Automatic Versus Intentional Movement Exercises to Enhance Arm Functions After Stroke

Automatic Versus Intentional Movement Exercises to Enhance Arm Functions After Stroke

Many patients retain upper-limb motor impairment following stroke. Most conventional rehabilitation techniques are aimed to improve motor intentional movement by repeated exercises. These techniques require attentional load and are responsible for significant fatigue that probably represents a limiting factor. Alternatively, the automatic control of action is now well documented. A rehabilitation method based on this principle could allow recovery of more natural movements.

Hypothesis: Stimulating automatic motricity improves upper-limb motor skills compared with a rehabilitation technique based on intentional movements.

Inclusion Criteria:

• All subjects must be between the ages of 18-80 and must not be pregnant
• Patients volunteer to participate in the study, with a written informed consent signed
• Affiliation to a national health insurance program
• Hemiplegia after stroke
• Stroke onset >6 weeks and <4 years prior to study enrollment
• Patients able to perform the exercises on the automated table

Exclusion Criteria:

• Pregnancy
• Excessive pain in any joint of the paretic extremity (VAS>5)
• Coexistent major neurological or psychiatric disease as to decrease number of confounders
• Subjects with global aphasia and deficits of comprehension
• Any substantial decrease in alertness, language reception, or attention that might interfere with understanding instructions for motor testing