Motor Learning after Stroke
Date
2023-05-10
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Motor learning is a pillar of stroke rehabilitation. Indeed, many therapeutic protocols and interventions are based on principles of motor learning. One of the assumptions made in rehabilitation is that motor learning remains intact after stroke and can be leveraged to facilitate recovery. However, a growing body of evidence has shown that motor learning can be impaired after stroke. Our understanding of how stroke influences the neural and behavioural processes that support motor learning is incomplete. This raises questions about how well our current understanding of motor learning, derived predominantly from studies in healthy adults, applies to stroke rehabilitation. The following dissertation describes four studies that examine reaching movements and a specific type of motor learning known as motor adaptation. This type of learning encompasses the processes that help to maintain accurate movements amidst changes in the body, environment, and task demands. Across three experiments in healthy adults (Chapter Two) and three experiments in participants with stroke (Chapters Three, Four, and Five), we characterized motor adaptation in health and disease. Overall, the works in this dissertation demonstrate the utility of robotics for quantifying motor adaptation. Impaired adaptation after stroke was associated with several clinical variables including: the side of the stroke affected limb (i.e., dominant versus non-dominant), time post-stroke, movement performance, proprioceptive abilities, and clinical assessments of motor impairment and functional independence. Notably these variables accounted for only a small portion of the variance in motor adaptation after stroke, suggesting that other clinical variables (e.g., lesion characteristics or other types of impairments) may be associated with adaptation after stroke. Our results reveal widespread impairments in visuomotor adaptation after stroke and generate numerous questions about the basic mechanisms underlying motor adaptation and how adaptation applies to stroke rehabilitation.
Description
Keywords
Stroke, Rehabilitation, Motor Learning, Motor Adaptation, Motor Impairment, Proprioception
Citation
Moore, R. T. (2023). Motor learning after stroke (Doctoral thesis, University of Calgary, Calgary, Canada).