stroke rehabilitation reaches a threshold中风康复达到一个阈值.pdfVIP

Stroke Rehabilitation Reaches a Threshold 1,2 2,3,4 5 Cheol E. Han , Michael A. Arbib , Nicolas Schweighofer * 1 Department of Computer Science, University of Southern California, Los Angeles, California, United States of America, 2 USC Brain Project, University of Southern California, Los Angeles, California, United States of America, 3 Department of Computer Science, University of Southern California, Los Angeles, California, United States of America, 4 Department of Neuroscience, University of Southern California, Los Angeles, California, United States of America, 5 Department of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, United States of America Abstract Motor training with the upper limb affected by stroke partially reverses the loss of cortical representation after lesion and has been proposed to increase spontaneous arm use. Moreover, repeated attempts to use the affected hand in daily activities create a form of practice that can potentially lead to further improvement in motor performance. We thus hypothesized that if motor retraining after stroke increases spontaneous arm use sufficiently, then the patient will enter a virtuous circle in which spontaneous arm use and motor performance reinforce each other. In contrast, if the dose of therapy is not sufficient to bring spontaneous use above threshold, then performance will not increase and the patient will further develop compensatory strategies with the less affected hand. To refine this hypothesis, we developed a computational model of bilateral hand use in arm reaching to study the interactions between adaptive decision making and motor relearning after motor