Priming the motor system enhances the effects of upper limb therapy in chronic stroke

Show simple item record Stinear, Cathy en Barber, Peter en Coxon, James en Fleming, MK en Byblow, Winston en 2012-03-05T01:21:12Z en 2008 en
dc.identifier.citation Brain 131(Pt 5):1381-1390 May 2008 en
dc.identifier.issn 0006-8950 en
dc.identifier.uri en
dc.description.abstract After stroke, the function of primary motor cortex (M1) between the hemispheres may become unbalanced. Techniques that promote a re-balancing of M1 excitability may prime the brain to be more responsive to rehabilitation therapies and lead to improved functional outcomes. The present study examined the effects of Active^Passive Bilateral Therapy (APBT), a putative movement-based priming strategy designed to reduce intracortical inhibition and increase excitability within the ipsilesional M1.Thirty-two patients with upper limb weakness at least 6 months after stroke were randomized to a 1-month intervention of self-directed motor practice with their affected upper limb (control group) or to APBT for 10^15min prior to the same motor practice (APBT group). A blinded clinical rater assessed upper limb function at baseline, and immediately and 1 month after the intervention. Transcranial magnetic stimulation was used to assess M1 excitability. Immediately after the intervention, motor function of the affected upper limb improved in both groups (P50.005).One month after the intervention, the APBT group had better upper limb motor function than control patients (P50.05).The APBT group had increased ipsilesional M1 excitability (P50.025), increased transcallosal inhibition from ipsilesional to contralesional M1 (P50.01) and increased intracortical inhibition within contralesional M1 (P50.005).None of these changes were found in the control group. APBT produced sustained improvements in upper limb motor function in chronic stroke patients and induced specific and sustained changes inmotor cortex inhibitory function.We speculate that APBT may have facilitated plastic reorganization in the brain in response to motor therapy. The utility of APBT as an adjuvant to physical therapy warrants further consideration. en
dc.publisher Oxford University Press en
dc.relation.ispartofseries Brain en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from en
dc.rights.uri en
dc.title Priming the motor system enhances the effects of upper limb therapy in chronic stroke en
dc.type Journal Article en
dc.identifier.doi 10.1093/brain/awn051 en
pubs.issue 5 en
pubs.begin-page 1381 en
pubs.volume 131 en
dc.rights.holder Copyright: Oxford University Press; The Author en
dc.identifier.pmid 18356189 en
pubs.end-page 1390 en
pubs.publication-status Published en
dc.rights.accessrights en
pubs.subtype Article en
pubs.elements-id 78457 en Medical and Health Sciences en School of Medicine en Medicine Department en Science en Exercise Sciences en
pubs.record-created-at-source-date 2010-09-01 en
pubs.dimensions-id 18356189 en

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