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

Stinear CM, Alan Barber P, Coxon JP, Fleming MK, Byblow WD

This 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 10-15 min 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. Immediately after the intervention, motor function of the affected upper limb improved in both groups. One month after the intervention, the APBT group had better upper limb motor function than control patients. The APBT group had increased ipsilesional M1 excitability, increased transcallosal inhibition from ipsilesional to contralesional M1 and increased intracortical inhibition within contralesional M1. None of these changes were found in the control group.

APBT produces sustained improvements in upper limb motor function in chronic stroke patients and induces specific and sustained changes in motor cortex inhibitory function. APBT may facilitate plastic reorganization in the brain in response to motor therapy.

Brain, 20 March 2008, online article ahead of press

Link to Abstract

Stroke Course

Every physiotherapist will work with someone who has had a stroke during their career. Gain a deeper understanding based on the latest evidence and become a better clinician.
Research article posted by: Rachael Lowe

Rachael Lowe is Co-Founder and Executive Director of Physiopedia. A physiotherapist and technology specialist Rachael has been working with Physiopedia since 2008 to create a resource that provides universal access to physiotherapy knowledge as well as a platform for connecting and educating the global physiotherapy profession.

Speak Your Mind