after stroke and whether lesion localization impacts MSkL. Here, we investigated MSkL in acute (1–7 days post) stroke patients compared with healthy individuals (HIs) and in relation to voxel-based lesion symptom mapping. Methods: Twenty patients with acute stroke and 35 HIs were trained over 3 consecutive days on a neurorehabilitation robot measuring speed, accuracy, and movement smoothness variables. Patients used their paretic upper limb and HI used their nondominant upper limb on an MSkL task involving a speed/accuracy trade-off. Generalization was evaluated on day 3. All patients underwent a 3-dimensional magnetic resonance imaging used for VSLM. Results: Most patients achieved MSkL demonstrated by day-to-day retention and generalization of the newly learned skill on day 3. When comparing raw speed/accuracy trade-off values, HI achieved larger MSkL than patients. However, relative speed/accuracy trade-off values showed no significant differences in MSkL between patients and HI on day 3. In patients, MSkL progression correlated with acute motor and cognitive impairments. The voxel-based lesion symptom mapping showed that acute vascular damage to the thalamus or the posterior limb of the internal capsule reduced MSkL. Conclusions: Despite worse motor performance for acute stroke patients compared with HI, most patients were able to achieve MSkL with their paretic upper limb. Damage to the thalamus and posterior limb of the internal capsule, however, reduced MSkL. These data show that MSkL could be implemented into neurorehabilitation during the acute phase of stroke, particularly for patients without lesions to the thalamus and posterior limb of the internal capsule. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01519843.

show abstract

Preserved motor skill learning in acute stroke patients

Cited by 12 publications

References 38 publications

Assessing Impairments in Visuomotor Adaptation After Stroke

Assessing Impairments in Visuomotor Adaptation After Stroke

Reinforcement Learning Is Impaired in the Sub-acute Post-stroke Period

Evidence of Motor Skill Learning in Acute Stroke Patients Without Lesions to the Thalamus and Internal Capsule

Contact Info

Product

Resources

About