Functional MRI Evidence of Cortical Reorganization in Upper-Limb Stroke Hemiplegia Treated with Constraint-Induced Movement Therapy

Levy, Charles E.; Nichols, Deborah S.; Schmalbrock, Petra; Keller, Paul J.; Chakeres, Donald W.

doi:10.1097/00002060-200101000-00003

Cited by 238 publications

(161 citation statements)

References 14 publications

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“…The mechanism underlying the recovery of motor function after stroke is known to be a use-dependent neural plasticity 19) . The cortical plasticity has been demonstrated in terms of expansion of topographic maps by various therapeutic interventions, such as constraint-induced movement therapy 20) and motor imagery 21) . Although the mechanism is not clear enough, changes in cerebral activation induced by MT may play an important role in inducing neural plasticity.…”

Section: Discussionmentioning

confidence: 99%

Sensorimotor Cortex Activation during Mirror Therapy in Healthy Right-Handed Subjects: A Study with Near-Infrared Spectroscopy

et al. 2008

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Abstract.Clinical studies have shown that functional motor recovery after stroke may be facilitated by mirror therapy (MT). However, its underlying mechanism is uncertain. In this study, we examined brain activation during unilateral hand movement in 5 right-handed healthy subjects (1 male and 4 females) with or without viewing a mirror reflection of the moving hand (MT). We measured the changes in the concentration of oxygenated hemoglobin in the primary sensorimotor cortex (SMC) using near-infrared spectroscopy. We calculated the laterality index (LI) using the extent of activation in the right and left SMCs. The LIs (± standard error of mean) during right hand grasping without and with MT were 0.17 ± 0.11 (left SMC predominance) and -0.42 ± 0.24 (right SMC predominance), respectively (p < 0.05). However, there was no significant difference in LIs during left hand grasping without and with MT (0.02 ± 0.05 and 0.08 ± 0.05, respectively). The findings suggest that MT is more effective when it is used for dominant right hand movement, and this phenomenon may be the related to the different manipulability between the dominant and non-dominant hands.

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Section: Discussionmentioning

confidence: 99%

Sensorimotor Cortex Activation during Mirror Therapy in Healthy Right-Handed Subjects: A Study with Near-Infrared Spectroscopy

et al. 2008

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“…A/P GRF (%BW) Figure 3 Representative plot of A-P (top) and vertical (bottom) GRF plotted over relative gait cycle (%) for both pre-RPT (blue) and post-RPT (red) time points in the lessinvolved limbs (left) and more-involved (right) at self-selected gait speed Recent therapeutic interventions examining gait in persons after CNS injury have largely focused on the task specificity of training with little focus on impairment level deficits. [26][27][28] Although the rationale for taskspecific training interventions to result in improvements in motor function is quite strong and shown to be effective in producing cortical reorganization, 29,30 we feel that in vivo muscle function is also a limiting factor in these persons, and appropriate training can also induce neuroplastic changes in these tissues, facilitating locomotor improvements by improving the element of muscle function dictated by locomotor task performance. Accordingly, given that few studies have attempted to examine the relationship between lower extremity strength and gait in persons after incomplete SCI, comparisons to other populations with CNS involvement yield valuable information.…”

Section: Discussionmentioning

confidence: 99%

Resistance training and locomotor recovery after incomplete spinal cord injury: a case series

et al. 2007

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Study design: Longitudinal intervention case series. Objective: To determine if a 12-week resistance and plyometric training program results in improved muscle function and locomotor speed after incomplete spinal cord injury (SCI). Setting: University research setting. Methods: Three ambulatory individuals with chronic (18.772.2 months post injury) motor incomplete SCI completed 12 weeks of lower extremity resistance training combined with plyometric training (RPT). Muscle maximum cross-sectional area (max-CSA) of the knee extensor (KE) and plantar flexor (PF) muscle groups was determined using magnetic resonance imaging (MRI). In addition, peak isometric torque, time to peak torque (T 20-80 ), torque developed within the initial 220 ms of contraction (torque 220 ) and average rate of torque development (ARTD) were calculated as indices of muscle function. Maximal as well as selfselected gait speeds were determined pre-and post-RPT during which the spatio-temporal characteristics, kinematics and kinetics of gait were measured. Results: RPT resulted in improved peak torque production in the KE (28.974.4%) and PF (35.079.1%) muscle groups, as well as a decrease in T 20-80 , an increased torque 220 and an increase ARTD in both muscle groups. In addition, an increase in self-selected (pre-RPT ¼ 0.77 m/s; post-RPT ¼ 1.03 m/s) and maximum (pre-RPT ¼ 1.08 m/s; post-RPT ¼ 1.47 m/s) gait speed was realized. Increased gait speeds were accompanied by bilateral increases in propulsion and hip excursion as well as increased lower extremity joint powers. Conclusions: The combination of lower extremity RPT can attenuate existing neuromuscular impairments and improve gait speed in persons after incomplete SCI.

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“…Evidence from a number of studies suggests that the size of the cortical representation of a body part in adult monkeys and humans depends on the amount of use of that body part [19][20][21]. Five recent focal transcranial magnetic stimulation, neuroelectric source imaging, and electroencephalograph readiness-potential studies with humans conducted by four groups of investigators and one intracortical microstimulation study with monkeys indicate that CI therapy produces a substantial change in brain organization and function correlative with its large clinical effect [22][23][24][25][26]. A second mechanism associated with the therapeutic effect of CI therapy is overcoming learned nonuse, which has been described in detail elsewhere [12][13]19,21].…”

Section: Constraint-induced Movement Therapymentioning

confidence: 99%

Constraint-induced movement therapy for recovery of upper-limb function following traumatic brain injury

Shaw

Morris

Uswatte

et al. 2005

JRRD

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Abstract-A volunteer sample of 22 participants with chronic traumatic brain injury (TBI) (onset >1 year) and relative hemiplegia that revealed moderate disability in the more-affected upper limb (UL) participated. Constraint-induced (CI) movement therapy (CI therapy) was employed for a 2-week period; treatments included massed practice, shaping of the moreaffected UL, behavioral contracts, and other behavioral techniques for affecting transfer to a real-world setting. We used the Wolf Motor Function Test, the Fugl-Meyer Motor Performance Assessment, and the Motor Activity Log to measure outcomes. All outcome measures improved significantly as a result of the intervention. More-adherent participants had more improvement compared with less-adherent participants. These preliminary results suggest that CI therapy may be effective for improving UL motor function following chronic TBI.

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Functional MRI Evidence of Cortical Reorganization in Upper-Limb Stroke Hemiplegia Treated with Constraint-Induced Movement Therapy

Abstract: Constraint-induced movement therapy produced significant functional improvement and resulted in plasticity as demonstrated by functional MRI.

Cited by 238 publications

References 14 publications

Sensorimotor Cortex Activation during Mirror Therapy in Healthy Right-Handed Subjects: A Study with Near-Infrared Spectroscopy

Sensorimotor Cortex Activation during Mirror Therapy in Healthy Right-Handed Subjects: A Study with Near-Infrared Spectroscopy

Resistance training and locomotor recovery after incomplete spinal cord injury: a case series

Constraint-induced movement therapy for recovery of upper-limb function following traumatic brain injury

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